Cannabis Use Disorder (CUD)

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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This paper is also stored here:   http://bit.ly/2XGXNLC      inside the CED Foundation Archive

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Benjamin Caplan, MDA Call for More Research: Adolescent Cannabis Use and Mental Health Risks
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Supplementing Antipsychotics with CBD Enhances Psychotic Symptom Treatment

Cannabidiol (CBD) as an Adjunctive Therapy in Schizophrenia: A Multicenter Randomized Controlled Trial

Most schizophrenia medications function by blocking the action of the dopamine D2 receptor and effectively treat positive psychotic symptoms, such as delusions or hallucinations, but fail to treat negative psychotic symptoms, such as lack of motivation or the lack of an ability to feel pleasure. Anecdotal evidence has pointed toward the potential for CBD to attenuate psychotic symptoms in conjunction with normally prescribed antipsychotics; additionally, CBD is not hypothesized to act on the D2 receptor, suggesting that it may afford unique advantages over anti-psychotics.

Researchers interested in further exploring this conducted the first known placebo-controlled CBD trial among schizophrenia patients. Although results did not suggest a potential for CBD to treat negative psychotic symptoms, in conjunction with antipsychotics, the CBD group experienced marked lower levels of positive psychotic symptoms. Both the placebo and CBD groups experienced equal levels of treatment-induced adverse events, suggesting that CBD is well-tolerated.

These results suggest that CBD may be effective in treating not only schizophrenia but also psychotic symptoms associated with Parkinson’s disease and THC-induced psychosis.

Additional Point: CBD has shown to act in a neuroprotective manner and reduce the psychoactive effects of THC, making it a viable option for patients who have experienced negative side effects with THC.

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This paper is also stored here:    http://bit.ly/2WztI04     inside the CED Foundation Archive

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Benjamin Caplan, MDSupplementing Antipsychotics with CBD Enhances Psychotic Symptom Treatment
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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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This paper is also stored here:     http://bit.ly/2JnOpss    inside the CED Foundation Archive

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Benjamin Caplan, MDVideo: Cannabinoids, Internal States, and Anxiety
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Benin Republic Hemp Improves Male Fertility

Cannabinoid-deficient Benin republic hemp (Cannabis sativa L.) improves semen parameters by reducing prolactin and enhancing antioxidant status

Cannabis sativa, specifically Nigerian hemp, has been found to have adverse effects on male fertility. It’s use has been linked to a decrease in semen parameters, germ cell proliferation, and reproductive organ weight. It can induce hyperprolactinemia, a condition causing infertility in 11% of men with low sperm count.

Data from the National Drug Law Enforcement Agency in Nigeria has suggested users preferentially obtaining hemp from the Benin Republic. In a recent study investigating the composition of Benin republic hemp, a lack of THC and lower levels of cannabinol were observed. Additionally, an ethanol extract of Benin republic hemp increased sperm count, morphology, and viability.   

Additional Point: Certain phytocannabinoids found in cannabis have demonstrated a detrimental effect on male fertility. However, analysis of hemp from the Benin republic shows a low to no levels of these toxic cannabinoids and evidence points to this particular hemp enhancing male fertility.

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This paper is also stored here:    http://bit.ly/2Yzc26y     inside the CED Foundation Archive

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Benjamin Caplan, MDBenin Republic Hemp Improves Male Fertility
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Looking for a genetic explanation for “Cannabis Use Disorder”

Genome-wide association study implicates CHRNA2 in Cannabis Use Disorder

Roughly 9% of cannabis users become dependent. In a recent study, scientists identified a significant association between CHRNA2 gene expression and a diagnosis of Cannabis Use Disorder. In other words, genetics might help to explain why some people may find themselves more dependent upon cannabis than others.

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This paper is also stored here:    http://bit.ly/2IVZJvJ     inside the CED Foundation Archive

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Benjamin Caplan, MDLooking for a genetic explanation for “Cannabis Use Disorder”
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Neem Oil vs Cannabinoid Hyperemesis Syndrome

Some people are concerned that Cannabinoid Hyperemesis Syndrome (CHS,) a rare condition involving cyclical vomiting, may be caused by neem oil or pesticides. However, symptoms are more consistent with an overload of CB1 receptors, circumstances that occur primarily with habitual, large-volume consumers. Here, an interesting review of the ongoing public conversation: http://bit.ly/2LepwAV

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Benjamin Caplan, MDNeem Oil vs Cannabinoid Hyperemesis Syndrome
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Case Studies Expose Under Recognition of Cannabis Hyperemesis Syndrome

“Cannabis hyperemesis syndrome: still under-recognized after all these years

After two years of chronic vomiting and pain and dozens of trips to emergency rooms a 23-year-old woman was found to have cannabis hyperemesis syndrome (CHS). Physicians are still unable to recognize the early symptoms of CHS as cannabis use is still in a legal gray area in much of the country. A lack of research, recognition, and trust often prevents a quick diagnosis when an illness is related to cannabis, leading to multiple referrals and invasive tests.

CHS was first described 15 years ago yet it is not frequently recognized in patients. The case study featured in this blog post highlights patients and physicians’ outcry for tolerance and support so that cannabis-related illnesses can be efficiently and effectively engaged.

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This paper is also stored here:    http://bit.ly/2IxMxNx     inside the CED Foundation Archive

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Benjamin Caplan, MDCase Studies Expose Under Recognition of Cannabis Hyperemesis Syndrome
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Capsaicin Cream Treats Cannabinoid Hyperemesis Syndrome in Adolescents

Capsaicin Cream for Treatment of CHS adolescent

Researchers have found that capsaicin cream is an effective and safe method of treating cannabinoid hyperemesis syndrome (CHS) in adolescents. Capsaicin cream has previously been shown to be effective at treating CHS in adults but adolescents have previously been treated with haloperidol, a drug known to have serious side effects. Capsaicin cream offers a much safer and more cost-effective method of treatment for adolescents.

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This paper is also stored here:   http://bit.ly/2F8Gtcc      inside the CED Foundation Archive

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Benjamin Caplan, MDCapsaicin Cream Treats Cannabinoid Hyperemesis Syndrome in Adolescents
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“Liver toxicity” of mice force-fed with unreasonable amounts CBD

Here, an excellent example of how valuable it is for scientific literature to be read critically and thoughtfully. When reporters read, or extract, or convey only partial conclusions, it is all-too-easy for consumers to absorb an incomplete, undigested message. As consumers of journalism, the public deserves a more knowledgeable understanding. Here (http://bit.ly/2KV0jeG), Forbes (Mike Adams) conveys an unfortunate lack of deep consideration in the reporting. Thankfully, a brief quote is conveyed by Dr. Koturbash, who “was quick to point out that the CBD products coming to market may not pose this particular risk” – but this stone-throw of even-handedness falls short to appropriately balance an article already dripping with misgivings and incomplete evaluation of the material at hand.

For a more layered view of the science, the word “gavage,” as was applied to the mice in the study, describes force-feeding animals with a tube down their throats, often taped to mouths which are then kept gaping open. This is meant to simulate the biological processes of eating (different from giving meds IV, for example.) There is no regard to the stress that this process causes the animals, as they are treated as though they are biological CBD-processing machines. In the days where many people are taking 10mg pills of CBD per day, the amounts of CBD that were force-fed to these animals in this study, if translated to humans, would be 4,305mg, 12,915mg, and 43,050mg over 10 days, or 17,220mg, 51,660mg, and 172,200mg in one-shot doses.) For reference, these days, most dispensaries sell CBD in doses of 10mg, 20mg, up to 2-300mg.)

In the study, the authors suggest that they allow animals to eat “ad libitum,” as if to convey that they are treated with a buffet. And yet, the animals being stuffed with 43,050mg (human equivalent) of CBD still lost weight, while others (given 172,200mg (human equivalent) had uneven weight distribution.) To any reader considering these values critically, it must seem absurd to make conclusions about the actions of CBD as what is causing these effects, as if the fact of over-stuffing itself has no impact at all.

An analogy to this study: If you add 17,000 cars (or 172,000!) to a tunnel on the way to the airport, and stuff each car full of way too many people, there might be problematic levels of concern inside that tunnel.

Let’s hope to see more even-handed consideration and reporting from Forbes, in the future.

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This paper is also stored here:    http://bit.ly/2WWNOGA     inside the CED Foundation Archive

Here, another study that shows very different results. Instead of overstuffing mice w/ unrealistic amounts, if one administers CBD at sensible doses in the same population of mice, it turns out that CBD could directly reduce alcohol drinking, improve healthy processes in the liver, and alcohol-related brain damage…

“CBD reduces alcohol-related steatosis & fibrosis in the liver by reducing lipid accumulation, stimulating autophagy, modulating inflammation, reducing oxidative stress, & by inducing death of activated hepatic stellate cells” This new study:

This paper is also stored here: http://bit.ly/2IAvzOz  inside the CED Foundation Archive

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Benjamin Caplan, MD“Liver toxicity” of mice force-fed with unreasonable amounts CBD
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Cannabinoid Hyperemesis Syndrome is Frequently Misdiagnosed as Cyclic Vomiting Syndrome

Association of Marijuana Use and Cyclic Vomiting Syndrome

A recent study has found that a subset of patients diagnosed with Cyclic Vomiting Syndrome actually suffers from Cannabinoid Hyperemesis Syndrome. Cannabinoid Hyperemesis Syndrome is a rare condition that primarily occurs in daily, long-term users of cannabis, more common among males than females. Chronic cannabis consumers should inform their physicians of any illicit drug use, as well as any cannabis consumption, during routine check-ups and/or emergency room visits, to ensure accurate diagnoses can be made.

View this review (yellow link) or download:

This paper is also stored here:   http://bit.ly/2F9YS8u      inside the CED Foundation Archive

To explore related information, click the keywords below:

Benjamin Caplan, MDCannabinoid Hyperemesis Syndrome is Frequently Misdiagnosed as Cyclic Vomiting Syndrome
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