All posts tagged: Cannabis Dependence

Adolescent Cannabis Use Linked to Sleep Disturbances

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.

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

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Benjamin Caplan, MDAdolescent Cannabis Use Linked to Sleep Disturbances
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Reducing Cannabis Use Equally Effective as Abstinence in Treating Cannabis Use Disorder

Reduction in Cannabis Use and Functional Status in Physical Health, Mental Health, and Cognition

In a survey of 111 cannabis use disorder (CUD) patients with abstinent, low use, or heavy use of cannabis, similar benefits were experienced by patients who reduced their use to zero or low use. Both groups exhibited significantly better outcomes than the heavy use group with respect to overall health, appetite, and depression. According to the study, CUD patients “who used cannabis at a low level did not differ from the abstinent individuals in any of the functional outcome measures.” With a relatively small subject population, it is challenging to know if this is applicable to broader audiences, but regardless, It is likely to open up some new treatment option for CUD patients.

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

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Benjamin Caplan, MDReducing Cannabis Use Equally Effective as Abstinence in Treating Cannabis Use Disorder
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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. 

View this review (yellow link) or download:

This paper is also stored here:    http://bit.ly/2K5JNYn     inside the CED Foundation Archive

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Benjamin Caplan, MDThe Effect of Chronic Cannabis Use on Volumetric Alterations in Brain Regions
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5 Benefits of Vaping Cannabis (vs smoking)

Within the inhalation method of consuming cannabis, there are many different ways one can inhale it.

The ancient way was almost always to smoke it. In the modern era of cannabis consumption, there are many more popular and advanced ways to consume either flower or concentrates:

  1. “Desktop” models that may use electricity for amplified power,
  2. Portable models that are more useful for inhalation-on-the-go,
  3. Cartridge-based “vape pens” to vaporize potent concentrates in a simple mechanism.

In short time, we will likely see adoption of (and a quickly massive rise in popularity of) aerosolization and nebulized cannabis consumption too!

Are the benefits of vaping strictly limited to cannabinoids? Certainly not.

Are the benefits of vaping even limited to terpenoids? Certainly not.

What else is there? Flavonoids.

And still more? Combinations of these that create entirely new results!

Benjamin Caplan, MD5 Benefits of Vaping Cannabis (vs smoking)
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Cannabis: Vaporizing vs Smoking

Smoking cannabis brings toxins and unhealthy combustion byproducts into the body. With temps in the ~2000’F range for flame, burning flower incinerates a large portion of the product being consumed. As the distance from the point of flame grows, temperatures are lower, and cannabinoids are vaporizing, in addition to being burned by the flame. Over time, as heating technology has improved, there is no longer a need for blasting temperatures way beyond what the material can safely sustain before turning to tar and ash.

Beyond developed habits of consumption, social familiarity, and simplicity of use, one of the reasons many enjoy combustion is the other effects of heat. As with any human contact with extreme heat, blood rushes to the source of heat, and this may present a platform, through which cannabinoids may enter the bloodstream more quickly. The extravagant heat is also aerosolizing many more cannabis compounds than vaporization temperatures typically support, so the effect of flame is often felt to be more intense.

Vaporizing cannabis, however, is less likely to introduce mutations in the polyphenol compounds found in abundance within cannabis, and some of the mutations create terrible molecules known to be caustic and destructive.

If the medical rationale for vaporizing (over combustion) is not convincing, please consider the financial argument: Though purchasing a vaporizer may be costly, it’s a smart investment that could save money in the long run. Learn more by watching this video:

Benjamin Caplan, MDCannabis: Vaporizing vs Smoking
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Can specific, isolated Cannabinoids reduce Cannabis Dependency?

Using cannabis to decrease dependency on cannabis? An Australian study shows promise using Nabiximols to target receptors and diminish the rate of relapse. The spray of equal parts CBD and THC had regular smokers smoking 19 fewer days than those on placebo

The News article: http://bit.ly/2YbSrN1

View this review (yellow link) or download:

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

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Benjamin Caplan, MDCan specific, isolated Cannabinoids reduce Cannabis Dependency?
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Standardized Registries may Improve Our Knowledge about Cyclic Vomiting Syndrome

Title: Cyclic vomiting syndrome- Pathophysiology, comorbidities, and future research directions

A recent article has called for the establishment of a multicenter registry in order to learn more about cyclic vomiting syndrome and related disorders. Creating such a registry would provide a database of patients for clinical trial recruitment, research on patient outcomes across different treatment methods, the underlying mechanism for the disorder, and the ability to identify potential biomarkers for the disorder. The registry would expand our understanding of the disorder, on all fronts, and hopefully, reveal the most effective treatment method. 


Could such a registry be created while still safeguarding patient privacy?


Highlighted in this article is the similarity of cyclic vomiting syndrome and cannabinoid hyperemesis syndrome (CHS). CHS is often misdiagnosed or goes undiagnosed for an exorbitant amount of time. By creating this registry for cyclic vomiting syndrome and related disorders, including CHS, the same information about genetics, underlying mechanisms, and effective treatments could also be determined.

Finding a genetic basis for cannabinoid hyperemesis syndrome would support patients looking into cannabis-based medicine to decide if cannabis would even be an effective treatment, by allowing them to discover possible side effects to which they might be more susceptible.

View this review (yellow link) or download:


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


See the full available literature on Cannabinoid Hyperemesis Syndrome here: http://bit.ly/2XHfdrI


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Benjamin Caplan, MDStandardized Registries may Improve Our Knowledge about Cyclic Vomiting Syndrome
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More Research Needed to Determine Impacts of Cannabis Use During Pregnancy

Cannabis Use in Pregnancy

With rates of cannabis use during pregnancy more than doubling between 2002 and 2017, a need for more studies, over longer periods of time, which investigate prenatal cannabis use has emerged. Existing data ranges from reporting an increased risk for preterm birth and low birth weight to cannabis reducing the risk of preeclampsia and gestational diabetes during pregnancy. Concerns are historically informed by preliminary alcohol and cocaine studies that falsely suggested no gestational harm, despite the eventual recognition that these substances ultimately carry significant risk. Pregnant women should exercise caution in their cannabis use until more definitive conclusions are found, regarding maternal cannabis use.

The decision of where, if anywhere, cannabis fits in relationship to pregnancy is populated with more questions than answers. There are a handful of good quality, long-term studies, to date, that show a pattern that informs some degree of generalization: by and large, the less frequently consumed, and the later during the pregnancy the consumption, the less potential risk. But, for the sake of any pregnant woman and her baby, this type of decision should always be made in direct consultation with the obstetrician supporting the pregnancy.

Additional Point: A lack of high-quality studies relating to cannabis use and gestational risk has resulted in conflicting evidence surrounding prenatal cannabis use. However, historical context involving prenatal alcohol and cocaine use studies informs the need to exercise caution before definitive conclusions are made

View this review (yellow link) or download:

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

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Benjamin Caplan, MDMore Research Needed to Determine Impacts of Cannabis Use During Pregnancy
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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.

View this review (yellow link) or download:

This paper is also stored here:    http://bit.ly/2WztI04     inside the CED Foundation Archive

To explore related information, click the keywords below:

Benjamin Caplan, MDSupplementing Antipsychotics with CBD Enhances Psychotic Symptom Treatment
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