Entries by Michelle Smith

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Research progress in the management of vascular disease with cannabidiol: a review

The morbidity and mortality rates associated with vascular disease (VD) have been gradually increasing. Currently, the most common treatment for VD is surgery, with the progress in drug therapy remaining slow. Cannabidiol (CBD) is a natural extract of Cannabis sativa L. with sedative, analgesic, and nonaddictive properties. CBD binds to 56 cardiovascular-related receptors and exerts extensive regulatory effects on the cardiovascular system, making it a potential pharmacological agent for the management of VD. However, most CBD studies have focused on neurological and cardiac diseases, and research on the management of VD with CBD is still rare. In this review, we summarize the currently available data on CBD in the management of VD, addressing four aspects: the major molecular targets of CBD in VD management, pharmacokinetic properties, therapeutic effects of CBD on common VDs, and side effects. The findings indicate that CBD has anti-anxiety, anti-oxidation, and anti-inflammatory properties and can inhibit abnormal proliferation and apoptosis of vascular smooth muscle and endothelial cells; these effects suggest CBD as a therapeutic agent for atherosclerosis, stress-induced hypertension, diabetes-related vasculopathy, ischemia-reperfusion injury, and vascular damage caused by smoking and alcohol abuse. This study provides a theoretical basis for further research on CBD in the management of VD.

January 11, 2024 by
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Individuals’ Values and Preferences Regarding Medical Cannabis for Chronic Pain: A Descriptive Qualitative Study

In Canada, cannabis for medical reasons has been legal since 2001. It has been used as one of the many strategies for chronic or ongoing pain, but doctors are not given consistent information regarding its use, and existing guidance does not include the patient point of view. We did this study to explore how people living with chronic pain feel about the use of medical cannabis. We asked 52 people living with chronic pain, including current medical cannabis users, previous users, and non-users. We found that many people who used cannabis for their pain had to experiment to determine what cannabis products, routes, and doses worked for them. Benefits of medical cannabis included relief from pain, better sleep, and improved mental health. Reasons for stopping medical cannabis included no to little improvement in pain and/or sleep or the presence of unwanted side effects. Cannabidiol (CBD) products resulted in fewer unwanted effects (eg, physical or mental impairment) compared to tetrahydrocannabinol (THC) products. People discussed different routes of cannabis use including oral routes that provided longer-lasting pain relief but with a slower onset and inhaled routes with a faster onset of relief but with shorter-lived effects. People’s decisions regarding medical cannabis use for chronic pain were varied, suggesting these decisions are likely to be sensitive to individual’s values and preferences. More research is needed to learn what doses, products, and routes work for specific chronic pain conditions.

January 11, 2024 by

Cannabis Use and Incident Atrial Fibrillation in a Longitudinal Cohort

Cannabis use is increasing worldwide. While prior studies have reported an association between cannabis use and a higher risk of atrial fibrillation (AF), most were cross-sectional and generally relied on diagnostic coding to identify cannabis users, which may not be representative of the typical, recreational cannabis user. To examine the association between recreational cannabis use and lifetime AF risk.

January 11, 2024 by
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Cannabis use in the United States and its impact on gastrointestinal health

Dysregulation of the endocannabinoid system might contribute to various GI disorders, including irritable bowel syndrome and cyclic vomiting syndrome, and endocannabinoids have been found to regulate visceral sensation, nausea, vomiting, and the gut microbiome. Cannabis has been shown to have antiemetic properties, and the US Food and Drug Administration has approved cannabis‐based medications for treating chemotherapy‐induced nausea and vomiting. Yet, chronic heavy cannabis use has been linked to recurrent episodes of severe nausea and intractable vomiting (cannabinoid hyperemesis syndrome). Given the consid- erable heterogeneity in the scientific literature, it is unclear if cannabinoid hyperemesis syndrome is truly a distinct entity or a subtype of cyclic vomiting that is unmasked by heavy cannabis use and the associated dysregulation of the endocannabinoid system. The changes in cannabis legalization, availabil- ity, and public risk perceptions have outpaced research in this area and there is a need for robust, prospective, large‐scale studies to understand the effects of cannabis use on GI health.

December 28, 2023 by

Patient Experiences with the Use of Medicinal Cannabis in the Netherlands: A Cohort-Event Monitoring Study

In 2003, patients in the Netherlands gained legal access to medicinal cannabis due to legislative measures by the Dutch government. Studies on patient experiences related to medicinal cannabis usage are necessary to complement the data obtained from randomized controlled trials. To gain insight into patient’s experiences with the use of medicinal cannabis in the Netherlands. We conducted an observational longitudinal cohort event monitoring study. Data were collected through online questionnaires. From March 2021 to March 2022, patients were included. After registration, par- ticipants received four online questionnaires over a 12-month period. Descriptive statistics were used to present the included variables using MS Excel 2022.

December 27, 2023 by
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Safety and risks of CBD oils purchased online: unveiling uncertain quality and vague health claims

The unmet need for highly effective, naturally derived products with minimal side effects results in the over-popularity of ever-newer medicinal plants. In the middle of 2010, products containing cannabidiol (CBD), one of the special metabolites of Cannabis sativa, started to gain popularity. For consumers and healthcare providers alike, the legal context surrounding the marketing of CBD products is not entirely clear, and the safety of using some products is in doubt. Companies in the online medicinal product market profit from the confusion around CBD oils.

December 27, 2023 by
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Assessing Cannabidiol as a Therapeutic Agent for Preventing and Alleviating Alzheimer’s Disease Neurodegeneration

To investigate the therapeutic efficacy of CBD in AD and to elucidate its underlying mechanisms, we aimed to contribute valuable insights for incorporating AD prevention recommendations into future CBD nutritional guidelines. Aβ1–42 was employed for in vivo or in vitro model establishment, CBD treatment was utilized to assess the therapeutic efficacy of CBD, and RNA-seq analysis was conducted to elucidate the underlying therapeutic mechanism. CBD mitigates Aβ-induced cognitive deficits by modulating microglial activity, promoting neurotrophic factor release, and regulating inflammatory genes.

December 26, 2023 by
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Cannabinoids in Treating Chemotherapy-Induced Nausea and Vomiting, Cancer-Associated Pain, and Tumor Growth

Cannabinoids have been found to affect tumors of the brain, prostate, colon and rectum, breast, uterus, cervix, thyroid, skin, pancreas, and lymph. However, the full potential of cannabinoids is yet to be understood. This review discusses current knowledge on the promising applications of cannabinoids in treating three different side effects of cancer—chemotherapy-induced nausea and vomiting, cancer-associated pain, and tumor development. The findings suggest that cannabinoids can be used to address some side effects of cancer and to limit the growth of tumors, though a lack of supporting clinical trials presents a challenge for use on actual patients. An additional challenge will be examining whether any of the over one hundred naturally occurring cannabinoids or dozens of synthetic compounds also exhibit useful clinical properties.

December 26, 2023 by
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A preliminary study evaluating self-reported effects of cannabis and cannabinoids on neuropathic pain and pain medication use in people with spinal cord injury

Approximately 60% of individuals with a spinal cord injury (SCI) experience neuropathic pain, which often persists despite the use of various pharmacological treatments. Increasingly, the potential analgesic effects of cannabis and cannabinoid products have been studied; however, little research has been conducted among those with SCI-related neuropathic pain. Therefore, the primary objective of the study was to investigate the perceived effects of cannabis and cannabinoid use on neuropathic pain among those who were currently or had previously used these approaches. Additionally, the study aimed to determine if common pain medications are being substituted by cannabis and cannabinoids.

December 23, 2023 by

Cannabis vaporisation: Understanding products, devices and risks

Vaporisation is a common method of cannabis administration. Inconsistent terminology and jargon regarding vaporisation has led to confusion. The increasing public interest and access to cannabis, combined with possible safety concerns associated with certain cannabis vaping products, warrants improved consumer and public and health care professional knowledge.

December 23, 2023 by
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The Evolving Landscape of Therapeutics for Epilepsy in Tuberous Sclerosis Complex

This review provides a comprehensive overview of the current state of knowledge regarding the pathogenesis, clinical manifestations, and treatment approaches for epilepsy and other neurological features of TSC. While narrative reviews on TSC exist, this review uniquely synthesizes key advancements across the areas of TSC neuropathology, conventional and emerging pharmacological therapies, and targeted treatments. The review is narrative in nature, without any date restrictions, and summarizes the most relevant literature on the neurological aspects and management of TSC. By consolidating the current understanding of TSC neurobiology and evidence-based treatment strategies, this review provides an invaluable reference that highlights progress made while also emphasizing areas requiring further research to optimize care and outcomes for TSC patients.

December 21, 2023 by
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Medical Marijuana for Pain Management in Hospice Care as a Complementary Approach to Scheduled Opioids: A Single Arm Study

Opioid therapy is critical for pain relief for most hospice patients but may be limited by adverse side effects. Combining medical cannabis with opioids may help mitigate adverse effects while maintaining effective pain relief. This single-arm study investigated the impact of combined medical cannabis/opioid therapy on pain relief, opioid dose, appetite, respiratory function, well-being, nausea, and adverse events in hospice inpatients.

December 21, 2023 by