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Omega-3 Fatty Acids Decreases Inflammation via the Endocannabinoid System

The role of n-3 PUFA-derived fatty acid derivatives and their oxygenated metabolites in the modulation of inflammation

Researchers have recently unveiled the role of n-3 PUFA-derived fatty acid, also known as omega-3 fatty acids, in the endocannabinoid systems anti-inflammatory and protective effects. The data reported shows that increasing the dietary intake of n-3 PUFA resulted in an increase in endocannabinoid concentrations. It was also found that n-3 PUFA derived endocannabinoids are metabolized by oxidative enzymes and their oxidized forms have higher anti-inflammatory and anti-proliferative properties than the base form of the endocannabinoids. This research includes a possible method for examining the metabolism of these biochemicals, calling for more research to be done to understand the full potential of dietary n-3 PUFA. 

The authors take care to emphasize how little is known about the human body despite centuries of research. Omega-3 fatty acids are commonly accepted as an essential part of humans diets which is why it is recommended to consume fatty fish, certain vegetables, or fish oil pills. As well recommended as these dietary supplements are there is still much debate surrounding the specific benefits of omega-3 fatty acids and the mechanism behind those benefits. Considering that omega-3 fatty acids act upon the endocannabinoid system to enhance many systems within the body, such as the cardiovascular system, the immune system, and the nervous system, more research is needed to fully dissect the interactions between the endocannabinoid system and n-3 PUFA. 

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Benjamin Caplan, MDOmega-3 Fatty Acids Decreases Inflammation via the Endocannabinoid System
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Cannabinoid Receptors in Brain Differ Due to Sex and Hormone Levels

Male and Female Rats Differ in Brain Cannabinoid CB1 Receptor Density and Function and in Behavioural Traits Predisposing to Drug Addiction- Effect of Ovarian Hormones

In Summary

A recent study has revealed that cannabinoid receptor 1 (CB1) density and function depend on sex and hormone levels. Researchers have found that the effects of CB1 receptors in brain regions of female rats caused them to engage in behaviors that are associated with a higher risk for substance abuse disorders. Interestingly, female rats reported a lower density of CB1 receptors, suggesting that an increase in cannabis receptors may improve rats’ chances of developing a substance use disorder. Further studies need to be conducted in order to test the validity of these findings for human mammals considering the differences between the human and rat cannabinoid systems. 

 This study highlights the inconsistency between rat and human endocannabinoid systems. Rat models are commonly used to study biological processes for ethical, efficient, and economic reasons, but they are not always appropriate. Previous studies featured on this blog have reported fundamental differences in the endocannabinoid systems of rats and humans, suggesting that they may not provide valid evidence. Non-human mammalian models such as monkeys may provide more valid results when looking into the therapeutic effects of cannabinoids or interactions between opioid and cannabinoid systems. 

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Benjamin Caplan, MDCannabinoid Receptors in Brain Differ Due to Sex and Hormone Levels
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Further Evidence for Cannabis as an Antitumor Agent

The heterogeneity and complexity of cannabis extracts as antitumor agents

In summary

 A recent study has exposed the complexity of cannabis extracts as antitumor agents depending on the exact cannabinoid composition and cancer cell line. Researchers utilized whole cannabis extracts, meaning that the extract contains various amounts of cannabinoids, terpenes, and flavonoids produced by the cannabis plant, and found that each extract had various effects depending on cannabinoid composition. It was also found that the antitumor effects were not completely due to ∆-9-tetrahydrocannabinol (THC) as pure THC extracts did not provide the same effects as a whole plant extract. Some extracts were found to have antitumor effects on specific cancer cell lines but further research is needed to specify which ratio of cannabinoid and other chemicals provides the most benefits for each cell line. 

Considering the difficulty of treating cannabis and the horrible side-effects associated with chemotherapy it seems shocking that cannabis-based medications are not more widely accepted for cancer treatments. As cannabis is still classified as a Schedule I under the Controlled Substances Act the federal government can not provide any support for cannabis research which means that current research relies almost entirely on private funding. When examing the emotional and economic toll of cancer patients it seems irresponsible to not fully examine the possible benefits of cannabis-based medications to finally determine if they can provide more benefits than easing the side-effects of chemotherapy such as cachexia, chronic pain, and nausea. 

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Benjamin Caplan, MDFurther Evidence for Cannabis as an Antitumor Agent
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Physician’s Role as Providers for Cannabis

Lost in the Haze- The Physician’s Role in Cannabinoid Prescribing and Advising

In Summary

A recent publication has come out providing commentary on physicians uncertainty of their role in medical cannabis. Providers have to be appropriately licensed and can find the federal legal status of cannabis intimidating, limiting the number of physicians who are comfortable recommending medical cannabis. Considering the number of local governments approving medical cannabis, the author suggests that physicians and pharmacists familiarize themselves with the pharmacological properties of the different cannabinoids and how various consumption methods alter the effects of those cannabinoids. 

This article highlights the difficulties in obtaining medical cannabis from affordable and trusted sources. As medical cannabis is not yet supported by the federal government it can be daunting to find a prescription for medical cannabis, a physician willing to discuss the effects and knowledgeable enough to know all of the current research and to afford cannabis once a medical license is obtained. Insurance is unable to help and cannabis is expensive due to the cultivation process and private funding. 

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Benjamin Caplan, MDPhysician’s Role as Providers for Cannabis
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The History and Current Legal Issues Concerning Cannabis-Based Medicine

Legal and Regulatory Issues Governing Cannabis and Cannabis-Derived Products in the United States

In Summary

A research article has come out describing the medical and legal history of medical cannabis as well as the challenges cannabis-based medicine will face in the coming years. This piece is a comprehensive summary of the modern history of cannabis, its medical purposes, the national and state difference in legal status, as well as the interactions between federal and state governments and how they address illicit cannabis use. Rounding out the article is the encouragement from the author for other researchers to develop cannabis-based medications, such as the successful Epidiolex®. 

Highlighted by this piece is the success of cannabinol (CBD) and the potential for proving cannabis medically beneficial without utilizing tetrahydrocannabinol (THC). Cannabis plants are host to a myriad of chemicals that have been revealed as promising therapies for various ailments, including the cannabinoids cannabigerol (CBG), cannabinol (CBN), and terpenes such as beta-caryophyllene, Linalool, and limonene. Developing therapies like Epidiolex®, which has been approved by the federal government, will help prove the medical benefits that cannabis plants provide and hopefully lead to the support of the federal government and rescheduling of cannabis. 

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Benjamin Caplan, MDThe History and Current Legal Issues Concerning Cannabis-Based Medicine
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Athletes Find Cannabis Beneficial While Actively Training

Cannabis use in active athletes- Behaviors related to subjective effects

In Summary

A recent study has found that the majority of athletes surveyed found cannabis beneficial when treating chronic pain and anxiety while still reporting elevated levels of fitness. The data suggested that adult athletes used cannabis in extremely responsible fashions, primarily reporting use for medical ailments, with 61% reporting daily use of cannabidiol (CBD), tetrahydrocannabinol (THC), or a combination of both. Those who reported the greatest benefits and the largest amount of negative effects were long term users of a combination of CBD and THC. Cannabis may prove to be a novel therapy for current athletes during their recovery. 

Interestingly, less than 30% of athletes who used cannabis products supported recreational use. There appears to be a group of medical users who find that the legalization of recreational cannabis is a hindrance to their care. Luckily most dispensaries in Massachusetts attempt to account for this issue by providing a separate entrance or section of the dispensary for medical use only so that they can avoid the mass of recreational users, although parking can still be an issue. Recreational use should not hinder medical care for patients, suggesting that separate retail locations or methods of retrieval should remain in place, if not become further segregated, to provide ease for medical users. 

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Benjamin Caplan, MDAthletes Find Cannabis Beneficial While Actively Training
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Cannabidiol Decreases Skin Inflammation

Cannabis sativa L. extract and cannabidiol inhibit in vitro mediators of skin inflammation and wound injury

In Summary

A recent study has revealed the effectiveness of cannabidiol (CBD) and cannabis extracts in the inhibition of skin inflammation. CBD was proven to be just as effective in the inhibition of inflammatory processes as the cannabis extract, proving that CBD is the main powerhouse behind the effects of the extract. Researchers determined that CBD was mediating the inflammation by inhibiting the nuclear factor-kappa B (NF-κB) pathway. By understanding the mechanism behind CBD’s inhibition of inflammatory processes researchers have a solid foundation to develop novel therapies for inflammatory skin conditions. 

This report emphasizes the beneficial effects of different cannabinoids and how isolating those compounds may prove more useful than whole chemical components of cannabis. Cannabinoids have a myriad of effects and interact with mechanisms differently meaning that they provide a myriad of therapeutic benefits. By isolating each cannabinoid and elucidating its effect novel therapies could be developed that utilize the effects of one cannabinoid while discarding undesired effects of a separate cannabinoid, tailoring each therapy for specific ailments. 

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Benjamin Caplan, MDCannabidiol Decreases Skin Inflammation
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Flavonoids Help Post-Workout Recovery in Endurance Athletes

Mixed Flavonoid Supplementation Attenuates Post-Exercise Plasma Levels of Protein Carbonyls and 4-Hydroxynonenal Protein Adducts Levels in Endurance Athletes (P23-009-19)

In Summary

Researchers have recently exposed the benefits of flavonoid supplements in endurance athletes. The mixed flavonoid supplement included quercetin, a flavonoid found in cannabis plants, and was able to mitigate the oxidative stress that occurs post-exercise in endurance athletes. The other flavonoids harnessed from green tea and bilberry extracts were also included in the antioxidant supplement whose combined efforts were able to minimize the damaging effects of oxidation. The development of these all-natural supplements may provide a beneficial way for athletes to recover from intense workouts while complying with regulations set by sports associations. 

Novel recovery techniques like the one featured in this paper are important for recovering athletes trying to navigate harsh regulations set by overarching organizations. Cannabidiol (CBD) has been praised and is well known for its therapeutic techniques, yet many athletes fear to utilize CBD during recovery from an injury or intense workout because it lays in a moral grey area for most athletic organizations. For example, tetrahydrocannabinol (THC) is a banned substance according to the NCAA and although CBD is not the NCAA still warns against its use due to the possibility of THC contamination. Athletes should be mindful to check with their organization for cannabis rules and ensure the products they use during recovery, such as CBD, come from a trusted source.

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Benjamin Caplan, MDFlavonoids Help Post-Workout Recovery in Endurance Athletes
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Those Who Increase Marijuana Use Between their Teens and Adulthood are Risky Drivers

Marijuana trajectories and associations with driving risk behaviors in Canadian youth 

In Summary

A recent study has found that drivers who increase their cannabis use as they transition from their teens into adulthood are more likely to participate in risky driving behavior. This data was gathered from interviews conducted utilizing the same population over a period of 6 years and split the groups into increased users, users who decreased use, those who abstained, and those who used cannabis occasionally. Only those who self-identified as increased users were likely to engage in dangerous driving situations, such as driving under the influence of drugs and alcohol simultaneously. This data will hopefully improve harm reduction strategies to prevent at-risk groups from engaging in dangerous behaviors, especially in combination with alcohol. 

This study brings to light the issue of driving while under the influence of cannabis. Not all of the active cannabinoids in cannabis are psychoactive which means they are not necessarily dangerous to drive while taking. Cannabidiol (CBD) is well known and praised for its therapeutic effects without being psychoactive which is why it is so widely consumed. Users should still be mindful of any side effects, but not all cannabis products will inhibit driving capabilities.

The study is available for review or download here

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Benjamin Caplan, MDThose Who Increase Marijuana Use Between their Teens and Adulthood are Risky Drivers
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Implementation of Cannabis Care Increased Diagnosis of Cannabis Use Disorder in Primary Care Practices

Integration of screening, assessment, and treatment for cannabis and other drug use disorders in primary care- an evaluation in three pilot sites 

In Summary

 A recent study has revealed that by implementing care for cannabis into primary care practices diagnoses for cannabis use disorder. The implementation of these practices also led to an increase of screening for cannabis and other drug use, the diagnosis of other substance use disorders, and treatment for substance use disorders. The continued evaluation of these new practices may aid other primary care practices to develop their own methods to more accurately diagnose and treat substance use disorders. 

By implementing such diagnostic practices and awareness into physicians offices we begin to normalize cannabis use. Normalizing cannabis within our society will hopefully decrease the current stigma enough to allow patients to be more forthcoming about their cannabis use and allow for better treatment methods and research to be conducted. Misdiagnosis or issues with treatment and sedation often arise due to unknown cannabis use so allowing patients to feel more comfortable when discussing drug use with their physicians should improve diagnostic practices and treatment. 

The study is available for review or download here

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Benjamin Caplan, MDImplementation of Cannabis Care Increased Diagnosis of Cannabis Use Disorder in Primary Care Practices
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