The first part of the 3rd edition of the INTERNATIONAL CONFERENCE PTMC - Portugal Medical Cannabis took place on June 16 and 17 in Lisbon. About 200 professionals from various fields, including medicine, pharmaceutical sciences, agronomy, scientific research, law and investment, took place at this conference.

It was intended with this initiative to offer two days of learning and networking, ending this event with a vip closing conviviality, a boat trip on the Tagus River. A second part of this third edition will take place on the island of Madeira on 26 and 27 October.

At the end of this article, the recordings of the sessions are available, summarized here.

June 16

The session of the first day, June 16, began with the opening held by Vasco Bettencourt, Director of the Licensing Unit of Infarmed, who summarized the work of the institution in favor of licensing companies operating around medicinal cannabis. In his speech, Vasco Bettencourt stressed the importance of the licensing process, continuously improved, for the development of the sector in Portugal, with the aim of making the country one of the most interesting in Europe, in this area. He also made it clear that Infarmed also learned from companies, limating edges and improving licensing procedures, always for greater effectiveness, without affecting the results in terms of accuracy and quality.

Vasco Bettencourt points out parameters such as the number of hours of sunshine, low costs of land, skilled labor and the existence of a favorable regulatory framework, as factors that have been attracting many companies to invest in Portugal. "There are currently about 200 companies that have applied for permits to carry out activities in the area of medicinal cannabis," he said.

The next intervention oversaw Professor Raphael Mechoulam of the Hebrew University of Jerusalem, where he has been a professor since 1972. His main area of scientific research is the chemistry and pharmacology of cannabinoids, in which he has been working for more than 50 years. In a recorded intervention, due to the impossibility of being present, Professor Mechoulam developed the theme of "Endogenous Compounds Similar to Anandamide".

It began with the following premise: "the modulation of endocannabinoid activity can have therapeutic potential in almost all diseases that affect humans", thus justifying the interest of many groups in the investigation of cannabinoids of plant origin. It then developed the numerous treatment possibilities, as well as their mechanisms of action, associated with these substances, which may be useful in various pathologies.

Then the stage was handed over to Carl Hart, Professor at Columbia University in New York. In his speech he developed the theme "Cannabis and Psychos-myths and facts". It began with a historical review of the prohibitions that have occurred in the United States since the beginning of the 20th century. They were also accompanied by campaigns aimed at gaining public support, Professor Carl Hart said.

He continued to analyze some studies dedicated to the appearance of psychoses in cannabis consumers, demonstrating errors in data analysis, present in some of these studies. These shortcomings in the analysis could, in your opinion, lead to an unjustified overvaluation of the problem.

Next, Bonni Goldstein, Pediatric Physician and Medical Director of Canna-Centers Wellness & Education in the United States, developed the theme "Cannabis for Children: Lessons from a Pediatrician."

Goldstein is also the author of two books on the subject, entitled "Cannabis Revealed" (2016) and "Cannabis is Medicine" (2020). It revealed that more than a third of patients suffering from epilepsy continue with the disease uncontrolled with the use of existing medicines. It then highlighted the promising data in the treatment with the use of CBD (cannabidiol). It also highlighted the cognitive and behavioral developments resulting from this type of treatment in children. He developed the theme of autism spectrum disorders, sometimes observed simultaneously with epilepsy, underlining his great professional experience with a huge number of patients.

Regarding the long-term effects of CBD use, the pediatrician referred to two recent studies that state that "CBD does not affect brain structure in patients with epilepsy" (Sharma et al 2019) and "long-term exposure to CBD in rats shows no effects on behaviour" (Niehaus. 2022), unlike medications such as antipsychotics.

Dani Gordon, a Canadian physician living in London, a member of The Medical Cannabis Clinicians Society, spoke about the endocannabinoid system, developing the clinical application of some cannabinoids and terpenes in various therapeutic indications. It also compared the effect of synthetic cannabinoids, with those obtained from plant extracts (also called 'full spectrum') and the different forms of administration of those compounds.  As a specialist in the treatment of complex chronic conditions, Dani Gordon shared with the audience some of his experience in various pathologies, such as anxiety, fibromyalgia, depression, insomnia, and chronic pain. 

The next speaker, already in the afternoon of June 16, was Gregor Zorn, biologist, specializing in medical education on cannabis, development of phytocannabinoid products and applications of cannabinoid therapy. It deepened the theme of the synthesis processes of several phytocannabinides in plants, highlighting the clinical interest of some lesser known cannabinoids, such as canabigerol (CBG), THCV or ∆8-THC. Gregor Zorn also highlighted the possibility of combining phytocannabinoids in the treatment of various pathologies.

The last speaker of the day, before the afternoon debate, was Luna Vargas, an anthropologist based in Canada and a trainer about cannabis at Inflore, where she provides a global view of the cannabis industry, based on science and experience. He spoke of the lack of information for the public in a market where cannabis retailers (for recreational use, allowed in Canada since 2017) do not offer a sufficiently informed health service and health professionals are still little informed on the subject, with pharmacies still far from being a place of education about cannabis. With a comprehensive view of the theme, Luna Vargas considers that cannabis education should consist of "mediation between different parts of the industry (science, culture) and the general public. A node that connects multiple paths, giving a more complete and complex feel of the plant."

For the closing of the first day was reserved an interesting debate about the "challenges of cannabis legislation", moderated by Alfredo Pascual, investment analyst in the cannabis industry based in Germany. The participants were Kai-Friedrich Niermann, a German lawyer who specializes in consumer protection, product safety and new ones from cannabis, Jorge Teixeira, political advisor to the Liberal Initiative  and Ricardo Rocha, a lawyer at PLMJ. The paths followed in Germany and Portugal were compared in the direction of the legalization of cannabis for recreational use.

Despite the consensus among the members of the coalition supporting the German government on the subject, some of the issues still under discussion have been presented in the direction of an agreement that can be voted on in Parliament, which is not due to happen until next year. In the case Portuguese, the path will be made through the presentation of several bills, such as the one recently presented by the Left Bloc and, later, we will try to reach a "consensus", in which the most daring suggestions will certainly disappear.

Alfredo Pascual also drew attention to the relative "failure" of the introduction of medicinal cannabis in Portugal which, despite having generated an exporting industry (destined, countries such as Germany and Israel) has failed to make products available to the public Portuguese. This apparent ambiguity can be explained by the lack of investment in the manufacture of finished products, i.e. ready for sale in pharmacies.

June 17

The June 17 sessions began with the intervention of Tej Virk, CEO of Acanda Corporation, a company that, in April of this year, bought RPK Biopharma (holigen subsidiary in Portugal). The intervention entitled "How to catch the green wave in Europe" points to the value of 2 860 million euros ($3B) for the European cannabis market in 2025 and has developed the perspective of companies entering this market. The CEO of Acanda Corporation pointed to the fragmentation of the rules in force in the various European countries as the main problem for the development of the sector. The company, which focuses its development in the areas of Europe, the Middle East and Africa (EMEA) sees Portugal as the "European Centre of Excellence in Cannabis" since "since the legalization of medicinal cannabis in 2018, Portugal has developed an import/export framework that has positioned the country as a global core for medicinal cannabis", "from which only growth can come",  Added. Tej Virk showed the excellence of the facilities acquired in Sintra and Aljustrel and stressed the importance of partnerships with other top brands and research and development projects.

Alfredo Pascual, a Uruguayan living in Germany, returned to the stage on the morning of the 17th to talk about the theme "International implications of the legalization of cannabis". It developed the interpretation of international treaties on the ban, namely the "Single Convention on Narcotic Drugs" of 1961, whose "prohibitionist interpretation failed to advance the health and well-being of humanity", which led Uruguay to reinterpret the treaty to better meet its objectives in 2012.

It was followed by Steven George, an American from Michigan, from the financial sector, who came to Portugal in 2017 to do an MBA and has been working in the European cannabis industry since 2018, notably tilray. He compared regulatory frameworks in Europe and the United States, noting that, whether for recreational or medicinal purposes, we are ultimately talking about the same plant. Thus, in the European Union, patients have access to cannabis for medicinal purposes, through a medical prescription, products are sold in pharmacies and regulated by the national health regulator. In the United States, patients have access to the products through a medical recommendation, the products are distributed in dispensaries and regulated by a regulator at the state level (not the FDA, the Federal Regulator). Access to cannabis for adult (recreational) use in the United States is possible above a certain age (typically 21 years), products are distributed in retail dispensaries and regulated by individual state regulators.

It also underlined the long-term advantages of the European system considering cannabis for medicinal purposes as a medicine, with exclusive distribution in pharmacies, involving health professionals in the process. In cannabis for a future recreational use, it defends its sale outside the pharmacy space. Regarding the quality of the products, the EU-GMP standards, the same ones used for the manufacture of medicinal products, for the manufacture of cannabis products, may be followed for any of the purposes, despite the associated costs.

This was followed by Juicy Fields speaker Shlomo Booklin, who graduated from the Jerusalem Technical Horticulture Institute and currently works in Canada. His speech, dedicated to the theme "GACP: how to apply pharmaceutical standards to botanical crops", began by mentioning that dispensaries remained open in Canada, even during the lockdowns of COVID-19. In the case of cannabis culture for medicinal purposes, stressed that we can obtain two types of products for medicinal use: flowers or other products based on extracts. This production cycle leads to the requirement of standards such as Good Agricultural and Collection Practices (GACP), Good Manufacturing Practices (GMP) and a transition area between them.

The last individual speaker was Jaime Gil-Robles, specialist in business development in regulated sectors, brought to the stage, in the company of the CEO of Kannabeira, the experience of the project they built together.

The closing debate was held around the theme "The future of drug reforms: how to regulate substance use in the 21st century" developed by a panel of guests, moderated by Laura Ramos. The panelists were Carl Hart, Professor at Columbia University, Teresa Summavielle, researcher at the University of Porto, Miguel Costa Matos, deputy for the Socialist Party and João Taborda da Gama lawyer of Gama Glória. It was stressed that not all substances should be regulated in the same way and the social stigma associated with the consumption of these substances and the need for mentality change were addressed.

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