CBD for the world

CBD for the world

Surely when talking about medical cannabis you have also heard about CBD, this cannabinoid is largely responsible for the medicinal properties of cannabis, but we go through steps defining and giving context to understand a little more.

 

Our beloved plant has more than 110 cannabinoids, which are those active compounds that belong to the group of terpenophenols and represent more than 40% of the extraction of marijuana. These are responsible for activating the receptors of the human endocannabinoid system (this topic will be developed in another article) and therefore for the pharmacological effects of the plant. They are also called phytocannabinoids because they are exclusive to cannabis production, while endogenous cannabinoids are those produced by humans and some animals.

 

The most famous cannabinoid previously is THC (Tetrahydrocannabinol) responsible for the psychoactive effect of marijuana, although it also has medicinal properties such as analgesic and antispasmodic. CBN, CBG, CBL … etc., the list is extensive and some despite being isolated and identified, few important effects on humans and / or very little research around to determine its benefits in detail.

 

On the contrary, CBD (Cannabidiol) has been extensively studied and with a margin of research to determine in more detail all its benefits. The following healing properties are attributed to CBD and, on the contrary, THC has no psychoactive effect.

  • Analgesic
  • Anti-inflammatory
  • Antiemetic
  • Antipsychotic
  • Antiepileptic
  • Antispasmodic
  • Neuroprotector
  • Regulates blood sugar levels
  • Antibacterial
  • Promotes bone growth
  • Fight insomnia
  • Relieves anxiety
  • Appetite stimulant

 

Depending on the cultivated species, a higher or lower concentration of CBD can be found, usually, without being a rule, finding a higher CBD content means a lower amount of THC, however there are few species and they depend on their care and cultivation, so Even in the extraction of these active components, their concentration and the level of technification with which it is made can vary, since if done domestically, it would be at the mercy of the initial concentration contained in the cultivated species.

 

You want to know more? Attend our symposium on May 12 and 13, 2020 in Bogotá, Colombia and expand your knowledge about the healing power of cannabis.

 

References:

  1. https://geaseeds.com/blog/cbd-cannabidiol/
  2. https://www.royalqueenseeds.es/blog-cbd-el-cannabinoide-mas-desconocido-n52
  3. http://cannabismedicinal.com.ar/historyofcannabis/18.php
Depression and medical cannabis

Depression and medical cannabis

As studies on the beneficial effects of CBD accumulation, it was only a matter of time before the medical community began to investigate the possibility of using CBD as a cure for depression.

 

In 2014, a study conducted with animal models showed that CBD has important antidepressant and anxiolytic properties. The laboratory mice underwent a series of tests and the results showed that when treated with CBD, the subjects showed fewer cases of depression and anxiety.

 

There is no conclusive evidence that CBD can have a positive impact on depression, however, studies have shown that the use of CBD can affect serotonin levels in the body and improve sleep patterns.

 

Research on the connection between depression and physical symptoms has shown that depression and pain share a common neurochemical pathway influenced by serotonin and norepinephrine.

 

Previous research has shown that CBD has antidepressant effects that trigger the release of anandamide, a neurotransmitter responsible for controlling serotonin levels in the human body.

 

It seems that CBD has a future beyond the management of inflammation or chronic pain. It is only a matter of time before all research protocols that specifically establish CBD as a relevant antidepressant therapy come to light, even reducing the use of current synthetic components for the treatment of this condition.

Medical Cannabis in Post Traumatic Stress

Medical Cannabis in Post Traumatic Stress

Post Traumatic Stress Disorder or PTSD is a clinical condition that is suffered as a result of living or seeing traumatic events such as war, hurricanes, rapes, physical abuse or a serious accident. This causes stress and fear in the patient after the event, thus affecting the normal development of his life and that of his environment. For the case in Colombia, the victims of the armed conflict among which are the civilian population, the armed forces and the ex-Colombian guerrilla fighters are highly prone to suffer this condition.

 

This is a condition that must be treated with psychological accompaniment and in which the treatment with medical cannabis can considerably help the treatment of it. All the symptoms of post-traumatic stress are directly related to the sensations of fear, anxiety and stress and it is known that the endocannabinoid system acts in all regions of the brain involved in these processes.

 

Cannabis possesses the cannabinoid THC (tetrahydrocannabinol) which, as an exogenous agent, can directly affect the endocannabinoid receptors and alleviate the sensations described, however the dose should be adequate since a high dose can, not only be ineffective, but also which can also disturb the patient in his state of anxiety and fear.

 

At the moment the possible treatment is found in studies and clinical trials to confirm what would be the appropriate doses, however it has been reported that veterans in the United States on their own have opted for the use of cannabis oil without having effective results with other types of treatments, having a notorious evolution in several symptoms such as insomnia, depression, excessive sweating, etc.

CannaCiencia promotes Medicinal Cannabis in the medical, scientific and business agenda of the country.

CannaCiencia promotes Medicinal Cannabis in the medical, scientific and business agenda of the country.

With close to 350 attendees, 24 presentations by experts in medicinal cannabis and a commercial space that gathered brands and enterprises at national and international level, Cannaciencia, the first Cannabis Science Symposium of the Americas is consolidated as the platform to educate, visualize advances scientists, academics, doctors, pharmacists and technologists in this field, and the challenges and opportunities for the development of the cannabis industry in Colombia.

 

The first edition of CannaCiencia leaves a good balance. The participation of world authorities such as Dr. Uma Dhanabalam, expert, activist, defender and educator of the therapeutic use of medicinal cannabis; and Dr. Sue Sisley, who has been working on the investigation of the use of cannabis in the treatment of post-traumatic stress in veterans of war in the United States, had a great reception as a reference of the advances and barriers that currently face in their exercise professional, and education as the first path to destigmatization both in the medical community and in the general imagination.

 

In this context, the educational impact is highlighted as one of the main achievements of the event, especially with the topics related to the analytical laboratory and quality control, where there was a great lack of knowledge in the country. The outstanding participation of Scott Kuzdzal, an expert in toxicology and therapeutic drug monitoring, emphasized the responsibility of the industry in the implementation of effective processes to guarantee the correct labeling and the production of safe and contaminant-free medicinal cannabis.

 

For his part, Joshua Crossney, Founder of jCanna and the Cannabis Science Conference in the USA, presented the advances in academic research, in its commitment to close the gap between analytical sciences and the medical industry of cannabis to help improve quality of the products that patients use.

 

CannaCiencia also made visible the Colombian scientists and the research they are currently carrying out, offering them a platform for discussion, interconnection and search for funding, at a point where it is crucial to promote research for medical, clinical and pharmaceutical development.

 

The context of legalization and regulation of Medicinal Cannabis in Colombia also opened a door for industry experts and investors from countries where the business is already on a journey, which focus on the opportunities and potential of the nascent local industry. The presence of important investors in Cannaciencia such as Tuatara Capital of New York, support the importance of this scenario.

 

In the same way, a new and growing generation of entrepreneurs was identified around the medicinal cannabis industry, eager for ideas, information and alternatives to access capital.

 

“We are facing the challenges of an industry that is at the starting point. The economic impact of the emerging industry worldwide is historic, with compound annual growth rates of up to 34% (CAGR). It requires a huge venture capital education (risk capital) component, clear regulation by the competent financial authorities and inclusion for the Latino community in the emerging industry worldwide, “says Carol Ortega Algarra, CEO of Muisca Capital Group, the first Latin investment management firm, Founder of CannaCiencia and the Network of Cannabis Entrepreneurs of Colombia ”

 

For his part, Ricardo Martinez Executive Director of CannaCiencia and the Network of Cannabis Entrepreneurs of Colombia, says that the 3 most outstanding results of the symposium were: advanced scientific education given to attendees, visualization of Latin American scientists and their findings , derived from research projects, and the visit of multiple investment firms and family offices in North America, Europe and Asia. CannaCiencia is positioned as an international benchmark in science related to Medicinal Cannabis.

 

As a result, in August, the first cycle of training for entrepreneurs linked to the Network of Cannabis Entrepreneurs of Colombia and individuals interested in training will begin, with the first CannaCiencia Workshop, which will include the participation of specialists in cultivation, production, transformation and economic science of medicinal cannabis.

Interview with Bibiana Rojas pioneer and entrepreneur of the Medicinal Cannabis Industry present in Cannaciencia

Interview with Bibiana Rojas pioneer and entrepreneur of the Medicinal Cannabis Industry present in Cannaciencia

From Cannaciencia, we welcome to Bibiana Rojas, she is one of the pioneering women of the Medicinal Cannabis industry in Colombia. She is currently co-founder and President of Colombian Cannabis SAS company.

 

We have made an interview, which we want to share, as an introduction to what will be your participation as a speaker of the Cannaciencia Symposium to be held on April 20 and 21, 2018 in the city of Bogotá.

 

RM: Ricardo Martínez Rivadeneira, BR: Bibiana Rojas

 

 

RM: You are a vertically integrated Colombian company. How do you see the Canadian companies established in the country?

 

BR: Yes, we are very proud of our 100% Colombian roots. We are the first company in Huila state to obtain all the licenses for Cannabis psychoactive cultivation, non-psychoactive cultivation, and manufacturing in all its uses including national sales, scientific purposes, and exports. We also have a farm of 130 hectares (320 acres) with ideal conditions for growing Cannabis; and we have a space of up to 16,000 m2 in the industrial area of ​​Neiva for the Cannabis extraction plant and future expansions.

 

Like most Colombians, we see in this industry the opportunity to transform a product / industry that was negative, into something positive both for the economy and for society in general. Our vision and goal is to position Colombia as a leader in this industry. We are convinced of the advantages we have as a country and local human resources to achieve this goal.

 

This without taking away that we also consider very important to leverage the knowledge and experience that exists in other countries that may have advanced more in the topic of medicinal Cannabis. This industry is becoming stronger thanks to international partnerships. Colombia is in a privileged position to shine on the international stage and it is important not to enclose ourselves within our borders. That’s why our slogan is: “Colombian Cannabis: medicinal cannabis from Colombia for the world!”

 

RM: How do you approach the Science of Medicinal Cannabis in your company?

 

BR: We have spent more than 2 years investing in knowledge and expertise of our team on the topic of Medicinal Cannabis. That is why we have attended more than 20 specialized cannabis conferences in California, Colorado, Oregon, Florida, Las Vegas, Washington DC, Canada, Jamaica, Israel, Costa Rica, and others within Colombia. We have also participated in Cannabis Advanced courses in the CCI (Corporación Colombia Internacional), the Cannabis University – Oaksterdam University, and even courses in the Universidad Nacional de Colombia. Moreover, now I am an international speaker too, since I have given talks about Cannabis in Portland, Hawaii, Barranquilla, and Bogotá.

 

We have also visited doctors and leading Cannabis companies in Canada, the United States, and Israel who have shared their best practices with us. With several of these we are evaluating partnerships to deepen our understanding and participation in topics like clinical studies, dosage, variety of medicinal products including gel capsules, tablets, patches, inhalers, tinctures, sprays, creams, among others.

 

RM: What is the thought as a woman in the Medicinal Cannabis Industry, where most companies’ managers are men?

 

BR: It’s a challenge… in this industry and all the rest. For me it is common to arrive at a meeting of CEOs and be the only woman at the table. At the same time, it is a source of pride to be the leader of one of the first companies in Colombia to have all the licenses and be their leader regardless of whether I’m wearing a skirt or pants. The important thing is what I have in my brain and the passion I bring into this industry.

 

But this is the opportunity. We can stand out even more. This industry is so new and it moves at such an impressive speed that it is possible to break the “glass ceiling”, as it is not an “old guard” industry with a rigid establishment or a patriarchy. This industry is flexible and we are part of those in the front line fighting for its advancement. We are making history and as such it is in our hands to shape its destiny.

 

RM: What do you think is the role of women in the Medicinal Cannabis industry in Colombia?

 

BR: Women have already played a very important role in the Medicinal Cannabis industry in Colombia and in the world. It has been thanks to those brave, fighting, and dedicated mothers who refuse to take a “no” for an answer. It is them who have opened the eyes of many legislators to understand that the rights to life and health are above any other clause, and that in nature we can find answers to our illnesses if we stop stigmatizing a plant for political reasons or disinformation.

 

Furthermore, there’s also an incredible pool of talented women. In Colombia we have highly qualified professionals who will be indispensable in this industry: agronomists, pharmaceutical chemists, nurses, doctors, etc. In all the links of the supply chain there are opportunities for women to stand out.

 

This is an industry where all Colombians can participate and make a difference.

 

RM: What is the opportunity we are experiencing in Colombia with the legalization of Medicinal Cannabis?

 

BR: It’s a wonderful opportunity! This industry seems to have been designed specifically for Colombia. Our beautiful country has all the conditions and advantages to be world leaders.

 

We have excellent climatic conditions, fertile soils, abundance of sun and water, variety of thermal floors, possibility of multiple harvests per year, flexibility of outdoor, greenhouse, or indoor cultivation, human resources with specialized knowledge for this type of crop, and even an ideal geographical position for ease of international trade.

 

We also have a government that supports and bets on this nascent industry. We have the privilege that before Colombia legalized cannabis, they learned and researched how it was done in other States or Countries, so that they could take the best from each part and thus have a very complete and worthy model to be adopted by other nations later on. For our company it has been a real pleasure to interact with the staff of Minjusticia, MinSalud, FNE, Invima, ICA, among others, where we appreciate the dedication of each of them to take this industry forward even when it is such a novel subject. Their support has been magnificent!

 

RM: Is there a possibility for more women to join this industry?

 

BR: Yes of course! This is just beginning!

 

RM: At this time, what are the main challenges the medicinal cannabis industry in Colombia faces?

 

BR: Being able to execute. We must move from theory to practice without drowning the entrepreneurial spirit.

 

There are a few issues on the government side that need to be further clarified and/or need more personnel and resources. For example, issues of characterizing and legalizing the Colombian genetics, allowing the importation of other genetic material, balancing the concept of allocation of quotas vs. a quick response to demand in the market, obtaining sanitary registries, allowing foreign capital inflows, and eventually monitoring and being more strict to those who have not followed the steps properly. Based on the successful execution of these topics, we will be able to tell if Colombia really becomes a world leader of Cannabis or dies in the attempt.

 

Thank you!

 

Dr. Scott Kuzdzal: Expert in Clinical Chemistry and Clinical in Cannaciencia

Dr. Scott Kuzdzal: Expert in Clinical Chemistry and Clinical in Cannaciencia

Dr. Scott Kuzdzal gave me a series of papers that allowed me to write these lines about him. I would define him as the expert in analytical and clinical chemistry in the medicinal cannabis industry.

I will start with analytical chemistry, it is about the study of the chemical composition of a material or sample, through different methods and laboratory tests. In our case, the Medicinal Cannabis plant can have more than 500 chemical compounds that must be studied. Among those that highlight Cannabinoids, terpenoids and flavonoids, in addition to the study of the relationships and synergies that could exist between these compounds.

 

The study of the analytical chemistry of Medicinal Cannabis has been blocked for more than 80 years, with which there is a lot of delay in this field, only until they have been giving legalizations to the use of Medicinal Cannabis have begun to make these studies.

 

The medical cannabis analytical tests are in their infancy, but it has all the importance to preserve the health of the patients. The medicinal Cannabis plant is exposed to many risks since it is grown: bacteria, fungi, yeasts, molds, heavy metals, pesticides, aflatoxins, mycotoxins, is processed and packaged: residual solvents, packaging and delivered to the patient. And precise labeling is required to guarantee the safety and quality of medical cannabis to the patient.

 

A deeper step is clinical chemistry, it is about the study of the chemistry of the human body versus treatments. By means of bio-markers, the response or tolerance of a medicine is evaluated and it is revealed if the treatment is effective. This development in the case of Medicinal Cannabis can lead to a personalized medicine approach.

 

With all this evidence, Dr. Kuzdzal’s assessment is overwhelming that today there are huge and important opportunities in the medical cannabis industry for analytical and clinical chemists and they have a decisive role.

 

Dr. Kuzdzal will participate in Cannaciencia with the lecture titled, “Cannabis Analytical Testing: From Cannabinomics to Contaminomics and Beyond.” This lecture will take a closer look at cannabis QC analytical testing and discuss some of the major challenges and opportunities, including a comprehensive look at cannabis heavy metals testing. Attendees will learn about analytical technologies employed in cannabis QC testing labs, understand the limitations of current lab testing applications and take a deep dive into cannabis heavy metals testing technologies. This lecture will also present future opportunities for cannabis testing and research.

 

Source:
Unraveling the cannabinome. By Scott Kuzdzal and William Lipps.

 

The Social Drama of Chronic Pain

The Social Drama of Chronic Pain

Colombia, like all countries worldwide, begins to present alarming levels in the number of people suffering from “Chronic Pain”, that is, the pain that is permanent and is maintained over time.

 

According to statistics 3.5 Colombians are condemned to live with chronic pain, and what happens when this chronic pain increases to unbearable levels? It begins to increase the consumption of opioids and in the end the addiction will lead many to suicide.

 

What does the person with limited resources do not have to buy an analgesic? Get used to chronic pain, live with chronic pain, he have no choice.

 

This is a great social drama, for everyone, both for those who have resources and those who do not. In the end the despair on the one hand and the resignation on the other end in more painful situations.

 

Below I include the words of a friend who suffers from chronic pain and shared his appreciation: “The pain is always marked by the moment, at that time the pain becomes a permanent part of one for a post-traumatic, an accident or a chronic degenerative disease and to that extent the pain has to interact with one, and in the end one ends up learning to interact with the pain. ”

 

Finally you learn that it is a balance, sometimes the chronic pain dominates you and other times you manage to dominate it.

When chronic pain reaches unbearable levels, it does not let you sleep, it does not let you relate to others, it does not let you work, it isolates you and you end up like a dead person in life. It is the moment when you perceive that something very serious has happened, and that is that the balance has been broken and you have lost control over chronic pain.

 

When you lose control over chronic pain, you also lose control of your health, your life, the care of your health, you will depend on others, and that is frightening.

 

The hope of every human being is that this chronic pain disappears some day, and it seems that day is increasingly distant for many people, if they continue with conventional treatments.

 

And there is a light of hope, when you discover a product as powerful as Medicinal Cannabis, with which you can recover this control of pain, your health and your life, you are reborn, as Dr. David Casarett says.

 

This is priceless, that is why there exists Cannaciencia!

Dr. Paola Santander: “Passion for research in Medicinal Cannabis”

Dr. Paola Santander: “Passion for research in Medicinal Cannabis”

I had the opportunity to meet Dr. Paola Santander in her natural environment: the cultivation of Medicinal Cannabis and the laboratory where she investigates Medicinal Cannabis. From the first moment what I perceived was an immense passion for what she does, a great happiness and a huge desire to contribute with her research to the solution of the health problems of thousands of sick people in Colombia and the world.

 

Dr. Paola has been a researcher all her life, to the point that she already has, together with her colleagues, a patent for a product to treat cancer patients. This has been one of his favorite disease of research, made at the time of knowing the laboratory where she conducts her research, I could see first hand how Medicinal Cannabis destroys cancer cells, this has been exciting for me, and even more so to see for myself that research is already being done on Medicinal Cannabis in Colombia.

 

And that is being done by great human beings like Dr. Paola, along with co-investigators, one of them the biologist Dr. Antonio Mejía, with whom we shared this visit, and in whom we saw the same passion that radiates Dr. Paola for the research of Medicinal Cannabis.

 

 

An important part of the work team are the people who collaborate in the cultivation and are pending the Medicinal Cannabis plants. We found Mr. Gustavo and his assistant, collecting the flower and processing it to have it ready for Dr. Paola’s research. Something that Gustavo mentioned, in relation to Dr. Paola; “Before, I was the person who arrived earlier in the cultivation, now it is Dr. Paola who arrives first than me and is looking for the Cannabis plants” and that is how Dr. Paola is, a dedicated and outstanding person. all the details so that your research can meet the proposed objectives.

 

At the end of this visit, my reflection revolves around that “We have researchers who are great human beings and professionals, with excellent Medicinal Cannabis plants that can be grown in Colombia, with people who grow these plants with a lot of passion and dedication, with a solid legislation that allows research in Medicinal Cannabis to be a reality in Colombia and with Colombian patients who long to have different alternatives for their treatments “.

 

We need to get down to work and follow the example of Dr. Paola and start researching with great passion to ensure that in a short time we have the evidence required to give greater evidence to doctors and patients of the benefits of Cannabis Medicinal for your treatments.

Chronic Pain and Medicinal Cannabis

Chronic Pain and Medicinal Cannabis

 

What is chronic pain?

 

The World Health Organization (WHO) considers chronic pain a disease in itself and not a symptom as medicine has traditionally treated pain. In addition, WHO describes chronic pain as the greatest threat to the quality of life worldwide and reiterates that the treatment of pain is a human right. 80% of cancer patients, in advanced stage, suffer from chronic pain.

 

What is chronic pain?

 

Chronic pain may be due to some traumatic injury, aging, incorrect lifting, obesity and poor posture. In many cases, chronic pain is an indication of an underlying disease, such as arthritis, diabetes, cancer, osteoporosis, herniated discs, herpes, neuropathy, multiple sclerosis, fibromyalgia, headaches, migraines, muscle pain, etc.

 

Chronic pain statistics:

 

An investigation by the Colombian Association for the Study of Pain (Aced), which analyzed the prevalence of chronic pain, found that it affects 46 percent of people in Colombia. Seven out of every 10 people (70%) who say they have it have received treatment without finding improvement.

 

A recent study by Torrance et al found that the relevance of chronic pain, of any origin, in the general population is 48%.

 

Pain is the most frequent cause of consultation with a health professional. The Spanish Society of Pain (SED) estimates that between 40% and 80% of medical consultations are related to pain, being the most frequent cause for patients to go to the medical center.

This graph shows the importance of chronic pain in Colombia, where it finds the greatest potential for drug demand. Unfortunately, this demand is currently focused on chemical and synthetic medicines.

 

Conventional treatments against chronic pain:

 

Pain relief is a human right. However, the absence of policies for its correct approach and the barriers to access to medicines mean that it is repeatedly violated.

 

The first medications that were used were the tricyclic antidepressants: amitriptyline. Neurolécpticos: Levomepromacin, and then extended the spectrum to anticonvulsants: Clonazepam, pregabalin, gabapentin. Anesthetics – anti-inflammatories: paracetamol, Non-steroidal anti-inflammatory drugs (NSAIDs), such as naproxen, celecoxib and ibuprofen and aspirin. Bisphosphonates, muscle relaxants, antidepressants specific inhibitors of serotonin and norepinephrine. Opioids: codeine, tramadol hydrochloride, morphine, fentanyl.

 

With most of these drugs tolerance to drugs can be generated (and the need to increase the dose), hyperalgesia (increased sensitivity to pain) and addiction. Those based on opioids can cause a variety of devastating side effects (restlessness, anxiety) and long-term problems (tachycardia, addiction, and suicidal tendencies). This has led to an epidemic of opioids, which has led to a considerable increase in deaths.

 

This has become in these countries a problem that has demanded attention and answers aimed at solving it in a different way.

 

Medicinal cannabis as an alternative to the relief of Chronic Pain:

Medical cannabis is an analgesic and provides a natural alternative to chemical pain medications. Those who consume medicinal cannabis as a treatment for pain may experience a general increase in their quality of life due to the many other medicinal benefits it provides.

 

Based on the experience of other countries such as Israel, Australia, Canada and the United States, cannabinoids are useful for the treatment of chronic pain.

 

In the words of Dr. Jordi Pérez, director of the Cancer Pain Program and Professor of Anesthesiology at McGill University in Montreal (Canada): “The available studies demonstrate its analgesic efficacy mainly in chronic pain pain such as neuropathic or oncological, providing benefits moderate for spasticity, insomnia, fatigue, anxiety and nausea. “

 

Dr. Pérez has pointed out that patients who treat chronic pain with medicinal cannabis and respond effectively, show a tendency to decrease the consumption of other analgesic drugs such as opioids, antidepressants and anti-inflammatory drugs and less possibility of developing dependence and addiction.

 

Medical cannabis is significantly safer for older people with chronic pain than opioids, according to researchers at Ben-Gurion University and Soroka University. Medical therapy with cannabis can significantly reduce chronic pain in patients over 65 years of age without adverse effects, according to researchers at Ben-Gurion University in Israel.

 

The new study, published in The European Journal of Internal Medicine, found that cannabis therapy is safe and effective for older patients seeking to address the symptoms of cancer, Parkinson’s, post-traumatic stress disorder, ulcerative colitis, Crohn’s disease, sclerosis multiple and other medical problems.

 

Some pain experts are advising that doctors recommend cannabis therapy, in addition to or in place of opiate medications to “reduce the morbidity and mortality associated with prescription pain medications.” Medical cannabis is a much better and safer and more effective alternative.

 

The Foundation for Health Research (Fuinsa) launched an initiative a decade ago, the Platform Without Pain, to raise awareness of the need for both the system and the patients themselves to take pain seriously. “The four vital signs are blood pressure, pulse, body temperature and respiratory rate. We defend that pain is added as a fifth sign, “says Antón Herreros, Fuinsa’s CEO.