Cannabis Innovation Summit to officially launch U of T-led research consortium

Researchers from the University of Toronto and its affiliated hospitals will meet this week to launch a partnership focused on the health effects of cannabis and related compounds.

The Toronto Cannabis and Cannabinoid Research Consortium (TC3) has attracted dozens of members and will officially launch Thursday at the Cannabis Innovation Summit, part of Health Innovation Week.

Ruth Ross, a professor and chair of the Faculty of Medicine's pharmacology and toxicology department, is a member of the TC3 steering committee, which is comprised of four other U of T faculty members – Tony George, a professor of psychiatry; Lakshmi Kotra, a professor at the Leslie Dan Faculty of Pharmacy; Bernard LeFoll, a professor in the departments of family and community medicine, pharmacology and toxicology, psychiatry and the Institute of Medical Science; and Romina Mizrahi, an associate professor in the departments of psychiatry, pharmacology and toxicology and the Institute of Medical Science.

Ross spoke with writer Jim Oldfield about the consortium, the emerging science and the perils and potential of cannabis legalization.

How big is the consortium?

We have over 50 members, who each bring trainees, so we number well over 100 at this point. Members are principal investigators with a faculty appointment at U of T, based at the university or a Toronto academic hospital, and we’re drawing people from right across that network. There is lots of cannabis and related work going on at U of T, but we’re really focused on cannabis and cannabinoid research that pertains to health, so the related benefits, safety and potential harms.

We see the consortium as having three pillars: the chemistry and biology that underlies how cannabis and cannabinoids work, or drug discovery and delivery; clinical or translational research; and public health. The landscape is changing very quickly with the legalization of cannabis, and for Canada to lead the way we need robust, world-class research, quickly translated to drive the public health agenda. We’re very well-positioned in Toronto to do that.

What are the priorities in your three main areas?

We need to know more about mechanisms of action and the pharmacokinetics, or how cannabis and cannabinoids interact with different systems in the body. That’s pre-clinical work in cells such as neurons or cancer cells, and in other model systems. We’ll also look at how the endocannabinoid system and cannabis work in different clinical conditions, and at potential harms in maternal use and effects on brain development. That’s the first pillar.

The second area is clinical research on several conditions including pain, Parkinson’s, Alzheimer’s, epilepsy and cancer. We need to know a lot more about efficacy and safety in these conditions, and that will require clinical trials and measuring harms in the clinic. A lot of this work will run through the Centre for Addiction and Mental Health, and will focus on cannabis use disorder, risk for schizophrenia and cannabis-induced psychosis, but also potential clinical use of certain cannabinoids.

The third pillar is public health, and there are a host of issues here, from youth psychiatry and maternal health to second-hand smoke and driving while intoxicated.

What advantages will the consortium bring to help address these issues and questions?

I think we’ll be unique in Canada given our size and scope. U of T is so big, and together with our clinical partners, the Toronto Academic Health Science Network really is a research powerhouse. This consortium will create all kinds of intersects across basic and clinical science and public health, and with experts working in many areas and the benefits of Toronto’s diverse patient population, we should be able to move nimbly into this space and make a real difference.

And there is an urgent need for that – many of the products in use now are much higher potency than in the past and there is a dearth of data on their effects. Many of the claims of benefit related to cannabis and CBD (cannabidiol) need to be backed up with good evidence. 

Can industry help improve our data?

Well, cannabis is a multibillion-dollar industry, and we need funding for evidence-based research. I think it’s fair to ask the cannabis industry to support quality research that is publicly available. The Canadian Institutes of Health Research have stepped up recently with an integrated cannabis research strategy and significant funding, and we hope to organize team applications for those grants. But research is expensive, particularly clinical research to demonstrate safety and efficacy and to follow the long-term outcomes for higher dose products or high CBD in recreational cannabis users. Washington State Initiative 502 directed a portion of the tax revenue from marijuana production and sales to support university research on the short- and long-term effects of cannabis use and for dissemination of findings. We could conceivably set up a similar structure or non-profit organization that could direct research funding in Canada. 

What is the most exciting research in this area right now?

There is a lot going on, but endocannabinoid research is very exciting. We’ve known for a long time that the cannabinoid system is everywhere in the brain and nervous system. It’s a key player in appetite, sleep, stress, memory and many other systems, and it responds differently to cannabis, its components including THC (tetrahydrocannabinol) and CBD, and other ingredients under different conditions. Response also depends on dose, frequency of use, age, genetics and other variables.

But we’re starting to understand the endocannabinoid system, which was only discovered in 1992, and to find out different illnesses affect it. This is fabulously interesting science, and it will be crucial in creating therapies that are safe and effective and to minimizing the potential harms of cannabis.