All posts tagged: Case Study

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.

View this review (yellow link) or download:

This paper is also stored here:   http://bit.ly/2Jt1Nfa      inside the CED Foundation Archive

To explore related information, click the keywords below:

Benjamin Caplan, MDThe Current Research on Cannabis-Alcohol Interactions and Risk Factors for Using Them Together
read more

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. 

View this review (yellow link) or download:

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

To explore related information, click the keywords below:

Benjamin Caplan, MDA Call for More Research: Adolescent Cannabis Use and Mental Health Risks
read more

The Endocannabinoid System may Provide Biomarkers for Endometrial Cancer

Title: Identification of Novel Predictive Biomarkers for Endometrial Malignancies- N-Acylethanolamines

A recent study has demonstrated that specific members of the endocannabinoid system may serve as potential biochemical markers for endometrial cancer. Elevated levels of two products of the endocannabinoid system (N-palmitoylethanolamine and N-arachidonoylethanolamine), reflect the production of endometrial tumors.

By screening for elevated levels of those substances, it may be easier for physicians to more quickly recognize the possible presence of endometrial tumors, leading to a potentially sooner diagnosis and intervention. Further research should be conducted to see if there is an even stronger connection between the dysregulation of the endocannabinoid system and endometrial cancer. 


This study highlights the far-reaching arms of the endocannabinoid system that are still so poorly understood. Until the federal government supports the research of cannabis and helps the general public to recognize it as a medically useful substance, research will continue to be limited and stifled. Government-sponsored research is required to boost the growing data that is currently limited by a reliance on private funding. State governments continue to legalize medical marijuana and recognize the medical and economic benefits of cannabis-based medicines. As local legislature demonstrates the success of medical cannabis programs, many patients continue to look to the federal government to follows suit, to further support our fellow citizens in need. 

View this review (yellow link) or download:

This paper is also stored here:    http://bit.ly/2XHXX5n     inside the CED Foundation Archive

To explore related information, click the keywords below:

Benjamin Caplan, MDThe Endocannabinoid System may Provide Biomarkers for Endometrial Cancer
read more

Maintain a Balanced Diet when Consuming Oral Cannabidiol

Title: Food effect on pharmacokinetics of cannabidiol oral capsules in adult patients with refractory epilepsy

Researchers have recently revealed the importance of maintaining a balanced diet, when consuming cannabidiol (CBD). Consuming oral capsules containing CBD may be a more consistent method of consumption than blending CBD into liquids or solid foods, but unfortunately, capsules do not prevent a high degree of potential fluctuation of dosing. The fat content of a meal may vary widely, and so may change the active concentrations of CBD which become active in the bloodstream. In other words, the effects felt by a consumer may be either stronger or weaker, and differ in duration, related to the method of consumption, and the product make-up taken. Patients considering CBD as a therapeutic intervention, who also want a consistency of effect, would be wise to be mindful to maintain a diet with a balanced amount of fat (oils, butter, etc.) when consuming CBD capsules. 


This article highlights the variation of effects felt when altering consumption methods. For example, edibles and inhaled cannabinoids of the same dosage have extremely different effects, because of how they are processed in the body processes. When inhaled, tetrahydrocannabinol (THC) diffuses across structures in the lungs known as alveoli, and are then transmitted to circulate throughout the bloodstream. Edibles introduce THC into the system by first metabolizing with liver enzymes, resulting in an altered metabolite of THC circulating throughout the body. This subtly-altered metabolite of THC can be more potent than the starting material, although the onset is delayed due to the process of consumption, digestion, and metabolism. All consumers would do well to research their consumption method of choice and proceed carefully when switching between methods. 

Tweet: Researchers have recently revealed the importance of maintaining a balanced #diet when consuming #cannabidiol (#CBD). Learn more at

View this review (yellow link) or download:

This paper is also stored here:    http://bit.ly/2Ju8KfY     inside the CED Foundation Archive

To explore related information, click the keywords below:

Benjamin Caplan, MDMaintain a Balanced Diet when Consuming Oral Cannabidiol
read more

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

To explore related information, click the keywords below:

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

Herbal Treatments may prove valuable to treat Alzheimer’s Disease

Promising Therapeutics with Natural Bioactive Compounds for Improving Learning and Memory — A Review of Randomized Trials  

A recent review has determined that herbal treatments, such as those including flavonoids, are beneficial when attempting to prevent neurocognitive decline, commonly seen in Alzheimer’s Disease. Galantamine, quercetin, examples of two flavonoids, as well as huperzine A, bacoside A, and ginkolide B, three flavonoid-like compounds, all proved to be effective when used as a treatment for poor memory function. The authors mention the need for similar results in clinical trials but find the current data compelling evidence for future drug development. 

Highlighted in this paper is the current perception of herbal products as natural, gentle, and safe in comparison to current synthetic drugs. While herbal products are generally safer and considered to be more gentle, it is important to note that for these herbal compounds to truly be effective when treating patients they likely need modification in order to optimize their benefits. The modification would increase potency, selectivity, and pharmacokinetic abilities, as well as lessen any possible side effects. Synthetic drugs may seem frightening, particularly in light of recent illnesses and mortality associated with their abuse, but technology can also be used to optimize novel drugs and it can be efficient to do so. 



View this review (yellow link) or download:

This paper is also stored here:     http://bit.ly/2Xtu8u5    inside the CED Foundation Archive

To explore related information, click the keywords below:

Benjamin Caplan, MDHerbal Treatments may prove valuable to treat Alzheimer’s Disease
read more

Stress Increases the Probability of Drug Abuse

The Effects of Trait Emotional Intelligence on Adolescent Substance Use- Findings From a Hungarian Representative Survey

A recent study has revealed that teenagers who have a difficult time managing stress and appear to lack empathy were more likely to abuse tobacco, alcohol, and cannabis.

The studies initial goal was to determine if emotional intelligence could predict future drug abuse, but found that those with more empathy and interpersonal competencies were less likely to engage in substance abuse. This study provides data that may help to develop targeted drug prevention programs in order to lessen adolescent drug abuse or the development of any future substance abuse disorders. 

Highlighted in this study was the possible inaccuracy of the conclusions as the results may have been skewed by teenagers merely providing what they thought was a socially acceptable answer. Despite the fact that the majority of states have legalized the use of medical marijuana a stigma against cannabis use remains.

Stigma has and continues to stand in the way of medical research. If the consumption of cannabis were less frowned upon then perhaps more observational studies, studies that relied on self-reporting use, or even appropriate medical treatment, would be improved. The more information that can be gathered, the more accurate the research that can be conducted. In order to fully understand all the benefits and limitations of cannabinoids, although this also applies to tobacco and alcohol consumption, the uninformed stigma must also be eroded.

View this review (yellow link) or download:

This paper is also stored here:   http://bit.ly/2YB4dgE      inside the CED Foundation Archive

To explore related information, click the keywords below:


Benjamin Caplan, MDStress Increases the Probability of Drug Abuse
read more

Cannabinoids have Opioid-Sparing Effects on Morphine Analgesia

Opioid-Sparing Effects of Cannabinoids on Morphine Analgesia- Participation of CB1 and CB2 Receptors

Researchers have recently provided evidence that synthetic cannabinoids are able to work synergistically with morphine to provide maximum pain relief while limiting opioid doses.

In an effort to control the current opioid epidemic researchers have been looking into the possible benefits of cannabinoids due to the interaction of the opioid and endocannabinoid systems. The results of this study showed that various synthetic cannabinoids (WIN and GP1a) were able to work synergistically with morphine in two separate pain models to maximize analgesic effects. Further evidence is still needed to validate these claims before patient use, but this paper provides further evidence that medical cannabis may help put an end to the opioid crisis. 

Highlighted in this paper is the lingering uncertainty of exact mechanisms within the endocannabinoid system. The authors of this article are left without definite answers as to whether or not the analgesic effect is mediated completely through cannabinoid receptor 1 (CB1) or if cannabinoid receptor 2 (CB2) is also involved. Research into cannabinoids is slow within the United States, as there are currently only privately funded studies. This severely limits the medical community from a full understanding. The better a system is understood, the more concrete answers can be found. Critics may never support the rescheduling of cannabis but without moving cannabis to a Schedule II or III, it remains impossible to back even their claims. 

View this review (yellow link) or download:

This paper is also stored here:    http://bit.ly/2Xh5PQl     inside the CED Foundation Archive


To explore related information, click the keywords below:

Benjamin Caplan, MDCannabinoids have Opioid-Sparing Effects on Morphine Analgesia
read more

80%: Cannabis extremely helpful for pain; 82%: helped reduce or stop over-the-counter medications; 88% able to stop taking opioid painkillers

“The study, published in the Journal of Psychoactive Drugs, which looked at 1,000 people taking legalized marijuana in an American state found that among the 65% of people taking cannabis for pain, 80% found it was very or extremely helpful.”

“82% of these people being able to reduce, or stop taking over the counter pain medications, and 88% being able to stop taking opioid painkillers.”

“74% of the 1,000 interviewees bought it to help them sleep – 84% of whom said the marijuana had helped them, and over 83% said that they had since reduced or stopped taking over-the-counter or prescription sleep aids.”

“The study adds weight to the theory that widening access to medical cannabis could lower the use of prescription painkillers, allowing more people to manage and treat their pain without relying on opioid prescription drugs that have dangerous side effects.”

“This is backed up with other research that shows that states with medical cannabis laws have a 6.38% lower rate of opioid prescribing and that Colorado’s adult-use cannabis law is associated with a relative reduction in opioid overdose death rate from 1999 to 2010.”

“”Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen cause GI bleeding or kidney damage with chronic use. Paracetemol (Acetaminophen) toxicity is the second most common cause of liver transplantation worldwide, and is responsible for 56,000 ER visits, 2600 hospitalizations, and 500 deaths per year in the U.S.”

Link to news brief: https://eurekalert.org/pub_releases/2019-07/tfg-cmb062819.php

View this review (yellow link) or download:

This paper is also stored here:    http://bit.ly/2JmB7Lv     inside the CED Foundation Archive

To explore related information, click the keywords below:

Benjamin Caplan, MD80%: Cannabis extremely helpful for pain; 82%: helped reduce or stop over-the-counter medications; 88% able to stop taking opioid painkillers
read more

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.

View this review (yellow link) or download:

This paper is also stored here:   http://bit.ly/2L9pCJZ      inside the CED Foundation Archive

To explore related information, click the keywords below:

Benjamin Caplan, MDCannabidiol May Provide Novel Treatment for Rare Ovarian Cancer
read more