Legal and Regulatory Issues Governing Cannabis and Cannabis-Derived Products in the United States
In Summary
A research article has come out describing the medical and legal history of medical cannabis as well as the challenges cannabis-based medicine will face in the coming years. This piece is a comprehensive summary of the modern history of cannabis, its medical purposes, the national and state difference in legal status, as well as the interactions between federal and state governments and how they address illicit cannabis use. Rounding out the article is the encouragement from the author for other researchers to develop cannabis-based medications, such as the successful Epidiolex®.
Highlighted by this piece is the success of cannabinol (CBD) and the potential for proving cannabis medically beneficial without utilizing tetrahydrocannabinol (THC). Cannabis plants are host to a myriad of chemicals that have been revealed as promising therapies for various ailments, including the cannabinoids cannabigerol (CBG), cannabinol (CBN), and terpenes such as beta-caryophyllene, Linalool, and limonene. Developing therapies like Epidiolex®, which has been approved by the federal government, will help prove the medical benefits that cannabis plants provide and hopefully lead to the support of the federal government and rescheduling of cannabis.
The study is available for review or download here
Cannabis sativa L. extract and cannabidiol inhibit in vitro mediators of skin inflammation and wound injury
In Summary
A recent study has revealed the effectiveness of cannabidiol (CBD) and cannabis extracts in the inhibition of skin inflammation. CBD was proven to be just as effective in the inhibition of inflammatory processes as the cannabis extract, proving that CBD is the main powerhouse behind the effects of the extract. Researchers determined that CBD was mediating the inflammation by inhibiting the nuclear factor-kappa B (NF-κB) pathway. By understanding the mechanism behind CBD’s inhibition of inflammatory processes researchers have a solid foundation to develop novel therapies for inflammatory skin conditions.
This report emphasizes the beneficial effects of different cannabinoids and how isolating those compounds may prove more useful than whole chemical components of cannabis. Cannabinoids have a myriad of effects and interact with mechanisms differently meaning that they provide a myriad of therapeutic benefits. By isolating each cannabinoid and elucidating its effect novel therapies could be developed that utilize the effects of one cannabinoid while discarding undesired effects of a separate cannabinoid, tailoring each therapy for specific ailments.
The study is available for review or download here
Cognitive functioning following long-term cannabidiol use in adults with treatment-resistant epilepsy
In Summary
A recent study has revealed that the cognitive function of adults taking cannabidiol (CBD) to treat their treatment-resistant epilepsy (TRE) was not affected by long-term use. Analysis of the study revealed no correlation between cognitive change scores and CBD dose, nor was there a correlation between change in seizure severity and cognitive test performance. Cognitive dysfunction commonly occurs comorbidly to TRE so it is important to note CBD has yet to show the ability to repair cognitive function but it will not further hinder cognitive function.
This post highlights the limitations of research for cannabis despite CBD being approved by the FDA to treat rare forms of epilepsy. This is because of a lack of a control group, which would be provided by adults not suffering from TRE but consuming the same dose of CBD or by adults suffering from TRE but not taking medication. If cannabis, or even just CBD, were supported for medical use at the federal level researchers would be able to create much more efficacious treatments within a more rapid time-frame.
The study is available for review or download here:
Cannabidiol inhibits sucrose self‐administration by CB1 and CB2 receptor mechanisms in rodents
In Summary
A recent study has uncovered cannabidiol’s (CBD) potential for treating psychiatric disorders characterized by binge eating and preventing the development of obesity. Researchers found that the administration of CBD in rodents reduced the self-administration of sucrose. Although clinical studies are needed to provide further evidence, the current data provide solid evidence for a novel treatment for the reduction of binge eating and development of obesity via a mechanism within the endocannabinoid system.
This article highlights the lack of treatment for obesity despite its prevalence among American society. Currently, there are no successful pharmacotherapies for obesity so the promising aspects of CBD as treatment warrant further research. CBD lowers the activity of the reward system in response to food, much like how it is thought to interact with opioids, and would, therefore, prevent people from seeking out food to engage in dangerous behavior.
The study is available for review or download here:
A systematic review of cannabidiol dosing in clinical populations
In Summary
A recent systematic review has revealed the need for dose-ranging clinical studies to provide a more definitive therapeutic range of cannabidiol (CBD). The review covered studies that showed clinical effectiveness for the treatment of epilepsy, anxiety, graft-versus-host disease, and a variety of others. CBD was found to be more effective at higher doses than lower doses in most cases, with few exceptions. Although CBD has been recognized to treat a slew of disorders phase III clinical trials that identify the most effective therapeutic range are severely lacking.
This study highlights the issue of dosing and why it has been so difficult to dose cannabis products. As cannabis is not recognized as having any medical value at the federal level it has been difficult to conduct research as there have been no federally funded studies. Cannabis contains a variety of cannabinoids and each cannabinoid would have to be tested separately and then in combination with each other, depending on the product, in order to elucidate dosing. The quicker cannabis is rescheduled by the federal government the quicker the pharmacy industry can supply definitive answers.
The study is available for review or download here:
“Short- and Long-Term Effects of Cannabis on Headache and Migraine “
In Summary:
There are many headache and migraine medications on the market that advertise how they can make you feel better. But what happens when they make you feel worse? Medication overuse headaches occur in 15% of patients taking conventional migraine medication, so it’s no surprise that people are looking for alternatives that bring them relief without reduced risk.
A team of physicians from Washington University wanted to see if cannabis could be a contender. By reviewing data from about 2,000 patients who logged the details of their smoking sessions with the app StrainPrint, researchers were able to see if inhaling cannabis Flower or concentrate could be a solution for headache and migraine relief. They learned that there was, in fact, good reason to be hopeful for the herb.
While concentrates did have a larger reduction in severity rating, there haven’t been enough studies to say it is certainly better than Flower. Overall, inhaled cannabis reduced the severity of migraines and headaches by 50%. Some patients did report needing to use a larger dose for future sessions, indicating the development of tolerance, but the severity of the headaches or migraines wasn’t getting worse or more frequent like what can happen with conventional medications.
In a time when plant-based and all-natural medicines are becoming more sought out, it’s exciting to see medical cannabis is being considered more seriously as a contender. With the positive results from this study, and similar related work will hopefully encourage more physicians (and patients) to explore this centuries-old option.
Here’s an argument for the need for accountability in #cannabisindustry. What is sold ought to be closer to what is advertised. Is government regulation the solution? 3rd party transparency? Individual accountability? Court of public opinion?
Kudos @abbierosner for this moving piece in CBD Today, “SENIORS, CBD, AND THE LAWS OF ATTRACTION” The article reviews an evolving #CBD playing field, the fears, the market, and a few sprinkled quotes by Dr Laurie Vollen, @JamiePaz, and me!
Starting with the 2014 Farm Bill, and continuing with the 2018 Farm Bill, we have seen a dramatic shift in the landscape governing hemp. Prior to 5 years ago, hemp production was entirely illegal, as the Federal government handled industrial hemp the same as it handled high-THC marijuana. It was an established Schedule 1 controlled substance, entirely illegal to grow, harvest, or possess.
As awareness has grown, and the true benefits of the hemp plant have become more widely understood, the federal government has passed legislation to decriminalize hemp. However, although it is no longer considered a controlled substance, the questions about the process and regulatory requirements abound. This is because all plants grown in the United States are highly regulated by the United States Department of Agriculture, or the USDA, which has a complex framework of licensing, reporting, and general requirements for every specific product grown in the country.
Last week, the USDA published the draft of its regulations
for the hemp industry. Since the 2018 farm bill, we have been living in the
“wild west” for hemp. As promised, the USDA released its rules in time for
farmers to get legal and licensed for the 2020 season. However, this
long-awaited release has been met with mixed results.
Many lawmakers and industry leaders are happy that the
federal government has finally put out regulations for hemp. First, they see
this as a dramatic shift from the era of prohibition, alone a cause for
celebration. Others see the certainty that we are going to have regulations put in place means that the industry will start to
grow and develop at a much faster pace. It is certainly true that the future is extremely
bright for hemp. But other farmers and individuals have expressed concerns with
some of the regulation’s details.
The “0.3% THC” limit, which delineates the difference
between legal “hemp” and illegal “marijuana”, may be too stringent for some
growers. They report that a mature hemp plant will have a THC content that will
vary from day to day, including some spikes over the 0.3% limit. The new
regulations require strict testing to be done prior to harvest, and if the
resulting THC content is too high, the entire crop must be destroyed. This may
cause farmers to harvest before true maturity, leading to a decrease in the
potency or effectiveness of the CBD derived from such a harvest.
The regulations also allow the states to develop their own plans
and submit them for approval. Some are concerned that some states may try to
infringe on the interstate commerce occurring there, which could cause all
kinds of problems and complications for the industry. Still others are worried that
the method for disposing of “hot crops” requires just a little too much DEA
involvement, which could also cause disruption or have a chilling effect on
growth.
It is clear that these regulations are a good step in the right direction. It’s also clear that this is just the beginning, and there is still plenty of room for improvement. The USDA announced a 60-day window for submitting public comments, and then they will consider any suggestions, and then publish a final rule in the future. I encourage you to read the regulations or a summary of them. I encourage you to think about how you would be affected by these rules, and what suggestions you may have. Speak to an expert about how you can do your part to improve the landscape of the industry for the future.
