SA Weekend cover story: Meet the queen of green putting Adelaide at the forefront of revolutionary medicinal cannabis research
The way conditions like dementia are treated could be revolutionised by world-leading nature-based research to be conducted at a new medicinal cannabis plant in Adelaide. Elisabetta Faenza is the ‘Queen of Green’ driving that revolution.
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Are you mad? This was the response Elisabetta Faenza had come to expect when explaining her plans to revolutionise Australian botanical medicine and bring it into the 21st century.
She wanted to mass-cultivate marijuana from the best overseas plant DNA she could find and manufacture it into world-leading medicinal cannabis products.
Faenza then wanted to sell these products to a nation that had just legalised the therapeutic use of the notorious natural weed but was nowhere near as advanced as overseas markets, like Canada and the United States.
People just could not understand why we would invest millions of dollars to produce medicinal cannabis legally when South Australians were making it for free, unregulated in their own kitchens and sheds.
That was four years ago. This is now. Faenza is the woman spearheading Australia’s largest medicinal cannabis facility, which will be built in suburban SA. She says the ancient wild plant has the potential to supersede the trailblazing path of penicillin.
“We are like penicillin in the 1930s,” says 55-year-old Faenza.
“This was really cutting-edge medicine. It was natural, it was saving people’s lives but we didn’t know at the time how it was working.”
Penicillin is nature’s antibiotic. It was first discovered accidentally when isolated from mould on a piece of fruit in a London lab in 1928. But it was not until 1941 that its mass healing potential was recognised after South Australian scientist Howard Florey learned it was an effective cure of bacterial infection in mice.
SA is now on the cusp of yet again becoming a global research player in unlocking the collective potential of botanic medicine.
Faenza, who is from the NSW South Coast, is the chief executive of Australian biomedical company LeafCann. She established the company in 2016 after medicinal cannabis was legalised in Australia, alongside board chairman and brother Ilario Faenza and long-term friend, colleague and biochemist Dr Jaroslav Boublik.
LeafCann is investing up to $350 million in a state-of-the-art medicinal cannabis processing plant in a secret location in Adelaide’s southern suburbs.
While medicinal cannabis is legal in Australia, it remains an unregistered product and requires regulatory exemption for approved prescription.
“Penicillin, even in World War II, was an unregistered medicine but it worked so well that we were allowed to use it,” Faenza says. “Over time the research caught up and we were much better off understanding how it worked and it saved many millions of people’s lives.”
Faenza envisions a similar path for the most stigmatised plant of natural medicine: cannabis.
“While people have lived with this plant for thousands of years, we still have a way to go to get it to a point where we can use it as a first line of treatment for serious conditions,” she says.
The mother of four is an Amazon best-selling author and a former professional dancer, sales and public relations executive in traditional, nutritional and therapeutic health, and a director of a disability not-for-profit. Right now, she’s planning the logistics of building a world-leading and Australia’s largest medicinal cannabis cultivation and manufacturing facility.
Once it’s finished in two or three years’ time, LeafCann’s SA plant will employ 1400 people and will treat 160,000 patients a year, both here and overseas.
Its location in the Onkaparinga Council area and planning specifics remain confidential for a number of reasons, including security. Expansion and renovation of an existing research facility was supposed to have begun in April but overseas supply of specialist equipment and the international funding environment affected by COVID-19 has meant the start date has been pushed out by up to six months.
In February, LeafCann’s SA facility plans received major project status from the Federal Government, recognising it as one of national significance for economic growth and employment.
“Three years ago people thought we were crazy,” Faenza says. “They’d say, ‘Why would you make something that someone can make illegally in their kitchen?’ But this is game-changing. This is precision botanical medicine which will give GPs the confidence to prescribe.
“Our aim is to prove that plant-based medicines like cannabis can be clinically validated, can be produced consistently to a high quality and standardised to provide patients with affordable medicine. That’s our goal – that is what we are motivated by.
“So a doctor can have certainty that the medicine they will prescribe today will have the same effect the next month and the next month, and that their patient will be safe.”
Latest Therapeutic Goods Administration figures show SA doctors have the lowest medicinal cannabis prescription rates of all mainland states.
SA doctors were issued 530 TGA exemptions to prescribe unregistered medicinal cannabis products from 2016 to February 29, 2020. This compares to 14,509 exemptions for Queensland doctors and 9449 for doctors in NSW over the same period.
South Australians suffering from chronic pain, nausea, post-traumatic stress disorder and epilepsy have repeatedly complained about the difficulty of finding an SA doctor willing to prescribe medicinal cannabis. Some have been forced to the black market to source medicinal cannabis that is not regulated but is much easier to find and up to a third of the cost of approved products from overseas manufacturers.
Doctors say they are reluctant to prescribe cannabis due to a lack of research and the fear of attracting the “wrong kind” of patient. They also say the TGA approval process is cumbersome and time-consuming. But things are changing, according to Faenza.
A detailed review by the American Academy of Science Engineering and Medicine in 2017 identified a handful of conditions for which the data supporting the use of medicinal cannabis was strong. The conditions included chronic pain in adults, chemotherapy-induced nausea and vomiting, and patient-reported multiple sclerosis spasticity symptoms.
The AASEM review recommended more research was needed to strengthen moderate evidence that cannabis can improve sleep disorders, fibromyalgia, Tourette syndrome, anxiety and post-traumatic stress disorder. “Those conclusions were based on a review of more than 10,000 scientific abstracts,” Faenza says.
“Today, the number of abstracts held by just one of the major databases – the US National Library of Medicine – stands at 22,000. Many of the new studies are reporting on new potential roles for medicinal cannabis as a tool for disease management.
“As access to research materials increase, and regulatory barriers to conducting the studies decrease, the range of conditions for which a role for medicinal cannabis in disease management can be shown is growing exponentially.”
LeafCann is planning to run its own research arm from the SA facility. Its first research focus will be testing medicinal cannabis to improve quality of life for dementia patients. My brother and I have a great aunt who died horribly from the worst form of Alzheimer’s, which is one of the reasons we were keen to look at this condition,” Faenza says.
She wants LeafCann to lead the world in medicinal cannabis research for PTSD, endometriosis, Crohn’s disease, irritable bowel syndrome, Parkinson’s disease, Tourette syndrome and anxiety.
“With the changes in Australia’s medical cannabis laws, the doors have been opened to a whole new industry. There is now a significant opportunity to establish change, to help patients and advance clinical research,” Faenza says.
Improving access to and reducing the financial burden of medicinal cannabis as a treatment option for everyday South Australians is at the heart of Faenza’s drive for new and better natural treatments.
“We are filling a unique gap – that niche of patients with serious conditions for whom there is no better alternative medical treatment – so people like me in a lot of ways.
“Most medication does not work for me. Now, while cannabis is not what I need, there are many others for whom it is the only help.”
The relentless pursuit for equitable access to medical therapies comes from Faenza’s own journey of countless traditional and natural-based treatments for a largely unknown condition, and often at great financial and personal cost.
Her parents were forced to sell all they had in NSW in 1966 when she was a toddler so that she and her mother could move to Italy for radical treatment. Faenza’s mother Ronda was a young mum caring for her sick child alone in a foreign country. Her father Alfio was forced to stay in Australia, working in opal mines in Coober Pedy to keep bread on the table and medical bills paid in Italy. Her mother died of breast cancer aged 44.
“Her life was not helped by the level of stress she was under,” Faenza says. “She was 20 when she had me – a child under the constant threat of dying and in some parts of our lives we were living in poverty.”
Faenza herself recounts a childhood cheated of normality by poor health and the inadequacies of a traditional medical system and conventional treatments that still question her symptoms. She spent many years in isolation due to unexplainable inflammatory reactions to foods, plants and perfumes.
She was born with neurocristopathy, a group of conditions caused by the failure of normal neural crest cell migration in utero. In Faenza’s case, cells failed to reach the bowel, causing Hirschsprung’s disease – a congenital disorder of the colon causing chronic constipation.
“My parents were told the condition was fatal within days of birth and to go home and hope for the best. They said I’d not live pass three years of age.”
Her parents found a treatment clinic in Rome that used a controversial pull-through bowel transplant. The technique had a high risk of infection, as part of the bowel was prolapsed outside the rectum for up to seven days.
Despite incredible odds, Faenza – aged two at the time of the transplant – survived. She spent one year recovering.
“As far as I am aware, and from what my parents were told, I was the youngest child to survive the procedure at that time,” Faenza says.
Life was never normal, with weight loss and fatigue a constant throughout childhood. Her health worsened still when she suffered four strokes aged 11.
Her body is unable to metabolise specific amino acids, causing a toxic build-up that somehow triggers blood flow restriction to her brain. It is thought to be yet another manifestation of neurocristopathy. She’s had seven strokes in total – the last in 2012.
Some have forced Faenza into intensive care. Her stroke symptoms have included short-term difficulty speaking and understanding speech, having trouble reading and writing, and the longer-term inability to link names to faces – an affliction known as prosopagnosia.
High amino acid build-up can also cause her severe central nervous system pain, dangerously high blood pressure and heart palpitations.
Anything containing a combination of certain amino acids can cause severe reactions including vomiting, shaking, hives, and skin, throat and eye irritation.
She must avoid foods such as overripe fruit and vegetables, anything fermented – like beer, or anything containing preservatives or artificial colours and flavourings.
When Faenza eats well and avoids these allergens she has noticed enhanced memory, exceptional recall and comprehension, and the ability to function optimally with much less sleep.
In the last few years she’s discovered her body is making excess endocannabinoids. These are molecules that help regulate our sleep, mood, appetite and memory. This may also be linked to the neurocristopathy.
Endocannabinoids bind to receptors in the spinal cord to relieve pain and/or to immune cells to signal the body is experiencing inflammation. They work like the main cannabinoids in cannabis, which can bind to the same receptors, blocking out pain and nausea.
Faenza believes her miracle survival of the bowel transplant in Italy and her super-human memory and comprehension on a few hours of sleep are linked to her body’s overproduction of these endocannabinoids.
The unique biochemical connection Faenza has with the cannabis plant’s healing properties is another motivator for the success of LeafCann’s plans in SA.
“My condition influences everything I do and have done, and pushes me to dig deeper into anything to do with food and natural medicine,” she says.
“Once I get a clue, I don’t give up until I have answers and speak to people who have definitive knowledge.
“So really the development of the company and my knowledge of what my condition means have grown together. As I have gotten older, I have obviously been concerned about what my future might look like. I also have worked throughout my life to support children and adults with rare conditions and their families through volunteer work, board work and fundraising.
“This is a key driver for LeafCann, and my involvement in medicinal cannabis, which helps so many children and adults with rare conditions for which little or no other treatments exist.”