Cannabis

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. 

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Benjamin Caplan, MDThe Effect of Cannabidiol on Alcohol
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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. 

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Benjamin Caplan, MDLong-Term Cannabis Use Can Impair Learning
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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.

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Benjamin Caplan, MDThe Respiratory Effects of Smoking Cannabis
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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. 

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Benjamin Caplan, MDThe Benefits and Limitations of Vaporization
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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.

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Benjamin Caplan, MDNew Opportunities Arise as Cannabis is Legalized in Canada
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Possible Associations Between Recreational Cannabis and Birth Outcomes

The association between the legalization of recreational marijuana and both small for gestational age births and NICU admissions in Colorado

In Summary

Researchers have recently found no evidence that the legalization of recreational cannabis increases the risk for small gestational age (SGA) births but may be linked to neonatal intensive care unit (NICU) admissions immediately post-birth. The study merely looks at the prevalence of both SGA and NICU admissions immediately post-legalization of recreational cannabis in Colorado and claims no causation conclusions can be drawn from the gathered data but did note an increase of 1% of NICU admissions per month immediately following legalization. The rate of the SGA births decreased following the new laws meaning cannabis may not affect the growth of a fetus or could improve development but future research is encouraged to ensure these results and identify possible causation for an increase in NICU admissions, which could be due to a myriad of factors. 

This article serves as a call for research so that patients who take cannabis and fall pregnant are fully aware of the possible risks associated with continuing cannabis use during pregnancy. Currently, most obstetricians and gynecologists advise against cannabis use due to the lack of knowledge concerning cannabis and fetal development but those who fall pregnant and rely on cannabis are often left unaware of alternative options. Considering the uncertainty of the effects of cannabis on pregnancy outcomes and the inconsistency between the few studies currently published more research is definitely needed so that pregnant women can continue to receive safe and effective treatment. 

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Benjamin Caplan, MDPossible Associations Between Recreational Cannabis and Birth Outcomes
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Utilizing Cannabis to Quit Smoking

Randomized Clinical Trials Investigating Innovative Interventions for Smoking Cessation in the Last Decade

In Summary

A recent analysis has found that cannabis-based therapies may prove useful for those attempting to quit smoking. Billions of dollars are spent every year attempting to treat smoking-related conditions yet mortality rates continue to rise, proving the current treatment methods rather ineffective. Researchers thoroughly examined previous clinical studies in a search for more effective treatments and found that the endocannabinoid system provides an ideal target as it not only reduces the desire to smoke but also minimizes the weight gain most addicts fear. Further research is needed as no specific cannabinoid or cannabis-based medicine has proven to be effective without producing negative side-effects, but the few trials that have been conducted have shown promising results. 

The issue this research aimed to address is the prevalence of smoking-related illnesses, highlighting the inability of the medical community to cease all tobacco use. Despite constant warnings and lessons in school concerning the danger of tobacco use new products like e-cigarettes have been made readily available for consumers and marketed on social media to teenagers who follow celebrities like Sophie Turner, an actress rarely seen without her choice of e-cigarette in hand. The tobacco industry is driven by the economy and, despite its proven deleterious effects on users’ health, has yet to be banned on a federal level. Better restrictions need to be put into place to prevent consumers from beginning tobacco use while researchers continue to look for effective treatment methods. 

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Benjamin Caplan, MDUtilizing Cannabis to Quit Smoking
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Safely Marketing Cannabis Products

Marketing of legalized cannabis- a concern about poisoning

In Summary

A recent op-ed has come out to discuss the danger of marketing cannabis edibles as sweet treats or other types of food a child may accidentally consume. The author warns that manufacturers should boldly label their products if it contains tetrahydrocannabinol (THC) and may pose a danger to nearby children. Often-times the recommended dose of a chocolate bar is only a few pieces, but for an adventurous child who wants chocolate, the entire bar may be consumed, resulting in the consumption of a very high dose of THC. The author of the piece calls for serious marketing restrictions for cannabis products, including vaporizer pens that look like e-cigarettes, in countries or states with legal cannabis. 

It’s interesting that this piece highlights the need for better marketing in concern for children’s accidental consumption but does not highlight proper storage for caretakers so that children are unable to access such products. Newer evolutions of cannabis edibles make them more convenient for public use as they are discreet, and taste better than other methods of consumption, which does make them appetizing for children. The marketing restrictions in the united states vary by state considering cannabis is only legal at state levels so each state has its own set of guidelines. What is consistent, is storage recommendations for dangerous substances around children. Like any pharmaceutical, cannabis should be kept out of children’s reach and in a sealed container for safety and freshness. 

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Benjamin Caplan, MDSafely Marketing Cannabis Products
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Further Evidence For Cannabis as an Effective Pain Reliever

Effects of Cannabinoid Administration for Pain- A Meta-Analysis and Meta-Regression

In Summary

A recent meta-analysis has found that cannabis is an effective treatment for those dealing with chronic pain. Researchers analyzed studies that compared cannabinoid-based therapies to placebos, concluding that those therapies served as an effective replacement or adjunctive therapy for more common pain relievers, such as opioids. Some studies included in the analysis disqualified the effectiveness of cannabinoids due to the psychoactive effects of tetrahydrocannabinol (THC) but the featured piece suggests future work should aim to synthesize cannabinoids that highlight cannabis’s analgesic effects while minimizing any psychoactive effects. Future research needs to discover more about the endocannabinoid mechanism within the body before this can occur. 

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.





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Benjamin Caplan, MDFurther Evidence For Cannabis as an Effective Pain Reliever
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Further Evidence for Cannabis as an Antitumor Agent

The heterogeneity and complexity of cannabis extracts as antitumor agents

In summary

 A recent study has exposed the complexity of cannabis extracts as antitumor agents depending on the exact cannabinoid composition and cancer cell line. Researchers utilized whole cannabis extracts, meaning that the extract contains various amounts of cannabinoids, terpenes, and flavonoids produced by the cannabis plant, and found that each extract had various effects depending on cannabinoid composition. It was also found that the antitumor effects were not completely due to ∆-9-tetrahydrocannabinol (THC) as pure THC extracts did not provide the same effects as a whole plant extract. Some extracts were found to have antitumor effects on specific cancer cell lines but further research is needed to specify which ratio of cannabinoid and other chemicals provides the most benefits for each cell line. 

Considering the difficulty of treating cannabis and the horrible side-effects associated with chemotherapy it seems shocking that cannabis-based medications are not more widely accepted for cancer treatments. As cannabis is still classified as a Schedule I under the Controlled Substances Act the federal government can not provide any support for cannabis research which means that current research relies almost entirely on private funding. When examing the emotional and economic toll of cancer patients it seems irresponsible to not fully examine the possible benefits of cannabis-based medications to finally determine if they can provide more benefits than easing the side-effects of chemotherapy such as cachexia, chronic pain, and nausea. 

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Benjamin Caplan, MDFurther Evidence for Cannabis as an Antitumor Agent
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