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THC Users Show No Increased Crash Risk

Cannabis use as a risk factor for causing motor vehicle crashes- a prospective study 

In Summary:

A recent study has revealed that drivers who use ∆-9-tetrahydrocannabinol (THC) do not show an increased risk of crashing. Users of THC were also showed a statistically insignificant increased risk of crash responsibility than drivers who tested negative for THC use. Further research should be conducted to include all types of vehicles while excluding those involving drugs of abuse. The results seen in the featured study may have been skewed by the inclusion of drivers who used one or more drugs in combination with cannabis, including alcohol. Accident rates involving just cannabis use may prove to be even less than those found here. 

Driving while under the influence is still very risky, but perhaps the featured research warrants an examination of how to trace the amount of THC effect driving. Adults who are above the legal drinking age can drive as long as they are under a 0.08 blood-alcohol level so theoretically, there may be a level of THC consumption that may be allowed when driving, especially considering the lasting effects of certain consumption methods such as edibles and tinctures. Researchers could possibly create a mechanism, similar to that of a diabetes test, that would prick a driver’s finger and test for various cannabinoid content in their blood. This would obviously have challenges as there is a vast array of natural and synthetic cannabinoids but may be worth looking into as cannabis becomes more popular throughout North America. 

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Benjamin Caplan, MDTHC Users Show No Increased Crash Risk
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Cannabis Prevents Antipsychotic-Induced Weight Gain

Cannabis consumption and non-alcoholic fatty liver disease. A three years longitudinal study in first episode non-affective psychosis patients

A recent study has revealed that cannabis is able to prevent weight gain in psychiatric patients taking antipsychotics. Cannabis was found to have a protective effect against liver steatosis, which is an accumulation of fat in the liver that can lead to obesity and type 2 diabetes. These findings may prove useful when developing improved treatments for schizophrenia as one of the main reasons patients find treatment so difficult to comply with is the weight gain caused by liver steatosis. 

Highlighted in this study is the lack of knowledge surrounding the mechanisms of the endocannabinoid system. In the featured study, the researchers were left uncertain about whether or not the cannabis was acting directly on the liver to prevent steatosis or if cannabis modulates weight indirectly through a related system. If more research concerning cannabis were able to be conducted so that the exact mechanisms underlying the endocannabinoid system could be elucidated than novel therapies could be developed for a slew of ailments. Our lack of knowledge concerning cannabis prevents us from possible developing therapies for treatment-resistant disorders. 

The study is available for review or download here

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Benjamin Caplan, MDCannabis Prevents Antipsychotic-Induced Weight Gain
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Binge Drinking While Using Cannabis Affects Brain Structure

Binge and Cannabis Co-Use Episodes in Relation to White Matter Integrity in Emerging Adults

In Summary

Researchers have recently revealed that the co-use of cannabis and alcohol can have deleterious effects on white matter in the brain. White matter integrity is frequently used as a measure of cognitive function and the negative effects of cannabis and alcohol on the white matter suggest a decrease of cognitive function in co-users. These negative effects were especially severe in co-users who frequented binge-drinking patterns. Researchers also found that those who co-used cannabis and alcohol were more likely to abuse more severe substances. These findings may prove useful when recommending cannabis for certain individuals whose cognitive function or abuse patterns are in question.

 This article highlights the nonlinear pattern that the effects of cannabis, meaning that too much cannabis can actually have negative effects rather than positive benefits. A way around negative effects from overindulging on cannabis when looking to alleviate symptoms from an ailment is micro-dosing. Micro-dosing refers to the practice of consuming the minimum amount of cannabis necessary to alleviate symptoms while avoiding possible psychoactive effects or anxiety. Micro-dosing is generally a safer way to ensure proper cannabis dosing as there is very little information or research to suggest a general dose for specific ailments.


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Benjamin Caplan, MDBinge Drinking While Using Cannabis Affects Brain Structure
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Endocannabinoid System may provide a target for schizophrenia treatment

Association of smoked cannabis with treatment resistance in schizophrenia 

A recent study conducted in Pakistan revealed that the endocannabinoid system may provide a target for novel schizophrenia treatments. Patients in the study who self-reported cannabis use, either acute or chronic, were more likely to show resistance to treatment. Schizophrenia is notoriously difficult to treat in general as the exact underlying mechanism is unknown, but the correlation between cannabis use and treatment resistance suggests that the endocannabinoid system plays a role in the biological processes of schizophrenia. Further research into the relationship between schizophrenia and the endocannabinoid system. 

This study highlights the amount of information that can be gained from open communication between patients and physicians. In the United States, there is a stigma surrounding cannabis use that frequently prevents users from speaking out despite the possible negative effects. The featured study relied on self-reporting use, which is an inconsistent and unreliable measure, but it gave the researchers a foundation that may spur future use. Open communication, in a general sense even beyond cannabis use, will only benefit researchers and patient outcomes. 

The study is available for review or download here

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Benjamin Caplan, MDEndocannabinoid System may provide a target for schizophrenia treatment
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Cannabinoid Receptor 2 is Novel Target for Treatment of Alcoholism

Alcohol-induced conditioned place preference is modulated by CB2 cannabinoid receptors and modifies levels of endocannabinoids in the mesocorticolimbic system

In Summary

A recent study has revealed that the endocannabinoid system may provide a novel treatment for alcoholism. Researchers have found that cannabinoid receptor 2 (CB2) is able to modulate the reward pathway for alcohol consumption. Specifically, when CB2 is antagonized or given an inverse agonist it is able to mitigate the positive effects of alcohol consumption. Dampening the positive effects felt when consuming alcohol will hopefully lower the need to drink felt by those suffering from alcohol use disorders. 

This article highlights the potential uses of synthetic cannabinoids and how different synthetic cannabinoids are able to have similar effects despite causing inverse reactions. Two synthetic cannabinoids were utilized for this study, an agonist and an antagonist for CB2, but both managed to minimize the positive effects of alcohol consumption. The only differing effect was that of the CB2 agonist in its ability to also decrease the positive effects felt when consuming food. Stumbling upon this secondary effect may provide a novel treatment for obesity, another prevalent disease in the United States. Further research into how the endocannabinoid system affects bodily processes and the development of synthetic cannabinoids may reveal hundreds of novel therapies. 


The study is available for review or download here:

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Benjamin Caplan, MDCannabinoid Receptor 2 is Novel Target for Treatment of Alcoholism
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The Neurocognitive Effect of Cannabis Varies

Adverse Effects of Cannabis Use on Neurocognitive Functioning- A Systematic Review of Meta- Analytic Studies

A recent study has revealed the variability of the effects of cannabis on neurocognitive functioning depending on dose and cannabinoid. A meta-analysis of other meta-analyses led the authors to conclude that cannabis has a negative effect on neurocognitive function. Here is the issue with the gathered data: half of the studies took place when cannabis use was completely illegal in most states meaning that any recorded cannabis use was either conducted in animals models which have proven to be inaccurate when modeling the endocannabinoid system, include limited cannabis use in their control groups despite the authors stating they excluded those studies, and included studies that allow alcohol and nicotine use in combination with cannabis use. The authors claim more controlled longitudinal studies need to be conducted, but still, draw broad conclusions. 

A recent post on this blog has also featured an article funded by the National Institute on Drug Abuse, a known critic of cannabis, and discussed the issue of bias among scientific findings. Biased articles are difficult to get around because they require fully delving into the material listed analyzed in the paper and looking into the studies that were included and left out of the meta-analysis to determine the validity of their findings. It is extremely frustrating to have articles presented to the public that are so heavily biased they cherry pick data just to prove their side of a politically controversial therapy. Not all cannabis use is beneficial and is not well understood, but posting articles like this one prevent the rescheduling of cannabis so that specific chemicals can be harnessed for novel therapies to treat ailments we have no effective treatment for, such as Alzheimer’s, specific cancer types, and a slew of psychiatric disorders. Scientists have a responsibility to remain objective and this type of biased research is disappointing to find.   

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Benjamin Caplan, MDThe Neurocognitive Effect of Cannabis Varies
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Flavonoids Improve Lipid and Glucose Metabolism in Dyslipidemic Overweight Subjects

Three‐arm, placebo‐controlled, randomized clinical trial evaluating the metabolic effect of a combined nutraceutical containing a bergamot standardized flavonoid extract in dyslipidemic overweight subjects

In Summary

A recent study has revealed the therapeutic benefits of flavonoids from bergamot fruits improve lipid and glucose metabolism in dyslipidemic overweight subjects. Dyslipidemic individuals have elevated levels of cholesterol and fats in their blood which increases their risk of suffering from a stroke or heart attack. The flavonoids present in bergamot extracts lowered total cholesterol, systemic inflammation, and a myriad of other chemicals that pose health risks, such as tumor necrosis factor-alpha (TNF-alpha). This study provides evidence that the flavonoids present in bergamot extracts may benefit those suffering from high cholesterol by lowering their risk of stroke and heart attack.  

This article highlights the potential health benefits of flavonoids. Flavonoids are commonly found among cannabis plants and various other crops that are already produced at a commercial level. Flavonoids are extremely understudied when considering their known therapeutic potential as well as how cost efficient producing flavonoid-containing supplements would be. Extracts and diets containing elevated levels of flavonoids would be a simple and effective method of providing a myriad of health benefits into users everyday lives, which warrants further research and development. 

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Benjamin Caplan, MDFlavonoids Improve Lipid and Glucose Metabolism in Dyslipidemic Overweight Subjects
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Medical Cannabis Treats Multiple Sclerosis and Associated Neuropathic Pain

Therapeutic impact of orally administered cannabinoid oil extracts in an experimental autoimmune encephalomyelitis animal model of multiple sclerosis

In Summary

A recent study has revealed the validity of treating multiple sclerosis (MS) and associated neuropathic pain (NNP) with medical cannabis. The therapeutic benefits of cannabis for MS and NNP was demonstrated by treating an experimental autoimmune encephalomyelitis animal model with cannabis which revealed an improved score on a neurological disability assessment and behavioral assessment. The authors describe this study as a critical step in advancing the literature describing the therapeutic effects of medical cannabis by validating the merit of such therapeutic effects. 

Highlighted in this study is the importance of the ratio of cannabinoids when treating various ailments. The vast array of cannabinoids has a myriad of effects on the body depending on how which receptor of the endocannabinoid they act on, how they act on that receptor, and how they interact with other cannabinoids that were taken simultaneously. Cannabidiol (CBD) is frequently recommended to help minimize feelings of anxiety, whereas tetrahydrocannabinol (THC) can actually worsen anxiety at higher doses. When consuming cannabis a patient should always be careful to note the ratio and effect of each cannabinoid.

The study is available for review or download here

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Benjamin Caplan, MDMedical Cannabis Treats Multiple Sclerosis and Associated Neuropathic Pain
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The impact of cannabis on surgical patients is uncertain

The impact of recreational cannabinoids on peri-operative outcomes

In Summary

A recent op-ed from a plastic surgeon discusses the uncertainty of how recreational cannabis effects peri-operative outcomes. Recreational cannabis does not always follow the same standardization requirements as medical cannabis depending on state laws. Multiple studies have reported their findings from patients who have reported using cannabis before their surgery but as peri-operative screening for cannabis is not routine and stigma prevents many from self-reporting, data is uncertain. Cannabis has been shown to affect anesthesia, post-operative hemostasis, drug metabolism, and pain control. Further research is needed to provide definitive evidence for the exact effect of cannabis on peri-operative outcomes. 

This study highlights the need for inclusion of self-reported cannabis use on national databases so larger studies are able to analyze the impact of cannabis on surgical outcomes, but also general patient outcomes. The stigma surrounding recreational cannabis use should be removed, not necessarily for legalization, but to provide researchers an way around national legalization. Allowing naturalistic studies where statisticians can find trends among recreational cannabis use and healthcare would provide a cost-efficient way to support research without federal funding. Removing stigma will help provide researchers the tools to further our knowledge so that we can better treat those using cannabis. 

The study is available for review or download here

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Benjamin Caplan, MDThe impact of cannabis on surgical patients is uncertain
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Cannabinoids prevent cardiotoxicity caused by popular anti-psychotic

Quetiapine induces myocardial necroptotic cell death through bidirectional regulation of cannabinoid receptors

In Summary

Researchers have recently revealed that cannabinoids are able to inhibit cardiotoxicity caused by the antipsychotic Quetiapine, both in mice and during bench testing. Quetiapine is a popular atypical antipsychotic that has recently been come under fire for causing myocardial injury by inducing necroptosis. The featured study has elucidated the mechanism behind Quetiapine’s cardiotoxicity and identified the combination of cannabinoid receptor 1 (CB1) antagonists and cannabinoid receptor 2 (CB2) agonists as a novel therapy. CB1 antagonists and CB2 agonists are able to inhibit the necroptosis induced by Quetiapine which should still make it a viable antipsychotic for those with access to medical cannabis. 

This article highlights the negative side effects associated with antipsychotics. There is still no cure for schizophrenia or bipolar disorder and the current treatment of antipsychotics and antidepressants often have horrendous side-effects that often deter patients from taking their medications. Better medications need to be developed to treat psychiatric disorders in general, but if we are able to develop therapies that assist patient compliance rates it would also be a huge step forward for the psychiatric community. Further research should be conducted to determine if cannabinoids can aid in other side-effects of antipsychotics that patients find difficult to cope with. 

The study is available for review or download here

View more studies like this in the CED Foundation Archive 

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Benjamin Caplan, MDCannabinoids prevent cardiotoxicity caused by popular anti-psychotic
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