The afternoon classes at Tuesday’s inaugural Hashish Well being Symposium 2025 moved past the basics of hashish drugs and its potential, to the sensible realities of prescribing this comparatively new drugs within the UK. 

These in-depth talks spanned the whole lot from pharmacy requirements and product high quality to the particular challenges of prescribing for ladies’s well being, ache administration, and weak affected person teams. 

What turned abundantly clear all through the day was that that is, and at all times has been, an trade pushed by sufferers and their highly effective tales, a theme that got here into sharp focus through the day’s closing panel dialogue.

READ PART 1 HERE

The Position of the Pharmacist: Greatest Follow for Meting out CBPMs

Zul Mamon, Associate at Pharma Specialists and Senior Accountable Particular person, opened the afternoon by illustrating the fragility of the present affected person expertise by the story of Sarah, a 45-year-old affected person with continual ache.

After lastly securing a prescription, Sarah was left with delays, silence from each clinic and pharmacy, and no thought learn how to use her medicine. Mamon pressured that her journey is “way more widespread than we prefer to admit.”

Key findings from the GPhC report

Referring to the October 2025 Basic Pharmaceutical Council inspection report, Mamon famous:

• 24 CBPM pharmacies had been inspected
• 68 considerations had been recognized throughout them
• Main points centered on lack of entry to scientific data, incomplete danger assessments, poor communication, and inappropriate prescribing, which pharmacists had been unable to problem

With out entry to affected person historical past, Mamon warned, pharmacists can’t reliably determine contraindications, drug interactions, or duplication of remedy.

Pharmacists as scientific gatekeepers

Mamon outlined that the pharmacist’s position begins lengthy earlier than meting out:

• Prescription verification: Legality, completeness, prescriber legitimacy
• Scientific security checks: Interactions, contraindications, product suitability
• Affected person schooling: Dosing, administration, uncomfortable side effects, storage, red-flag signs
• Monitoring and intervention: Encourage reporting, liaise with prescribers, alter plans

At the moment, CBPM meting out has ‘devolved into placing it in a field and transport it,’ with little or no pharmacist-patient contact.

Coaching, provide chain, and communication gaps

• Coaching is commonly based mostly on unverified sources; some groups had no CBPM-specific coaching
• Frequent inventory shortages, due largely to advanced imports and short-dated merchandise
• Poor communication meant clinics had been unaware of points, and sufferers had been left confused

Options included digital stock-tracking, proactive clinic-pharmacy communication, sturdy procurement processes, and shared affected person info assets utilizing plain-language explanations.

Three pillars for elevating requirements

Mamon proposed a sector-wide framework constructed on:

1. Steady scientific schooling: Skilled networks (MCCS, symposiums, peer boards)
2. High quality assurance: Audits, documentation requirements, and safeguarding
3. Affected person-centred care: Energetic pharmacist involvement all through therapy journey

He closed by reimagining how Sarah’s journey would have modified if she had been supported by a well-trained pharmacist with scientific data, clear communication traces, and an energetic position in care.

Exploring the Proof Base: CBPMs in Psychiatry & Neurodiversity

Dr Niraj Singh explored using CBPMs in psychological well being and neurodivergent populations, an space he described as promising however advanced.

Psychiatric and neurodevelopmental situations

Singh outlined that psychiatric displays fluctuate broadly and infrequently overlap with neurodevelopmental issues, together with nervousness and despair, PTSD, OCD, autism, ADHD, mental incapacity, and dyspraxia. These situations hardly ever exist in isolation, and people usually current with intertwined organic, psychological, and environmental elements.

What the proof reveals

The proof base is heterogeneous however rising, with research overlaying nervousness, PTSD, ADHD, agitation, temper instability, and autism-related signs. Actual-world information recommend significant enhancements for chosen sufferers.

THC and CBD present totally different benefit-risk profiles, and matching affected person phenotype to formulation is important.

Singh cautioned that psychiatric sufferers might reply in non-linear or surprising methods, so cautious titration and monitoring are important.

Scientific classes from follow

Key insights:

• Some neurodivergent sufferers expertise paradoxical reactions (e.g., CBD inflicting sedation or agitation)
• Many profit most from balanced oils or high-CBD daytime formulations
• Girls, on common, might require decrease THC doses than males, although not universally

The emphasis was on personalisation and recognising that ‘one measurement doesn’t match all.’

Moral and security concerns

Singh highlighted the necessity for clinicians to know vulnerabilities comparable to co-morbid trauma, emotional dysregulation, or sensory sensitivity. The significance of knowledgeable consent and shut follow-up can’t be overstated, and future analysis ought to deal with granular subgroups, not broad diagnostic labels.

From Plant to Affected person: Security, High quality & Consistency in CBPMs

Dr Callie Seaman, plant scientist and formulation chemist, delivered a densely informative deep-dive into how pharmaceutical-grade hashish is grown, processed, and standardised.

Chemotypes and cannabinoid profiles

Seaman outlined three core chemotypes:

• Sort I: Excessive THC
• Sort II: Balanced THC:CBD
• Sort III: Excessive CBD, low THC

She famous rising Sort IV/V merchandise wealthy in minor cannabinoids (e.g., CBDV), although few seem on UK formularies.

Why solely the feminine flower issues

Male vegetation produce little biomass and minimal cannabinoids. The medically related compounds reside in glandular trichomes of unfertilized feminine flowers, which comprise cannabinoids, terpenes, flavonoids, lipids, and different secondary metabolites.

Environmental affect and stress response

Cannabinoid and terpene expression is extremely depending on mild spectrum and depth, temperature, nutrient availability, abiotic and biotic stress, and genetics. Stress triggers elevated manufacturing of defensive secondary metabolites—a lot of which have therapeutic exercise.

Cannabinoids, terpenes, and flavonoids

Seaman highlighted:

• 147+ cannabinoids, many of great pharmacological curiosity
• Over 200 terpenes with roles in synergy and anti-microbial protection
• Below-researched flavonoids, together with cannabis-specific cannflavins A, B, and C

Flavonoids, she famous, warrant way more consideration given their potential therapeutic relevance.

Cultivation, harvesting, and manufacturing

Seaman in contrast cultivation strategies:

• Indoor: Excessive management, excessive value
• Greenhouse: Blended pure/supplementary mild
• Out of doors/area: Cheaper however excessive contamination danger

She detailed processes together with phenohunting, cloning, flowering, trimming, curing, moisture management, extraction, and GMP packaging.

Why full-extract issues

Seaman contrasted full-plant extracts (retaining secondary compounds) with isolates:

• Isolates usually require greater doses for related impact
• Full-spectrum preparations show extra sturdy outcomes attributable to synergy

Affected person expectations vs scientific actuality

Seaman warned clinicians to know what sufferers could also be used to from the illicit market—”bag attraction,” frostiness, sure aromas—and put together them for variations in pharmaceutical-grade merchandise.