One of the significant challenges in psychedelic medicine is effectively personalizing dosage. The process today relies on a lot of imprecision—to the detriment of the patient. And that translates to lost opportunities for patients, clinicians, and psychedelic medicine as a whole.
Greenway DNA is developing individual genetic tests to resolve that imprecision, using genetic variants in metabolism receptors to make dosing recommendations for cannabis and psychedelics. We recently spoke with Greenway DNA CEO Gregg Steinberg about the tests, the process, and what the company’s technology can mean for psychedelic medicine.
Psychedelic Invest: Let’s start from the very beginning. What are you working on? What are you building? What’s the company all about?
Gregg Steinberg: We’ve spent the last three years developing individual genetic tests that use a similar methodology as 23andME or Ancestry.com to look at lineage, hereditary, genealogy, etc. You take a spit test, that test goes to a molecular lab, and we do full genomic sequencing on it.
Rather than looking solely for genetic variance, which is what 23andMe is doing, we’re looking at genetic variants relative to metabolism receptors, brain receptors and body receptors. We overlay that against the endocannabinoid system as well as against different medical conditions. We then create a recommendation on an individualized basis for that patient for different medical conditions.
We look at things like insomnia, stress, pain, anxiety, and an individual’s genetic variance relative to those core factors. We can then make a dosing recommendation of how many milligrams of CBD or THC, and then at what ratio. We look at when it should be taken for insomnia or pain, anxiety, PTSD, these types of things. Obviously, for each individual and their medical indications, those ratios are different.
PI: That’s fascinating. It’s essentially personalized medicine for natural products. You’re focused on THC and CBD right now, but tell me what you have going on in the psychedelic space.
GS: After starting the company three years ago, we quickly filed a patent in the cannabis space, which we brought to market earlier this year. As we got into the early part of this year, we started drilling into the psychedelic space.
We were trying to understand if we could take the same theory and methodology we’re using for the chemical compounds of THC and CBD and apply them to psychedelics. There is some crossover, but there are obviously different receptors for each of these compounds.
But the methodology we use looks at those receptors, looks at the metabolism ability of the body based on what that genetic information will tell us, looking at the ability for those receptors to be open, closed, partially opened, or partially closed, and the messaging that’s going to send to the body. We look at that data and then drill down on writing the appropriate algorithm, which we did on cannabis.
Now we’re getting ready to take that into internal trials, working with several different health and wellness centers, clinics, etc., partnering with them to do facilitated sessions.
PI: How are these clinics doing their dosing now? Is it just a guessing game?
GS: They’ve got core formulas based on the individual factors of a medical condition they’re trying to deal with.
With cannabis, the approach is start low and iterate up to see what the impact is… but that method is imprecise.
For the dosing component in psychedelics, especially from a medical perspective, the impact of a potential bad experience is very different than cannabis. The ability to invoke some type of a psychosis is unlikely with too high a dose of cannabis, but it is a risk with psychedelics.
We believe the dosing dial is an important component we can bring to the industry. Part of what we built into our algorithm and part of the variance that we look at is accounting for the risk of psychosis in our psychedelic model.
That could be prior occurrences or just genetic predisposition to something like that. We base that on 40 genetic variants in 20 genes on the cannabis side, and we’re expanding that to about 200 variants when we look at the bucket of psychedelics that we’re adding to the algorithm.
PI: Who’s your customer for this? Is it going to be the clinics? The users? A little bit of both?
GS: For cannabis, probably both. The recreational marketplace for cannabis is quite different from the physician practitioner market.
Our view on psychedelics though is that these products should be targeted towards the medical professional and research community to develop and better understand them as a medical treatment.
PI: How long does your process take? What does that look like?
GS: After purchasing a kit, we send it straight to your front door to collect a saliva sample. Once you take the test, you send it into our lab in Oregon. It’s a molecular lab tied to a university, and it’s one of the best genetic research labs in the country. They do the testing, we get the data back, and it’s all HIPAA compliant.
Once we get back the genetic sequencing, we’re able to tie that together with the genetic data we gathered from you as a patient. When you take that test, you also go online to activate that kit, and there are several questions you answer. We then marry those two sets of data together, the sequencing, lifestyle data, personal data, and then plug it into our algorithm to generate your reports. That entire process from getting the test to generating your reports takes about two weeks.
PI: Can you touch on the choice of one receptor over another?
GS: Most people are familiar with CB1 and CB2 receptors, but there are about six other key receptors for THC and CBD.
Similarly, when we look at psychedelics, there are several core receptors to look at. We’re looking at the variants against each one of those receptors to assess how a person can metabolize a specific chemical compound.
The common thinking is that things like weight have a major impact on dosing regardless of what we’re talking about. What we’ve seen is that there’s not a correlation between weight and dosing because our metabolism isn’t tied to weight. So, we see that dosing decisions being made on weight are causing either overreactions or underreactions. As a result, people have a bad experience and decide not to do it again, when really it has nothing to do with the chemical compound itself. It’s just the way they metabolize it.
We also look at the nature of what that genetic variant says in terms of the receptors. They could be totally open. They could be totally closed. They could be partially open or partially closed. It depends on several genetic variants that play together in a sequence. That will impact whether someone’s going to be receptive to a certain dosage.
Then there’s the signaling from the receptor, the transduction that takes place from that receptor to that specific part of the body, whether that messaging is going to be slow or fast and the reaction time to that messaging.
PI: And someone having a bad experience turns into a lost opportunity for the patient and the clinic.
GS: We see a lot of things that are thought of as core factors but don’t play as much of a role as they’re believed to. It’s really about these other core factors, like a predisposition to psychosis or addiction. We look at a bunch of these core components relative to what the person is doing in their normal life and studying the core lifestyle components to tie it together to the genetic piece.
It’s definitely in the early days, and there’s still a lot of work to be done. There’s a lot of opportunity for personalized plant medicine.
Learn more about Greenway DNA.