Citizen Science

Sex differences in the anxiety effects of cannabinoids

In overarching trends, one pattern that is seen in the medical literature is a greater tendency for males to be more likely to develop drug abuse disorders than female counterparts, whilst females are more likely to develop anxiety disorders than male counterparts.

Of course, these trends are merely observational patterns in the current literature, which represents a biased perspective of biased subjects, and certainly not etched in stone. Further, many people do not conform to one pre-determined organization system as simple as gender to help educate whether they would be likely to develop drug dependence or anxiety, and even others don’t conform to a single gender. So, a sizeable grain of salt must be taken with what we understand from this literature.

That given, the relevant punch line here is what role might cannabis play in inducing or reducing anxiety across sexes, and how does cannabis might relate to addiction/dependence.

We are still at early stages of these important questions, but one recent study found, that female rats were significantly more likely than male rats to experience anxiety when given large doses of cannabis.

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This paper is also stored here:    http://bit.ly/2J15XdL     inside the CED Foundation Archive

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Benjamin Caplan, MDSex differences in the anxiety effects of cannabinoids
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The Cannabinoid System is a Promising Source of Targets for Treating Pain

A Budding Source of Targets for Treating Inflammatory and Neuropathic Pain ECS

The cannabinoid system provides momentum to develop cannabinoid-based medications to treat inflammatory and neuropathic pain as researchers continue to find promising therapeutic targets. These new targets may lead to the formation of novel pain-relief medications that may serve well to alleviate pain for those suffering from cancer, multiple sclerosis, and fibromyalgia. Cannabis-based pain medicine is also being researched for opioid-sparing effects and effectiveness in reducing the necessary dose of opioids.

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

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Benjamin Caplan, MDThe Cannabinoid System is a Promising Source of Targets for Treating Pain
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Cannabidiol May Provide Novel Treatment for Rare Ovarian Cancer

Dramatic response to Laetrile and cannabidiol (CBD) oil in a patient with metastatic low grade serous ovarian carcinoma

A recent case study has examined a patient’s response to the consumption of cannabidiol (CBD) as a treatment for a rare type of ovarian cancer. Rather than participate in chemotherapy, which has been shown to only be effective in 5% of patients with low grade serous ovarian carcinoma, an 81-year-old decided to take a combination of amygdalin and CBD. Although CBD has only been shown to have effective anti-cancer properties in murine models the featured patient reported a significant decrease in tumor size, revealing that CBD may, in fact, be an effective treatment for patients looking into alternative care methods.

Although proven ineffective, the use of amygdalin highlights alternative therapies derived from naturally occurring chemicals found in common plants. Flavonoids and terpenes are chemical components of cannabis plants, also found in a variety of fruits and vegetables, that are just now being investigated for their therapeutic benefits. The results of those inquiries may prove useful for similar patients suffering from illnesses that are resistant to the usual treatments.

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Benjamin Caplan, MDCannabidiol May Provide Novel Treatment for Rare Ovarian Cancer
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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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Benjamin Caplan, MDCase Studies Expose Under Recognition of Cannabis Hyperemesis Syndrome
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Characteristics of Canadians likely to try or increase cannabis use following legalization for non-medical purposes

In October 2018, recreational cannabis became legal in Canada. And in 2019, researchers asked nearly 20 thousand Canadians over the age of 15 about their cannabis habits. The survey found that 1 in 5 Canadians plan on trying or increasing cannabis use following legalization for non-medical purposes, particularly those who are younger, who have used cannabis in the past 3 months, and who have a higher income. To ensure responsible cannabis use and informed decision-making, clinicians and policy-makers should pay close attention to these higher risk populations.

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

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Benjamin Caplan, MDCharacteristics of Canadians likely to try or increase cannabis use following legalization for non-medical purposes
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Prospective analysis of safety and efficacy of medical cannabis in a large, unselected population of patients with cancer

In a study of 2,970 cancer patients, researchers determined that cannabis as a palliative treatment seems to be well tolerated, effective and a safe option to help patients cope with cancer-related symptoms.

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Benjamin Caplan, MDProspective analysis of safety and efficacy of medical cannabis in a large, unselected population of patients with cancer
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Pregnant women are using more cannabis over time

Statistics show that in the past 15 years, the number of pregnant women using marijuana, especially in their first trimester, has risen greatly. These numbers may be slightly skewed, but they show the importance of more research being done on the effect of cannabis on pregnant women. https://cnn.it/2WWQV1e

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Benjamin Caplan, MDPregnant women are using more cannabis over time
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Vaping cannabis among adolescents: prevalence and associations with tobacco use from a cross-sectional study in the USA

Out of 2,835 high school students from North Carolina, 272 students (or 9.6%) reported ever vaping cannabis. Interestingly, the odds of ever vaping cannabis were significantly higher among males (11.0%) compared with females (8.2%), and significantly higher among non-Hispanic white students (11.3%) compared with non-Hispanic black students (5.0%).

It’s clear that white males are the most likely to have ever vaping cannabis. Why might minority students engage less with recreational drug use?

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Benjamin Caplan, MDVaping cannabis among adolescents: prevalence and associations with tobacco use from a cross-sectional study in the USA
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CED Foundation Archive

This week, CED Foundation added 77 more #cannabis studies, & 50 about #flavonoids. Read & search for free, and please consider uploading so that others may enjoy the materials you have! This week’s folder: http://bit.ly/2KYfOCF For the whole archive: http://tinyurl.com/MMJarchive

Benjamin Caplan, MDCED Foundation Archive
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Video: Cannabidiol as a suggested candidate for treatment of Autism Spectrum Disorder

This 2018 review summarizes the available data regarding the safety and effectiveness of medical cannabis in young ASD patients. Here’s our video adaptation:

  • Autism spectrum disorder (ASD) defines a group of neurodevelopmental disorders that are frequently associated with general cognitive deficits
    • DSM-5 criteria of ASD include:
      • A. Persistent deficits in social communication and social interaction
      • B. Restricted, repetitive patterns of behavior, interests, or activities
      • C. Symptoms must be present in the early developmental period
      • D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
      • E. These disturbances are not better explained by intellectual disability or global developmental delay
    • ASD is frequently accompanied by co-morbidities:
      • sleep disorders
      • attention-deficit/hyperactivity disorder (ADHD)
      • Psychosis
      • Anxiety
      • mood and cognitive disorders
      • epilepsy
    • Despite it being one of the most severe chronic childhood disorders with relatively high prevalence, morbidity and impact on the society, no effective treatment for the core symptoms of ASD is available yet.
    • There is increasing interest in cannabinoids, especially cannabidiol (CBD), as monotherapy or add-on treatment for the core symptoms and co-morbidities of ASD.
  • CBD Use for Epilepsy
    • 20-30% of people with ASD also suffer from epilepsy
    • Surveys conducted among parents of children suffering from epilepsy suggest improvement following treatment with CBD-enriched cannabis extracts. These results however, do not necessarily apply when it comes to treating adults with epilepsy (Alexander et al., 2009).
    • Still, in a retrospective study that examined the effect of CBD enriched medical cannabis oil on children with intractable epilepsy, the treatment caused a reduction in seizure frequency in 89% of patients (Tzadok et al., 2016).
  • CBD Use in Psychiatry
    • CBD in Psychosis
      • In some cases, psychosis can be a comorbidity of ASD, with the simultaneous onset of schizophrenia at adolescence or early adulthood (Sagar et al., 2013).
      • Ineffective
        • A 2006 study that investigated the influence of CBD as monotherapy in treatment-resistant schizophrenia found that it was ineffective (Zuardi et al., 2006).
      • Effective
        • But a 2018 study showed that, in patients with schizophrenia, adding CBD to ongoing antipsychotic treatment resulted in greater antipsychotic activity and beneficial effects, as compared to placebo add-on (Mcguire et al., 2018).
    • CBD and Anxiety
      • Many ASD patients suffer from anxiety disorders that harm their quality of life (Gu, 2017; Haan et al., 2008; Perrin, 2011).
      • CBD may possess anxiolytic effects both in animals and humans (Bergamaschi et al., 2011).
      • When tested in humans, CBD showed an anxiolytic effect in patients that suffer from social anxiety disorder (SAD), contrary to THC that may induce anxiety (Devinsky et al., 2014).
    • CBD, mood and cognitive disorders
      • It was previously shown that a variety of psychiatric co-morbidities may occur in ASD patients, the most common one being mood disorders (Ghaziddin and Zafar, 2008).
      • Risks of THC
        • THC use may be associated with onset or aggravation of depression, bipolar disorder, mania and psychosis (Rong et al., 2017).
        • THC administration may also result in memory impairment (Ranganathan and Souza, 2006; Rong et al., 2017).
      • Benefits of CBD
        • On the other hand, CBD possesses agonistic activity at the 5-HT1A serotonin receptor and shares similar mechanisms with lithium. These pharmacological properties may indicate its potential role in the treatment of mood disorders (Rong et al., 2017).
        • Therapeutic CBD properties were investigated for cognitive deficits as well. In a preclinical study that tested the effect of CBD on cognition in an Alzheimer’s Disease mouse model (APPxPS1), chronic CBD treatment reversed the cognitive deficits without affecting anxiety-related behaviors (Cheng et al., 2014).
    • CBD and sleep disorders
      • Sleep disorders are highly prevalent among children with ASD.
      • In the general population insomnia is the most common sleep complaint, and treatment with medical cannabis may be effective, especially when the insomnia is associated with pain (Gates et al., 2014).
      • It has been claimed that long term use of cannabis may induce sleep disturbances (Gates et al., 2014). however, a case series indicated that CBD treatment may actually improve the quality of sleep in Parkinson’s disease (Chagas et al., 2014).
    • CBD and ADHD
      • ADHD is one of the most common psychiatric co-morbidities in young ASD patients (Ghaziddin and Zafar, 2008), with comorbidity rates in the range of 40-70% (Antshel et al., 2016).
      • In a pilot randomized placebo-controlled experimental study of a cannabinoid medication (an oral spray containing 1:1 ratio of THC:CBD) in adults who suffer from ADHD, there was no significant improvement in the cognitive performance, but there was a significant improvement in the hyperactivity, impulsivity and inhibition measures after the treatment with the medical cannabis (Cooper et al., 2017).
    • The role of cannabis use for social behavior
      • Risks
        • Some studies show that THC administration may lead as well to a reduction in social interaction in rats, while co-administration of CBD seems to attenuate this effect (Malone et al., 2009).
      • Benefits
        • On the other hand, in a study that tested the influence of marijuana smoking on healthy human volunteers, subjects reported retrospectively that while smoking marijuana they were happier, friendlier and calmer, responded more warmly to others, seemed to have a better understanding of their peers’ state of mind and were less likely to respond angrily or defensively. However, they had a harder time focusing and paying attention to what others said (Galanter et al., 1974).
        • CBD Use for Children
    • The administration of cannabinoids for children and adolescents suffering from ASD is a controversial legal and ethical issue (Khalil, 2012).
      • Risks
        • Those who oppose the use of medical cannabis in pediatrics claim that this treatment might harm young children and adolescents’ brain development.
      • Benefits
        • In the field of pediatric mental illnesses, CBD is sometimes used as a treatment for anxiety disorders. In a case report describing a 10-year-old girl who suffered from PTSD after being sexually abused, it was reported that CBD treatment reduced her anxiety and improved her sleep (Shannon, 2016).
  • Conclusions
    • The use of cannabinoids in general and CBD in particular in the treatment of numerous medical and mental conditions, including ASD, is growing rapidly.
    • There certainly is a big gap in the field and such studies are needed before drawing any conclusions on the potential therapeutic applications of cannabinoids in ASD.
    • Further pre-clinical and clinical studies are needed in order to examine the pros and cons of CBD and other cannabinoids in ASD, before they are established as a treatment for ASD symptoms and co-morbidities.

View this review (yellow link) or download:

This paper is also stored here:   http://bit.ly/2FfC5rQ      inside the CED Foundation Archive

To explore related information, click the keywords below:

Benjamin Caplan, MDVideo: Cannabidiol as a suggested candidate for treatment of Autism Spectrum Disorder
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