Blog

Further Evidence for Cannabis as an Adjunctive Therapy to Opioids

Effects of cannabinoid administration for pain- A meta-analysis and meta-regression

In Summary

A recent meta-analysis provided further evidence that cannabis can be used as a replacement and adjunctive therapy option for opioids. Across all of the studies, it was found that cannabis had a medium-to-large effect on the subjective pain felt. The included studies included a range of given doses, all reported in milligrams and were conducted in various pain models, including Human Immunodeficiency Virus, Cancer, Neuropathic Pain, Diabetes, and more. Further research is needed to standardize an appropriate dose for each condition and ensure the validity of such medications. 

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

View more studies like this in the CED Foundation Archive 

To explore related information, click the keywords below:

Benjamin Caplan, MDFurther Evidence for Cannabis as an Adjunctive Therapy to Opioids
read more

The Effect of Cannabidiol on Alcohol

Effects of Cannabidiol on Alcohol-Related Outcomes- A Review of Preclinical and Human Research

In Summary

A review of preclinical research studies has revealed to possible beneficial effects of cannabidiol on alcohol-related outcomes. It was found that cannabidiol (CBD) is able to lessen alcohol consumption although the mechanism is not well understood. CBD may also protect consumers from the negative effects of alcohol use such as liver and brain damage. It is likely that CBD provides these protective effects through its modulation of inflammatory processes. It is recommended that further research is conducted in order to validate these findings and expand upon the knowledge of how CBD interacts with other common substances. 

As cannabis-based products become more widely accepted among the medical community and within society it is imperative that the interactions between cannabis and other drugs are known. Those who wish to use cannabis for certain ailments but are already on other medications may consume cannabis and experience negative side-effects due to the interaction of those drugs. Cannabinoids, terpenes, and flavonoids need to be modeled alongside other common medications so that physicians can safely recommend medications and so that pharmacists are able to accurately advise customers when they pick up prescriptions. Research is needed to ensure public safety in this time of evolving medications. 

The study is available for review or download only from the original publisher

View more studies like this in the CED Foundation Archive 

To explore related information, click the keywords above:

Benjamin Caplan, MDThe Effect of Cannabidiol on Alcohol
read more

Long-Term Cannabis Use Can Impair Learning

Cognitive, physical, and mental health outcomes between long-term cannabis and tobacco users

In Summary

Researchers have recently compared long-term cannabis and tobacco users, finding that cannabis users had more difficulties learning but better health overall than tobacco users. This study compared tobacco and cannabis users after they had abstained from their chosen substance for 15 hours before running through a myriad of texts. Although it took cannabis users longer to acquire and recall novel information cannabis users reported better psychological, somatic, and general health than tobacco users, as well as lowered stress levels, more similar to controls. Tobacco users were also revealed to have more emotional problems than cannabis users and controls. This research may prove beneficial in the creation of programs that utilize cannabis to aid in the cessation of tobacco use. 

This research, while highlighting the advantages of cannabis use over tobacco use, also emphasizes the negative impact of cannabis on individuals in school. Whether those individuals are enrolled in a high school or upper-level academic program, consistent use of cannabis may prove harmful to their overall performance. Patients should always discuss their concerns with their recommending physicians, and should be mindful of the current gaps in medical knowledge concerning cannabis. This information also does not apply to every cannabis-based product, like most topicals. Topicals, unless high-dose tetrahydrocannabinol patches, generally do not cause psychoactive effects and would, therefore, have no affect learning. More research is needed to fully understand which cannabinoids, doses, and frequency of doses, affect learning so that patients are well informed about their medications. 

The study is available for review or download here

View more studies like this in the CED Foundation Archive 

http://bit.ly/drcaplanTo explore related information, click the keywords below:

Benjamin Caplan, MDLong-Term Cannabis Use Can Impair Learning
read more

Saliva Analysis Relates to Diet, Stress, and the Endocannabinoid System

Biological underpinnings from psychosocial stress towards appetite and obesity during youth- research implications towards metagenomics, epigenomics and metabolomics

In Summary

A recent study has revealed how saliva analysis demonstrates the relationship between diet, stress, and the endocannabinoid system. Stress can be measured by the concentration of cortisol in saliva; an increased concentration of cortisol has been positively correlated to increased activity of the endocannabinoid system which then leads to an increase in appetite. One suggested a mechanism for this occurrence is that the increase in cortisol modulates microbes that regulate endocannabinoids which eventually leads to uncontrolled eating habits. The dysregulation of the endocannabinoid system by stress has therefore been related to obesity and is a promising target for the treatment of obesity.

The authors mention utilizing saliva as a tool to discover the cause of patients’ obesity. By determining the cause in a timely fashion, physicians may be able to recommend more accurate treatment or diet plans to bring patients’ weight back under control. Cannabinoids, in combination with stress-relieving techniques, may also provide an easier method for dropping weight than the more traditional diets that are often difficult to adhere to. Considering the obesity rates in America, especially among adolescents, looking into these alternative therapies for obesity is in the best interest of America’s national health.

The study is available for review or download here

View more studies like this in the CED Foundation Archive 

To explore related information, click the keywords below:

Benjamin Caplan, MDSaliva Analysis Relates to Diet, Stress, and the Endocannabinoid System
read more

The Pain-Relieving Effects of Tetrahydrocannabinol Differ Depending on Age

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

View more studies like this in the CED Foundation Archive 

To explore related information, click the keywords below:

Benjamin Caplan, MDThe Pain-Relieving Effects of Tetrahydrocannabinol Differ Depending on Age
read more

The Respiratory Effects of Smoking Cannabis

A Systematic Review of the Respiratory Effects of Inhalational Marijuana

In Summary

A recent meta-analysis has compiled a list of all known effects of smoking medical cannabis. Smoke is produced when medical cannabis is combusted by a flame, like when users smoke a bowl of flower products. Although fewer carcinogens were found in the smoke produced from cannabis than the smoke produced from cigarettes, those who choose to smoke medical cannabis still put themselves at great risk of developing lung cancer, spontaneous pneumothorax, bullous emphysema, and COPD. The medical benefits like bronchodilation, pain relief, and uplifting feelings are still able to take effect but patients considering smoking cannabis should be made aware of the risks associated with the inhalation of smoke. Other consumption methods such as vaporization, edibles, or topicals pose much less of a health risk to users. 

This article highlights the importance of choosing an appropriate consumption method depending on your ailment. Those suffering from lung cancer or COPD may be less inclined to vaporize their marijuana because of the lung strain, or more inclined to vaporize marijuana to replace a possible cigarette habit. Vaporization occurs at a much lower temperature than combustion, which requires a flame, which provides more efficient delivery of the cannabinoids, terpenes, and flavonoids present in a flower product. Each cannabinoid has a specific vaporization temperature that optimizes the benefits of that cannabinoid and many vaporizers have been designed with the ability to heat up to specific temperatures so that patients can get the most out of their product. Users should discuss the best options for their ailment with their physicians and budtenders.

The study is available for review or download here

View more studies like this in the CED Foundation Archive 

To explore related information, click the keywords below:

Benjamin Caplan, MDThe Respiratory Effects of Smoking Cannabis
read more

The Benefits and Limitations of Vaporization

A Qualitative Analysis of Cannabis Vaporization Among Medical Users

In Summary

Researchers have recently analyzed popular vaping behavior and revealed the advantages of vaporizing medical cannabis. The general advantages of vaporizing medical cannabis include portability, concealability, and efficiency, while the medical advantages like promoting tobacco cessation and it’s quick-acting effects. There are also limitations to vaporization, like technology-use barriers for those who find technology difficult to work with and the cost of such devices. Vaporizing may also prove to be advantageous or disadvantageous for patients depending on their medical condition, meaning that all patients should discuss consumption mechanisms with their physician. 

As the cannabis industry continues to grow various consumption methods become readily available for consumers, each presenting its own benefits and limitations. Patients should thoroughly research the different consumption methods and discuss which method would work best for them. Vaporizers in the featured article were mainly portable but desktop vaporizers are also available and often more efficient. The world of edibles continues to grow and it better for those looking for longer-lasting, stronger, and delayed effects. Tinctures are easy to prepare at home or buy online and are ideal for incorporating into patients’ favorite meals, smoothies, or can be taken sublingually for fast-acting effects and raw cannabinoids. Experimentation is encouraged, just be sure to start at a slow dose and slowly feel out the effects. 

The study is available for review only from the original author/publisher, per their request.

View more studies like this in the CED Foundation Archive 

To explore related information, click the keywords below:

Benjamin Caplan, MDThe Benefits and Limitations of Vaporization
read more

New Opportunities Arise as Cannabis is Legalized in Canada

“Tea” Time? Cannabis Legalization in Canada

In Summary

Last summer an op-ed came out in response to cannabis legalization in Canada discussing the risks and benefits of the legalization. The author acknowledges the myriad of health benefits that cannabis has been shown to treat but also brings forth the gaps in our knowledge that still remain. The piece urges physicians to fully discuss the most current information with their patients when recommending cannabis and for at-home cultivators to carefully manage their plants to prevent underage consumption. The author ends the piece on a hopeful note, mentioning that the only certainty of legalization cannabis is that much more robust research will be able to be conducted and provide more information for the public. 

The author emphasizes the research opportunities that have now opened up in Canada due to the legalization of cannabis, highlighting the limitations of cannabis research in the United States. As cannabis is currently ruled a schedule I drug under the Controlled Substances Act the federal government sees no medical benefit in medical cannabis, despite an abundance of research. Researchers around the world have found evidence that cannabinoids, terpenes, and flavonoids can provide novel therapies for various disorders yet research in the US is still extremely limited by the lack of federal funding. Canada’s decision to legalize cannabis opens the door for so many cannabis-based therapies to be developed, and for economic and healthcare reasons, other countries should follow along.

The study is available for review or download here

View more studies like this in the CED Foundation Archive

To explore related information, click the keywords below:

Benjamin Caplan, MDNew Opportunities Arise as Cannabis is Legalized in Canada
read more

Brief Interventions by Pediatricians can Reduce Adolescent Alcohol and Drug Abuse

Understanding Which Teenagers Benefit Most From a Brief Primary Care Substance Use Intervention

In Summary

A recent study has revealed that brief interventions given by primary care physicians can reduce alcohol and drug abuse among at-risk adolescents. This study aimed to address only alcohol and cannabis use disorders in teenagers who already reported the misuse of such substances. Participants were randomly assigned to receive an intervention from their physician or assigned as controls and then asked about their substance use habits 12 months later. Those who received an intervention reported a marked decrease in substance use through self-reporting and chemical screening. This research suggests that pediatricians and other general practitioners should speak candidly about the risks of substance use disorders with their patients. 

Pieces like the featured article highlight the importance of responsible cannabis use. Cannabis is becoming more socially acceptable as states continue to put forth policies that legalize medical and recreational use. Like alcohol and other drugs, cannabis should remain a semi-controlled substance whose availability is restricted by age or other factors so that at-risk youth are unable or less likely to abuse its benefits. State laws currently decide who has access to cannabis but as at-home cultivators become more prominent it will be necessary to ensure the security of those plants to prevent adolescents from misusing plants grown by family or friends. 

The study is available for review or download here

View more studies like this in the CED Foundation Archive 

To explore related information, click the keywords below:

Benjamin Caplan, MDBrief Interventions by Pediatricians can Reduce Adolescent Alcohol and Drug Abuse
read more

A Cannabinoid-Like Compound Modulates Neuronal Excitability, May Reduce Seizures

The Cannabinoid-Like Compound, VSN16R, Acts on Large Conductance, Ca2 -Activated K  Channels to Modulate Hippocampal CA1 Pyramidal Neuron Firing

In Summary

Researchers have recently found a cannabinoid-like compound, VSN16R, which is able to modulate Ca2+– activated potassium channels and may reduce seizure severity. By hyperpolarizing the neurons through the opening of Ca2+– activated potassium channels VSN16R ultimately results in the reduction of hyperexcitability seen in individuals who suffer from seizures. The compiled data reveals that cannabinoids or compounds structurally similar to cannabinoids may prove useful in the treatment of seizures or epileptic disorders, similar to the cannabinol-based Epidiolex® medication for rare forms of epilepsy, reducing the chance of a seizure or minimizing its duration. Further research is needed to aid the development of more readily available cannabis-based therapies for seizure activity and more general forms of epilepsy. 

Highlighting in this article are the options for treatment that the endocannabinoid system provides us, even in the absence of naturally occurring cannabinoids. If structurally similar compounds like VSN16R are able to be synthesized and proven effective, it could mean novel therapies could be developed even while red tape surrounds cannabis. The endocannabinoid system affects a myriad of systems within the human body and is severely under-researched considering its potential. Epidiolex® is the only cannabinoid-based medication currently approved by the federal government but cannabis has shown promise in so many other areas where the current treatment is either ineffective or lacking. Research utilizing the endocannabinoid system as a target should continue and be pushed to the forefront of the medical community.

The study is available for review or download here

View more studies like this in the CED Foundation Archive 

To explore related information, click the keywords below:

Benjamin Caplan, MDA Cannabinoid-Like Compound Modulates Neuronal Excitability, May Reduce Seizures
read more