Nicco Reggente   |   April 15, 2020

How Cannabis Leaders Can Move into Personalized Medicine

Personalized cannabinoid formulations could be the future of cannabis supplementation.
Co-founder of Strain Genie, a Los Angeles based startup that offers a cannabis DNA test to match patients and recreational users with the right cannabis products, strains, terpenes, and dosage recommendations. Nicco received his Ph.D. in…

Ask people what their first experience with cannabis was, and you will no doubt get a variety of answers: "I fell asleep," "I got the giggles," "It made me super paranoid," and so on. This variation arises from the chemical composition of the product, and how different people metabolize these compounds; a one-size-fits-all approach is rarely effective in recreational or therapeutic cannabis use.

However, the industry has been inundated with a variety of products aimed at harnessing the powers of the cannabis plant to tackle an array of ailments. CBD-infused products are touted for their ability to mitigate conditions, including anxiety and stress, pain, sleep disorders, and cancer. Cannabis companies have also seized the cosmetics market, with the release of CBD-infused skincare, haircare, and make-up products. Even pets are not exempt from this trend, with CBD dog treats and oils also available to consumers.

The chemical composition of these products is often elusive to customers, but business owners in the industry know that people respond differently to different cannabis products, so why aren't they considering personalization in their business approaches?

The power of personalized medicine

The entire medical community is moving towards personalized medicine, thanks to a greater understanding of genetics and their contributions to different diseases. While one cancer drug might work well for one individual, due to differences in genetic make-up, the treatment could be entirely ineffective in another.

This approach towards personalization in the medical community is associated with the relatively new field of pharmacogenetics, a study dedicated to learning how people's DNA can influence their response to drugs. The market promotes a generation of targeted, safe, and effective therapies, and takes the guesswork out of establishing treatment regimes for individuals.

As a result of this customization, pharmacogenetics is rapidly bleeding into mainstream industries and promoting the design of personalized products. Instead of a trial and error approach, medical industries are now able to predict how people might respond to treatments, diets, exercise, and other lifestyle alterations, and the cannabis market should be no exception to this trend. 

Consumers often want to achieve a specific outcome from their cannabis products, whether that is to relieve anxiety, reduce pain, or have a particular recreational effect. Instead of viewing these advances in pharmacogenetics as an attempt to make cannabis more complicated, industry leaders should consider the benefits of having unparalleled insights into their customers.

Pharmacogenetics in action

An illustrative example of personalized medicine in action is with the drug clopidogrel, a remedy doctors frequently prescribe to reduce the risk of stroke or heart disease in high-risk individuals, such as those who have recently suffered a heart attack, angina, or are affected by other circulatory problems. The drug's mechanism of action is to inhibit a receptor called P2Y12, which, when activated, promotes platelet aggregation. Clopidogrel achieves this intended result when converts into its active metabolite through the cytochrome P450 (CYP) enzyme. However, of particular importance is the enzyme CYP2C19. 

Variation in the gene that encodes CYP2C19 has been associated with responsiveness to clopidogrel. In a clinical study, researchers found that individuals who harbored the genetic variant were unable to properly metabolize CYP2C19, increasing their risk of suffering from cardiovascular events following clopidogrel treatment. Therefore, an alternative drug that works through a different mechanism would be more appropriate for people who possess the genetic variant, which is something that would be unknown without pharmacogenetics.

This research represents one study in a growing sea of investigations that are continually changing our understanding of how different people process compounds. However, it is not only pharmacological agents that are metabolized by the body; there are vast amounts of chemicals that people consume that they have to metabolize, and cannabis is one of them. 

To ensure recreational and medical cannabis users have the most desirable experience and achieve their desired outcomes, cannabis brands must take advantage of advances in pharmacogenetics and explore a whole new avenue of personalization.

Making customization the new standard

To incorporate some of the ideals of pharmacogenetics into cannabis-based strategies, business leaders should implement three primary strategies. 

1. Seek to know your customer through questionnaires

Brands should aim to truly understand each of their customers. This understanding can begin with the use of simple questionnaires: What is their gender? How much do they weigh? Are they a recreational user? Are there particular symptoms they want to target? Is there a specific effect they want to achieve? This line of thinking can move cannabis brands away from a one-size-fits-all approach to tailored products that target specific individuals based on basic information.

2. Use customer feedback to tailor recommendations

Finding out what works and what doesn't work for each consumer can also be extremely helpful for product development and recommendations. For example, cannabis brands can ask customers if they experienced any adverse effects from a product, and then use feedback from other customers to highlight a different product that still ticks all of their boxes, but might prevent unwanted side effects. This level of personalization can increase the lifetime value of a customer and lead to long-term success for cannabis brands.

3. Capture insights on users' genetics to personalize products

There is a growing field of direct-to-consumer DNA testing, with giants like 23andMe and AncestryDNA leading the way, and with more specific companies such as Vinome, which matches people with wine based on their DNA, and Orig3n, which has more of a fitness focus. Cannabis brands are taking more notice, and there are now several companies that offer DNA testing to maximize users' cannabis experience. 

This innovation might seem like a gimmick, but the foundation is backed by science. When someone ingests a cannabinoid, whether it's CBD or THC, their body responds to that input. The receptors in their endocannabinoid system, a complex network that's linked to a variety of physiological processes, such as cognition, emotion, memory, pain, inflammation, and reproductive health, interact with the phytocannabinoids that enter the body and cause a reaction. 

For example, when chemical compounds like CBD and THC bind to CB1 and CB2 receptors, they work together to initiate a signaling cascade in the body's cells. However, various genes can determine whether or not the body can effectively process those cannabinoids. One of them is the CYP2C19 gene, and another is a CYP gene known as CYP2C9. If there is variation in these genes, which are responsible for encoding the enzymes that metabolize cannabinoids, then it can lead to an inefficient breakdown of cannabinoids. Inefficient metabolism of THC can lead to a longer-lasting high, with the effects lasting for up to 3 days after the exposure.

This scenario is relevant when someone consumes edibles, which has to go through "first-pass metabolism." Individuals with this mutation could, however, use vape pens instead of edibles if the person wants to avoid bypass first-pass metabolism and avoid unwanted side effects. This example showcases exactly how genetic information can help business leaders tailor a cannabis product to an individual, based on one genetic trait.

Shifting to deeper personalization

Brands in the cannabis industry must remain relevant and take advantage of consumers' changing interests. Now that the cannabis space is as active as ever, companies must find new ways to diversify their products and personalize their approach. With the heightened interest and research into cannabis as a therapeutic agent, the timing couldn't be better for brands to move into the world of personalized medicine.

 

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