October 17, 2019, marked the first anniversary of cannabis legalization in Canada, and now Cannabis 2.0 is in effect, which includes topicals, edibles, and extracts. In this market, a lot can change in a year, and we have new information coming in. This is an update on the legal, economic, and practical state of cannabis in Canada. It is also looking at topical cannabis, a new class of cannabis products that are about to hit the market, and what it means for cannabis-related products in skincare and dermatology.
Cannabis in Canada: Quick Recap
Canada legalized cannabis with the passing of the Cannabis Act (Bill C-45) on October 17, 2018, legalizing cannabis plants and oils. We wrote an article about the potential for cannabis research and its effects on dermatology last year. At the time, topical cannabis was still future speculation, as only plants and oil were legal. It’s only been a year since legalization in Canada, but a lot has happened in the cannabis industry since. The biggest change in Canada is the expansion of legal cannabis products to include extracts, edibles, and topical cannabis products. These alternate products became legal effective October 17, 2019, a year after the Cannabis Act, often dubbed Cannabis 2.0.1 The reason for the staggered timeline of legalization is to evaluate unique health risks with edible and topical cannabis products and cannabis extracts,2 as different delivery systems have different physiological effects.3,4 Like traditional plant cannabis, these new products come with restrictions on packaging and labeling, claims about health, diet, or cosmetic effects.
With a population of just 37 million, Canada is not a powerhouse economy, but cannabis legalization in Canada is likely to have major implications:
- Legalizing cannabis creates a new industry and a source of tax revenue that is expected to grow rapidly. Cannabis is a 7 billion dollar market, and Cannabis 2.0 (topical, edibles, and extracts) is expected to add another 2.7 billion dollars.5
- This puts significant pressure on other countries to do the same or risk being left behind. The global market is estimated at 25 billion USD as of 2019 but forecasts a rise to 60 billion USD by 2024.6
- With legalization and regulation, tangible data is coming in, and research is likely to expand in scope and depth. Cannabis law is evolving in Canada as a response. It is expected to continue to adapt as more information comes in.
On the other hand, cannabis legalization is still in its infancy stage, and cannabis still faces many challenges outside of the legal framework. One of the most important concerns is the large disparity between supply and demand. The stated goal of legalization is to cut out the black market (and procure tax revenue). Still, today’s legal market can’t supply the demand, which is reflected in the staggering price difference between legal and illegal cannabis.7 The price disparity also hurts medicinal users the most, as they typically consume far more than recreational users. The market is expected to level out eventually as access expands, driving prices lower over time but looking at the precedent of legalized US States, this is expected to take many years.
Cannabis 2.0 legalizes extracts, edibles, and topicals in addition to the plant and oil forms of cannabis. All forms of cannabis can have a therapeutic effect on various skin conditions, but the most direct and promising medium is topical cannabis.8
What’s the advantage of topicals?
In general, the advantage of topical medication over systemic medication is that any side-effects are likely to remain local. The same principle applies to cannabis.
Will topical cannabis make me high?
It’s possible in theory but extremely unlikely in practice. Your skin absorbs slowly, and unless you apply topicals over an open wound, cannabis will not enter the bloodstream. Also, most topical products will use CBD, which is non-psychoactive, rather than THC.
How strong is the evidence for topical cannabis?
In terms of established science, not very much. While interest in cannabis has surged in recent years,9 acceptance, use, and interest in cannabis have run far ahead of the hard science in terms of efficacy.
What beneficial effects is the dermatology community researching?
The reason that cannabis has such wide-reaching potential is its effect on the endocannabinoid system (ECS), which acts as a modulator for various other functions, including pain, inflammation, sleep, appetite, mood, and a host of other health factors.
Of these, the most interesting from a skin perspective are:
- Inflammatory conditions (atopic dermatitis, contact dermatitis, psoriasis, eczema, etc.)
- Pain management (psoriatic arthritis)
- Wound Care
- Skin cancer (the evidence is still weak, however)
- Other (burns, eczema, anti-aging)
What is the endocannabinoid system?
We all have an endocannabinoid system or ECS (even if you’ve never taken cannabis); this was discovered relatively recently in 1992.10 Cannabinoid receptors are located all over the body, including the skin, which is how topical cannabis can still stimulate your body without going into your bloodstream or brain.
The ECS is complex and involves regulating a variety of biological processes such as digestion, metabolism, pain, immune function, stress, skin and nerve function, and many more.11 In dermatology specifically, the therapeutic potential of cannabis products can extend into a variety of common conditions like acne, atopic dermatitis, itching, and pain relief.12
Why do products have widely differing claims?
Labeling is an important legal point when it comes to cannabis. Like labeling laws with tobacco or alcohol, there are significant labeling restrictions to all cannabis products in Canada. Some have called for differentiation between CBD products and THC products, as CBD is not psychoactive, but as it stands, both products fall under the Cannabis Act, restricting what a product can claim. In the United States, the FDA has similar labeling restrictions on CBD products even for legal States.13
Lastly, legal or not, many companies will make claims that are prohibited, and hyperbolic claims are certainly not uncommon in this industry. The FDA has sent warning letters to companies for making drug claims or for false claims about CBD levels.14 In the future, we are likely to see more standardization as the evidence (and lack of for some uses) becomes more established and labeling laws to reflect this.
The Future of Cannabis as Medicine
As cannabis becomes more legal and more mainstream, the number of legitimate and reliable studies will also increase. Canada is trailblazing in many ways with cannabis legalization. A 3.0 and 4.0 will likely be needed to work out various factors like access, public safety, and economics of cannabis, but what we do know is that the information floodgates are open. We can expect more high-quality studies to come forth.
The cannabis landscape is quickly changing outside of Canada as well, as demand worldwide is on the increase both for recreational and medicinal use. In the United States, CBD sales may surpass 20 billion USD by 2024, according to a BDS Analytics study. Topicals (and edibles) will likely expand in the marketplace going forward. There are many more possibilities for expansion in this market, as foods and topicals can add another dimension to cannabis. The legal framework is also more likely to evolve here as well. There is a move to reclassify CBD in Canada as a natural health product.15 This can have the effect of increasing availability and may destigmatize CBD products for consumers as well.
8 Although legal effective October 17, 2019, due to processing time, the earliest it can reach shelves is mid-December. It may take much longer until they become widely available.
9 A quick search on PubMed will bring up tens of thousands of studies.