Cannabis has long been treated worldwide as a narcotic that causes hallucinations, and except for uses such as fabric or paper raw materials, its cultivation and use have been banned. Recently, however, cannabis has been attracting attention as a treatment. The cannabidiol (CBD) component of cannabis has shown effectiveness for various conditions such as epilepsy, Parkinson's disease and depression, increasing the possibility of development into a therapeutic. In 2018, a new epilepsy drug made from a cannabis component was also released.
As cannabis components showed effects on various conditions, the movement to legalize medical cannabis around the world accelerated. Medical cannabis is currently legalized in more than 56 countries, including the United States, Canada, the United Kingdom, Germany and Australia. Japan, conservative on drugs, allowed CBD use in 2023, and France is currently amending laws to legalize it. Korea also allowed CBD treatments on a limited basis in 2019.
If cannabis is developed for medical use, benefits could accrue not only to patients but to the entire country. That is because it could create new growth engines for the pharmaceutical industry while recycling agricultural byproducts. If imported medical cannabis is domestically produced, medical costs could be reduced and it could be developed as an export drug. According to market research firm Global Market Insights, the global medical cannabis market is expected to grow to $108 billion (Hanwha 158.4 trillion won) in 2032, seven years from now.
◇reduces overexcitement and seizures and protects nerve cells
Different parts of the cannabis plant are used for different purposes. The stem is used as industrial hemp for fiber, paper and building materials. The seeds are rich in protein and omega fatty acids, are called a "superfood," and are used in cosmetics and health supplements.
The controversial parts are the flowers and leaves. The marijuana we know as a drug is due to the tetrahydrocannabinol (THC) component, which causes hallucinations and addiction. Cannabis flowers and leaves contain THC, but they also contain the therapeutic CBD component. For cannabis to be transformed into a medicine, CBD must be extracted from the flowers and leaves and go through a purification process to reduce the THC component to below 0.3%.
CBD relieves pain without addiction and suppresses excessive excitation. In 2015, researchers at the Evelyn F. and William L. McKnight Brain Institute's epilepsy center at New York University Langone published research showing CBD alleviates symptoms of epilepsy. Epilepsy causes excessive activation of nerve cells leading to seizures, and CBD reduces seizures by enhancing the function of GABA receptors, an inhibitory neurotransmitter in the brain. Repeated epileptic seizures cause inflammation in the brain and damage nerve cells, and CBD also plays a role in protecting nerve cells through its anti-inflammatory effects.
The World Health Organization recognized the safety of cannabis CBD in 2017. The following year, following WHO recommendations, the United Nations narcotics commission removed cannabis from the list of narcotics for the first time in 60 years. British pharmaceutical company GW Pharmaceuticals developed the CBD epilepsy treatment Epidiolex and received U.S. Food and Drug Administration approval in 2018. It was the first FDA approval for a CBD-based drug.
Clinical trial results showed Epidiolex reduced seizure frequency by more than 50 percent in patients with the rare pediatric treatment-resistant epilepsies Dravet syndrome and Lennox-Gastaut syndrome. In 2021, the FDA also approved its use for tuberous sclerosis, which has the largest number of patients. There are 65 million epilepsy patients worldwide and 500,000 in Korea.
Since then, studies have reported that cannabis CBD has effects on various brain diseases beyond epilepsy, including Parkinson's disease and Alzheimer's dementia. GW Pharmaceuticals is investigating whether Epidiolex is effective for dementia and autism spectrum disorder (ASD). Researchers at the University of Colorado are conducting a phase 2 clinical trial to examine the efficacy of CBD in Parkinson's disease patients.
◇in Korea it cannot leave the laboratory
The medical cannabis market is growing rapidly. GW Pharmaceuticals, which developed Epidiolex, was acquired by Jazz Pharmaceuticals in the United States for $7.2 billion (8 trillion won) in 2021. Epidiolex posted sales of $972.4 million (1.44 trillion won) last year and is on the verge of entering blockbuster status (a drug that generates $1 billion in annual sales).
Countries that allow medical cannabis, such as the United States, Japan, Israel, Germany and Australia, have permitted research and development (research and development) as well as cultivation, production and export. Medical cannabis has become a new source of revenue in agriculture and has established itself as a new growth industry that contributes to job creation and regional economic revitalization. In particular, the United States became the world's largest CBD market after the 2018 Farm Bill revision allowed a variety of CBD products such as oils, cosmetics, food and beverages and pharmaceuticals. As of last year, the market size reached $8 billion (10 trillion won).
Medical cannabis is also being researched domestically. The Natural Products Research Center at the Gangneung branch of the Korea Institute of Science and Technology (KIST) is a representative example. In Andong, North Gyeongsang Province, designated as a regulatory free zone by the Ministry of SMEs and Startups in 2020, cultivation, development and production technologies for medical cannabis are being demonstrated. Domestic company NeoCannBio succeeded for the first time in extracting high-purity CBD in the special zone in 2021 using KIST patented technology. NeoCannBio was founded by Ham Jung-yeop, principal researcher at KIST's Natural Products Research Center.
However, because there is no institutional foundation for industrialization domestically, the market has struggled to open. Domestic medical cannabis extraction and production technology is at a level comparable to overseas, but it cannot actually be utilized. For CBD to be an active pharmaceutical ingredient for export, facilities that meet good manufacturing practice (GMP) must be established. But domestically there are no clear regulations allowing this, so industry consensus is that it is virtually impossible to obtain approval from the Ministry of Food and Drug Safety.
Kim Jeong-guk, CEO of NeoCannBio, said, "It is not that Korea lacks the technology to produce medical cannabis," and noted, "If a few of the solid regulatory barriers are removed, many domestic patients, like those in several foreign countries, could benefit from medical cannabis with low expense and high accessibility, and it could lead to industrial development."
☞cannabis
Cannabis is a dicotyledon in the genus Cannabis. Fibers from the stem are used as raw materials for hemp cloth or nets, and the seeds are used as seasonings or oil. Cannabis herb refers to the dried leaves and flowers of cannabis and is commonly called marijuana. Cannabis herb contains the psychoactive component tetrahydrocannabinol (THC), which causes hallucinations and addiction, so it is regulated as a narcotic in most countries. Recently, the cannabidiol (CBD) component of cannabis has shown effectiveness for various conditions such as epilepsy, Parkinson's disease and depression, increasing the possibility of development into a treatment. Currently, more than 50 countries worldwide permit the use of medical cannabis.