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Olivier Dufourmantelle Talk About The European Cannabis Market and Educating Health Care Professionals

By Dr Julie Moltke


Copenhagen Cannabis Symposium 2019

I went to the first ever European Cannabis symposium hosted by MJBiz Daily and was fortunate to be able to interview one of the main speakers, the charismatic Olivier Dufourmantelle, the chief operating officer for Canadian based Canopy Rivers, the venture capital investment arm of Canopy Growth. Formerly he held executive positions within Canopy Growth, one of the leading players on the Canadian cannabis market.

I got to ask Olivier about how he sees the challenge of education and information of the medical community, the main gateway for medicinal cannabis to reach the patient. I also had the chance to ask him some questions about how he sees the cannabis industry development in Europe and what we are to expect from the market.


How has it been since Canada legalised recreational cannabis in October 2018?

When Canada made cannabis legal, most of the people who bought it illegally ended up buying legally. We saw an increase in the number of people trying cannabis in the first few months, but it has now levelled out. Some people tried it in the first three months, realised it was not for them and went back to not using cannabis. It is cheaper to buy marijuana in a dispensary than on the black market, which has the effect of slowly phasing out the black market. The average retail cannabis price is 8.7 Canadian dollars per gram. On the black market it will be 12-14 dollars, and there is no control over pesticides or quality. The only problem with adoption has been the lack of supply – empty stores.


How do you think we can get more information about medicinal cannabis and CBD to the European health care professionals? How have you done it in Canada?

The key problem is the lack of medical evidence. The gatekeepers are the College of Doctors, who do not recommend the use of medicinal cannabis. Likewise, other physicians are following these recommendations. As an example, in Denmark, The Ministry of Health tells us that Denmark is an excellent place for medicinal cannabis and they have rolled out a medicinal cannabis scheme for patients with chronic pain, but since the head of the College of Doctors does not believe in medicinal cannabis, adoption is going to be very low.

There are  issues around educating doctors and making the clinical studies available to them . Many doctors are confused about dosage. Even if they want to prescribe cannabis, they do not know how many grams are needed and so on. We need to give them information about key factors such as capsules, vaporisers, drugs, delivery methods, dosage and application forms. Most doctors are used to capsules, but for cannabis, that gives an extended delivery time, so we need education about alternative modes of consumption such as cannabis sprays  

What worked in Canada was giving access to specialised clinics. There is a two-track system which is the doctors who are not prescribing, and then  the specialised clinics that are prescribing. Instead of trying to convince the doctors about prescribing, we have to find a way to convince doctors to make a reference to specialised clinics that know how to handle medicinal cannabis.



Do you think that it will be crucial to first have the specialised clinics, and later as we get more evidence, every doctor will be able to handle the prescription of medicinal cannabis and maybe even learn about it in medical school?

More than 800 clinical studies are getting done right now, so it is a significant amount of data that is going to come in the following years to prove or disprove things. In the meantime, the more people who use cannabis, the greater the incentive will be to make clinical studies. There is a chicken and an egg situation happening at the moment around cannabis.


Where do you see the European medicinal cannabis market going, as opposed to the CBD market, which is more wellness-based?

I think there are four primary markets for cannabis: pharmaceutical cannabis, the CBD and wellness market, medicinal cannabis and last, recreational cannabis which is a no-go in Europe. Pharmaceutical cannabis will be supported by  big pharmaceutical companies, and there are already about ten drugs out there. The market will keep increasing in size, but only to a certain extent as many of the symptoms that they treat are quite narrow, like multiple sclerosis and treatment-resistant epilepsy. Having said that, there are some drugs with more significant market potential, such as those that treat the side effects of chemotherapy.

Medicinal cannabis touches a greater number of people for conditions ranging from pain management, to  anxiety and sleep treatments. These are pathologies that you find in vast portions of the population, so I feel that the opportunity for the market is really the medicinal cannabis. It is about broadening access for patients and  consumers to products that treat a wide array of pathologies, without having all the clinical science ready.


If you should narrow it down, where do you see the most significant potential for medicinal cannabis?     

For me, the big three are: pain management, anxiety and sleep disorders. From what I hear, which is not yet backed by science, there is a synergy between CBD, THC and terpenes. If you take only pure synthetic CBD it will not have the same effects, and especially when it goes through the stomach, it has to pass the liver and suddenly what was a micro-dose, becomes a micron-dosage. This means that the effects are more reduced. The opportunity here is to better understand the world of terpenes and the CBD:THC ratio, along with the flavonoids and other compounds in cannabis. We also need to find ways to bypass the liver to get more CBD into the bloodstream. Right now, there are not a lot of reasonable solutions out there.


What are your views on the CBD-wellness side of the cannabis industry and the lack of evidence?

The lack of clinical evidence is less of a problem in the wellness industry because people look for ways to feel better and not necessarily for numbers and science. The biggest threat to the wellness industry in Europe is the rules around novel foods. Ingestion remains the best source of absorption, better than through the skin, so if you remove the option to ingest the product due to the novel food rule, it will reduce the access of the product to the people.   


Lastly, how did you come on to this path yourself, and what is your primary purpose for working with cannabis?

I got married and moved to Ottawa, but I could not find a job there, so I still worked out of Montreal.  After my first daughter was born, my wife said that I had to go back to Ottawa so I suddenly needed a job. I got in touch with Canopy Growth, which was a small company at the time, and joined. I did not have a vision that cannabis was going to be big. But as I started working, I saw the benefits of cannabis.

The trigger for me was the workers at Canopy Growth, and their personal stories. They have had their lives changed by cannabis products--  people with chronic, invalidating diseases. It’s speaking to people who tell you: "I could not get out of bed before, and now I have my life back". In that way, I feel we can give back to society, and those personal stories are what win you over.

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How do you think CBD and cannabis affect the society?