Cognition

The Effect of Chronic Cannabis Use on Volumetric Alterations in Brain Regions

Title: Neuroanatomical alterations in people with high and low cannabis dependence

A recent article has been published revealing some volumetric alterations in specific brain regions in people who report dependence on cannabis. Magnetic resonance imaging revealed that the volume of certain regions, including the hippocampus, the cerebellum, and the caudate, in cannabis dependent users, were all reduced in size, relative to recreational cannabis users who did not use cannabis chronically. Future research will likely focus on the effects of the structural alterations on patients’ reward, stress, and addiction-relevant circuitry to examine the possible relevance of cannabis dependance on those circuits. 

There are certainly possibilities that suggest this volume difference could be of concern, but there are also a great number of explanations (more than likely) whereby this is related to another variable that we have not yet fully appreciated.

Currently, cannabis use is thought to have a little-to-no risk of addiction (beyond any “normal” product of medical value, such as coffee or eyeglasses), because it does not act directly on the reward circuit. Opioids have a high risk of addiction, and therefore a concerning safety profile, in part because of the direct effect of the opioid system on the reward pathway of the central and peripheral nervous systems. While the endocannabinoid system has been observed to act directly up the reward circuit, it does so in subtle, soft ways, making it an ideal adjunct therapy for opioids to help with pain management. Current research provides inconsistent results and appropriately emphasizes a need for more testing to validate the possibility of cannabis as a recommended pain medication. 

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Benjamin Caplan, MDThe Effect of Chronic Cannabis Use on Volumetric Alterations in Brain Regions
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Video: Do-It-Yourself Cannabis Tinctures

One of the terrific realities of modern Cannabis is that it is possible, and often quite simple, to make effective products at home. With suitable education and access to testing facilities, the soil, nutrients, and plant growth can be supported at home, lab-tested for make-up and potency, as well as safety-checked for potential microscopic contaminants, and ultimately, individualized medicine can be created right at home!

Here is a sample instructional for just one way that cannabis tincture can be made at home. There are countless others and hopefully, many that are yet to be discovered!

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Benjamin Caplan, MDVideo: Do-It-Yourself Cannabis Tinctures
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Hangovers Resulting from Drinking Negatively Impact Everyday Memory

Alcohol Hangover Has Detrimental Impact Upon Both Executive Function and Prospective Memory

A recent study revealed that alcohol hangovers negatively impact everyday memory, specifically executive function (EF) and prospective memory (PM). EF and PM are cognitive functions that underpin everyday memory; things such as remembering an appointment or where you placed your keys. Participants of the study who suffered from hangovers were able to recall significantly fewer items from memory tasks than their peers. The findings of this study may prove useful when looking into how alcohol and cannabis interact with patients.

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Benjamin Caplan, MDHangovers Resulting from Drinking Negatively Impact Everyday Memory
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The Current Research on Cannabis-Alcohol Interactions and Risk Factors for Using Them Together

Title: Cannabis and Alcohol- From Basic Science to Public Policy

This new analysis summarizes the most recent preclinical trials and epidemiological studies concerning the interactions between cannabis and alcohol, as well as possible risk factors for co-use. Specific risk factors, such as frequency of use or belonging to particular groups, were found to be significant within studies (but not across separate studies.) The compiled data reveals that previous research is inconsistent and emphasizes the need for further research to elucidate at-risk populations.  


This article highlights a few secondary findings which all focus on the gaps in our knowledge concerning cannabis, of which there are many. There may be potential concerns with the integration of cannabis into modern culture, which has essentially normalized alcohol consumption. Future research will undoubtedly evaluate these concerns, and highlight potential advantages that cannabis consumption may offer as an alternative option.

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Benjamin Caplan, MDThe Current Research on Cannabis-Alcohol Interactions and Risk Factors for Using Them Together
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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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Benjamin Caplan, MDA Call for More Research: Adolescent Cannabis Use and Mental Health Risks
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Incidents of Driving Under the Influence of Drugs Reveals A Need for Stricter Regulations

Title: A review of drug abuse in recently reported cases of driving under the influence of drugs (DUID) in Asia, USA, and Europe

A recent literature review has found that the current driving regulations in Asia, Europe, and the US have not prevented cases of driving under the influence of drugs. The authors observed steady trends of incidences of driving under the influence in all three regions, despite legislature specifically enacted against such actions. In the literature, there is a consistent recommendation that drivers should be regularly tested, especially in the case of an accident, in order to gather more data on the role of drugs in traffic accidents. 


This review highlights the different illicit drugs that contribute to traffic accidents, depending on the region of the world. Cannabis is legal in certain areas of Europe, whereas it is still considered an illicit substance here in the US, and many other locations, worldwide. Looking at the differences in severity or circumstance of the accidents between the type of illicit drug used may provide data to create more beneficial regulations for each country. As the legal status of cannabis continues to evolve, and it becomes more common to find drivers on the road who have consumed a minimal amount of cannabis, new screening techniques will likely be developed to help the culture establish what it considers an “acceptable amount” of blood-borne cannabinoids to be.

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Benjamin Caplan, MDIncidents of Driving Under the Influence of Drugs Reveals A Need for Stricter Regulations
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False Memory Formation Does not Differ between Cannabis Users and Controls

Title: False memory formation in cannabis users- a field study

This new study has revealed that although cannabis use does not increase the rate of false memory acquisition, cannabis use did increase the uncertainty of participants. It was also determined that intoxicated cannabis users were less accurate when recognizing true events, providing evidence that cannabis intoxication hinders memory formation.

This research provides a basis of knowledge for those interviewing people under the influence of cannabis for legal proceedings to determine the validity of their statements. If cannabis intoxication increases the uncertainty and liberal answers provided by users then their statements should be used sparingly or well-corroborated. 


This research highlights the importance of understanding cannabis for legal proceedings. More and more state governments are legalizing medical and recreational cannabis, each year, increasing the amount of those eligible to legally consume cannabis. As cannabis use continues to climb in popularity, witnesses or others interviewed in legal settings may not provide the most accurate information. Acute cannabis use should be a consideration related to legal proceedings so that the users’ statements can be weighed appropriately.  

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Benjamin Caplan, MDFalse Memory Formation Does not Differ between Cannabis Users and Controls
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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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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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Benjamin Caplan, MDVideo: Cannabinoids, Internal States, and Anxiety
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