Pharmacist says questions still to be answered about medicinal marijuana
RESPECTED pharmacist, Bandele Serrano, has expressed his concern about how and by whom medicinal marijuana will be administered and the impact that it could have on those already taking other drugs.
He was part of a panel discussing the topic, “Understanding Medical Cannabis”, hosted at Queen’s College by the DLP’s St. James South constituency branch office on Sunday evening.
In fact, Serrano holds the view that as it relates to recreational use, Barbadians should vote “No”, if or when it comes to a referendum. “The pure cannabis is a problem. We don’t have the social network here to support this thing. If there is a referendum, please vote no. Don’t waste time. And please go and vote.”
The pharmacist opined that while focus should be placed squarely on developing an industry, it appears as though medicinal marijuana is being driven by public opinion in Barbados. “Public persuasion is deciding this product should be used rather than science. That doesn’t make sense to me. You can’t have a medicinal product that is chosen by the public.
“It has to be chosen through the same factors and the same pathways that even the Panadol ... Aspirin. But that has to go though all sorts of rigorous tests.
“I have no problem with CBD (Cannabidiol) in terms of its potential to do things, but it is not a cure-all. It can’t be. I have problems if it is not standardised. I have problems to say, ‘I have this bush to sell you.’ I am not going to buy it. I am not going to recommend it to anybody.
“The concerns any right-thinking person would have when you have medicinal cannabis is that the cannabis is standardised. That if I get cannabis from Avis pharmacy, I would get the same cannabis from Massy pharmacy. That has to happen.”
Serrano, a former President of the Barbados Pharmaceutical Society, gave an example of the popular glucosamine, saying that not everyone knows that it can only work at 1500 mg. “So if you take 500 mg, it won’t work. If you take 1400, it still isn’t going to work. How many milligrams do we need of CBD to effect the response we need?” he queried.
The pharmacist told the audience that the liver has an enzyme referred to as P450, which breaks down drugs and allows it to pass through and out of the body.
“Marijuana has the propensity to sit right there because it is attracted to that same P450. You can’t risk taking the cannabis and your medicine together. One isn’t going to work. And if the cannabis has a strong affinity for that P450, it means then… Let’s say something like Crestor ... for cholesterol; there is a reason why they tell you do not use grapefruit juice with these things. What happens is that the grapefruit has a strong affinity to the same enzyme.
“At the airport if a plane can’t land, what will it do? It will circle. So you take the Crestor and it can’t land, it will circle. Because you are doing what your doctor says and what your pharmacist suggested, you are going to take the next dose the next night. The first one hasn’t gone anywhere yet. You take a second one … so you have two tablets sitting. You now have 20 mg of this drug that haven’t gone anywhere yet. Then you have 40 mg,” he said, warning that it could have an adverse effect on the patient.
He marvelled that persons are now willing to spend more money with herbalists than they spend with the doctor. “They would question you, ‘Are you sure this will work?’ But go to a herbalist, sit down and pay $600 and walk around feeling smart with $600 in ‘bush’. That is what is happening out there.”
It is for this reason, he said, they must be upfront with their pharmacist about what they are taking. (JH)