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“Is medical cannabis safe for my patients?” A practical review of cannabis safety considerations

Medical cannabis use is increasing worldwide. Clinicians are commonly asked by patients to provide guidance on its safety and efficacy. Although there has been an increase in research on the role of medical cannabis for a number of different conditions, we found that there was a paucity of clear safety guidance on its use. We aim to address this issue by answering two pertinent clinician safety questions:
1 Can medical cannabis be safely used in this patient?
2. What strategies can be used to ensure that any harms from medical cannabis are mitigated?

A Systematic Review of Fibromyalgia and Recent Advancements in Treatment: Is Medicinal Cannabis a New Hope?

Analysis of over 100 Cannabis samples quantified for terpene and cannabinoid content and genotyped for over 100,000 single nucleotide polymorphisms indicated that Sativa- and Indica-labelled samples were genetically indistinct on a genome-wide scale. Instead, we found that Cannabis labelling was associated with variation in a small number of terpenes whose concentrations are controlled by genetic variation at tandem arrays of terpene synthase genes.

Cannabis labelling is associated with genetic variation in terpene synthase genes

Analysis of over 100 Cannabis samples quantified for terpene and cannabinoid content and genotyped for over 100,000 single nucleotide polymorphisms indicated that Sativa- and Indica-labelled samples were genetically indistinct on a genome-wide scale. Instead, we found that Cannabis labelling was associated with variation in a small number of terpenes whose concentrations are controlled by genetic variation at tandem arrays of terpene synthase genes.

Cannabinoids in the Treatment of Epilepsy: A Review

Cultural and social misconceptions and roadblocks about the use of cannabinoids persist and represent an ongoing obstacle to increasing research and therapeutic use of these compounds. This review focuses on all these aspects and of the use of these cannabinoids in the treatment of epilepsy and seeks to offer a fairly comprehensive description of the facets of cannabinoid therapy for refractory epilepsy.

Effects of cannabis ingestion on endometriosis-associated pelvic pain and related symptoms

The use of cannabis for symptoms of endometriosis was investigated utilising retrospective archival data from Strainprint Technologies Ltd., a Canadian data technology company with a mobile phone application that tracks a range of data including dose, mode of administration, chemovar and their effects on various self-reported outcomes, including pelvic pain.

Update and perspectives on minor plant-derived cannabinoids of biomedical interest

Recently, the first publically-funded Latin American cannabinoid research network (CannaLatan, www.cyted.org/es/cannalatan), formed by academic investigators and pharma companies of different countries, was launched. CannaLatan aims to promote and boost the results obtained by the different partners of the consortium developing collaborative research and educational projects. The CannaLatan network is devoted to tackle the potential therapeutic applications of under-investigated phytocannabinoids and novel cannabinoid-based molecules, as well to clarify their undesired actions. Here we discuss one of the ongoing projects initiated by CannaLatan with the financial support of Fundación Canna (www.fundacion-canna.es/) , in which we address the anti-psychotic and cognitive actions of acidic forms of phytocannabinoids, namely THCa

The Potential Use of Cannabis in Tissue Fibrosis

Numerous publications suggest that cannabinoids and extracts of Cannabis sativa have potent anti-inflammatory and anti-fibrogenic properties. In this review, we describe the types and mechanisms of fibrosis in various tissues and discuss various strategies for prevention and dealing with tissue fibrosis. We further introduce cannabinoids and their potential for the prevention and treatment of fibrosis, and therefore for extending healthy lifespan.

Lung cancer patient who had declined conventional cancer treatment: could the self-administration of ‘CBD oil’ be contributing to the observed tumour regression?

Conventional lung cancer treatments include surgery, chemotherapy and radiotherapy; however, these treatments are often poorly tolerated by patients. Cannabinoids have been studied for use as a primary cancer treatment. Cannabinoids, which are chemically similar to our own body’s endocannabinoids, can interact with signalling pathways to control the fate of cells, including cancer cells. We present a patient who declined conventional lung cancer treatment. Without the knowledge of her clinicians, she chose to self-administer ‘cannabidiol (CBD) oil’ orally 2–3 times daily. Serial imaging shows that her cancer reduced in size progressively from 41 mm to 10 mm over a period of 2.5 years. Previous studies have failed to agree on the usefulness of cannabinoids as a cancer treatment. This case appears to demonstrate a possible benefit of ‘CBD oil’ intake that may have resulted in the observed tumour regression. The use of cannabinoids as a potential cancer treatment justifies further research.

Analgesic Potential of Terpenes Derived from Cannabis sativa

Decades of research have improved our knowledge of cannabis polypharmacy and contributing phytochemicals, including terpenes. Reform of the legal status for cannabis possession and increased availability (medicinal and recreational) have resulted in cannabis use to combat the increasing prevalence of pain and may help to address the opioid crisis. Better understanding of the pharmacological effects of cannabis and its active components, including terpenes, may assist in identifying new therapeutic approaches and optimizing the use of cannabis and/or terpenes as analgesic agents.

Cannabis Glandular Trichomes: A Cellular Metabolite Factory

While growers tend to focus on improving whole flower yields, our understanding of the “goldmines” of the plant – the trichomes – is limited despite their being the true source of revenue for a multi-billion-dollar industry. This review aims to provide an overview of our current understanding of cannabis glandular trichomes and their metabolite products in order to identify current gaps in knowledge and to outline future research directions.

Phytocannabinoids: Origins and Biosynthesis

hytocannabinoids are bioactive terpenoids that were thought to be exclusive to Cannabis sativa, but have now also been discovered in Rhododendron species, some legumes, the liverwort genus Radula, and some fungi.

Many cannabinoids display promising non-hallucinogenic bioactivities that are determined by the variable nature of the side chain and prenyl group defined by the enzymes involved in their synthesis.

Cannabinol and Sleep: Separating Fact from Fiction

In recent years, marketers of cannabis (i.e., marijuana) products have claimed that cannabinol (CBN) has unique sleep-promoting effects. Despite a plausible mechanism, it is possible that such claims are merely rooted in cannabis lore. The aim of this narrative review was to answer the question: “Is there sufficient clinical evidence to support claims that CBN has sleep-promoting effects?”