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Navigating dementia: exploring the potential of cannabis in care

Written by Contributor on . Posted in Insight.

January marks Alzheimer’s Awareness Month, a time to reflect on the growing impact of dementia on individuals and families across Canada. The numbers are frankly alarming – over 700,000 Canadians are currently living with this condition, and projections suggest that the number could double by 2050.

It’s not just the memory loss; for many with moderate to severe Alzheimer’s, agitation and aggression become a daily struggle, deeply affecting both the individuals themselves and those who care for them. 

As a pharmacist, I’ve witnessed these struggles firsthand and seen the frustration when conventional treatments just don’t seem to make enough of a difference. It’s in this context that the potential role of cannabis has begun to spark interest and raise important questions.

A glimmer of hope: what the research suggests

The connection between cannabinoids and dementia is still a developing area of research, but some promising findings have emerged. As a pharmacist, I find it particularly intriguing to see studies exploring cannabinoids’ potential to address challenging symptoms like agitation and aggression in Alzheimer’s patients. 

For example, a 2018 study conducted at Sunnybrook Health Sciences Centre demonstrated that nabilone, a synthetic cannabinoid, significantly reduced agitation in patients, with a 47% decrease compared to a 23% reduction in the placebo group. A more recent 2024 study from Johns Hopkins and Tufts Universities found that dronabinol, another synthetic cannabinoid, showed similar benefits in reducing agitation, with fewer side effects than traditional antipsychotics.

While these early studies give a glimmer of hope, they also emphasize the need for cautious, informed application of cannabinoids in dementia care, given the complexity of their effects on the brain.

The importance of careful guidance

Cannabinoids interact with a brain affected by Alzheimer’s in unique and sometimes unpredictable ways. While many people turn to cannabis for its calming properties, dementia patients may experience adverse effects, such as heightened confusion or excess sedation. As a pharmacist, I’ve seen firsthand how these complexities require thoughtful consideration and a tailored approach. 

This is why I advocate for pharmacist-led guidance when exploring the use of cannabis. With our clinical training and understanding of both conventional and alternative therapies, pharmacists are uniquely positioned to ensure cannabis is used safely, effectively, and in alignment with the specific needs of each patient. At Apothecare, my co-founder Ajay Chahal, a fellow University of Toronto-trained pharmacist, and I are dedicated to closing the gap between traditional and alternative medicine. 

As pharmacists, we understand the complexities of incorporating cannabis into patient care, and we’re passionate about empowering patients and caregivers to make informed decisions. Our approach is rooted in evidence-based cannabis education, ensuring that any use of cannabis is accompanied by close monitoring and a plan tailored to each patient’s unique needs. We see ourselves as trusted navigators, helping patients and their families understand the intricacies of cannabis therapy, and prioritizing safety and efficacy every step of the way.

Looking ahead: the future of research

The conversation around cannabis for wellness purposes is constantly evolving, and Canada is playing a key role in this ongoing research. While the initial findings on cannabinoids and their potential to improve quality of life for dementia patients are preliminary, it’s important to remember that more research is needed. We need larger-scale studies to really establish best practices and robust safety guidelines. That said, even the limited research done so far offers some encouragement.

For anyone considering cannabis as a potential treatment option, I urge you to have a thorough conversation with your healthcare provider. It’s about making informed decisions, weighing the potential benefits against the risks, and ensuring proper oversight. With the right approach – grounded in education, careful monitoring, and personalized care – cannabinoids could potentially become a valuable tool in our efforts to provide better care and a better quality of life for those living with this challenging condition.

About the Author:

Anushya Vijayaraghevan is a licensed pharmacist and co-founder of Apothecare. She holds a Doctor of Pharmacy from the University of Toronto and is deeply committed to integrating evidence-based cannabis use into patient care.

Canada’s wholesale cannabis market shifting from buyers’ to sellers’

Written by David Brown on . Posted in Insight.

While the beginning of cannabis legalization in Canada was characterized by a surplus of product, many in the industry now say that trend has been shifting to a shortage in recent months. 

This is good news for cannabis growers, as it means having more leverage on the market, putting brokers and third-party processors in a less-than-ideal position for potentially the first time. 

Jacquie Trombley, director of sales, marketing, and product development at Agmedica Bioscience Inc. in Ontario, says she has seen a significant shift in 2024 from a buyer’s market to a seller’s market. 

There’s been a significant shift to 100% cash up front and we’re getting it! Before the product leaves our facility.

Jacquie Trombley, Agmedica Bioscience Inc

Agmedica sells in Canada’s medical and non-medical markets, both under their own brands and in the B2B market, and exports to international markets. 

“Historically, we would usually have at least some inventory in our vaults, but right now the majority of the requests we receive for product go unfilled,” explains Trombley. “We get asked for product pretty much every day, and we cannot meet the demand.”

This is in part because of the increasing demand of the export market, she says, but it’s also the result of the number of cannabis producers closing up shop. Some struggling producers who might have been desperate to move products at a discounted rate are now out of the market, and, over time, this benefits those who have been able to stick it out.  

This is reflected by the increase in price for not only top-quality flower, but also the rise in price for smalls and trim, which generally aren’t making their way to the international markets. 

“Pricing has come up dramatically,” she continues. “We used to sell A [grade] flower for what we’re selling B [grade] flower for now. B flower and trim pricing has probably doubled.” 

Another big turn, says Trombley, is payment terms for growers who are selling to processors, something that is arguably more impactful than the price increase, where various consignment deals and terms have been common for growers in the first few years of legalization, meaning full payment might not have been provided for some time after product had sold in a provincial market. 

“We are no longer offering terms to B2B domestic buyers because you just might not get your money,” she continues. “There’s been a significant shift to 100% cash up front and we’re getting it! Before the product leaves our facility.”

This is a big deal for small growers who are struggling to keep the lights on. 

“Right now, I think some of those smaller companies absolutely can demand cash up front right now, or at least improved payment terms.”

Steve Clark, founder of the Canadian Cannabis Exchange, says the issue is something many in the industry have been discussing this year. 

“We are seeing domestic supply shrinking in a number of ways,” says Clark. “The closures of growing facilities and reduction of square footage of canopy in Canada. The companies who were producing for their own internal supply in these facilities have flipped from net sellers to net buyers, (further taking supply off the market), and the pull from export into intensive markets is reducing overall flower availability.”

​​Michael Gorenstein, president and CEO of the Cronos Group, another cannabis company that sells domestically and in international markets, made similar comments on a recent quarterly report earnings call. 

“We’ve really seen a huge shift in the supply dynamics where we’ve had significant oversupply in the past,” said Gorenstien. 

Although he says he still believes there is a large supply of low-quality cannabis flower in the market, this isn’t necessarily a product with much market demand. Quality cannabis, he says, is a different story. 

“As we said in the past, there’s a difference between available cannabis inventory and available inventory that’s sellable as quality flower,” continued Gorenstien. “While there’s plenty of the former, there is now a shortage of high quality desirable flower that is sellable to consumers in Canada.”

The company’s most recent quarterly report also noted: “We are anticipating shortages in raw materials and may be unable to obtain adequate supplies of raw materials in a timely manner and at commercially reasonable prices.”