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Update on the Vape Pen Crisis: Considerations for Healthcare Professionals

By | News

By The Society of Cannabis Clinicians

In the wake of the vaping crisis that has caused a number of hospitalizations and deaths in the USA, Puerto Rico, and the Virgin Islands, the Society of Cannabis Clinicians has been monitoring the issue and potential considerations for public health. Key findings, published in Morbidity & Mortality Weekly Report confirm a decline in emergency department visits related to EVALI (vaping-related lung damage). This could be due to a large amount of press that the issue has received. Additionally, more consumers may be abstaining from vaping. 

In a study published in The New England Journal of Medicine involving 51 patients with EVALI in 16 states, vitamin E acetate was detected in samples of bronchoalveolar-lavage fluid from 94% of the patients (12/20/19). The Food and Drug Administration has stated that while it appears that vitamin E acetate is associated with EVALI, there are many different substances and product sources that are being investigated, and there may be more than one cause. The FDA mentioned that the best way for people to ensure that they are not at risk while the investigation continues is to consider refraining from the use of all e-cigarette or vaping products. 

But is prohibiting vaping as a mode of administration for cannabis medicine an appropriate approach to this situation? Vape pens are a popular and easy to use method that certain demographics favor. For example, elderly patients with arthritis may benefit from pain management by using a vaporizer pen with easy-to-install cartridges, but may find it difficult to properly break up flower and put it in a vaporizer, pipe, or joint. Some critics of vape pen products have noted that other easy to use alternative options, such as sublingual oils, exist.

In light of these considerations, the SCC sent a poll to our membership to gauge how those within the organization were approaching the issue.

What Clinicians are learning and telling patients about vaping

In response to a questionnaire, 67 members of the Society of Cannabis Clinicians reported what they were advising patients (34% of whom said they used vaporizer products regularly).  Their recommendations were wide-ranging:

  • Use only regulated products that have been tested
  • Buy from a dispensary AND vape flower only
  • Vape flower only (don’t use oil-filled cartridges)
  • Use delivery systems other than vape pens
  • Vaporize only organic products
  • Use vape products without any additives 
  • Vaporize using the lowest heat setting that will produce vapor
  • Ask to see a certificate of analysis (COA) that tests for cannabinoid, terpene content, and contaminants (heavy metals, microbials, pesticides); learn more about the product and its manufacturer at the dispensary and online

Many clinicians also told their patient base to be aware of imitation products that look almost identical to regulated products. They recommend not buying products from any source other than a licensed dispensary. None of the respondents mentioned or advised banning vape products.

Other advice 

  • Vaporize only organic products (2 respondents)
  • Use vape products without any additives (7 respondents)
  • Vaporize using the lowest heat setting that will produce vapor, not combustion (2 respondents)

Patients reporting pulmonary symptoms

 Four survey respondents (6%) had seen patients who experienced pulmonary symptoms as a result of vaping. Of these:

  • 1 patient experienced chest discomfort and an “inflammatory” response that lasted through the night and into the next day. The patient stopped using cannabis after that experience. 
  • 1 clinician diagnosed two young men for EVALI. Neither of them plans on vaping again. 
  • 1 clinician reported seeing patients with pulmonary symptoms after using products with additives. They abstained from using vape products after that. 
  • 1 patient had “unusual pains” after using a CBD vape pen from the illicit market. Their symptoms stopped after vaping was discontinued. The patient now uses products from dispensaries only.

Dr. Jahan Marcu on Vaping Risks

Jahan Marcu, PhD, the Chief Science Officer and co-founder of the International Research Center on Cannabis and Health, was the featured speaker at the SCC quarterly meeting on December 8th, 2019. His topic was on “Vaping Risks and Product Safety”. The vape crisis affects people of all age ranges, Marcu said. It was made possible by an unregulated and illicit market. The underground market has no quality control and cannot be relied upon to give patients safe options. 

Dr. Marcu emphasized that many vape pens are actually burning the plant material or concentrate, rather than turning it into vapor. If coils on the vape pen devices are red hot, then the substance is being burnt rather than vaporized. It is important to distinguish between vaporizers and vape pens. Devices that vaporize flowers, such as the Volcano and Pax, have shown improved lung function in a clinical setting and are being used in clinical trials. They have the advantage of temperature control, which is useful in delivering cannabinoids and terpenes. These vaporizers are more expensive than devices with cartridges filled with cannabis oils. Handheld vape pens and cartridges are typically inexpensive, have disposable hardware, and pose the most risks.[1] 


Full video is available to SCC members here.

Cartridges may contain additives and thinning agents, such as Vitamin E acetate. Vape cartridges with oils high in diluents and emulsifiers have led to the epidemic of lung damage (EVALI). According to Marcu, Vitamin E acetate does not account for some of the pain, digestive problems, and nausea that people have attributed to using vape pens. When a case of EVALI is reported, it is difficult to pinpoint the source as these products are typically coming from the unregulated market. Isomers of Vitamin E have different effects on inflammation, which makes it difficult to study the toxicological impact. More analysis has to be done in order to discern which specific symptoms are linked to which additives or constituents. 

Discussion and Considerations for Clinicians

Currently, there is a lack of information for physicians as to what constitutes safe use for patients and consumers. Further testing on vaporization needs to be done to ensure safety. Marcu hopes industry professionals will educate regulators.

States are banning vape pen products in an attempt to improve public health. However, Marcu observed, it is regulation that minimizes risks to consumers. Vape bans only punish those who are in the legal market and not the illicit purveyors. Physicians are urged to stay informed on the latest information coming out on the subject in order to educate their patients. 

The SCC Member Vape Survey results indicate that patient education is an essential tool to help to evade some of the potential risks to vape pen products. Until further research is done on which specific issues are linked to specific constituents, consumer discretion is advised. During this time it is important to review the facts and stay abreast of new information to best understand the nuances of this complex situation. 


  1. Marcu, Jahan. “Vaping Risks and Product Safety”. SCC Quarterly meeting, 2019.
  2. Hawkins, Derek. “Doctors Say They’ve Performed The First Double Lung Transplant Due to Vaping”. The Washington Post, Nov. 14, 2019. Link

Further Reading

IACM 2019 Highlights: Defending Doctors’ Rights Across the Globe

By | News

By: Christine Milentis

The 2019 International Association for Cannabinoid Medicines (IACM) conference was held in Berlin Oct. 31-Nov. 1. It offered an opportunity for clinicians, researchers, patients, and advocates to learn how different nations’ medical cannabis programs are structured.

The IACM seeks to disseminate reliable information on cannabis and the endocannabinoid system, and to support research and promote information exchange between healthcare practitioners, patients, researchers, and the public. A declaration adopted at the IACM’s founding conference in 2000 stated that it is a doctor’s right to discuss the medicinal use of cannabis with their patients. The pragmatic data presented in many of the clinical sessions were based on patient treatments in real-world settings.

The IACM conference opened with Daniele Eigenmann, a pharmacist from Switzerland, reviewing the history of medical cannabis: from China, where in 2700 BC it was used for rheumatism, malaria, and constipation, to Egypt, which is mention in the Papyrus Ebers, to India, and ancient Greece. In 1841, the Irish physician William O’Shaughnessy returned to England after being stationed in Calcutta, India, where he had been using cannabis therapeutically and published a comprehensive study on the successful use of Indian hemp in the treatment of cholera, tetanus, convulsions, rheumatism and other ailments.

The early 1900s marked a high point of medical cannabis use. Pharmaceutical companies, including Merck and Eli Lilly, were widely manufacturing cannabis preparations to treat pain, convulsions, insomnia, asthma, and many other conditions. In 1937 federal prohibition was imposed in the US. In 1961 a United Nations treaty imposed worldwide prohibition. Research re-emerged in the 1990s when the endocannabinoid system was fully elucidated. From 1945 to September 30, 2019, there have been 25,774 publications on cannabinoids listed in Pubmed; 3-4 new publications are currently being released per day.

With cannabidiol (CBD) products gaining rapid popularity for treating a range of medical problems, a topic of concern at the conference was quality control in the cannabis market, especially the reliability of CBD oils. In his talk, “The Trouble with CBD,” the Dutch chemist Arno Hazekamp addressed the uncertainties that remain about the legality, quality, and safety of this new “miracle cure.” Hazekamp purchased CBD oils from the United States, the Netherlands, and Australia and sent each product to several testing labs. He found very few samples labeled correctly, with CBD products being mislabeled, containing THC, or even testing positive for synthetic cannabinoids such as “K2” and “Spice.”  Many CBD products listed a misleadingly low “effective dose” on the bottle. CBD products were found to contain heavy metals, pesticides and other contaminants that put consumers at risk. As the market continues to grow, laboratories will need to develop appropriate tests for analyzing these different modes of administration (edibles, topicals, water-soluble, drinks, etc.). Hazekamp wants to see product standards and audits, a system that disqualifies products that do not meet established regulations, and the opportunity for product-makers to improve their products.

The global interest in CBD has been accompanied by inaccurate information on CBD’s effects and mechanisms of action. Ethan Russo set the record straight, addressing common misconceptions of CBD on the first day of the conference. He reported that CBD alone is not very potent. Given its safety profile, more is better, as higher doses are needed to produce pharmacologic effects. CBD alone is not sedating, but it can have that impact when taken in very high doses, in combination with terpenoid effects (e.g. myrcene), or as a result of drug-drug interactions. CBD upregulates endogenous levels of anandamide, which affects endocannabinoid system expression, but CBD is not converted into THC in the body. Despite CBD products being widely available in the United States, CBD is not legal in all 50 states under federal law. (For a through read on this topic, see Russo 2017, Cannabidiol Claims and Misconceptions, Trends Pharmacol Sci 38(3), 198-201.)

In another talk, Russo discussed the potential of herbal cannabis for Alzheimer’s disease, sharing results from Jeffrey Hergenrather’s study in an assisted-living facility. Using primarily tinctures and confections, Hergenrather found it conferred significant benefits—improved memory and increased appetite—while reducing agitation, aggression, anxiety, insomnia/restlessness, anorexia, pain, and depression.  This impact greatly decreased the demand on the nurses.

Lihi Bar-Lev Schleider’s group from Israel presented similar results in their phase II, randomized, double-blinded, placebo-controlled trial investigating CBD-rich oil for dementia. Using Avidekel oil developed by Tikun Olam, a CBD-rich 20:1 whole plant extract (1 cultivar extracted with ethanol), patients received drops of oil applied under the tongue three times per day over the course of 16 weeks (112 days). They found a statistically significant difference in Cohen-Mansfield Agitation Inventory from baseline to after medication between the treatment and placebo groups. The treatment was found to be safe and efficient for reducing agitation and aggression.

Kirsten Muller-Vahl commented on the medical cannabis situation in Germany, where cannabis has been available by prescription since March 2017. It is still illegal to cultivate cannabis, so products are imported from the Netherlands or Canada. Physicians recommend a strain on the prescription (26 are currently available, but the options are constantly changing). Whole-flower vaporization is the most highly recommended method of administration. The future market is predicted to include novel, portable inhalers with preloaded cartridges for metered-dose delivery. In her patients with Tourette syndrome, Muller-Vahl found increases in specific endocannabinoids, but did not identify a change in endocannabinoid receptor genes from Tourette patients compared to healthy individuals. A large trial is being conducted to determine the efficacy of cannabinoid therapy in adult patients with Tourette syndrome. Promising results are coming forth, and Muller-Vahl speculates that the positive effect in children with Tourette syndrome may be even stronger. She has seen the condition of an 8-year-old patient improve greatly, which she attributes to the possibility of the developing brain being altered before the symptoms of Tourette syndrome have taken full effect.

IACM Executive Director Franjo Grotenhermen, discussing interactions and side effects, said that no other molecule on earth had such broad therapeutic potential as tetrahydrocannabinol (THC) except perhaps cannabidiol (CBD). A side effect in one patient may be a therapeutic effect in another (e.g. increased appetite, sedation, muscle relaxation, euphoria, reduction of bowel movements, lowering of blood pressure, dry mouth—could be therapeutic in the case of hypersalivation). Although pharmacokinetic interactions with other medicinal drugs can occur with very high doses of THC or CBD, these are very rare cases. THC and CBD have been given to millions of patients using other drugs without serious side effects.

Special consideration should be given to patients with heart disease, as acute side effects of cannabis consumption may increase heart rate and change blood pressure. A main concern when evaluating cannabis treatment for cancer patients is whether they are undergoing immune therapy. Tomoxiphen binds to both CB1 and CB2 receptors and thus may interfere with cannabis treatment. To avoid disturbing the immune system during this process, physicians may avoid giving THC and CBD during immune therapy treatment.

After opening Canna-Centers in 2008 in Los Angeles, Bonni Goldstein has seen more than 15,000 patients (~900 of them are children). Eighty-five percent of her patients had already tried conventional therapies. Goldstein stated that “with medical supervision, there is clear clinical evidence of significant benefits with no toxicity.” She found that many of her patients who try Epidiolex (CBD) end up switching back to whole plant oils.  Epidiolex contains alcohol and sucralose, and as these patients are very sensitive they were getting other side effects from the medication. She also found that CB2 receptors are upregulated in white blood cells of children with autism. This may be a biomarker to diagnose children with autism in earlier stages, more research is needed.

Ilya Reznik (Israel) presented data showing that the passage of medical cannabis laws in Israel has reduced chronic pain in self-assessed health among older adults. Following this observation, Addie Ron presented data from the prospective observational registry study in women and men above 65 years of age who were licensed by the Israeli Ministry of Health to use medical cannabis. Of the 184 patients who initiated treatment, 58.1% were still using cannabis after the six-month treatment period with positive results. All patients were cannabis-naïve, and practitioners utilized slow titration of medication under a safety-first regimen, following the dosing mantra “start low and go slow.” In this cohort, they found sublingual oil to be the preferred route of administration. Ron noted that ameliorating baseline disturbances like pain increases the chances of improving other symptoms, such as depression, trouble sleeping, etc. Caution is warranted in older adults due to polypharmacy, pharmacokinetic changes, nervous system impairment, and increased cardiovascular risk. Cannabinoid receptors may also decrease as we age, and thus cannabis therapies may not always be as effective in older adults.

Ziva Cooper, from the University of California, Los Angeles reported on the first placebo controlled double blind study investigating the role of cannabinoids to decrease or eliminate opioid use for pain management. This study bridges the gap between promising preclinical evidence and population-based studies, testing opioid analgesia, intoxication, and abuse liability in healthy participants. Supported by grants from the US National Institute on Drug Abuse, early findings show the potential for cannabis to enhance opioid analgesia, supporting THC-opioid synergy observed in preclinical investigations. Other cannabinoid constituents including CBD and specific terpenes may similarly reduce or eliminate reliance on opioids for pain relief. The group has a study currently underway to compare the effects of CBD alone, THC alone, and CBD/THC in combination for their ability to reduce or eliminate the use of opioids for pain.

The presentation by Atilla Ollah (Faculty of Medicine at University of Debrecen, Hungary) concerned endocannabinoid signaling system in the skin and the potential role of phytocannabinoids in dermatology. The skin is much more than a passive barrier, and through its diverse signaling capabilities, it can smell, taste, see, talk, listen, and respond to cannabinoid therapy. As he explained in his recently published review on cannabinoid signaling in the skin (Molecules 2019, 24(5), 918; https://doi.org/10.3390/molecules24050918), “although the best studied functions over the endocannabinoid system are related to the central nervous system and to immune processes, experimental efforts over the last two decades have unambiguously confirmed that cutaneous cannabinoid signaling is deeply involved in the maintenance of skin homeostasis, barrier formation and regeneration, and its dysregulation was implicated to contribute to several highly prevalent diseases and disorders, e.g., atopic dermatitis, psoriasis, scleroderma, acne, hair growth and pigmentation disorders, keratin diseases, various tumors, and itch.”  With CB1 and CB2 receptors located in the epidermis, there is clinical translation potential for extracellular-restricted CB1 agonists to alleviate inflammation (J Clin Invest. 2014 Sep;124(9):3713-24). Olah notes that local, topical treatment would be desirable to avoid systemic side effects and that rigorous preclinical testing is still needed.

Javier Fernandez-Ruiz (Professor at Complutense University of Madrid, Spain) reported on cannabinoid-based neuroprotective therapy for neurodegenerative disorders. Living longer means more possibilities for neurodegenerative disorders to be visible, and with aging as the major risk factor for Alzheimer’s, Parkinson’s, and Huntington’s disease, there are higher incidences in countries with higher life spans. In 2005, there were an estimated 4.1 million individuals with Parkinson’s worldwide. This number is expected to double by 2030 to 8.7 million individuals. As current licensed treatments have limited efficacy and frequent activity mainly on symptom relief, the broad-spectrum profile of cannabinoids is well poised to encourage neuronal homeostasis and survival, neuroprotection, and neurorepair. In ALS (amyotrophic lateral sclerosis), cannabinoids can increase trophic support, while reducing toxicity, excitotoxicity, and oxidative stress.

Mario van der Stelt (Professor of Molecular Physiology at Universiteit Leiden, Netherlands) covered mechanisms underlying the endocannabinoid system (ECS) and its modulation, and touched upon emerging drugs based on the ECS. Endocannabinoids modulate communication between nerve cells, are rapidly degraded, and regulate appetite, fear, sleep, and memory. In an attempt to block the endocannabinoid action for the treatment of obesity, rimonabant (Acomplia) was developed by Sanofi-Aventis in 2006 as a selective CB1 endocannabinoid receptor antagonist. However, it was withdrawn from the market in 2008 due to increased prevalence of depression and suicide (data showed a doubling of the risk of psychiatric disorders in patients taking Acomplia in comparison with placebo). As alternatives to rimonabant, Van der Stelt has outlined some potential research categories of interest to exploit the ECS for therapeutic benefit that include peripherally restricted CB1 receptor antagonists, signaling specific CB1 receptor inhibitors, and negative allosteric CB1 receptor modulators.

Exploring future research directions, Russo said cannabis shows promise in limiting damage after concussion and traumatic brain injury and urged more research. Also, cannabinoids have been shown to diminish neuropathic pain associated with endometriosis, and endocannabinoids have been shown to modulate apoptosis in endometriosis and adenomyosis (Dmitrieva et al., Pain. 2010 Dec; 151(3): 703–710, Bouaziz et al., Cannabis Cannabinoid Res. 2017; 2(1): 72–80).  Cannabis also has great potential to treat dysmenorrhea, premature labor, hyperemesis, aid in childbirth postpartum hemorrhage, toxemic seizures, and menopause, according to Russo.

Several speakers touched on the topic of cannabis and pregnancy during the conference, noting that cannabinoids have been used most widely in pregnancy for hyperemesis and mental health issues. After thoroughly discussing the risks and benefits with the mother, physicians should consider whether the patient’s health is suffering more by not intaking cannabinoids during pregnancy.

At the closing physician panel, speakers highlighted future strategies for the burgeoning field of medical cannabis. They repeated the need for more clinical trials and strong objective evidence, recognizing that the system is biased towards randomized controlled trials. Observational studies should be included in decisions about medical cannabis and the need to collate clinical data from large databases is strong. Surveys collecting data from patients who self-medicate can be helpful sources of information to lead the development of clinical trials to test the claims. The question of “where will we be in 10 years?” embraced hopes from clinicians of moving medical cannabis into previously forbidden areas such as psychiatry and obstetrics and gynecology, and reducing the regulatory and political obstacles to medical cannabis research.

The 2019 conference concluded with an echo of the IACM’s original declaration: doctors in all countries should be able to recommend and prescribe medical cannabis to their patients without backlash or stigma from the medical establishment.

Changing My Specialty

By | News

by Sarah Mann, MD

I have spent the better part of the last decade working from 7 pm to 7 am in a busy Intensive Care Unit in a suburb of Chicago, Illinois, where the medical use of marijuana wasn’t legalized until 2013.

In the ICU we deal in life-saving drugs like epinepherine and amiodarone. We deal in life-draining drugs, like opiates and alcohol. We deal with overdoses of drugs like Xanax and fatal underdosing of drugs like Coumadin. One thing we do not deal with is cannabis. We don’t deal with cannabis overdose. We don’t deal with cannabis intoxication. We don’t deal with cannabis withdrawals. On rare occasion, we may see a case of fatal stupidity, in which cannabis may or may not have played a role.

In a world where survival is key, you wouldn’t think the subject of marijuana would come up very often. And yet, over the past couple of years, cannabis did creep into my critical-care world. At first, it was just patients who had medical cannabis cards. They were admitted with unrelated problems. Despite my copious supply of high-grade pharmaceuticals, these patients were all anxious to get back to their home medications. They felt cannabis worked better and were frustrated by the diminished pain and anxiety control during admission, not to mention their trouble sleeping. A few of them even checked out against medical advice, reporting they were in too much pain to stay. At that time, my biggest problem was whether to list cannabis under “medications” or “illicit drugs.:

As the years passed and social acceptance increased, I started to get more questions from patients about initiating use. I had several patients admitted with brain injuries and spinal cord injuries starting to ask about initiating cannabis. “Do you think it will help, doc?” I would think back to my recent readings, “There isn’t much evidence, but what there is looks promising. It certainly doesn’t seem harmful.”

A look of hope would flash across their faces, “where can I get it, doc?” And I would reply, “I don’t know, the corporations behind the hospital forbid us to write recommendations. You will have to Google it.” And their dejected look would return, as if they hadn’t already exhausted that option.
As word spread about the relief people were receiving with cannabis, even more patients began to ask me. People with histories of fibromyalgia and PTSD to name a few. People who had been considering this option, but were too afraid to ask their own doctors. People who were emboldened by near-death experience, or desperate with pain, or possibly just knew they would never have to see me again. Whatever the reason behind it, the trend was clear.

Then one morning, I just couldn’t say no anymore. It was a cold and icy Chicago winter. During the dawn light, a 22-year-old man on his way to coach an early youth baseball team, fell asleep at the wheel and drove his car off an exit ramp. He arrived to me in good spirits but poor condition. His spinal cord was badly damaged, his chances of walking again were minimal. He only had a bit of sensation in the hip, and that sensation was extremely painful. His only movement was spasm, nothing voluntary.

Over the next few nights I spent hours talking to that young man about his prognosis and his options. He posed the same questions as former patients about the possible helpfulness of cannabis. When I gave the same answers, or lack of answers, he persisted. “But doc, I read that it is important to start right after a spinal cord injury. I read that it could save neurons.” I confirmed his supposition. At this point, I didn’t have a better option. I just couldn’t look into those eyes and say no. Instead, I heard myself say “I will look into it.”

After thoroughly reviewing Illinois cannabis law, I found what I had to do. That cold day in January 2019, the Mindful Medicine Clinic was born. I found a co-work space and rented an office where I would be free to practice medicine without corporate restrictions. I muddled through that first certification as soon as my young, paraplegic patient was discharged from the hospital (in compliance with Illinois law and hospital policy). Patients began trickling into my office on word of mouth alone. My colleagues from the hospital sent the earliest patients over. They didn’t know much about this emerging therapy, but I had earned their trust. These doctors and nurses began to refer their patients and family members to me with the hope that they could find relief.

I started seeing patients in that co-work space on my days off. By springtime I was able to move into a single office with a lease and as summer approached I expanded to a four-room clinic. The Mindful Medicine mission seemed obvious from the beginning, “Helping People Live Better.” Although we have only been open six months now, we are already adding services to help further that mission. After more than 10 years of dedicating myself to saving lives, I finally get to help people!

Education, Knowledge, and Practice Characteristics of Cannabis Physicians: A Survey of the Society of Cannabis Clinicians

By | News

By Kevin M. Takakuwa, Anthony Mistretta, Vanessa K. Pazdernik, and Dustin Sulak
“Cannabis and Cannabinoid Research, http://doi.org/10.1089/can.2019.0025, published online August 23, 2019″


Context: Medical cannabis use has increased in recent years despite being a federally illegal drug in the United States. States with medical cannabis use laws require patients to be certified by physicians. However, little is known about the education, knowledge, and practice characteristics of physicians who recommend and supervise patients’ use of medical cannabis.

Objective: This study assessed how U.S. physicians who practice cannabis medicine are educated, self-assess their knowledge, and describe their practice.

Read Full Article >>

Cannabis and Sexual Health Survey

By | News

Many people are interested in cannabis and sex, but what is the relationship between the two? Does cannabis use impact the sex lives of women and men differently? Those are some of the questions a new Stanford study hopes to answer. Genester Wilson-King, MD (SCC Co-Vice President and Medical Director and Founder of Victory Rejuvenation Center) and Dr. Michael Eisenberg (Stanford University School of Medicine) are conducting research on cannabis and sexual health.

The survey will provide an opportunity for the general public to participate in cannabis research. The survey takes about 10 minutes to complete. The study has been approved by the Institutional Review Board (IRB) and is in compliance with the privacy protections provided by HIPAA. Full information is available through the link at the beginning of the survey.

Take The Survey >>

A History of the US Medical Cannabis Movement and Its Importance to Pediatricians: Science Versus Politics in Medicine’s Greatest Catch-22

A History of the US Medical Cannabis Movement and Its Importance to Pediatricians: Science Versus Politics in Medicine’s Greatest Catch-22

By | News

By Kevin M. Takakuwa MD, MA, (SCC Member)

Never in recent times has Western medicine seen the rise, fall, and reemergence of a botanical that sparks as much controversy with both fervent supporters and detractors as cannabis. With the first ever Food and Drug Administration (FDA) approval for a natural component of cannabis—cannabidiol (CBD) for 2 rare pediatric seizure disorders—pediatricians have now been pushed to the forefront of the controversy to determine how they will grapple with inevitable questions from parents: “Can cannabis help my child?”

Cannabis has been used for thousands of years throughout the world. Its earliest medical recordings note indications for rheumatism, constipation, and gynecological disorders in China. It gained notoriety in Europe in the mid-19th century when Irish physician William O’Shaughnessy published an article based on his experiences treating tetanus and convulsive diseases with cannabis while serving in India. Cannabis was first listed in the US Pharmacopeia in 1851 as “extractum cannabis,” and more than 100 medical articles were published in Europe and the United States in the later 19th century, including a report of Indian hemp for seizures. However, due to the difficulty of extracting uniform cannabis plant derivatives, it was replaced by other agents with more reliable dose formulations than cannabis, which fell out of favor in the early 20th century.

Continue reading >>
Takakuwa, K. M., & Schears, R. M. (2019). A History of the US Medical Cannabis Movement and Its Importance to Pediatricians: Science Versus Politics in Medicine’s Greatest Catch-22. Clinical Pediatrics. https://doi.org/10.1177/0009922819875550

Medical Use of Cannabis in 2019.

By | Medical Cannabis

Authors: Kevin P. Hill
JAMA, 9 August 2019

Nearly 10% of cannabis users in the United States report using it for medicinal purposes.1 As of August 2019, 33 states and the District of Columbia have initiated policies allowing the use of cannabis or cannabinoids for the management of specific medical conditions. Yet, the…

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Opportunities for cannabis in supportive care in cancer.

By | Cancer, Medical Cannabis, Palliative Care

Authors: Amber S. Kleckner, Ian R. Kleckner, Charles S. Kamen, Mohamedtaki A. Tejani, et al
Therapeutic Advances in Medical Oncology, 1 August 2019

Cannabis has the potential to modulate some of the most common and debilitating symptoms of cancer and its treatments, including nausea and vomiting, loss of appetite, and pain. However, the dearth of scientific evidence for the effectiveness of cannabis in treating these symp…

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Potential Adverse Drug Events and Drug-Drug Interactions with Medical and Consumer Cannabidiol (CBD) Use.

By | CBD, Drug Interactions

Authors: Joshua D. Brown, Almut G. Winterstein
Journal of Clinical Medicine, 8 July 2019

Cannabidiol (CBD) is ubiquitous in state-based medical cannabis programs and consumer products for complementary health or recreational use. CBD has intrinsic pharmacologic effects and associated adverse drug events (ADEs) along with the potential for pharmacokinetic and pharm…

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A Not-So-Proud Memory

By | News

It’s Pride month, but we owe it to history to recall an embarrassing, tragic twist in the relationship between AIDS activism and the medical marijuana movement. Money from marijuana sales funded a disinformation campaign that led to hundreds of thousands of deaths…

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