As cannabis finds its place back into modern human culture quickly, there is much still to be learned. As the science grows and adapts to modern need and expectations, the “can we” may be out-pacing the “should we.” On the other hand, there are circumstances where modern culture really “should be” and is handicapped by years of misinformed stigma.
Here, a few controversial questions about cannabis:
Should teachers be allowed to use cannabis around children?
Should spiritual leaders be allowed to use cannabis, as they have for millennia?
Should taxi drivers be allowed to use cannabis on the job?
Should pilots be allowed to use cannabis?
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Benjamin Caplan, MDVideo: Controversial Questions in Cannabis Today
Title: Novel approaches in clinical development of cannabinoid drugs
A pamphlet has recently been published that highlights new approaches in the clinical development of cannabinoid-based therapies. The pamphlet begins with a look into how current cannabinoids affect patients based on gender, stress, physiological variations, and also delves into how cannabis works on the body in general.
A novel therapy that features an oral version of tetrahydrocannabinol (THC) and a synthetic activator of cannabinoid-receptor-1 (CB1) is explored in this piece and frames it to be a promising future therapy. The pharmacological properties of these two novel therapies were optimized during development after various analysis techniques, forming medications that the authors hope to see in future clinical trials.
Although the authors remain hopeful that their cannabis-based therapies will reach clinical trials soon, trials featuring cannabinoids are difficult to test in a formal setting because of a dire lack of funding. The federal government still lists cannabis as a Schedule I substance, under the Controlled Substances Act, meaning that the federal government does not support the idea that cannabis has any medical use. Considering the legal status of cannabis, only privately-funded studies are able to take place, and unfortunately, that leaves cannabis research in an area of complete bias and prohibitively underfunded. Considering the massive literature supporting a myriad of novel therapeutic benefits, this is a costly reality to the health and well-being of millions.
A recent letter to the editor exposes the large discrepancy between the number of registered medical marijuana patients and those who self-reported medical cannabis use. Estimates given by the National Survey on Drug Use and Health (NSDUH) suggest that 2.5% of Americans over the age of 12 used medical cannabis in 2013-2015 but a study from 2016 found that only 641,176 people were licensed to receive medical cannabis, a prevalence of 0.4%. If the numbers published by the NSDUH are accurate then states may need to delve into how so many people are accessing medical cannabis without proper licensing in order to better regulate the supply. If the numbers are extrapolated to 2019 and include all states where medical cannabis use in legal then more than 6.2 million people should be licensed but may not be.
Medical cannabis can be difficult to acquire due to its cost, post-legalization. Although medical cannabis in Massachusetts is readily available with a large number of dispensaries across the state, the cost of obtaining a doctor’s recommendation, complying with state fees, and then paying for the cannabis at a dispensary can be too much for some patients. Although MA will soon be waving the state fee, to obtaining a license, clinicians are still expensive and without the support of the federal government allowing national insurance companies to cover medical cannabis the costs still add up quickly. Fortunately, some dispensaries are designed to cater to those who need financial support.
Impacts of cannabinoid epigenetics on human development- reflections on Murphy et. al. ‘cannabinoid exposure and altered DNA methylation in rat and human sperm’ epigenetics
An op-ed has praised the work published last year which exposed how pre-conception exposure to cannabis in males is related to alterations in epigenetic regulation of the central nervous and immune systems. Murphy et. al.’s paper ‘Cannabinoid exposure and altered DNA methylation in rat and human sperm,’ revealed that the sperm cells of men who have consumed cannabis are a key vector that may affect neuraxis, heart blood vessels, immune stimulation, secondary genomic instability, and carcinogenesis in the fetus offspring. The author of the response piece extrapolates the data collected by Murphy et. al. to conclude the genome-epigenome is extremely sensitive to environmental toxicants and that further research should examine the epigenomic toxicology of multiple cannabinoids.
The effect of prenatal exposure to cannabis on birth rates, birth outcomes, and the health of the mother is still uncertain. Studies focussing on cannabis use during pregnancy are limited, and what little has been reported, is inconsistent. The featured article now brings to light that bothparents may need to be cautious when attempting to conceive or when having unprotected sex as cannabis may affect both germ cells. Currently, governing bodies of obstetricians advise that pregnant mothers cease any cannabis use so if someone who needs cannabis for a medical purpose that improves their quality of life becomes pregnant they need to seek out alternative methods of treatment. Research is needed so that pregnant women can safely continue their medication or so that alternatives can be found so that women do not need to suffer for the duration of their pregnancy and possible breastfeeding period.
“Among all surveyed consumers, 49% reported reducing their over-the-counter painkiller use since starting cannabis, and 52% reduced prescription drug use. Another 37% said they’ve reduced alcohol consumption since starting cannabis”
Medical marijuana is legal in 33 states, and recreational marijuana is legal in 11. But on a federal level, the use and possession of marijuana is illegal for any purpose. The illegal status of cannabis prohibits research opportunities and hinders the safety of cannabis sales.
Watch this video for 4 reasons to legalize marijuana on a federal level
Benjamin Caplan, MDVideo: Legalization of Cannabis?