Growing medical cannabis
First tour of its kind gives inside look into highly regulated Maui Grown Therapies production site in Kula
KULA — The Upcountry site where cannabis is cultivated and manufactured for Maui Grown Therapies, Hawaii’s first licensed dispensary, is part James Bond and part Albert Einstein.
It is a far cry from growing marijuana in the cane fields or in secret greenhouses under grow lights.
Christopher Cole, director of product development, this week took the media for the first time through Maui Grown Therapies’ cloning, vegetation, extraction and manufacturing rooms — each pristine, organized and cataloged to meet biosecurity and legal standards. Up until about six months ago, media were not allowed in such Hawaii facilities, said Teri Freitas Gorman, Maui Grown Therapies director of community relations and patient affairs.
An extensive criminal background check, fingerprinting and state approval are all required for the few, if any, visitors approved to enter the heavily secured and surveiled site on 7 acres of Kula farmland. State Department of Health investigators may arrive unannounced to check on Maui Grown Therapies at any time; Hawaii has some of the most rigid rules for medicinal marijuana operations in the country, dispensary officials say.
Lab coats, hairnets and visitor identification are mandated on arrival. A company official directs the tour at all times.
Not to be a buzzkill, but Maui Grown Therapies — one of two certified marijuana dispensaries on the island — takes medical marijuana very seriously.
“Hawaii has some of the highest standards in the nation,” Gorman said. “Compliance is paramount.”
Backed by a science and medical advisory board that includes a long list of doctors in integrative medicine, pediatric neurology, oncology, psychiatry and internal medicine, the company conducted the state’s first legal sale of cannabis in August 2017.
Two years later, Gorman said the company’s science, medicine and mission still set it apart.
“Our science and medical advisory board, they’re top notch,” she said. “Also, when this company began, we were very clear on what kind of company we intended to be, and we’ve never veered from that.”
The Clone Room
Cole details the meticulous operation as aromatic scents from rare and diverse marijuana plants waft through a windowless production center.
First, the plants start out in the clone room.
Commercial cannabis cultivation uses clonal propagation, a process of asexual reproduction by creating genetically identical copies of individual plants.
Maui Grown Therapies takes a proven mother plant, cuts off shoots, dips them in rooting hormone then places them in substrate. Over a period of seven to 10 days, the shoots grow onto roots, and “it becomes basically a genetic copy of the plant it was cut from,” Cole said.
Cole said growing from seed creates a lot of variation in the final plant.
“The reason (clonal propagation) is important is because once these get potted and they flower, it’s going to be highly uniformed. You’ll wind up with the same phytochemistry and eventually the same chemotherapeutic effects in patients who are using them.”
The Flower Rooms
Next stop for the plant is one of three flower rooms.
Thousands of plants at various life stages spend about eight weeks here before harvest. Maui Grown Therapies has scores of varietals in its library; some hold proprietary genetics and others have been acquired.
“Durbin No. 5,” for example, is very rare. The plant was found growing wild in South Africa and contains THCV, or tetrahydrocannabivarin, a homolog, or a shared ancestry, of THC, Cole said. (THC is the chemical that gives recreational marijuana users their high.)
“It has a different molecular structure and has all sorts of medical promise,” he said.
“Durbin No. 5” is in the flowering process, and the team will release products derived from the rare plant later this year.
“It’s common that people have only heard about THC and more recently CBD; all these other cannabinoids have a pharmacology of their own, and it’s barely been explored,” Cole said. “We are committed to having a diverse genetic library and developing it continuously and through careful analysis, developing unique lines that have therapeutic properties.”
“Kula Cherries,” on the other hand, is an easier to find hemp varietal and contains high CBD and low THC. “Mango Haze” has CBD and THC in more or less equal amounts.
Then there’s “Pineapple Fields,” which is high in CBG, or cannabigerol, also a rare find in cannabis genetics. Though in its early days of study, CBG shows promise for pain relief and its antidepressant and anti-anxiety properties, Cole said.
“We are happy to have that in our genetic library.”
The Dry Room
Once the flowers are ready to harvest, they head to the dry room.
Cannabis plants contain 80 percent water, and the room, with stacked netted drying racks, is designed for a controlled, even process of pulling out moisture.
“It’s geared toward careful, controlled removal of the moisture, while preserving bioactive compounds present in the flowers,” Cole said.
Gorman said some people, especially those accustomed to growing at home, often look for stickier, wetter products when visiting a dispensary. However, state DOH requires that flowers can’t be above 15 percent moisture content.
“The more moist the flower is with water content, the more microbes it will have on it,” Cole said, explaining why drying is important. “Some of the microbes are likely to be pathogenic, or bad for human health, particularly for people who are immunocompromised. And of course, a lot of our patients have serious illnesses and fall into that category.”
Gorman said the product remains cold and dry, even as it’s moved and stored for sale at the dispensary. She said the team provides careful instructions for patients about storing products to ensure potency and safety.
The Processing and Manufacturing Rooms
The processing room is filled with staffers who are carefully removing leaves. A trimming machine removes some but the rest of the clipping is done by hand to preserve the quality and structure of the flower.
Almost zero waste occurs, Cole said. Even the leaf gets saved, tagged and put in the vault for extraction and product manufacturing. The plant stems and stalks move into composting.
From there, the manufacturing room looks like the “Breaking Bad” lab.
Whirring machines, beakers, vials and other measuring devices are stationed around the science hub.
Many of company’s well-known products are made here when the flower material is refined in various ways. Food-grade carbon dioxide is used as a solvent to dissolve oils in plant material. It’s the best extraction form, Cole said, because it doesn’t leave harmful residues.
More than 60 percent of Maui Grown Therapies’ products are nonflower items, which runs counter to the national dispensary trends, Cole said.
Some of their more popular products are sleeping capsules that Cole developed, according to Gorman. Also, a higher-strength THC capsule provides relief from pain overnight.
“A lot of older folks like them,” Gorman said.
The products also are well-liked, she said, because “people like to be very precise on their dosage.”
When using flowers, dosage can vary due to personal intake volume or strength or flower size variations.
The vault is the last stop before the product reaches the Maui Grown Therapies dispensary.
For new items, a third party sampler visits the facility, obtains product, tests it, then posts results online. Testers are looking for a handful of heavy metals, any of 52 different pesticides, microbial contaminants, microtoxins and potency. If it passes scrutiny, the item makes it to the dispensary.
“The standards are very strict,” Cole said.
Gorman, who emphasized the importance of compliance when it comes to medical and governmental standards, said staff members at Maui Grown Therapies are meticulous.
“There is very little room for error,” said Gorman. “If you fail, you have to destroy your product.”
At the end of the production line is the dispensary, located in the Maui Lani Village Center.
Patients move in and out of the reception, education and sales areas as staff members assist. Many on this day are elderly.
The company prioritizes jobs for qualified local candidates, as opposed to drawing from hundreds of applications from the Mainland, Gorman said.
Maui Grown Therapies, the first medical cannabis dispensary to receive a state license on April 29, 2016, marked its two-year anniversary of dispensing this August. It employs 37 people between its two sites: 16 work at the Kahului site and the remainder at the Kula location.
Its advisory board is led by Chief Science Officer Andrew Weil, a doctor renowned for his work in integrative medicine, and includes medical doctors Greg Yim, a Honolulu-based pediatric neurologist; Gregory Park, a Maui oncologist and internist; and Donald Abrams, San Francisco General Hospital chief of hematology-oncology; Julie Holland, New York-based psychiatrist and psychopharmacologist; and Brian Becker, Arizona-based internal and integrated medicine physician.
As of Aug. 27, Maui Grown Therapies had served 4,572 different patients, the company said. Its youngest patient is 9 years old; the oldest patient is 98. Nearly half, 43 percent, are older than age 50. A quarter of patients are between ages 60 and 69.
Cole said the patients and their stories of relief are what keep staff members passionate about their work.
“The best part about it by far is the stories of patients getting relief and being happy with the products,” he said. “I can’t tell you how many inspiring and heartwarming stories we hear from patients who pharmaceutical medications have failed them or a certain symptom they’re trying to manage just can’t be addressed with conventional pharmaceutical medication. They try cannabis and it just gives them great relief.”
Gorman said more than 20 patients have been able to reduce dependency or completely come off opioids as a result of Maui Grown Therapies products.
Continual feedback (nearly 5,000 patient-initiated product validation reports have been received) via an app called Releaf. It helps the new company continue to improve, she added.
* Kehaulani Cerizo can be reached at firstname.lastname@example.org.
Facts about cannabis and its properties
Marijuana cultivation and use date back some 6,000 years. The cannabis plant has more than 100 unique chemical components that are called cannabinoids. These active ingredients bind to specific receptors in the brain and other parts of the body. Two most common types of ingredients are tetrahydrocannabinol, or THC, which contains the mind-altering properties sought by recreational users, and cannabidiol, or CBD, which has no psychoactive effect, according to a Harvard Medical School journal.
CBD does not by itself cause a high and there is no evidence of public health-related problems tied to pure CBD, the World Health Organization said. All 50 states have laws legalizing CBD with different levels of restriction, while the federal government still sees CBD to be in the same class as marijuana. The FDA recently approved the first-ever cannabis-derived medicine for epilepsy, which contains CBD.
However, many health effects of cannabis aren’t well studied, partly because under federal law cannabis is a Schedule I substance, meaning it has “no currently accepted medical use and a high potential for abuse.” That designation places numerous restrictions on researchers, making it hard to rigorously study, the journal said.
In Hawaii, the state Department of Health oversees the Medical Cannabis Registry Program, which requires qualified patients to have a licensed doctor and obtain a 329 Registration Card to begin or continue legal use of medical cannabis. Recreational cannabis use and growing sites remain illegal in the state. For information, visit health.hawaii.gov/medicalcannabisregistry/.
— Kehaulani Cerizo, staff writer