Adolescents

CB1 and CB2 receptors play differential roles in early zebrafish locomotor development

Scientists found that blocking CB1 receptors and CB2-receptors in young zebrafish resulted in morphological deficits, reductions in heart rate, and non-inflated swim bladders. These findings indicate that the endocannabinoid system is pivotal to the development of the locomotor system in zebrafish, and that disturbances to the endocannabinoid system in early life may have detrimental effects.

The translation of these effects to humans is obviously not direct, but it is important for science to learn about safety and expected effects, to examine how chemistry interacts in petri dishes, how basic organic/animal functions are impacted in a living thing, and when the time is appropriate, to then assess any effects in humans

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Benjamin Caplan, MDCB1 and CB2 receptors play differential roles in early zebrafish locomotor development
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Student-Athletes are at an Increased Risk for Binge Drinking and Substance Use

Title: Psychological correlates and binge drinking behaviours among Canadian youth- a cross-sectional analysis of the mental health pilot data from the COMPASS study

A recent study has examined data from the COMPASS program and found that student-athletes in Canada were more likely to engage in binge-drinking and illicit substance use. Researchers focussed on the measure of flourishing, defined as an overall healthy mental state and emotional connectedness, and how flourishing related to concerning drinking and substance use behavior. Student-athletes were found to be the most at risk for binge-drinking, defined as consuming 5 or more drinks in a single session, and those more likely to binge-drink were also more likely to co-use illicit substances. This research provides evidence for the formation of targeted prevention programs.

Cannabis use is banned among athletes by most sports organizations. Cannabis appeals to athletes considering the many different consumption methods, allowing discreet consumption and personalization with variable potential opportunities for relief. Cannabinoids are generally naturally occurring substances unless clearly manufactured, and have been shown to be beneficial for post-workout recovery, muscle soreness, anxiety, sleep, and relaxation. All of those symptoms, including the emotionally driven ones, are common among student-athletes who often feel an immense amount of pressure to perform in competition. As in most other areas of modern culture, Cannabidiol (CBD) finds itself in a grey area for most sports organizations’ substance regulations given that it is not intoxicating and readily available with a notable safety profile. Even if cannabis is not federally legal, CBD is so widely available that many athletes are embracing it, in lieu of more dangerous, or potentially addictive, medications.

Tweet: A recent study has examined data from the #COMPASS program and found that #studentathletes in Canada were more likely to engage in #binge-drinking and illicit substance use. Read this and other linked studies:

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Benjamin Caplan, MDStudent-Athletes are at an Increased Risk for Binge Drinking and Substance Use
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Surveys show medical professionals’ opinions clashing around Cannabis

Surveys on medical professionals’ opinions on medical cannabis show that while many are still skeptical and do not think it is completely safe, younger doctors and those on the East coast are more supportive. This clash could be good for solving some common concerns with cannabis. http://bit.ly/2XQVxWz

Benjamin Caplan, MDSurveys show medical professionals’ opinions clashing around Cannabis
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A Call for More Research: Adolescent Cannabis Use and Mental Health Risks

Title: Adolescent Cannabis Use and Risk of Mental Health Problems – The Need for Newer Data

Here, an article presenting a case, justifying the need for new research to determine how cannabis use in adolescents may affect their risk for mental health. Few recent studies have come out discussing mental health and adolescent use. This is problematic because, over the years, cannabis products have been curated to be significantly more potent than in the past. Considering how vulnerable the brain is, during adolescence, because it is still developing, longitudinal studies need to be conducted to fully elucidate the effects of cannabis on development. 


This review highlights how poorly adolescents consuming cannabis seem to be at titrating their dose, or correctly self-regulating consumption of cannabis. There is an overall need for greater education before cannabis is acquired, from a dispensary or otherwise. For adults and teens seeking to self-regulate their use of cannabis, irrespective of the consumption method, it is difficult to succeed, considering the gross lack of knowledge and sophistication around the dosage. The wide variability in choice and make-up of cannabis products, added to the complexity associated with how each patient may process the myriad of cannabinoids within the products consumed leads to a complexity of confounding variables, and here, a call for more studies to be conducted on more than just adolescents. 

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Benjamin Caplan, MDA Call for More Research: Adolescent Cannabis Use and Mental Health Risks
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Incidents of Driving Under the Influence of Drugs Reveals A Need for Stricter Regulations

Title: A review of drug abuse in recently reported cases of driving under the influence of drugs (DUID) in Asia, USA, and Europe

A recent literature review has found that the current driving regulations in Asia, Europe, and the US have not prevented cases of driving under the influence of drugs. The authors observed steady trends of incidences of driving under the influence in all three regions, despite legislature specifically enacted against such actions. In the literature, there is a consistent recommendation that drivers should be regularly tested, especially in the case of an accident, in order to gather more data on the role of drugs in traffic accidents. 


This review highlights the different illicit drugs that contribute to traffic accidents, depending on the region of the world. Cannabis is legal in certain areas of Europe, whereas it is still considered an illicit substance here in the US, and many other locations, worldwide. Looking at the differences in severity or circumstance of the accidents between the type of illicit drug used may provide data to create more beneficial regulations for each country. As the legal status of cannabis continues to evolve, and it becomes more common to find drivers on the road who have consumed a minimal amount of cannabis, new screening techniques will likely be developed to help the culture establish what it considers an “acceptable amount” of blood-borne cannabinoids to be.

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Benjamin Caplan, MDIncidents of Driving Under the Influence of Drugs Reveals A Need for Stricter Regulations
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In Vivo Availability of Cannabinoid 1 Receptor Levels in Patients With First-Episode Psychosis

A 2019 study found that patients with early-stage psychotic disorders had lower levels of CB1-R (Cannabinoid Receptor – 1) compared to healthy individuals. These findings suggest that targeting CB1R with cannabis-based products could potentially treat psychotic disorders. Interestingly, reductions in CB1R levels were associated with greater symptom severity and poorer cognitive functioning but only in male patients. More research is needed into the intersections of gender and psychotic disorders.

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Benjamin Caplan, MDIn Vivo Availability of Cannabinoid 1 Receptor Levels in Patients With First-Episode Psychosis
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More Research Needed to Determine Impacts of Cannabis Use During Pregnancy

Cannabis Use in Pregnancy

With rates of cannabis use during pregnancy more than doubling between 2002 and 2017, a need for more studies, over longer periods of time, which investigate prenatal cannabis use has emerged. Existing data ranges from reporting an increased risk for preterm birth and low birth weight to cannabis reducing the risk of preeclampsia and gestational diabetes during pregnancy. Concerns are historically informed by preliminary alcohol and cocaine studies that falsely suggested no gestational harm, despite the eventual recognition that these substances ultimately carry significant risk. Pregnant women should exercise caution in their cannabis use until more definitive conclusions are found, regarding maternal cannabis use.

The decision of where, if anywhere, cannabis fits in relationship to pregnancy is populated with more questions than answers. There are a handful of good quality, long-term studies, to date, that show a pattern that informs some degree of generalization: by and large, the less frequently consumed, and the later during the pregnancy the consumption, the less potential risk. But, for the sake of any pregnant woman and her baby, this type of decision should always be made in direct consultation with the obstetrician supporting the pregnancy.

Additional Point: A lack of high-quality studies relating to cannabis use and gestational risk has resulted in conflicting evidence surrounding prenatal cannabis use. However, historical context involving prenatal alcohol and cocaine use studies informs the need to exercise caution before definitive conclusions are made

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Benjamin Caplan, MDMore Research Needed to Determine Impacts of Cannabis Use During Pregnancy
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Video: Cannabinoids, Internal States, and Anxiety

A new literature review summarizing the recent findings relating to cannabis and anxiety.

Researchers conclude that CBD and low-dose THC can cause relaxation and decrease anxiety and self-spun thoughts. Some studies show that high-dose THC can cause psychotic symptoms; however, studies also show that CBD can protect against those THC-induced symptoms. Therefore, using cannabis extracts with THC and CBD could be a safe way to reduce anxiety. 

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Benjamin Caplan, MDVideo: Cannabinoids, Internal States, and Anxiety
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Stress Increases the Probability of Drug Abuse

The Effects of Trait Emotional Intelligence on Adolescent Substance Use- Findings From a Hungarian Representative Survey

A recent study has revealed that teenagers who have a difficult time managing stress and appear to lack empathy were more likely to abuse tobacco, alcohol, and cannabis.

The studies initial goal was to determine if emotional intelligence could predict future drug abuse, but found that those with more empathy and interpersonal competencies were less likely to engage in substance abuse. This study provides data that may help to develop targeted drug prevention programs in order to lessen adolescent drug abuse or the development of any future substance abuse disorders. 

Highlighted in this study was the possible inaccuracy of the conclusions as the results may have been skewed by teenagers merely providing what they thought was a socially acceptable answer. Despite the fact that the majority of states have legalized the use of medical marijuana a stigma against cannabis use remains.

Stigma has and continues to stand in the way of medical research. If the consumption of cannabis were less frowned upon then perhaps more observational studies, studies that relied on self-reporting use, or even appropriate medical treatment, would be improved. The more information that can be gathered, the more accurate the research that can be conducted. In order to fully understand all the benefits and limitations of cannabinoids, although this also applies to tobacco and alcohol consumption, the uninformed stigma must also be eroded.

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Benjamin Caplan, MDStress Increases the Probability of Drug Abuse
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Pediatric Oncology Center Justifies the Use of Medical Cannabis

Pediatric oncologists from Minnesota recently published an article justifying their use of medical cannabis as palliative care for their patients.

The majority of patients at the oncology center were approved for medical cannabis use during their first round of treatment, in order to immediately address the negative side effects of chemotherapy such as nausea, pain, and cancer cachexia. The data provided from the center described much higher chemotherapy compliance rates among patients, and that patients have a much better quality of life when utilizing cannabis.

This article highlights a few promising trends and issues with using medical cannabis; one promising trend is the hope for cannabis to provide antitumor effects. Cannabis has been a subject of exploration for antitumor effects and it has shown promising results. But, there are many limitations to the few studies that have been published, leading the authors to defer any definitive conclusions. The center in Minnesota noted that many of the patients diagnosed with brain tumors were especially hopeful that cannabis would aid in curing them of cancer, second to utilizing the drug for nausea. This is a promising trend because it means the greater public is showing interest in the therapeutic possibilities of cannabis and their support and call for research will aid the drive for the federal rescheduling of marijuana. 

Also highlighted in this article is that, of all the patients certified to use medical cannabis, a subset of 24% never actually registered through the state to receive it. The authors have no firm explanation for these circumstances but seem to suspect that the $200 annual certification fee, on top of the cost for each additional dispensed product may be limiting of patients abilities to afford cannabis. Without the backing of the federal government, insurance companies are unable to cover medical cannabis. As the depth and reach of cannabis research grow, there are good reasons for patients to feel optimistic about medical cannabis.

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Benjamin Caplan, MDPediatric Oncology Center Justifies the Use of Medical Cannabis
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