Mental Health

Variations in Genes Influences Cannabis’ Acute Effects on Behavior

CNR1 and FAAH variation and affective states induced by marijuana smoking

A recent study has revealed that variations within cannabinoid receptor 1 (CBR1) and fatty acid amide hydrolase (FAAH) influences cannabis’ acute effects on affect. Variations of CBR1 and FAAH are known to be associated with cannabis dependence. The current study now adds that the variations in genes also affect an individual’s behavior when ingesting cannabis. The results of this study provide useful information for understanding an individual’s motivation for marijuana use, as well as risks and associated behaviors.

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Benjamin Caplan, MDVariations in Genes Influences Cannabis’ Acute Effects on Behavior
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Recently Identified Mechanism of Chronic Stress-Induced Pain

Chronic Stress Is Associated with Pain Precipitation and Elevation in DeltaFosb Expression

Researchers have identified Delta-FosB, an osteosarcoma viral oncogene, as a useful molecular marker of sustained pain. The expression of Delta-FosB is significantly elevated by stress-induced pain, exposing its role in the adaptability of nerves. This study supports theories that Delta-FosB plays an important role in drug addiction, depression, and stress adaptation. The interaction between stress, depression, and pain is something that is not yet well-understood. But, as we learn more about cannabis-based medicine, many of the age-old questions about pain have become much clearer.

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Benjamin Caplan, MDRecently Identified Mechanism of Chronic Stress-Induced Pain
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Medical Marijuana and Treatment of Pediatric Epilepsy Patients

Medical Marijuana in the Pediatric Population With Epilepsy—What You Should Know

A recent review has discussed the known benefits of treating children who are suffering from epilepsy with cannabis-based medicine. Medical marijuana (MM) is a viable option for treating this population that comes with risks due to the high that comes from THC and its legal status as a Schedule 1 drug. The legal status is currently preventing larger scale research to be done so that physicians can better educate parents on how to care for a child taking MM.

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Benjamin Caplan, MDMedical Marijuana and Treatment of Pediatric Epilepsy Patients
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Video: Cannabis, Cannabinoids, and Sleep: a Review of the Literature

Researchers published a literature review that investigates the relationship between cannabis and sleep. They examined six major sleeping disorders: insomnia, sleep apnea, REM behavior disorder, nightmares, sleep with chronic pain, and daytime sleepiness.

They found that THC might worsen daytime sleepiness and delayed onset of sleep; however, THC might help patients who suffer from sleep apnea and nightmares. Meanwhile, CBD might reduce daytime sleepiness and insomnia while increasing the total amount of sleep.

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Benjamin Caplan, MDVideo: Cannabis, Cannabinoids, and Sleep: a Review of the Literature
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Evidence for Therapeutic Benefits of Cannabidiol, Including Treatment of Ischemic Strokes

Therapeutic Potential of Non-Psychotropic Cannabidiol in Ischemic Stroke

Cannabidiol (CBD) has a unique therapeutic profile as it has a cannabinoid receptor-independent mechanism, limited side-effects, and patients do not seem to develop an insurmountable tolerance. Research currently focussed on the therapeutic benefits of CBD has demonstrated long-lasting neuroprotective properties against global and focal ischemic injury, such as ischemic stroke. This piece points to CBD as a major component of cannabis-based medicine as a non-psychoactive component. Further research is needed to evaluate the full clinical capabilities of CBD, including its neuroprotective effect.

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The US patent on Cannabinoids as Antioxidants and Neuroprotectants, from 1999: https://patents.google.com/patent/US6630507B1/en

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Benjamin Caplan, MDEvidence for Therapeutic Benefits of Cannabidiol, Including Treatment of Ischemic Strokes
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The Education of Dispensary Staff is Varied and Lacks Regulation

Training and Practices of Cannabis Dispensary Staff

How much medical training does your local budtender possess? An online survey sent to medical marijuana dispensary staff reported only 55% of staffers had any formal training for their position, with 20% reporting some background in medical/scientific training. The analysis reported that many among the dispensary staff are recommending cannabis choices that are consistent with current evidence, but some are recommending strains that are either ineffective or exacerbate a patient’s condition. The findings of this study stress the importance of consistent and well-regulated training of dispensary staff.

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Benjamin Caplan, MDThe Education of Dispensary Staff is Varied and Lacks Regulation
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High-potency cannabis and incident psychosis: correcting the causal assumption

Scientists offer a strong counter-position to the belief that cannabis causes psychosis, pointing out the difference between correlation and causation. They argue that smoke exposure from any source (including cigarettes) could explain the reported link between cannabis and psychosis. 

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Benjamin Caplan, MDHigh-potency cannabis and incident psychosis: correcting the causal assumption
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Cannabidiol (CBD) as an Adjunctive Therapy in Schizophrenia: A Multicenter Randomized Controlled Trial

A 2018 study showed that, for patients with schizophrenia, adding CBD to ongoing antipsychotic treatment reduced psychotic activity, as compared to placebo add-on

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Benjamin Caplan, MDCannabidiol (CBD) as an Adjunctive Therapy in Schizophrenia: A Multicenter Randomized Controlled Trial
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Cannabinoids in Attention- Deficit/Hyperactivity Disorder: A randomized-controlled trial

In a placebo-controlled study of a cannabis oral spray in patients with ADHD, there was no significant improvement in cognitive performance, but there was a significant improvement in hyperactivity and impulsivity.

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Benjamin Caplan, MDCannabinoids in Attention- Deficit/Hyperactivity Disorder: A randomized-controlled trial
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Alcohol Hangover Has Detrimental Impact Upon Both Executive Function and Prospective Memory

In a study that excluded cannabis users, researchers found that alcohol hangovers significantly impair both executive function (paying attention, regulating emotions, etc.) and prospective memory (remembering future plans).

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Benjamin Caplan, MDAlcohol Hangover Has Detrimental Impact Upon Both Executive Function and Prospective Memory
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