Pain

The Pain-Relieving Effects of Tetrahydrocannabinol Differ Depending on Age

March 31, 2020 cannabinoid, Pain

Age-Related Differences in Δ9-TetrahydrocannabinolInduced Antinociception in Female and Male Rats

In Summary

Researchers have recently found that the antinociceptive effects of ∆-9-tetrahydrocannabinol (THC) differ depending on the age of the subject. While examining the effects of THC on the nociceptive receptors of rats it was found that the THC was not as effective of a pain reliever in adolescent rats as it was in adult rats. It was determined that although adolescent and adult rats metabolize the cannabinoid differently it is not the cause of the differences in THC’s effect on nociception. Further research is needed to determine the mechanism that underlies the difference in age-dependent effects.

This article brings to light the issues of dosing between age and gender. Clinical trials often occur in a population of healthy young men and are rarely dosed specifically for women. By noting the differences in effect and metabolism of drugs depending on sex and age clinical trials need to be broadened to accurately dose drugs for all users. Although the featured study was conducted in mouse models it provides evidence that the effects of cannabis are age-dependent and should be a serious consideration for researchers moving forward with the development of cannabis-based therapies.

The study is available for review or download here

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Further Evidence For Cannabis as an Effective Pain Reliever

March 22, 2020 cannabinoid, Cannabis, chronic, Pain

Effects of Cannabinoid Administration for Pain- A Meta-Analysis and Meta-Regression

In Summary

A recent meta-analysis has found that cannabis is an effective treatment for those dealing with chronic pain. Researchers analyzed studies that compared cannabinoid-based therapies to placebos, concluding that those therapies served as an effective replacement or adjunctive therapy for more common pain relievers, such as opioids. Some studies included in the analysis disqualified the effectiveness of cannabinoids due to the psychoactive effects of tetrahydrocannabinol (THC) but the featured piece suggests future work should aim to synthesize cannabinoids that highlight cannabis’s analgesic effects while minimizing any psychoactive effects. Future research needs to discover more about the endocannabinoid mechanism within the body before this can occur.

The authors take care to emphasize the need for alternative pain therapies for opioids that are safer and more economically responsible. Currently, pain-related costs from patients, caretakers, and healthcare facilities continue to grow beyond $600-billion annually, as more people grow dependent on opioids. Cannabis is much more cost-effective, and even if it does not entirely replace opioid therapies and is simply an adjunct therapy, it has the potential to greatly reduce the amount of opioid prescribed and lower the necessary dose. Opioids are highly addictive whereas cannabis has a much better safety profile, yet cannabis is still deemed medically irrelevant by the federal government. More research needs to be conducted to reduce the chance of addiction, the opioid crisis in general, and reduce the economic burden of pain-related costs in the United States.

The Study is available for review or download here

Effects-of-Cannabinoid-Administration-for-Pain-A-Meta-Analysis-and-Meta-Regression Download

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Cannabis for Rheumatic Pain is Under-researched

March 19, 2020 Arthritis, Pain

Cannabis for rheumatic pain- hope or hype?

In Summary

Despite the large number of patients utilizing cannabis for rheumatic pain there is a lack of clinical evidence for such use. A recent review has come out discussing the inconsistent results found amongst previous clinical trials that examine the effects of cannabis on patients with rheumatoid arthritis, fibromyalgia, and spinal pain. Previous studies have found a myriad of results, all uncertain when compared to each other or statistically analyzed despite the many online articles boasting about the benefits of cannabis for rheumatoid arthritis. Physicians of those suffering from chronic pain are advised to caution their patients and make them fully aware of the lack of clinical evidence, but also to push for clinical studies so that evidence can be provided as many continue to suffer.

It is important to note the “known side effects” of cannabis are different depending on the person and consumption method. The author of the featured piece highlights the dangerous side effects including psychosis and short-term dizziness or sleepiness. Various cannabinoids have different effects and act on different receptors, meaning that blanketing the entire plant with a warning label is often misleading. Patients should discuss cannabis use with their physicians and should be careful to mind which cannabinoids they aim to use and the method of consumption as that can greatly affect the potency and perceived effects. Consume cannabis responsibly and continue reading blogs like this one or other well-researched articles to remain fully aware of current findings.

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Brazilian Medicinal Plant Shows Important Anti-inflammatory Action

January 14, 2020 Anti-inflammatory properties, Non-Cannabis Plant, Pain

Anti-inflammatory activity of Protium spruceanum is associated to immunomodulation and enzymes inhibition

In Summary:

Protium spruceanum, a plant often used in traditional Brazilian medicine, can reduce inflammation. Investigation into the molecular action of the plant shows that treatment using both leaves and branches can result in the inhibition of ROS, NO, NAG, MMP-9, COX-2, and iNOS, all normal mediators of inflammation. Protium spruceanum is one of many plants containing high phenol/flavonoid, terpenoid, and glycoside content that exhibits notable anti-inflammatory properties.

Related image Protium spruceanum with anti-inflammatory activity

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Anti-inflammatory activity of Protium spruceanum (Benth.) Engler is associated to immunomodulation and enzymes inhibition Download

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A Flavonol from Sweetscented Marigold Alleviates Pain

December 24, 2019 Analgesic, Arthritis, Cooking, Flavonoids, Future Medicine, Muscle Pain, Non-Cannabis Plant, Pain

Tagetes Lucida as a potential analgesic

In Summary:

Researchers have recently provided evidence that a flavonol extract derived from a common flower has antinociceptive (pain-relieving) properties. Sweet-scented Marigold has been used is frequently used in cooking techniques in South America and has now been found to alleviate pain through serotonin and opioid mechanisms of action. The antinociceptive properties of this flavonol, like those of many other plant-derived compounds, are ripe for testing in a clinical setting to determine their effectiveness in human patients. In this small animal study, it clearly demonstrates promise as a safe alternative to commonly used pain medications.

Dr. Caplan and the #MDTake:

Modern medicine seems to have largely forgotten its roots. Long before pharmaceutical companies were the source of all medication, the earth served as a resource for medications, and apothecaries, pharmacists, and druggists, as they were known, supported the medical industry with formulations and a deep understanding of natural resources. As the greater scientific arena and dominant culture have lost touch with the earth’s natural medicinal resources, our culture has lost a deeply valuable reservoir of opportunity. As the fast-paced life of modernity demands faster results on an ever-greater, mass-production scale, the construction of sprawling cities, which often demands deforestation and destruction of natural resources, may turn out to be a greater threat to human health than most of us have yet to even understand.

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Tagetes Lucida as a potential analgesic Download

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Medical Cannabis for Adults Over 50

December 22, 2019 Adult, Adverse Effects, Aging, Arthritis, Behavior change, Business of Cannabis, Cannabis, Cannabis Education, Cannabis Science, Case Study, Cognition, Dementia, Depression, Elderly, Future Medicine, Geriatrics, Mental Health, Pain, Pharmaceutical, Retail Cannabis, Seniors

In Summary:

As with all elements of the aging process, the human endocannabinoid system loses tone over time. Whether it is a reduction in the numbers of cannabinoid receptors or a slow waning of the machinery used to create the signaling molecules that bind to the receptors or the natural senescence of the system that supports all of these normal signaling processes, the fact remains that adults over 50 are best-suited for external support for the endocannabinoid system.

Indeed, the average age at dispensaries is surprising to most who are not familiar with the modern medical cannabis arena. Baby Boomers, perhaps more than any other age group, tend to dominate the medical cannabis dispensaries. This is no new phenomenon, however. Through the ages, across cultures and around the globe, cannabis has been consumed primarily by older adults. Whether by tribe elders, wise councilmen, spiritual leaders, or the educated elite, cannabis has been an integral part of human aging for as long as we have recorded history.

Here, a review out of Israel followed at 184 patients over 65 (average age was 81.2) beginning cannabis treatment. 63.6% were female. “After six months of treatment, 58.1% were still using cannabis. Of these patients, 33.6% reported adverse events, the most common of which were dizziness (12.1%) and sleepiness and fatigue (11.2%). Of the respondents, 84.8% reported some degree of improvement in their general condition.”

Appropriately, the authors advise caution for older adults related to those adults who may be consuming multiple pharmaceuticals, for potential medication interaction effects, as well as nervous system impairment, and increased cardiovascular risk for those who may quire the concern. Wisely, they recommend that “Medical cannabis should still be considered carefully and individually for each patient after a risk-benefit analysis and followed by frequent monitoring for efficacy and adverse events.”

Dr. Caplan and the #MDTake:

At CED Clinic, we have long seen that the average age of medical patients is over 50. Whether for concerns related to sleep, pain, mental or physical health, it seems as though Baby Boomers have either weathered enough politics to have developed a healthy cynicism for the misinformation campaigns of the 1930s and 1970s, or they have direct or indirect experience with cannabis to have learned of its safety and efficacy. Either way, it is quickly reclaiming its historical place in the care of older adults, although oddly… it seems to be a demographic skipped over by the marketing systems of most establishments in the cannabis arena, at least for now.

direction of action for cannabis treatments

bar of significant improvement with cannabis

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Medical Cannabis for Older Patients—Treatment Protocol and Initial Results Download

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Should Oncologists Recommend Cannabis?

November 27, 2019 Blood-Levels, Breast Cancer, Cancer, Cannabis, Cannabis Science, Colon Cancer, Endometrial Cancer, Impairment, Ovarian Cancer, Pain, Prostate Cancer, Science, Women in Cannabis

Oncologists Should Recommend Cannabis-Based Medicine for Palliative Care

Oncologists are encouraged to recommend cannabis: cannabis-based medicine for palliative care and more

In Summary:

Earlier this June, a review was published that encourages oncologists to recommend cannabis products to their patients as a safe and effective method of palliative care. The opinion piece highlights how cannabis is a useful treatment for a variety of illnesses (nausea, vomiting, sleep, mood, anxiety), and encourages practitioners to prescribe cannabis for their patients so that they can appreciate the safety and effectiveness of the product.

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Should Oncologists Recommend Cannabis?Download

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Participants in Cannabis for Chronic Pain Study Describe Life-Changing Results

November 14, 2019 Adolescents, Adult, Adverse Effects, Anti-inflammatory properties, Anxiety, Cannabinoids, Cannabis, Cannabis Education, Cannabis Science, Case Study, Cognition, Future Medicine, Impairment, Memory, Pain

Restored Self: A Phenomenological Study of Pain Relief by Cannabis

In Summary:

In an Israeli qualitative study investigating the impact of cannabis use on chronic pain patients, all but one of the nineteen study participants experienced pain relief after cannabis use. Participants explained how cannabis allowed them to not just discontinue medications treating their pain, but also medications treating secondary outcomes of their pain, such as poor sleep and anxiety. Patients described feeling “a sigh of relief,” being “reborn” or being saved by cannabis use after years of debilitating pain and medication side effects.

Dr. Caplan and the #MDTake:

The pathway through which cannabis works to combat pain is different from the usual pathways doctors have used for the last 90 years. Prior to the 1930s, cannabis was used routinely, just about everywhere, but political and social agendas kidnapped the medicine and hid it away from most of the mainstream and from routine medical education.

Patients often describe typical pain relievers as adjusting the impact of the pain. Reducing or quieting the pain, softening discomfort, allowing the sufferer to perform previously typical tasks without debilitation or dysfunction. Cannabis, on the other hand, is sometimes described as “taking the sufferer away from the pain,” rather than the other way around. The effects that cannabis can have on the reduction of inflammation, attention, memory, and relaxation, provide a new type of opportunity for relief.

Still, other patients describe the effects of cannabis through a lens of mental focus. Whereas in daily use we typically open a standard set of drawers, some have said, the use of cannabis allows the consumer to open up a different set of draws, and through this adjusted lens, to see discomfort from a different perspective.

For those suffering with chronic pain, years upon years of discomfort, suffering that, when paired with modern medicines, has only met frustration and further discomfort, cannabis is frequently seen as a welcome “sigh of relief.”

Sample of text discussing lack of adverse side effects of cannabis

This paper is also stored here: http://bit.ly/32FZkUU inside the CED Foundation Archive

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Restored Self: A Phenomenological Study of Pain Relief by CannabisDownload

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Cannabinoids Further Demonstrate Therapeutic Potential in Interactions with Adrenaline and Serotonin Systems

November 7, 2019 Adult, Behavior change, Biosynthesis, Cannabinoids, Cannabis, Cannabis Science, CB1, CB2, Depression, Future Medicine, Genetics, Mental Health, Neuropathy, Obesity, Pain, Schizophrenia

Regulation of noradrenergic and serotonergic systems by cannabinoids: relevance to cannabinoid-induced effects

In Summary:

Among many system-wide interactive effects, the noradrenergic and serotonergic hormone/signaling systems are responsible for pain, mood, arousal, wakefulness, learning, anxiety, and feelings of reward. A recent review dives deeper into the interactions between cannabinoids and these two systems: cannabinoids play roles in exciting, inhibiting, and regulating the nerve activity and feedback of both the noradrenergic and serotonergic systems. This data further underscores the therapeutic potential of cannabis for conditions such as depression, chronic pain, and insomnia, all of which are mediated, at least in part, by these systems. Further research may uncover more specific therapies targeted toward the noradrenergic and serotonergic systems and their interactions with cannabinoids.

Dr. Caplan and the #MDTake:

It would be shocking to imagine that, in addition to the usual fruits and vegetables on display at supermarkets, all of a sudden, there was a new category of healthy food. Similarly, the recognition that cannabinoids play a central role in animal physiology is embarrassingly recent. Surveying a sea of illnesses that have become increasingly common, over the last hundred years, before which cannabis was a common household product, also begs the question about a relationship between the circumstances. Might some of the common maladies of modern medicine be attributable to a cannabinoid deficiency syndrome?

A Schematic overview for regulation of NA/LC and 5-HT/DRN cells by the CB1 receptor

Neurochemical Evidence for cannabinoid-induced effects

Electrophysiological evidence for acute effects of cannabinoids on neuronal activity

Neurochemical evidence for cannabinoid-induced effects in the locus coeruleus

Functional evidence fo cannabinoid-induced effects

Electrophysiological evidence for acute effects of cannabinoids

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Regulation of noradrenergic and serotonergic systems by cannabinoids: relevance to cannabinoid-induced effectsDownload

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Veterans Using Cannabis Medicinally More Likely to have PTSD than Recreational Users

October 25, 2019 Adult, Behavior change, Cannabinoids, Cannabis, Cannabis Education, Cannabis Science, Depression, Future Medicine, Impairment, Insomnia, Legislation, Opiates, Pain, PTSD, Reefer Madness, Stigma, Veterans

Title: Medicinal versus Recreational Cannabis Use among Returning Veterans

In Summary:

A recent study found significant mental and physical health differences between veterans who use cannabis that they label as “medicinal” use versus those who prefer to label their use as “recreational.” Veterans who feel that they are self-medicating with cannabis, in what they believe fits more closely with a “medical” label are five times more likely to suffer from post-traumatic stress disorder (PTSD), nearly four times more likely to suffer from Major Depressive Disorder, and are more likely to experience Insomnia, or trouble sleeping. Furthermore, a majority of veterans medicating with cannabis suffer from conditions that qualify them to receive a medical marijuana registration card. Even so, they tend to refrain from discussing their interest in access with their doctors, out of fear of losing their valuable VA benefits.

Dr. Caplan and the #MDTake:

Over the years, countless veterans have valiantly and courageously dedicated themselves to missions of support for their fellow men, women, and country. In preparation, training, service, battle, leadership, education, and so many other ways, veterans have given back to their culture in a way few others can. The understanding that they may be shunned by their culture for seeking help, related to the suffering they may have experienced while serving their country, is unconscionable. It is shameful that the government and military have not appreciated and supported the easy opportunity to give back to our veterans, and it is long overdue that the culture gives back to those who have given a piece of themselves so that others may share the liberties they have served to uphold.

group differences between medicinal and recreational cannabis users in diagnoses, cannabis-related problems, reasons for using marijuana, and other health-related and substance use outcomes

characteristics of medicinal cannabis users

Medicinal versus Recreational Cannabis Use among Returning VeteransDownload

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