If you grew up in the 80s or 90s in the U.S., you likely remember all the “Got milk?” commercials centered around getting enough calcium and vitamin D in our diets.

I was a kid back then so all I really paid attention to was the images of celebrities that I knew adorning white milk mustaches, but the true focus of the campaign was bone health. Since then, cow’s milk has grown a bit controversial about whether or not it’s even helpful, the message still remains that diet is one of the most important factors in overall bone health.

But calcium alone won’t put you in the clear. Things like physical exercise, tobacco, alcohol, and drug use, eating disorders, certain medications, hormone levels, and even race, age and gender all contribute to overall bone health and the likelihood of developing certain disorders. For example, bone loss is more prevalent in Asian and Caucasian women and can be exacerbated by steroids.

As it turns it, cannabis might also have a place in this list of things that can affect our bones. But what are the implications of this? Can cannabinoids help restore bone health and prevent or delay the onset of bone disease?

What is Osteoporosis?

Let’s start with the most common bone disease, Osteoporosis, which literally means porous bone. It’s a disorder characterized by decreased bone density that leads to reduced bone strength and increased risk of sprains and fractures. It’s estimated that more than 200 million people are currently suffering from osteoporosis.

Before developing into Osteoporosis, the patient will have a condition known as osteopenia – a disorder where the bone is only slightly less dense than regular bone. Often times, there are no symptoms indicating the presence of osteopenia or even osteoporosis. Many patients are first diagnosed when a simple, everyday task results in an unexpected fracture.

There are two types of fractures: “cracking”, like with a fractured hip, or “collapsing”, like in the case of a spinal or vertebral compression fracture. A break can occur in just about any bone in the body, but the most susceptible areas are your hips, ribs, spine, ankles, and wrists.

Osteoporosis has numerous causes – many of which are lifestyle related – but the most common triggers are due to hormonal issues such as low estrogen, low testosterone, and other age-related imbalances.

A 2016 headline that got a lot of attention was titled “Heavy marijuana use linked to 5 percent reduction in bone density”. For their study, the research team analyzed the data of 284 adults who attended primary care centers in the U.K. between 2011-2013; and the results are self-explanatory.

However, other research indicates that cannabidiol (CBD) can help prevent bone disease, hinder degeneration, and accelerate healing. A study published in the American Society for Bone and Mineral Research shows that cannabis treatment helps control osteoporosis by way of the Endocannabinoid System (ECS), which plays a pivotal role in developing, strengthening, and preserving the bones.

During the study, researchers injected either a combination of CBD with THC (tetrahydrocannabinol), or just isolated CBD, into rats with broken thigh bones. While the THC mixture did help relieve pain related to bone injuries and fractures, it was not very effective in actually healing the bone itself or speeding up the rate of recovery. On the other hand, CBD had quite an impact, not at making the bone heal quicker, but at strengthening it to prevent a future break.

According to the results, the bone treated with CBD was up to 50% stronger than the non-treated bones.  

What is Osteogenesis Imperfecta

Osteogenesis Imperfecta is a congenital disease (meaning it’s present at birth) that causes extremely fragile bones. It’s commonly referred to as brittle bone disease and it’s caused by a defect in the gene that produces type 1 collagen – an important building block of bones. There are multiple different variations that can affect this gene.

The severity of OI depends on the specific gene in question. As of now there are 8 known types of OI and the severity is as follows: Type 1 is mild, types 4, 5, 6, and 7 are moderate, and the most severe are types 2, 3, and 8. Most cases of OI are inherited from one parent, although in rare circumstances they can be the result of a new genetic mutation . OI is in autosomal dominant disease and there is a 50% chance of parents passing the genetic mutation, and thus the disease, on to their children.

There is no cure for this disease, but certain therapies and medications can reduce pain and complications associated with OI. Commonly used drugs are biophosphonates which have been successfully used to treat osteoporosis. Further intervention can include physical therapy and surgically inserted metal rods that can be used to artificially improve bone strength and reduce the risk of fractures.

Cannabis and Osteogenesis Imperfecta

As of now, there is no official research on the effects of cannabinoid medication and OI. However, there are multiple studies looking at the impact that cannabinoids have on bone cell formation and function, which indicates that it could be a viable, future option in treating this disorder. OI is a qualifying condition for a medical cannabis card in only one state so far, Connecticut. Disorders of the bones are not yet frequently discussed in the medical cannabis community. 

In 2007, researchers at the University of Sheffield in UK discovered that “cannabinoids may stimulate the recruitment of mesenchymal stem cells (MSCs) from the bone marrow indirectly via an accessory cell and mediated via the CB(2) receptor.” This mechanism is believed to be responsible for increased bone formation following cannabinoid treatment “in vivo”.

Another study, titled ‘Cannabinoids and bone: endocannabinoids modulate human osteoclast function in vitro’, found that low concentrations of CBD and CBG (cannabigerol) can activate human osteoclasts “in vitro”. According to the study, “There is a dynamic regulation of the expression of the CB(2) receptor and the production of the endocannabinoids during the differentiation of human bone cells. These data suggest that small molecules modulating the endocannabinoid system could be important therapeutics in human bone disease.”

Final Thoughts on Cannabis and Bones

Although it’s still a bit unconventional, it seems that cannabis has great potential as possible future therapy for those suffering from diseases of the bones. More research is needed on this topic to determine the full capacity of what cannabinoids can do for these patients, but for the time being, it can be used to relieve secondary symptoms caused by osteoporosis or osteogenesis imperfecta, such as pain cause by a fracture or anxiety relating to the disorder.

There is a common misconception that cannabis brands and dispensaries are unable to market their businesses using modern day digital advertising tools.

While it is true that the major players in online advertising (e.g. Google and Facebook) have severe restrictions or outright bans on advertising cannabis and/or hemp products via their advertising platforms, there are digital advertising solutions (such as Surfside) which cater specifically to the cannabis and hemp industries that can be equally or more effective in helping a company acquire and retain customers. 

The best of these solutions make use of the same cutting-edge tools that mainstream digital marketing providers offer, including data modeling, intelligent targeting, and programmatic advertising.

However, effective digital marketing takes more than the right tools -- you also need the right strategy. Here are some tips that can help maximize the impact of your digital marketing efforts:

1. Get to Know Your Customers

The most important thing a company can do in order to accurately target new and existing consumers is to understand who its current customers are and how they are interacting with the brand.

This means being able to track every touchpoint a customer has with a company in both the physical and digital worlds. These kinds of interactions include purchases, brick and mortar visits, social media interactions, website visits, and participation in loyalty programs or other offline events.

Aggregating all these siloed events and creating a single-view of the customer allows a brand to see all the different interactions a consumer may have with a brand to better understand what touchpoints are leading to certain actions.

Understanding how customers enter and exit the purchase funnel will allow you to influence existing and new customers at the right moment and location in order to continue to grow your business.

2. Personalize Your Message

Once you have created a schema to collect and analyze your customer data, you can begin to segment those customers into different audiences based on their attributes.

Audience segmentation is a great way to identify and market to similar consumers based on their purchase habits, similar demographic profiles, or even their behaviors in the physical or digital world.

By analyzing your customer data and the attributes that define a given segment, you can start to personalize the messaging and experience for each audience. This allows your brand to create tailored and unique experiences based on the interests of your different audience so that there is less friction for the consumer when making a purchase or interacting with your brand.

These personalized experiences can be utilized within advertising copy, website design, and even product development so you are always growing and developing based on changing market demand. 

3. Understand the Power of Lookalike Audiences

In order to grow your business you will need to reach people who are not yet your customers.

But how do you know who you should spend time and money on trying to reach?

This is where the power of lookalike audiences comes into play. Lookalike audiences enable you to identify and market to people who most closely resemble your best existing customers.

By tracking real-world cannabis behaviors, like purchase history and dispensary visits, and marrying these attributes to a larger demographic profiles, including financial and lifestyle attributes, you can use your current customers to identify prospective customers through advanced lookalike modeling. By reaching people who are most similar to your best existing customers, you are much more likely to find new customers in a much more efficient manner than trying to reach the entire online universe. 

4. Stay Compliant

One of the tricky parts of marketing cannabis products in the digital space is ensuring you are in compliance with the laws and regulations that govern each state’s cannabis industry.

This means ensuring your ads are only being seen by individuals of legal age in states where cannabis is legal.

One of the best ways to ensure this is through location-based advertising and device-level targeting to verified audiences. Location targeting is essential in cannabis/hemp advertising as it ensures that you are not targeting locations that are blacklisted, like schools, and stay within the bounds of states, cities, or even stores.

Audience targeting allows you to predefine the type of consumers you are looking to reach before delivering a campaign – this could be legal-aged consumers, lookalike audiences, dispensary visitors, or people who recently purchased cannabis products.

The combination of location targeting and audience targeting ensures you are reaching the right people in the right locations. In order to accomplish this type of targeting at scale, it is necessary to use programmatic advertising platforms.

Programmatic advertising allows advertisers to access billions of ad impressions with enough targeting and filtering options to be able to reach your predefined audiences in the right locations. Another value to the scale of programmatic advertising is that you can advertise in apps and on sites that have audiences that are 71.6% or greater over the age of 21, which is generally a requirement for any property you advertise cannabis products on.

5. Optimize, Optimize, Optimize

As you begin to run your digital advertising campaigns targeting your different audience segments and lookalike audiences, you will start to collect enormous amounts of data on how effective and efficient these campaigns are.

Measuring the success of these campaigns requires the ability to track engagements beyond simply clicks. It is necessary to receive full attribution data on your media so that you can understand if your ads are driving sales. Once the proper measurement is in place, experimenting with slight changes to your targeting parameters, ad design, and calls to action can have significant impacts on how effective your digital advertising campaigns are.

By collecting and comparing data from all these minor variations you can identify the optimal combination of ad attributes and targeting parameters to dramatically improve the performance of your campaigns and reduce your customer acquisition cost. 

A UK company is planning to list a £100m float on the stock market – poising it be the biggest cannabis company on the London Stock Exchange.

Cannaray, a British medical cannabis company, closed last Monday with a £7.8m (~€8.8m) Series A Funding round and hopes to raise more than £30m in the coming year in the hope of floating the £100m value.

The round came to an end at the same time Cannaray announced its new purchase of Therismos – a European drug importer and distributor – which could mean the company will see itself becoming a lead player on the emerging European medical cannabis market.

Cannaray, Newey, and Brexit

Cannaray has already set up a subsidiary in the Republic of Ireland in order to avoid future Brexit-related problems. It has also partnered with Newey which is allocating Cannaray space for cannabis growth. Newey is currently pending licencing and if it is successful it will be the third company in the UK to secure a permit for growing cannabis. Newey is the largest horticultural company in the UK and will also be providing lab space alongside growth space.

Cannaray is set to launch its range of CBD based products later this year. The company already has a strong scientific advisory board comprising neurology specialists, palliative care specialists, pharmacists and drug delivery experts, as well as having former banking colleagues on the boars including Sir Nigel Knowles, ex global co-chairman of DLA Piper and Chris Sullivan, ex-deputy group CEO of RBS.

Cannaray has put together a team whose expertise covers IPOs, building companies through consolidation, life sciences, media, consumer and retail. Following the Therismos, Cannaray will be pushing its strategy to become the leading European medical cannabis company, planning to raise additional capital in order to fund medical cannabis production and open up markets beyond the UK, beginning with Germany and Poland this year.

An Oregon analytic laboratory is offering a new test for cannabis products to detect the presence of vitamin E acetate, an additive that has been implicated in the rash of vaping-related lung illnesses that have sickened hundreds and led to at least six deaths. Pixis Labs in Portland began conducting the test for consumers on Monday, according to a report in local media.

Pixis Labs developed the test after it was announced that state and federal health officials were looking into the possibility that vitamin E acetate, also known as Alpha-tocopherol acetate, could be associated with the hundreds of pulmonary illnesses that have been reported in dozens of states. The substance, a supplement designed for oral or topical use, is sometimes used to thin or dilute the cannabis oil in vape cartridges.

Derrick Tanner, the general manager of Pixis Labs, said that the company has tested several cannabis oils from existing customers to validate the process, although he declined to say if any vitamin E acetate was detected in the samples provided. He also said that he expects the new test to generate considerable interest from not only consumers but the cannabis industry, as well.

“Anyone who’s […] not even just generating cartridges and oils, anybody who’s ancillary in this service line is interested in having this as an additional test for their product,” Tanner said. “Everyone’s concerned about it right now.”

Tanner said that diluting commodities to increase profits isn’t restricted to the cannabis industry. The practice is also sometimes carried out in the food industry, with honey and olive oil being notable examples.

“Any time you have a commodity that’s highly valued, and there’s a way to increase your profits one way or another, there’s going to be certain people who may take advantage of that and try to [stretch their commodity] out.”

Tanner told High Times in an email that the new test for Alpha-tocopherol and Alpha-tocopherol acetate is available at a cost of $140 and requires a 3-gram sample to perform.

Are Tighter Regulations Coming?

The Oregon Liquor Control Commission, the agency tasked with regulating the legal cannabis industry in the state, does not currently require testing products for vitamin E acetate. But with the continuing spate of lung injuries, Mark Pettinger, a spokesman for the agency, said that stricter regulations could be enacted.

“Because of the vaping illness crisis, the OLCC will consider taking whatever action is necessary to protect consumer health, including the recall of tainted product, and banning inclusion of questionable additives into marijuana products that threaten human health and public safety,” he said.

The Centers for Disease Control and Prevention reported late last week that there have been 380 confirmed and probable cases in 36 states of lung illnesses experienced by people who vape. The previous week the agency had announced that more than 450 cases of pulmonary disease could be associated with vaping, but that number also included reports of possible cases.

Also last week, the Trump administration announced that it would ban the sale of flavored nicotine vape products.