Cannabidiol (CBD) is a nonintoxicating phytocannabinoid used in clinical treatments and sold widely in consumer products. CBD products may be designed for sublingual or oral delivery, but it is unclear whether either is advantageous for CBD absorption. This study compared CBD pharmacokinetics after providing CBD oil as sublingual drops and within orally ingested gelatin capsules, at a dose relevant to consumer products.
https://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.png00Michelle Smithhttps://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.pngMichelle Smith2023-09-26 03:54:402023-09-26 03:54:40Cannabidiol Oil Ingested as Sublingual Drops or Within Gelatin Capsules Shows Similar Pharmacokinetic Profiles in Healthy Males
Damage caused by physical exertion (anti-inflammatory) (Gamelin et al., 2020;Kennedy, 2017;Stone et al., 2023;Villanueva et al., 2022), and reduce pain caused by high physical demands (pain and soreness reliever) (see figure 1) (Gamelin et al., 2020;Henson et al., 2022;Kennedy, 2017). substances promote sleep controlled by the endocannabinoid system, which we can activate by consuming CBD (McCartney et al., 2020;Rojas-Valverde, 2021).Sleep management requires a precise balance of neurotransmitters, and CBD’s actions on the endocannabinoid system contribute to this balance. CBD interacts with adenosine receptors, which is significant since adenosine is a neurotransmitter that promotes sleep and relaxation.CBD promotes tranquillity and preparedness for sleep by boosting adenosine signalling.Furthermore, CBD’s effect on GABAergic neurotransmission adds to its sleep-enhancing properties (Kaul et al., 2021;Kesner & Lovinger, 2020). GABA is an inhibitory neurotransmitter that promotes relaxation and drowsiness by lowering neuronal excitability.CBD’s effect on GABA receptors can promote deeper, more comfortable sleep. Furthermore, CBD’s ability to relieve anxiety and stress, which are significant causes of sleep disruption, indirectly supports greater sleep quality (Blessing et al., 2015;Moltke & Hindocha, 2021;Ortiz Rios et al., 2022). CBD provides a biological foundation for its action via modifying endocannabinoid system signalling, increasing adenosine effects, and regulating GABAergic neurotransmission (Martinez Naya et al., 2023;Yarar, 2020;Zou & Kumar, 2018).
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Many patients with ulcerative colitis after ileoanal pouch anastomosis report improvement of pouchitis with the use of cannabis. Nine patients with chronic pouchitis used 1 g/d of cannabis: 7 patients were male with average age 51 ± 16 years. Average partial pouchitis disease activity index were 11 (range 8–17), 6 (range 5–8), and 5 (range 4–8); endoscopic subscores were 7 .3 ± 2.3, 6 ± 1.1, and 4.4 ± 0.9; average bowel movements per day were 14 (range 8–20), 8 (range 2–13), and 10 (range 13–8); and quality of life increased from 72 ± 1 to 90 ± 16 and 97 ± 10 (P = 0.001) before cannabis treatment and after 8–12 and 52 weeks, respectively. No adverse events were reported.
Main body
The purpose of this article is to review the current state of the opioid epidemic; the shifting picture of cannabinoids; and the research, policy, and current events that make opioid risk reduction an urgent public health challenge. The provided table contains an evidence-based clinical framework for the utilization of cannabinoids to treat patients with chronic pain who are dependent on opioids, seeking alternatives to opioids, and tapering opioids.
https://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.png00Michelle Smithhttps://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.pngMichelle Smith2023-08-26 08:52:152023-08-26 08:52:15Cannabis Improves Clinical Outcomes and Quality of Life in Patients With Chronic Pouchitis
Physicians’ ability to guide their patients on the use of medical cannabis can vary widely and is often shaped by their training, experiences, and the regulations and policies of their state. The goal of this qualitative study is to understand how prepared physicians are to certify and advise their patients to use medical cannabis. A secondary goal is to explore how physicians integrate certification into their clinical practices, and what factors shape their decisions and behaviors around certification.Using semi-structured interviews with 24 physicians authorized to certify patients to use medical cannabis in Pennsylvania, a state with a medical access only program, we explored how physi- cians are trained and set up their practices. Interviews were analyzed using a blend of directed and conventional, and summative content analysis.
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The use of cannabis with various forms of exercise (e.g., running) has received increased media attention in recent years, contradicting the popular stereotype that cannabis is associated with sedentary behavior. Although cross-sectional evidence suggests a positive association between cannabis use and exercise engagement, to date, the acute effects of cannabis on exercise remain unclear. The present within-subjects crossover study compared participants’ experiences of running after ad libitum use of legal market cannabis (cannabis run) to running without cannabis (non-cannabis run) in a real-world setting. Participants (n=49) were cannabis users between the ages of 21 and 49 years (mean=30.82, standard deviation [SD]=6.21). The majority of participants were male (61.5%) and non-Hispanic White (81.6%).
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Scientific literature examining cannabis use in the context of health behaviors, such as exercise engagement, is extremely sparse and has yielded inconsistent findings. This issue is becoming increasingly relevant as cannabis legalization continues, a situation that has been associated with increased initiation of use among adults, and increased potency of available products in legalized states. Physical activity is among the most important health behaviors, but many Americans do not meet minimum exercise recommendations for healthy living. Common issues surrounding low exercise rates include inadequate enjoyment of and motivation to exercise, and poor recovery from exercise. It is unclear whether cannabis use shortly before and/or after exercise impacts these issues, and whether this co-use affects exercise performance. The present online survey study examines attitudes and behaviors regarding cannabis use with exercise among adult cannabis users living in states with full legal access (N = 605). Results indicated that the majority (81.7%) of participants endorsed using cannabis concurrently with exercise, and those who did tended to be younger and more likely to be males (p < 0.0005 for both). Even after controlling for these differences, co-users reported engaging in more minutes of aerobic and anaerobic exercise per week (p < 0.01 and p < 0.05, respectively). In addition, the majority of participants who endorsed using cannabis shortly before/after exercise reported that doing so enhances their enjoyment of and recovery from exercise, and approximately half reported that it increases their motivation to exercise. This study represents an important step in clarifying cannabis use with exercise among adult users in states with legal cannabis markets, and provides guidance for future research directions.
https://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.png00Michelle Smithhttps://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.pngMichelle Smith2023-08-04 08:07:052023-08-04 08:07:05The New Runner’s High? Examining Relationships Between Cannabis Use and Exercise Behavior in States With Legalized Cannabis
There is a growing interest in semi-synthetic cannabinoids, including THC-O-acetate (THC-Oac). Some cannabis marketers and users have claimed that THC-Oac produces psychedelic effects; the current study is the first to examine this claim. Researchers developed an online survey for THC-Oac consumers based on previous cannabis and psychedelic use surveys and in consultation with the moderator of an online forum. The survey assessed the experiential profile of THC-Oac and included items from the Mystical Experience Questionnaire (MEQ), an instrument for assessing psychedelic experiences. Participants reported a low to moderate level of cognitive distortions (altered sense of time, difficulties concentrating, difficulties with short-term memory) and few visuals or hallucinations. Participants’ responses were significantly below the threshold for a complete mystical experience on all four MEQ dimensions. Participants who had used classic (5-HT2A agonist) psychedelics had lower scores on all MEQ dimensions. When asked directly, 79% responded that using THC-Oac is “not at all” or “a little” of a psychedelic experience. Some reports of psychedelic experiences may be due to expectations or contaminants. Those having prior experience with classic psychedelics had lower ratings of mystical experiences.
Anxiety is a condition for which current treatments are often limited by adverse events (AEs). Components of medicinal cannabis, cannabidiol (CBD) and tetrahydrocannabinol (THC), have been proposed as potential treatments for anxiety disorders, specifically posttraumatic stress disorder (PTSD). To evaluate quality-of-life outcomes after treatment with various cannabis formulations to determine the effectiveness and associated AEs.
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Cannabis sativa is a plant used for recreational and therapeutic purposes; however, many of the secondary metabolites in the plant have not been thoroughly investigated. Stilbenes are a class of compounds with demonstrated anti-inflammatory and antioxidant properties and are present in cannabis. Many stilbenes present in cannabis have been investigated for their therapeutic effects. Fourteen stilbenes have been identified to be present in cannabis, all of which are structurally dihydrostilbenoids, with half possessing a prenylated moiety. The stilbenes summarized in this analysis show varying degrees of therapeutic benefits ranging from anti-inflammatory, antiviral, and anti-cancer to antioxidant effects. Many of the identified stilbenes have been researched to a limited extent for potential health benefits. In addition, predictive in silico modeling was performed on the fourteen identified cannabis-derived stilbenes. This modeling provides prospective activity, pharmacokinetic, metabolism, and permeability data, setting the groundwork for further investigation into these poorly characterized compounds.
https://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.png00Michelle Smithhttps://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.pngMichelle Smith2023-07-15 12:54:052023-07-15 12:54:55Therapeutic Potential and Predictive Pharmaceutical Modeling of Stilbenes in Cannabis sativa
Cannabis-based medicinal products (CBMPs) have been identified as novel therapeutics for generalised anxiety disorder (GAD) based on pre-clinical models; however, there is a paucity of high-quality evidence on their effectiveness and safety. This study aimed to evaluate the clinical outcomes of patients with GAD treated with dried flower, oil-based preparations, or a combination of both CBMPs. A prospective cohort study of patients with GAD (n = 302) enrolled in the UK Medical Cannabis Registry prescribed oil or flower-based CBMPs was performed. Primary outcomes were changes in generalised anxiety disorder-7 (GAD-7) questionnaires at 1, 3, and 6 months compared to baseline. Secondary outcomes were single-item sleep quality scale (SQS) and health-related quality of life index (EQ-5D-5L) questionnaires at the same time points. These changes were assessed by paired t-tests. Adverse events were assessed in line with CTCAE (Common Terminology Criteria for Adverse Events) v4.0.
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Hyperhidrosis can significantly curtail patient quality of life, from debilitating physical symptoms to social stigmatization and reduced life opportunities. Current treatments often prove unsatisfactory, especially in sufferers of generalized hyperhidrosis. In this open trial, we present the case of a refractory generalized hyperhidrosis treated with cannabinoids. We found a remarkable reduction in the volume of sweat and an improvement to the patient’s quality of life using this novel low-cost and low-impact approach.
In 1991 the U.S. Congress mandated that the National Institutes of Health (NIH) form the Office of Alternative Medicine to study alternative medical therapies, especially in oncology care. Shortly after, the National Cancer Institute (NCI) created its own division of complementary and alternative medicine (Office of Complementary and Alternative Medicine). At the genesis of the field 30 years ago, what were we hoping to see accomplished by now? In this article we take a look back at milestones, shortfalls and future directions. Exciting opportunities exist to direct our established subspeciality’s future directions and we have made valuable advances the field of integrative oncology over the last 30 years: 1, IV high dose ascorbate has clinical research-based applications when used concurrently with some chemotherapeutic agents. 2. Whole body, extracorporeal and locoregional hyperthermia are being applied in treating solid tumors, including brain tumors. 3. PDL-1 tumor microenvironment testing and PDL-1 inhibitor immunotherapies have surprisingly excellent outcomes in a subgroup of cancer patients. 4. Tumor DNA sequencing (resected tumor and circulating tumor DNA in blood) has led to personalized precision targeted treatments. 5. Glucose metabolism’s role in cancer progression is better understood and better therapies are available (e.g., intermittent fasting, metformin). 6. Medical cannabis has a larger role in treating chemotherapy-related side effects and shows promise for anti-proliferative effects.
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