Mental Health

  1. home
  2. blog
  3. Mental Health

More Research on Adolescent Cannabis Use and Mental Disorders

May 14, 2020 , ,

The persistence of the association between adolescent cannabis use and common mental disorders into young adulthood

In summary

Further examination of chronic cannabis use in adolescents correlates with a higher prevalence of anxiety. Research discussing adolescent cannabis use and mental disorders has been inconsistent, mainly debating whether or not some mental disorders are caused by cannabis use. The featured article found no evidence of causation but did notice a positive correlation between chronic (described here as daily) adolescent cannabis use and the development of anxiety. The development of major depressive disorders was not positively correlated with cannabis use, even in regular users. Causation, especially for psychosis, should continue to be looked into in order to determine the full safety profile of cannabis-based medications. 

Adolescent cannabis use does seem risky when considering that cannabis directly affects the brain while the brain is still developing and very few researchers have published well recognized and accepted data discussing the effect of cannabis on neural development. It seems interesting that chronic cannabis use is positively correlated to the development of anxiety when the most abundant non-psychoactive cannabinoid and multiple terpenes are praised for their anxiolytic effects. Research into the effect of each chemical component of cannabis should be researched to fully elucidate which cannabinoid or combinations of cannabinoids, terpenes, etc., cause alternations in neurodevelopment and other effects. 

The study is available for review or download here

The-persistence-of-the-association-between-adolescent-cannabis-use-and-common-mental-disorders-into-young-adulthoodDownload

View more studies like this in the CED Foundation Archive 

To explore related information, click the keywords below:

Benjamin Caplan, MDMore Research on Adolescent Cannabis Use and Mental Disorders
read more

Cannabis Legalization in Canada will Minimally Impact Emergency Departments

May 8, 2020 , , ,

Planning capacity for mental health and addiction services in the emergency department- a discrete-event simulation approach

In summary

A study published in June of 2019 has revealed the forecast for emergency department visits based on the current opioid crisis in Canada and the legalization of cannabis. Researchers observed an increase in the number of emergency department visits at hospitals in Canada, specifically for mental health addiction complaints. It was determined that the opioid crisis will continue to cause issues for emergency departments but that the legalization of cannabis will cause a minimal amount of issues due to the low-risk of addiction. While forecasting the effects of addiction-related emergencies researchers determined that there would be increased waiting times and the length of stay will deteriorate. It is recommended that Psychiatric Emergency Service Units increase their number of beds and that programs aimed at preventing alcohol and opioid addiction will be especially helpful for managing the future influx of patients. 

The opioid crisis is ravaging more than just the emergency rooms in Canada, extending all over North America. Opioids are incredibly dangerous considering their high risk of addiction, often leading to people illegally obtaining opioids or other illicit drugs like heroin. Opioids most commonly act on µ-opioid receptors which affect the reward pathway in the central nervous system, preventing pain and convincing the body that opioids are a great substance. Some doctors are all too willing to overprescribe opioids for chronic pain or during recovery periods leading many to begin their lifelong addiction. Considering the economic cost of dealing with addicts, the emotional cost to families and caretakers, and the promise of cannabis as an anti-nociceptive, the federal government should seriously consider rescheduling cannabis so that it can be more seriously considered as an adjunct or replacement therapy for pain.

The study is available for review or download here

Planning-Capacity-for-Mental-Health-and-Addiction-Services-in-the-Emergency-Department-A-Discrete-Event-Simulation-Approach-1Download

View more studies like this in the CED Foundation Archive 

To explore related information, click the keywords below:

Benjamin Caplan, MDCannabis Legalization in Canada will Minimally Impact Emergency Departments
read more

Long-Term Cannabis Use Can Impair Learning

April 2, 2020 , , ,

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. 

The study is available for review or download here

Cognitive-physical-and-mental-health-outcomes-between-long-term-cannabis-and-tobacco-usersDownload

View more studies like this in the CED Foundation Archive 

http://bit.ly/drcaplanTo explore related information, click the keywords below:

Benjamin Caplan, MDLong-Term Cannabis Use Can Impair Learning
read more

Medical Cannabis for Adults Over 50

December 22, 2019 , , , , , , , , , , , , , , , , , , , ,

In Summary:

As with all elements of the aging process, the human endocannabinoid system loses tone over time. Whether it is a reduction in the numbers of cannabinoid receptors or a slow waning of the machinery used to create the signaling molecules that bind to the receptors or the natural senescence of the system that supports all of these normal signaling processes, the fact remains that adults over 50 are best-suited for external support for the endocannabinoid system.

Indeed, the average age at dispensaries is surprising to most who are not familiar with the modern medical cannabis arena. Baby Boomers, perhaps more than any other age group, tend to dominate the medical cannabis dispensaries. This is no new phenomenon, however. Through the ages, across cultures and around the globe, cannabis has been consumed primarily by older adults. Whether by tribe elders, wise councilmen, spiritual leaders, or the educated elite, cannabis has been an integral part of human aging for as long as we have recorded history.

Here, a review out of Israel followed at 184 patients over 65 (average age was 81.2) beginning cannabis treatment. 63.6% were female. “After six months of treatment, 58.1% were still using cannabis. Of these patients, 33.6% reported adverse events, the most common of which were dizziness (12.1%) and sleepiness and fatigue (11.2%). Of the respondents, 84.8% reported some degree of improvement in their general condition.”

Appropriately, the authors advise caution for older adults related to those adults who may be consuming multiple pharmaceuticals, for potential medication interaction effects, as well as nervous system impairment, and increased cardiovascular risk for those who may quire the concern. Wisely, they recommend that “Medical cannabis should still be considered carefully and individually for each patient after a risk-benefit analysis and followed by frequent monitoring for efficacy and adverse events.”

Dr. Caplan and the #MDTake:

At CED Clinic, we have long seen that the average age of medical patients is over 50. Whether for concerns related to sleep, pain, mental or physical health, it seems as though Baby Boomers have either weathered enough politics to have developed a healthy cynicism for the misinformation campaigns of the 1930s and 1970s, or they have direct or indirect experience with cannabis to have learned of its safety and efficacy. Either way, it is quickly reclaiming its historical place in the care of older adults, although oddly… it seems to be a demographic skipped over by the marketing systems of most establishments in the cannabis arena, at least for now.

suggested dose for elderly and cannabis
direction of action for cannabis treatments
bar of significant improvement with cannabis

View this review (yellow link) or download:

Medical Cannabis for Older Patients—Treatment Protocol and Initial ResultsDownload

This paper is also stored here:    http://bit.ly/2QbJ6yE     inside the CED Foundation Archive

To explore related information, click the keywords below:

Benjamin Caplan, MDMedical Cannabis for Adults Over 50
read more

Cannabinoids Further Demonstrate Therapeutic Potential in Interactions with Adrenaline and Serotonin Systems

November 7, 2019 , , , , , , , , , , , , , , ,

Regulation of noradrenergic and serotonergic systems by cannabinoids: relevance to cannabinoid-induced effects

In Summary:

Among many system-wide interactive effects, the noradrenergic and serotonergic hormone/signaling systems are responsible for pain, mood, arousal, wakefulness, learning, anxiety, and feelings of reward. A recent review dives deeper into the interactions between cannabinoids and these two systems: cannabinoids play roles in exciting, inhibiting, and regulating the nerve activity and feedback of both the noradrenergic and serotonergic systems. This data further underscores the therapeutic potential of cannabis for conditions such as depression, chronic pain, and insomnia, all of which are mediated, at least in part, by these systems. Further research may uncover more specific therapies targeted toward the noradrenergic and serotonergic systems and their interactions with cannabinoids.

Dr. Caplan and the #MDTake:

It would be shocking to imagine that, in addition to the usual fruits and vegetables on display at supermarkets, all of a sudden, there was a new category of healthy food. Similarly, the recognition that cannabinoids play a central role in animal physiology is embarrassingly recent. Surveying a sea of illnesses that have become increasingly common, over the last hundred years, before which cannabis was a common household product, also begs the question about a relationship between the circumstances. Might some of the common maladies of modern medicine be attributable to a cannabinoid deficiency syndrome?

A Schematic overview for regulation of NA/LC and 5-HT/DRN cells by the CB1 receptor
Neurochemical Evidence for cannabinoid-induced effects
Electrophysiological evidence for acute effects of cannabinoids on neuronal activity
Neurochemical evidence for cannabinoid-induced effects in the locus coeruleus
Functional evidence fo cannabinoid-induced effects
Electrophysiological evidence for acute effects of cannabinoids

View this review (yellow link) or download:

Regulation of noradrenergic and serotonergic systems by cannabinoids: relevance to cannabinoid-induced effectsDownload

This paper is also stored here:      http://bit.ly/2pS3mMn    inside the CED Foundation Archive

To explore related information, click the keywords below:

Benjamin Caplan, MDCannabinoids Further Demonstrate Therapeutic Potential in Interactions with Adrenaline and Serotonin Systems
read more

Adolescent Cannabis Use Linked to Sleep Disturbances

September 9, 2019 , , , , , , , , , , , , , , ,

Sleep Disturbances, Psychosocial Difficulties and Health Risk Behavior

Summary info:

A Dutch study investigated sleep disturbances in adolescents. Sleep disruption was linked to cannabis use, psychosocial difficulties, health risk behavior, and increased suicidality. Additionally, gender disparity in results suggests that girls may be more susceptible to sleep disturbances than boys , a result consistent with past recognition of some gender discrepancies in cannabis activity. These results highlight the importance of discouraging haphazard cannabis use, during adolescence, and the need for further gender-focused research surrounding sleep habits and cannabis use.

Dr Caplan, CED Foundation, and the #MDTake:

There are a few important issues that converge in this review. Generally, the question of adolescents’ use, (as an alternative way of describing the question of effects on a developing brain.) Also, this paper raises valuable questions about how cannabis may be interacting with sleep hygiene, for better or for worse. Psychosocial impact and risky behaviors are very complex topics to engage, even with a fairly large population sample of (n=16,781.) There are lots of intercorrelated topics assessed, analyzed, and discussed in the review, and it is all-too-easy to want to find causal patterns that are not apparent, again for better or worse, unless one chooses to construe the results or interpretation with causation in mind. Realistically, it is very likely to find overlap in a population of adolescents who have psychosocial difficulties, engage in risky behaviors, have increased risk of suicidality, and consume cannabis. To point to one of the components, arbitrarily, as the primary cause of the others is to unnecessarily and unjustly oversimplify a complex set of circumstances. The essential tenet, different genders seem to react differently with cannabis, is an excellent take-away, and also that we have much more still to learn.

View this review (yellow link) or download:

Sleep Disturbances, Psychosocial Difficulties and Health Risk BehaviorDownload

This paper is also stored here:    http://bit.ly/314TsEC     inside the CED Foundation Archive

To explore related information, click the keywords below:

Benjamin Caplan, MDAdolescent Cannabis Use Linked to Sleep Disturbances
read more

Psychiatric Disorders Reduce Survival Among Immune-Mediated Inflammatory Disease Patients

September 4, 2019 , , , , , , , , , , , , ,

Psychiatric comorbidity increases mortality in immune-mediated inflammatory diseases

Summary Information:

A new study finds that a diagnosis of depression, anxiety, and/or bipolar disorder increases mortality rates for patients of one of three immune-mediated inflammatory diseases (IMID):

1) multiple sclerosis (MS), or

2) inflammatory bowel disease (IBD), or

3) rheumatoid arthritis (RA).

Depression and bipolar disorder can cause poor health behaviors in patients, as depression, bipolar disorder, and anxiety disorders are “associated with increased inflammation and immune dysregulation.” Suicide risk and attempts are increased among IMID patients with mental illness, compared with IMID patients who are not also suffering from one of these additional battles. Given that cannabis has shown promise in treating both inflammation and a range of psychiatric disorders, there is reason to be optimistic for further cannabis research to uncover multifunctional treatment options.  

Dr Caplan and the #MDTake:

Clinically, it’s rare to see medical patients who have only one concern. Sure, there are some who are hoping that cannabis will help them to treat seizures, headaches, anxiety, sleep troubles, or terrible back pain, but more often, it is a combination of several troubles that each add to a cumulative tipping point.

Naturally, very few individual systems act alone. When a body part is injured, sleeping (or not sleeping) effects the course of illness. Similarly, feeling less anxious, or improving sleep, may make symptoms of a struggle with consistent headaches seem more tolerable. Even when there aren’t direct connections between symptoms, a treatment which implements a systemic treatment can have multiplied benefits.

Many patients have found that cannabis offers them a way to attack more than one problem, with a single actor. Some with Diabetes are finding that some formulations are not only helping them reduce blood sugar levels, but also reducing appetite. Similarly, some patients with ADD are turning to cannabis options which may help them focus, without their ability to get to sleep at night.

To a related note, many elderly patients are treated with too many medications. Modern Western medical treatment often compels patients into silos of treatments by isolated specialists, who are not always monitoring the patient as a being beyond individual organ systems. Medications, such as cannabis, which have the opportunity to treat more than one system, without multiplying the risk of potential drug-drug interactions presents a much safer approach to care

View this review (yellow link) or download:

Psychiatric comorbidity increases mortality in immune-mediated inflammatory diseasesDownload

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

To explore related information, click the keywords below:

Benjamin Caplan, MDPsychiatric Disorders Reduce Survival Among Immune-Mediated Inflammatory Disease Patients
read more

Medical Marijuana Offers Benefits Comparable to Prescription Medication, Without the Side Effects

August 2, 2019 , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Title: Preferences for Medical Marijuana over Prescription Medications Among Persons Living with Chronic Conditions: Alternative, Complementary, and Tapering Uses

In a survey of 30 patients using medical cannabis for a range of diseases including rheumatoid arthritis, cancer, hepatitis C, PTSD, among others, patients reported an array of benefits they have reaped from cannabis use. Patients successfully used cannabis in several ways: as an alternative to prescription medication, complementarily with prescription medicine, and to gradually replace use of prescription medication.

Benefits described by participants included the effects of cannabis lasting longer than that of opioids, lower risk of addiction, fewer side-effects. Patients also saw their sleep, anxiety, appetite, and adverse reactions improve with the use of medical cannabis. Larger, more controlled studies may suggest cannabis more affirmatively as an alternative or complementary therapy with prescription medications.

View this review (yellow link) or download:

Preferences for Medical Marijuana over Prescription Medications Among Persons Living with Chronic Conditions: Alternative, Complementary, and Tapering UsesDownload

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

To explore related information, click the keywords below:

Benjamin Caplan, MDMedical Marijuana Offers Benefits Comparable to Prescription Medication, Without the Side Effects
read more