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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?

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?”

Daily Cannabis Use is Associated With Lower CNS Inflammation in People With HIV

Recent cannabis exposure has been associated with lower rates of neurocognitive impairment in people with HIV (PWH). Cannabis’s anti-inflammatory properties may underlie this relationship by reducing chronic neuroinflammation in PWH. This study examined relations between cannabis use and inflammatory biomarkers in cerebrospinal fluid (CSF) and plasma, and cognitive correlates of these biomarkers within a community-based sample of PWH.

Spiritual Benefit from Cannabis

Like many mind-altering plants, cannabis has been part of spiritual practices for thousands of years. It has deep roots in Hinduism, Islam, Rastafarianism, and indigenous traditions in Asia, Africa, and elsewhere. Yet almost no attention has been given to how contemporary adults employ it spiritually. A sample of 1087 participants (mean age = 38.9) completed an online survey assessing their use of cannabis and other substances, as well as spiritual and psychological characteristics.

Inflammatory Bowel Disease and Cannabis: A Practical Approach for Clinicians

This randomized, double-blind, placebo-controlled, cross-over study was conducted to evaluate the safety and efficacy of two-weeks of nightly sublingual cannabinoid extract (ZTL-101) in treating chronic insomnia (symptoms ≥three months).

Cannabis, a Miracle Drug with Polyvalent Therapeutic Utility: Preclinical and Clinical-Based Evidence

Cannabis sativa L. is an annual herbaceous dioecious plant which was first cultivated by agricultural human societies in Asia. Over the period of time, various parts of the plant like leaf, flower, and seed were used for recreational as well as therapeutic purposes. The main chemical components of Cannabis sativa are termed as cannabinoids, among them the key psychoactive constituent is Δ-9-tetrahydrocannabinol and cannabidiol (CBD) as active nonpsychotic constituent. Upon doing extensive literature review, it was found that cannabis has been widely studied for a number of disorders. Very recently, a pure CBD formulation, named Epidiolex, got a green flag from both United States Food and Drug Administration and Drug Enforcement Administration for 2 rare types of epilepsies. This laid a milestone in medical cannabis research. This review intends to give a basic and extensive assessment, from past till present, of the ethnological, plant, chemical, pharmacological, and legal aspects of C. sativa.

Cannabis is associated with blood pressure reduction in older adults – A 24-hours ambulatory blood pressure monitoring study

Medical cannabis use is increasing rapidly in the past several years, with older adults being the fastest growing group. Nevertheless, the evidence for cardiovascular safety of cannabis use is scarce. The aim of this study was to assess the effect of cannabis on blood pressure, heart rate, and metabolic parameters in older adults with hypertension.

Ingestion of a THC-Rich Cannabis Oil in People with Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Authors Carolina Chaves, MD, Paulo Cesar T Bittencourt, MD, MSc, Andreia Pelegrini, PhD Published in Pain Medicine October 2020 Abstract Objective To determine the benefit of a tetrahydrocannabinol (THC)-rich cannabis oil on symptoms and quality of life of fibromyalgia patients. Methods A double-blind, randomized, placebo-controlled clinical trial was conducted for eight weeks to determine the…

A Comprehensive Review of Cannabis in Patients with Cancer: Availability in the USA, General Efficacy, and Safety

Dylan Zylla, MD and colleagues give an overview of cannabis treatments for cancer patients. They provide guidance to clinicians on how to have informed discussions regarding their care.

Oncology Clinicians and the Minnesota Medical Cannabis Program: A Survey on Medical Cannabis Practice Patterns, Barriers to Enrollment, and Educational Needs

Authors: Dylan Zylla, Grant Steele , Justin Eklund, Jeanne Mettner, Tom Arneson Published in Cannabis and cannabinoid research October 2018 Abstract Background:Medical cannabis has been available in the State of Minnesota since July 2015 through the Minnesota Medical Cannabis Program (MMCP). Objectives: Our study aimed to delineate oncology providers’ views on medical cannabis, identify barriers…

Acute effects of naturalistic THC vs. CBD use on recognition memory: a preliminary study

Authors: Tim Curran , Hélène Devillez , Sophie L. York Williams and L. Cinnamon Bidwell Published in Journal of Cannabis Research  2020 Abstract The ratio of Δ9-tetrahydrocannabinol (THC) to cannabidiol (CBD) varies widely across cannabis strains. CBD has opposite effects to THC on a variety of cognitive functions, including acute THC-induced memory impairments. However, additional…

The practical knowledge, experience and beliefs of US emergency medicine physicians regarding medical Cannabis: A national survey

Author: Kevin M Takakuwa, Frances S Shofer, Raquel M Schears Published in The American Journal of Emergency Medicine  January 2020 Introduction Medical cannabis is legal in 33 US states [ 1 ] but remains federally illegal. The majority of legal states require physicians to provide cannabis recommendations in order for patients to have access to it….