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Cannabis Use Causes Increased Impulsivity

Cannabis and alcohol use, affect and impulsivity in psychiatric out-patients’ daily lives

In Summary

A recent study revealed the increased impulsivity seen throughout the day in psychiatric out-patients who consumed cannabis. Cannabis was also found to increase momentary hostility in psychiatric patients, namely those suffering from bipolar disorder. The study also compared the difference of activity between alcohol and cannabis, finding that although alcohol also caused an increase in impulsivity it was only momentary rather than prolonged. By observing the effects of alcohol and cannabis in patients researchers were able to determine that the two compounds are part of separate processes and operate on different time-scales. 

Very little research has been conducted that addresses drug interactions with cannabis. As the prevalence of cannabis use continues to rise as state governments continue to legalize medical and recreational cannabis it is imperative to understand how cannabis affects everyday medications. For those who need blood thinners, muscle relaxants, etc., drug interactions can be dangerous, even fatal, emphasizing the importance of understanding how cannabis interacts with other medications at the cellular level. Pharmacists and physicians need more knowledge to be able to thoroughly inform patients consuming marijuana of the potential risks. Future research should be conducted, as well as chemical modeling studies, to ensure the safety of cannabis users. 

The study is available for review or download here

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Benjamin Caplan, MDCannabis Use Causes Increased Impulsivity
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The Canadian Association of Gastroenterology Requires Guidance when Recommending Medical Cannabis

Canadian Association of Gastroenterology position statement- use of cannabis in gastroenterological and hepatic disorders

In summary

The Canadian Association of Gastroenterology has stated that guidance is required on the issues of relevance for gastroenterologists who discuss cannabis benefits and harms with patients. In their statement, they reviewed the current evidence for cannabis use among common gastroenterological and hepatic disorders providing a brief statement and commentary.  Inflammatory bowel disease is not thought to benefit from cannabis use. Alcohol liver disease, nonalcoholic fatty liver disease, and GI symptom control are thought to benefit from cannabis due to the anti-inflammatory and anti-nociceptive effects. Further evidence is needed before the association can fully sign off on the medical use of cannabis for their patients but they acknowledge the potential of cannabis-based medications. 

Despite the fact that cannabis is now legal for medical and recreational use cannabis is not an approved therapeutic substance by Canada’s governing medical body. The legalization for recreational use across the country was recent (2018) and it should be interesting as a country where legalization is varied to watch the research and other policies that come out in the near future. Perhaps the findings of the Canadian government will provide American politicians the evidence they need to support or reject the medical benefits of cannabis.

The study is available for review or download here

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Benjamin Caplan, MDThe Canadian Association of Gastroenterology Requires Guidance when Recommending Medical Cannabis
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Addictive Disorders are Associated with Neuroticism, Low Agreeableness, and Low Conscientiousness

Big Five personality traits and alcohol, nicotine, cannabis, and gambling disorder comorbidity

In summary

In a recent study published by the American Psychological Association researchers determined that addictive disorders, like cannabis use disorder, are associated with neuroticism, low agreeableness, and low conscientiousness. Neuroticism, agreeableness, and conscientiousness are some of the Big Five personality traits, which was the taxonomy chosen by the researchers to examine possible personality underpinnings of addictive behavior and comorbidity. As all three of the traits were equally associated with substance use disorders they may explain the co-occurrence of addictive behaviors but these traits also may more broadly associate the propensity to develop any psychiatric disorder. Further research is needed to fully elucidate the relationship between neuroticism, agreeableness, and conscientiousness for substance use disorders as the research may lead to the development of better prevention programs. 

The idea of cannabis use disorder is interesting as the endocannabinoid system does not act upon the reward system, making the threat of addiction almost nil. Cannabis is often pedestilized by advocates for its safety profile, especially when compared to other pain medications like opioids, yet there are still some concerns for dependency. The endocannabinoid system is ever changing, especially as we learn more about it. Very little research has been done that assesses cannabis dependency although it is known that, like with most substances, frequent users gain a tolerance to cannabis.  Tolerance to cannabis can be reset with abstinence, supposedly for a 48 hour period, but again more research is needed. Tolerance, addiction, and dependence all need to be properly defined and standardized across the medical community, not just the advocates, because addiction and dependence can be frightening words that should not be thrown about.

The study is available for review or download here: https://drive.google.com/file/d/1xQqAEU3sr5niKtarRR_nUutUwDE6E4um/view?usp=sharing

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Benjamin Caplan, MDAddictive Disorders are Associated with Neuroticism, Low Agreeableness, and Low Conscientiousness
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Drug Resilience is Age-Dependent

Behavioral effects of chronic WIN 55,212-2 administration during adolescence and adulthood in mice

In summary

 A recent study has revealed that adolescents appear resilient to some effects of cannabis yet early use leads to increased impulsivity later on in life. Researchers administered 3.0 of a cannabis receptor 1 (CB1) agonist, WIN55,212-2, per day for 21 days to one group of mice in adolescence and another in adulthood before testing their impulsivity, judgment, and learning abilities. Adolescent mice who had been given cannabis performed as well as controls at the learning activity while the adult group experienced a serious delay, suggesting an age-dependent difference in the cannabinoid system. Adolescent mice who had been given cannabis and then tested later as adults demonstrated increased impulsivity suggesting that exposure to cannabis during development does have a lasting effect on processes. Further research will need to validate these findings in non-human primates or be examined in naturalistic observation studies. 

When considering the implications of a study like this one it is important to note the varying accuracy of cannabis research conducted in murine models. While rats and mice are convenient physiological models due to their availability and economic value they do not always provide the most accurate representation of specific biological systems in humans. The endocannabinoid system of rats has been shown in previous featured studies to act differently than the human or primate endocannabinoid system meaning that any scientific evidence for cannabis-based medicine found from murine studies cannot be conclusive without further validation.

The study is available for review or download here
https://drive.google.com/open?id=12Yzwxy5Vd1MXmyBjeGCIcHOmHIiO6VIg

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Benjamin Caplan, MDDrug Resilience is Age-Dependent
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Legalizing Medical and Recreational Cannabis May Decrease Adolescent Use

Association of marijuana laws with teen marijuana use- new estimates from the youth risk behavior surveys

In summary

 Earlier this July a letter was published providing evidence that adolescent cannabis use may actually decrease post-legalization of medical and recreational cannabis. An analysis of Youth Risk Behavioral Surveys from the past two decades revealed that legalizing medical cannabis had little to no effect on cannabis use among adolescents in 8th and 10th grade but that legalization of recreational cannabis actually led to an overall decrease of adolescent cannabis use across the states. The authors hypothesize that the rate of adolescent use may decrease as illegal drug dealers are replaced by legal, regulated dispensaries. This evidence may prove compelling for the possible rescheduling of cannabis under the federal Controlled Substances Act. 

Adolescent substance use, like that of alcohol, has been found to be detrimental to brain development. There have been varying results regarding the effects of adolescent cannabis use on brain development yet some caretakers are given special permission to administer cannabis-based products to children experiencing rare forms of epilepsy or other seizure disorders. Cannabis-based medications may be a more ethical and far less dangerous substance to administer to children so that they aren’t set up for a substance use disorder at a young age.  Research focussed on adolescent cannabis use needs to be conducted for better regulations and to better advise the parents and pediatricians of adolescents who have accidentally consumed cannabis or need a cannabis-based medical intervention.  

The study is available for review or download here

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Benjamin Caplan, MDLegalizing Medical and Recreational Cannabis May Decrease Adolescent Use
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The Relationship Between Social Support in Socially Stigmatized Populations and Substance Use

An inverse relationship between perceived social support and substance Use frequency in socially stigmatized populations

In Summary

Researchers have recently attempted to elucidate the relationship between perceived social support and frequency of substance use in socially stigmatized groups revealing contextual differences. The two groups utilized in this study, substance-using male prison inmates and primary-methamphetamine using men who have sex with men, showed different results in the study, leaving the researchers with more questions than answers. In the inmates’ group perceived social support was negatively correlated to life-time substance use for alcohol, tobacco, and cannabis yet the methamphetamine-users only demonstrated the same negative correlation for a 30-day period. The authors are uncertain as to the differences in results but suggest that future research delves into the psychosocial or contextual differences behind these two groups. 

Looking into the substance use frequency and patterns of stigmatized or marginalized groups are not often done leaving many populations without specialized treatment or prevention programs. Our culture, peers, family, and environment all come together to shape who we are and mold how we think about the world and our place in it. People begin using substances for different reasons although some motivations are common among certain populations. By examining the underlying motivation for substance use frequency members of the healthcare community may be able to develop custom prevention or treatment methods by utilizing psychology or another science to drastically decrease the frequency of substance use disorders in all populations. 

The study is available for review or download here

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Benjamin Caplan, MDThe Relationship Between Social Support in Socially Stigmatized Populations and Substance Use
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The Relationship Between Cannabis and Nicotine may Reveal Novel Treatments

Acute separate and combined effects of cannabinoid and nicotinic receptor agonists on MMN-indexed auditory deviance detection in healthy humans

In Summary

Researchers have attempted to elucidate the relationship between nicotine and cannabis revealing a possible benefit for sensory and cognitive processes. A cannabinoid receptor 1 (CB1) agonist, nabilone, and nicotine were compared against each other and combined and compared with a placebo, resulting in the region and deviant-dependent effects. Temporal regions of the brain were not affected by coadministration of nabilone and nicotine, while frontal regions showed improved cognitive function. Future research should continue to develop therapies that combine CB1 agonist while minimizing the need for nicotine in order to develop therapies for the dysregulation of sensory and cognitive processes. 

So little is still understood about the interactions of the endocannabinoid system, nicotinic receptors, and the opioid system. If the mechanisms underlying these various systems were well understood perhaps novel therapies could be developed to aid in the treatment of substance abuse disorders. Cannabis poses much less risk for addiction than opioids or nicotine as cannabis does not enact upon the reward system. Cannabis holds promise to lessen the troubles associated with the opioid academic by treating current addicts and preventing future addiction by serving as an adjunct therapy. Further research is needed to validate these hypotheses, but the current data provides hope for more ethical treatment methods.

The study is available for review or download here

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Benjamin Caplan, MDThe Relationship Between Cannabis and Nicotine may Reveal Novel Treatments
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Is Cannabis Safe to Give to Animals?

A survey of veterinary student attitudes concerning whether marijuana could have therapeutic value for animals

In Summary

A recent analysis has compiled the data provided by a questionnaire sent out to veterinarians, reporting an overall belief that animals may benefit from cannabis. Very little research has been conducted concerning cannabis use in animals but some veterinarians fear that cannabis may result in toxic effects in animals. Although there is wariness due to the lack of research, many are still hopeful that cannabis products would provide similar benefits in animals as has been shown in humans. Although they may not recommend cannabis for use veterinarians are urged to educate themselves on the effects of different strains and cannabinoids so they may act according when presented with an animal who has been given cannabis products. 

While some pet owners are purposefully administering cannabis products for their animal’s accidental consumption can be incredibly frightening for some pet owners. Accidental consumption by pets highlights two important happenings that need to occur: pet owners need to ensure they are appropriately storing their cannabis product to prevent accidental consumption by pet or child, and veterinarians need to have a reliable database of knowledge concerning the possible adverse effects of cannabis on animals. Future research may save a family an accidental tragedy by appropriately information vets of their options and how to soothe their animal post-consumption. Research is needed to maintain the responsibility of pet owners and caretakers. 

The study is available for review or download here

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Benjamin Caplan, MDIs Cannabis Safe to Give to Animals?
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Flavonoid Shampoo is Chemical Free and Nourishing

A Completely Polyherbal Conditioning and Antioxidant Shampoo- A Phytochemical Study and Pharmaceutical Evaluation

In Summary

Researchers have recently developed a conditioning shampoo using flavonoids and a foaming agent that nourishes hair and provides antimicrobial effects. Generic storebought shampoos have been found to have detrimental effects on hair follicles and scalp health, often stripping them of their natural oils and causing dryness and irritation. The leaves of Salix babylonica L., Ziziphus spina-christi L. (Willd), and Glycyrrhiza glabra rhizomes were used to make an extract rich in flavonoids and other phenolic compounds. The extract was altered until the ideal microbial effect was found and then combined with a foaming agent, forming the natural shampoo. Future research should continue to develop a line of all-natural cosmetic products for those who are sensitive or wish to avoid chemicals. 

This piece reflects the current trend of the beauty industry and the apparent future of cosmetics as all-natural products. Researchers and estheticians will likely create products that appease trend-followers desire to endorse all-natural products while also enjoying the effects of the products that have been enhanced by modern science. The cannabis industry, will all of the benefits provided by cannabinoids, flavonoids, and terpenes, would do well to capitalize on the rapidly growing and fiercely loyal beauty community by promoting natural products that are as effective as they are trendy. 

The study is available for review below, or in the CED Foundation Literature Archive.

The study is available for review or download here

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Benjamin Caplan, MDFlavonoid Shampoo is Chemical Free and Nourishing
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Oleamide and the Endocannabinoid System Protect Against Excitotoxic Damage

A cannabinoid receptor-mediated mechanism participates in the neuroprotective effects of oleamide against excitotoxic damage in rat brain synaptosomes and cortical slices

In Summary

Oleamide, an endocannabinoid-like compound, has been found to work with the endocannabinoid receptors to protect against excitotoxic damage. Utilizing tryptophan metabolite quinolinic acid to induces the overactivations of N-methyl-D-aspartate receptors (NMDAr), eliciting excitotoxic effects. Various doses of oleamide were given to excitotoxic rats, revealing that oleamide did provide protective effects. Further examination confirmed that oleamide served a protective role by working through the endocannabinoid system. Future research should examine other compounds that could enact neuroprotective effects through the endocannabinoid system. 

Researchers continue to find novel targets for treatment within the endocannabinoid system. Although cannabis is not currently supported for medical use by the federal government the endocannabinoid system has far-reaching possibilities that can still be studied in the meantime. By using compounds like oleamide or other others that work on the endocannabinoid system researchers can determine new targets and therapeutic benefits of the endocannabinoid system. Researchers should continue to push for federally funded projects revolved around the endocannabinoid system as the underlying mechanism is still poorly understood considering the potential it holds. 

The study is available for review or download here

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Benjamin Caplan, MDOleamide and the Endocannabinoid System Protect Against Excitotoxic Damage
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