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Peter Reynolds

The life and times of Peter Reynolds

Archive for the ‘Science’ Category

An ‘Expert Panel’ On Medicinal Cannabis Without A Single Expert On It?

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Dr Michael McBride, Chair of the Cannabis-based Medicines Expert Panel

To be fair, the members of the expert panel are hardly a surprise.  It’s the medical establishment writ large.  The chairman, Dr John McBride, was, according to Charlotte Caldwell, “instrumental” in stopping Billy’s medicine being prescribed, despite the original prescription coming from a consultant neurologist specialising in paediatric epilepsy.

A government which has denied any medicinal value in cannabis for nearly 50 years needs ‘cover’ for its long overdue U-turn.  Surely though, there needs to be at least one member of the panel who has some expertise in the subject? It’s doubtful that any of the members have ever seen a vaporiser or could tell the difference between weed, hash and a concentrate. They’d probably just call them all ‘skunk’.

Professor Dame Sally Davies, Chief Medical Officer

The intention is probably to turn ‘medicinal cannabis’ into a pill or a bottle of medicine, a nice square peg that these bureaucrats can slot into their square hole. Such servants of the status quo are incapable of considering that modern medicine might have anything to learn from traditional, plant-based medicine that has been used successfully for millennia, instead of barely a century of the simplistic, reductionist theory that they represent.  Of course it shouldn’t be a matter of either/or, we should use the best of both theories because both have much to offer to the health of the nation.

It’s instructive that Professor Dame Sally Davies managed to find “overwhelming” evidence of the medicinal value of cannabis in about 24 hours flat. The evidence has been wilfuly ignored by every government and the self-serving individuals who have held the role of Home Secretary since 1971.

It’s astonishing though that in her review, delivered at lightning speed, she’s come up with this pejorative term “grown cannabis” yet seems enthusiastic about synthetic cannabinoids on which there is precious little clinical research and strong evidence of severe, even life-threatening side effects, totally different from the natural product.

Dame Sally writes: “Cannabis has many active chemicals and only cannabis or derivatives produced for medical use can be assumed to have the correct concentrations and ratios. Using other forms, such as grown or street cannabis, as medicine for therapeutic benefit is potentially dangerous.”

Where else does cannabis come from if it isn’t ‘grown’?  It has to be synthesised in a lab. Why on earth would Dame Sally want to go down that route when no other jurisdiction enabling legal access to medicinal cannabis has done so? Bedrocan products are grown specifically for medical use and standardisation of “correct concentrations and ratios” is exactly what the company is focused on.

This is a clash between two different approaches to medicine which, as I say should be regarded as complementary, not contradictory but we cannot possibly move forward if the only ‘experts’ have no expertise!

To be fair, this is all unfolding at breakneck speed.  Imagine Theresa May hovering in the wings, the hard line prohibitionist eager for any opportunity to kick this back into touch. As it stands, the expert panel will fail, it’s bound to.  We have to give Dame Sally a chance to adjust to the new reality.  With the assistance of Professor Mike Barnes, CLEAR will be keeping a close watch on progress and we will keep Dame Sally apprised.  We have already written to her twice this week setting out our concerns and we will do so on a regular basis.

 

 

 

 

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Written by Peter Reynolds

July 5, 2018 at 7:06 pm

The Facts About CBD In The UK. April 2018.

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This article is an update to ‘The Facts About CBD In The UK. December 2016.

The past three years have seen a true phenomenon develop around the cannabis law reform movement which has quickly crossed into mainstream society, commerce and general awareness.  It’s the explosion of the CBD market, a trade that has grown from zero to £50 million per annum in the UK in this very short period.

There has been a great deal of nonsense published about the market, the products and their legality both under drugs laws, food and medicines regulation. The facts that are set out in this article are established from close involvement with the developing market on a daily basis as well as consultation with a number of lawyers of all types and levels of experience as well as direct contact with the Home Office, the Medicines and Healthcare products Regulatory Agency (MHRA), the Food Standards Agency (FSA) and other authorities.

The market has been driven initially because of growing interest in the medical benefits of cannabis and the recognition that, within certain constraints, products derived from low-THC cannabis, legally grown under licence as industrial hemp, are a legal alternative.  An important factor has been that CBD is most often consumed by placing a few drops of oil under the tongue. This has avoided the stigma of smoking a joint and is more in line with the way people perceive a medicine or health food.

The CBD market has also exposed the contradictions, inconsistencies and errors in the Misuse of Drugs legislation and particularly in the confused and inconsistent way in which the Home Office attempts to administer it. For instance, currently there are CBD products produced legally in other EU countries and the USA which can legally be sold in the UK but which the Home Office will not permit UK companies to produce.

Ironically, the most significant development has been that responsible CBD suppliers have moved away from claiming the sort of medical benefits that are, in fact, the reason for the market’s existence.  Although everyone knows this is why people are buying CBD, if you’re in the business of supplying the products you can’t say a thing, not even indirectly, about the medical benefits it offers.

18 months ago, all the leading and responsible suppliers of CBD products in the UK joined together to create their own trade association.  The Cannabis Trades Association UK (CTA UK) now represents 80% by turnover of all the CBD suppliers in the UK. It is governed by its members who have established a set of standards on products, labelling and marketing which all abide by.  These standards are designed to protect and inform consumers and to ensure that all CTA UK members are compliant with the law.

The formation of CTA UK was prompted by the MHRA issuing warnings to some suppliers about making medical claims for their products. To remain within the law, CBD products must be sold as food supplements and the most that can be said about them is that they help to improve and maintain health and wellbeing.  Before any product can be marketed with medicinal claims it must have a marketing authorisation from the MHRA. Food supplements must also comply with certain laws and regulations administered by the FSA.

CTA UK is now engaged in a continuous dialogue with both the MHRA and FSA.  Regular meetings are held to consider new suppliers and products entering the market to ensure they comply with the law, regulations and CTA UK standards.

When supplied by a CTA UK member, consumers can be certain that the product they are buying is 100% legal and is accurately labelled and described.  CBD is not a ’controlled drug’.  It does not appear in any of the classifications or schedules to the Misuse of Drugs Act 1971.

There is widespread misunderstanding about the 0.2% THC limit in industrial hemp.  This is the limit in the growing plant and is not relevant to CBD products.  Clearly what may be under 0.2% in the growing plant would be far higher in an extract which is, by definition, concentrated. The Misuse of Drugs Regulations 2001 make it clear that any product derived from low-THC cannabis grown legally under licence as industrial hemp is “exempt” provided it contains “not more than one milligram” of THC or CBN. This is the limit that matters. See The Misuse of Drugs Regulations 2001 ‘Interpretation’ 2-(1) (a)(b)(c)

Contrary to suggestions that the market is “in chaos”, “half-legal”, “a bit of a mess” and other spurious claims, in fact, it is a model of self-regulation where the industry itself has put aside its competitive instincts to co-operate for the benefit of consumers and in its own long term self-interest.

No suppliers will be admitted to membership of CTAUK unless they cease making medicinal claims, stop selling illegal products (for instance with high levels of THC, described as ‘indica’ or intended for pets or veterinary purposes).  Indeed, any suppliers that continue such conduct are likely to be subject to enforcement action by the MHRA and Trading Standards.

There are further changes or clarifications in the law relating to some CBD products which have emerged in the last few weeks.  These arise out of regulations from the FSA.  Isolates or pure CBD are now no longer permitted as they have been classified as ‘novel foods’.  This could mean a prison sentence of up to two years for anyone selling them.

It’s a myth, although regularly reported in the press, that there has been any change in the law or that CBD has been made legal or classified as a medicine. CBD products can already be prescribed by doctors without any restriction, just as any other food supplement. When the inevitable cannabis law reform takes place it will still be unlawful to make medicinal claims about any CBD or cannabis product without a marketing authorisation from the MHRA.

Within the next few months, the first CBD medicine will receive a marketing authorisation from the MHRA. Epidiolex, a whole plant extract, refined to deliver 98% CBD, is GW Pharmaceuticals’ second cannabis-derived prescription medicine which is intended for severe forms of paediatric epilepsy. It is not derived from industrial hemp but from high CBD strains of cannabis grown specifically for the purpose. It should be noted that this is to be administered in massive doses of up to 20 mg per day per kg of body weight,  CBD as a food supplement for adults has a maximum recommended dose of 200mg per day.

The CBD food supplement market will continue to grow.  Other medicines may be authorised in the near future, most likely under the MHRA’s Traditional Herbal Registration scheme, which will permit them to be described as medicines for minor ailments not requiring the supervision of a doctor.

Clearly, it remains urgent that our government gets to grips with the reality of the need and benefits of cannabis for medical use in the wider sense. However, even as we begin to make progress the CBD market in its present form will continue to fulfil an important need for many years to come.

 

 

 

 

“The Settled View Of Ministers Is That The Medicinal Campaign Is Just An Excuse To Take Cannabis”.

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These are the words of Sir Oliver Letwin, my MP, during a meeting with him just a few days ago.

To some this may be an astonishing revelation, to others it will be depressing confirmation that this bigoted and out-of-date view still persists.  Anyone with even a modicum of knowledge will agree that it is deeply ignorant and in defiance of a vast quantity of scientific evidence.

This is the end point of my two and half years of discussion with Sir Oliver.  He’s not currently a cabinet minster but through his 20 year parliamentary career he’s always been at the top of the Conservative Party: Shadow Home Secretary, Shadow Chancellor and then in government in 2010 elevated to the status of right hand man to David Cameron.  As Minister for Government Policy and then Chancellor of The Duchy of Lancaster, he was been described as ‘the intellectual powerhouse of the Tory Party’ and as ‘number three in the government after Cameron and Osborne’.

So what goes through Oliver’s mind is a pretty good indication of how the Tory Party establishment thinks.  I’m absolutely certain that what he has told me is exactly the present mindset of ministers from Theresa May down.

Back in 2015 Oliver wrote to George Freeman MP on my behalf, then the minister with responsibility for medicines.  He’s also written to Jeremy Hunt, the Health Secretary and Amber Rudd, the Home Secretary.  None of this correspondence has resulted in anything but the usual, anodyne words that are nothing but a brush off.  I did think I was getting somewhere though when he told me he would establish with the Department of Health what its position was on the scientific evidence. Back came the answer that all the evidence had been considered, expert advice had been taken and the conclusion was that the risks of  legalising for medicinal use would outweigh the benefits.

Now this didn’t make sense to me. I wanted to know what evidence and what experts.  After half a dozen requests for this information and no response I submitted a Freedom of Information Request to the Department of Health.  Eventually it was returned stating quite clearly that it had neither requested, received nor considered any evidence on medicinal cannabis. Coincidentally, just a few days later, Paul Flynn MP asked almost exactly the same question in Parliament and received the same answer. So I wrote to Oliver and said that either he had been misled or he was misleading me, which was it? It was at this point that he stopped replying to my emails.

After several months of repeated requests and no response I went direct to his parliamentary secretary and booked a surgery appointment to see him as a constituent.  I was quite prepared to confront him face to face.  I was amused to receive an email from Oliver the very same day in which he said that would reluctantly agree to see me on the subject “one last time”.  So at the meeting his explanation was that it had all been a huge misunderstanding, he didn’t mean to suggest that any evidence had been examined, it was simply “the settled view of ministers is that the medicinal campaign is just an excuse to take cannabis”.

Such is the state of our so-called democracy and so-called evidence-based policy.

Written by Peter Reynolds

October 18, 2017 at 4:26 pm

The Daily Telegraph Misrepresents ‘Skunk’ Cannabis Mental Health Cases With Figure of 82,000. True Figure is 1,600.

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Martina Lees

Two almost identical articles were published in The Daily Telegraph on 11th and 12th August 2017

Does smoking skunk trigger psychosis? And if so… why aren’t we doing more about it?

The secrets of skunk

In both articles, journalist Martina Lees wrote that:

“…hospital admissions with a primary or secondary diagnosis of drug-related mental and behavioural disorders have more than doubled over the past decade, to almost 82,000 a year. Most are believed to be cannabis-related.”

This is a combination of wildly misleading manipulation of data and brazen falsehood.

Hospital Episode Statistics are maintained in great detail by the NHS using a system of coding called ICD10 – a medical classification list by the World Health Organization (WHO). containing codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.

The specific code for ‘mental and behavioural disorders due to use of cannabinoids’ is F12.  For the past 11 years, ‘finished admission episodes’ (FAE) for F12 have averaged 973, so the claim that most of the 82,000 are cannabis-related is simply false. (Unless of course, Ms Lees is going to claim she made a mistake.)

So where does the extraordinary figure of 82,000 come from (the exact figure is 81,904)?

Firstly, it is for all illicit drugs or ‘drug misuse’ including the following ICD10 codes:

F11 Mental and behavioural disorders due to use of opioids
F12 Mental and behavioural disorders due to use of cannabinoids
F13 Mental and behavioural disorders due to use of sedatives or hypnotics
F14 Mental and behavioural disorders due to use of cocaine
F15 Mental and behavioural disorders due to use of other stimulants, including caffeine
F16 Mental and behavioural disorders due to use of hallucinogens
F18 Mental and behavioural disorders due to use of volatile solvents
F19 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances

Secondly, the figure is not just for primary diagnosis but for secondary diagnosis.  So the primary reason for one of these cases might be a broken leg or any other medical condition. The secondary diagnosis might be that the person was high on speed or any of the drugs mentioned.  The primary diagnoses for all these codes adds up to about 8,000 FAEs but the figure is inflated ten-fold by the inclusion of secondary diagnoses.  Why do this?  Why have the figures been presented in this way?  With what purpose?

If the whole premise of her article is about the mental health effects of cannabis, why does Martina Lees use this massively larger figure for all illicit drugs when the specific figure for cannabinoids is easily available?  And if the purpose of the article is to investigate the effect of cannabis on mental health, why look at secondary diagnoses – except that it handily inflates the figure ten-fold?

Three other important points about this data:

1. ‘Finished admission episodes’ is not the same as people, its caseload, so those 1606 cases in 2015-16 almost certainly includes cases where the same person has been admitted more than once.

2. ‘Cannabinoids’ includes synthetic cannabinoids such as Spice and anyone with any knowledge of current affairs will know how problems with Spice have exploded in recent years.  It is a fact that Spice is much more harmful to mental health than cannabis so the increase in F12 FAEs in recent years is almost certainly explained by this.

3.  I’m not a believer in always comparing any data about cannabis with equivalent data for alcohol but it is worth noting, to put these figures into perspective, in 2015-16 the number of FAEs for mental and behavioural disorders due to use of alcohol was 44,491.   As there about 10 times more people use alcohol regularly than cannabis, that means anyone is nearly three times as likely to be admitted for ‘alcohol psychosis’ as ‘cannabis psychosis’.

I have written to Martina Lees asking her to comment on this data and explain why she has used it in such misleading fashion.

 

 

Irresponsible, Reckless BBC Broadcasts Dangerous Claim That So-Called ‘Skunk’ is More Harmful Than Heroin.

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Louisa Philips Kulukundis. Psychotherapist at Soul Counselling, counsellor at Steps2Recovery, member of the British Association for Counselling and Psychotherapy.

“I would say give me a room full of heroin addicts than skunk addicts…

I remember saying to my older son I would prefer you to take heroin than to smoke skunk…

There will be generations of kids with severe mental health issues.”

Source: ‘Cannabis: Time for a Change?’ From 28:20

There is huge and justifiable righteous anger about the idiotic words spoken by this woman on the BBC Newsbeat documentary ‘Cannabis: Time for a Change?’

It would be easy to launch into a tirade against Ms Kulukundis but her words and their crass stupidity speak for themselves. I wonder how many kids, listening to her recommendation on the BBC’s ‘yoof’ channel will think ‘Well I’ve smoked weed loads of times with no trouble, now this woman who’s an expert says heroin is safer, maybe I’ll see if I can get hold of some.’

I understand that Ms Kulukundis supports the idea that cannabis with a higher proportion of CBD should be legally available instead of so-called ‘skunk’ which with zero or very little CBD dominates today’s illegal market.  She deserves credit for this and I would be very surprised if she wasn’t already regretting the very serious mistake she has made.

Ms Kulukundis does however subscribe to the falsehood that cannabis is a major cause of mental health problems.  The facts of hospital admissions and GP/community health service treatment prove this is not the case.  While we shouldn’t turn away from protecting those very few people who can be vulnerable, it is about time that the media started reporting accurately instead of the gross distortions and misrepresentation seen recently, particularly from the brazenly dishonest and ‘fake news’ Daily Telegraph.

Far, far more serious and the place where responsibility really lies for this broadcast is with the BBC.  Its negligence in allowing these words to be broadcast is unforgivable and CLEAR is pursuing a complaint.  The BBC’s complaints procedure is of course notorious for its determination to brush aside viewers’ concerns with anodyne responses that mean nothing. Many don’t realise that until you get to stage three you’re not even communicating with the BBC but with Capita to whom it outsources its complaints handling.  We will pursue this complaint until it reaches the BBC Editorial Complaints Unit and if necessary we will appeal it to OFCOM which, with the demise of the BBC Trust, is now the independent regulator.

It is a shame that the BBC has spoiled what is a clear shift in its position on cannabis.  Instead of mindless obedience to the government’s bad science and propaganda it is now recognising that reform is the only rational way forward.  As usual its coverage is dominated by stereotypical caricatures of what it regards as cannabis users.  It still seems incapable of recognising that most of the three million regular cannabis consumers in the UK are not relics of the hippy era but hardworking people with families and ‘ordinary’ lifestyles.  It also allowed its debate programme ‘Newsbeat Debates. Legalising Cannabis’ to be dominated by the ‘Gateway Theory’, an idea comprehensively disproven many times over, which even our prohibitionist government recognises is invalid.  What is the point of debate if it is hijacked by misinformation and not informed by science and evidence?

The BBC should take the initiative in apologising, correcting and broadcasting a full explanatuion of why Ms Kulukundis’ claim is scientifically inaccurate and extremely dangerous. Sadly, it will almost certainly have to be dragged kicking and screaming to provide any meaningful response at all.

 

 

 

The Drugs Policy Debate. House Of Commons, 18th July 2017.

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This debate was held in Parliament following the publication on 14th July 2017 of the ‘2017 Drug Strategy’.

The debate may be watched in full here.  It starts at 13:17 and finishes at 19:00.

Highlights include:

Crispin Blunt MP at 14:09

 

 

 

 

 

Jeff Smith MP at 15:21

 

 

 

 

 

Norman Lamb MP at 16:10

 

 

 

 

 

 

Paul Flynn MP at 16:32

Written by Peter Reynolds

July 26, 2017 at 4:07 pm

Why Is CLEAR Supporting Lord Monson In His Campaign Against So-Called ‘Skunk’?

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Lord Nicholas Monson

Lord Nicholas Monson

CLEAR’s first and overriding objective is to end the prohibition of cannabis.  The tragedies that have struck the Monson family demonstrate all too clearly that prohibition of cannabis is futile.  Not only does it not protect people from harm, it actually maximises the harms and dangers of the cannabis market.

Nicholas Monson’s eldest son, Alexander, was arrested in Kenya in 2012. allegedly for smoking cannabis.  Toxicology reports found no evidence of cannabis in his system. According to both a government and an independent pathologist he died from a fatal blow to the back of his head while in police custody.  Clearly, it was the law against cannabis that led directly to Alexander’s death.

Nicholas Monson with his son Rupert

Just three months ago, Rupert, Nicholas Monson’s younger son, took his own life after a descent into depression and psychosis in which the excessive consumption of so-called ‘skunk’ was clearly a significant factor.  Rupert himself said that he was addicted and there is good evidence to show that cannabis without CBD is more addictive.  It is well established from research as far back as the early 1990s that approx 9% of regular users develop dependence which produces real physical withdrawal symptoms: insomnia, lack of appetite and irritability, sometimes a headache.  For most people these are easily overcome within a week or so but not for everyone.  Most importantly though, cannabis in the early 1990s contained, on average, half to a third as much THC as it does now and always a healthy buffer of CBD.  The addictiveness of so-called ‘skunk’ with zero or very little CBD, is several times greater than the cannabis available 20 to 30 years ago.

It’s important to add that Rupert was also very badly failed by the dire state of mental health services. Surrey and Borders Partnership NHS Foundation Trust, a specialist provider of mental health and drug treatment services said that he needed to be admitted but a bed was not available.  It was just a few days later that he committed suicide.

Nicholas Monson has called for so-called ‘skunk’ to be made a class A drug but also for lower potency cannabis, with a maximum THC:CBD ratio of 3:1 to be made legally available through a regulated system.  Theresa May wrote to him after reading coverage of the story in the press.  She expressed her sympathy and said how she shared his concerns.  Importantly, she suggested that Lord Monson prepare a paper and a presentation to the Home Office on his proposals.  This is a tremendous opportunity towards introducing measures that will better protect vulnerable people like Rupert and also for wider reform of the cannabis laws that will reduce all the harms presently caused by prohibition.  Cannabis would be purchased from government licensed outlets just like alcohol and the aim would be to collapse the criminal market just like the market in dangerous, ‘moonshine’ whisky.

CLEAR does not agree that raising so-called ‘skunk’ to class A would be an effective measure.  It would be virtually impossible to enforce, requiring a massive increase in laboratory testing of cannabis and the supply of high potency varieties would simply be pushed underground. The price will go up and all the harms of a criminal market will be increased.  All the evidence is that drug classification or penalties have absolutely no effect whatsoever on consumption.  However, Lord Monson suggests that all personal cannabis possession should be decriminalised and police would focus only on dealers in so-called ‘skunk’.  There is a very strong argument that with high quality cannabis available legally, people would turn away from the black market.

Of course, we support the idea of legally available cannabis with a maximum THC:CBD ratio of 3:1.  This could be the basis of a system that could work very successfully. The product would be available only through a limited number of licensed outlets to adults only.  It would be supplied in appropriate packaging with detailed labelling of contents.  Possession of any cannabis not in this packaging would be reasonable grounds for it to be seized and tested.

Lord Nicholas Monson, Peter Reynolds

This will, of course, provoke outrage amongst many cannabis consumers, particularly those who grow their own but it would be fantastic progress.  It would usher in a far more rational, sensible regime where we could establish real data about harms and risks.  If appropriate, this could lead to the regulation of higher potency varieties.  Of course, we recognise that for medical use, a completely different approach to cannabinoid content is required and much higher potency may be necessary in some instances.

CLEAR is in the business of reform and this is the most likely path to reform that has ever emerged in the UK.  We are not in the business of promoting a cannabis market which enthusiasts and connoisseurs would regard as some sort of utopia.  The only purpose of any drugs policy must be to reduce harm and this proposal, if implemented, would massively reduce all the social harms caused by prohibition and reduce the risk of health harms.

Finally, it has to be said that, in typical fashion, a substantial part of the cannabis community has reacted in almost hysterical anger to Lord Monson’s proposals.  The only effect of such behaviour is to hold back reform.  We have been horrified and disgusted at the abuse directed at the Monson family.  It has shown cannabis consumers in the very worst light and demonstrated that some are so stupid that they damage the very cause they seek to advocate.  Nicholas Monson is a grieving father who, despite his agony, has seen the rational way forward and lent his energy and commitment towards reform that will benefit everyone.  We stand alongside him and we urge all cannabis consumers to consider these ideas carefully – and please, lend us your support!

Lord Nicholas Monson adds:

“The motivation for my campaign is to protect the young and vulnerable in particular from ingesting any substance whose contents can have a deleterious short or long term effect on their minds. To watch one’s son spiral into psychosis from a heavy usage of skunk is distressing to behold. Rupert’s psychiatric team put his psychosis down to skunk. This is unequivocal. Yes there are other psychoactive drugs around but skunk is what did for Rupert. It so happens that the remedy for skunk is a legalised and regulated market in cannabis where clear information is available. This should be applauded by the recreational cannabis community. Separately I have long supported the medical community’s initiatives to prescribe variants of cannabis with high CBD for people suffering from a wide variety of conditions.”

Written by Peter Reynolds

June 7, 2017 at 7:10 pm