The World Cannabis Congress was held in Saint John, New Brunswick this week, where industry experts gathered from across the world to discuss the market's most pressing issues. Medicinal applications of cannabis are one of the items atop this list. There are nearly 30 US states with medical marijuana programs, as well as the entire country of Canada and several other international countries. With the rise of legality comes an increase in normalization and therefore increased rates of use. So, how are medical marijuana companies dealing with these changes? Civilized decided to put the question to a group of industry leaders to find out.

"We're chasing the $10 billion chronic pain market," says Dr. Guy Chamberland, chief scientific officer for Tetra-Bio Pharma, a cannabis medications developer. Like many in the cannabis pharmaceuticals sector Tetra-Bio is seeking entry to markets currently ruled by opiate medications.

There has certainly been a push in recent months for cannabis medications to be implemented as a treatment for opioid use disorder with states like Illinois establishing official programs. Still, Constance Finley, founder of Finley Therapeutics, says there may be a future where cannabis and opioids come together. She says her company ran trials some years ago that tested a cannabis-opioid blend for pain treatment, which she said proved to be very effective.

"It's still what I turn to when I have [pain] that nothing else can knock out," said Finlay.

Dr. Bruno Battistini, CEO of the New Brunswick Health Research Foundation, says the biggest roadblock for implementing such a drug is the scientific understanding of each substance. "We need clarity on both of these products, and only one we do," he said. The ones we know a lot about are the opioids, with cannabis research still lacking. Battistini says in order to get the information needed to further progress, "human studies need to happen."

Chamberland also chimed in on the idea of cannabis-opioid blended drugs saying traditional herbalists often used a blend of available plants to produce effects that couldn't be achieved with a single substance. This is similar, he said, to the way the numerous compounds in cannabis interact with each other. Those inter-cannabis relationships are what his company is focusing on. Tetra-Bio has been looking into what Chamberland calls "drug-drug combinations," where various cannabinoid combinations are being tested for their medical properties. He says this also extends to the ability to combine synthetic cannabinoids with "botanical" ones.

He says synthetic products may not be appealing to everyone, but they do come with a set of advantages that the NAPRA (the Canadian equivalent of the FDA) looks for - primarily in regards to a physician's ability to guarantee strength and content of the medication, something that will require much more research before it can be achieved with cannabis flower.

Panel moderator and founder of iCann, Saul Kaye agrees research is massively important. He suggested that "we need to re-do trials," suggesting much of the current data on cannabis isn't correct, or wasn't collected under rigorous enough standards. In the end though, he believes that the exploration of the medical applications of the various cannabinoids need to be a focus moving forward.

"There are so many cannabinoids, way more than just THC and CBD," explained Kaye. "They all have different properties and we need to be looking at those."

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