Two federal agencies are alerting CBD companies that their marketing claims are illegal. The FTC and FDA sent out letters to several CDB companies deemed to be making false or unsubstantiated claims about their products’ health benefits and carrying out improper marketing and selling practices. The first round of letters went out in March and a second group in September. Three companies were alerted in each incidence; in the first, PotNetwork Holdings in Florida, Nutra Pure in Washington state, and Advanced Spine and Pain in New Jersey were contacted. The agencies did not reveal the names of the companies who received the second round of written alerts. The various businesses reportedly marketed their CBD products (like tinctures, capsules, oils, gummies and creams) as able to limit, treat or cure cancer, autoimmune diseases, neurodegenerative conditions and other maladies. The FTC expressed in a letter that it is illegal “to advertise that a product can prevent, treat or cure human disease unless you possess competent and reliable scientific evidence, including, when appropriate, well-controlled human clinical studies, substantiating that the claims are true at the time they are made.” “Your products… are not generally recognized as safe and effective for the above-referenced uses and, therefore, these products are “new drugs”... New drugs may not be legally introduced or delivered for introduction into interstate commerce without prior approval from the FDA,” another letter states. Hemp and its derivatives, like hemp-derived CBD, are now legal via the recent Farm Bill, but the FDA has not completed a process to approve CBD usage in foods or dietary supplements. While research has shown CBD can be effective in helping people with substance use disorders, it has only been federally approved to treat seizure disorders as a component of the medicine Epidiolex. Because CBD is part of an approved drug, “products containing [it] are outside the definition of a dietary supplement,” the FTC states, further complicating the marketing field. In all cases, the letters required that the recipients respond to the federal bodies within 15 days, lest they be subject to legal injunctions and/or orders to refund money to consumers. FDA Commissioner Scott Gottlieb tweeted in the spring that the warning letters “make clear that #FDA has and will continue to monitor the marketplace and use our authorities to take action against companies illegally selling these types of products when they are putting consumers at risk.” Gottlieb previously indicated that it will likely take years to create a CBD regulatory plan without additional movement from congress, Forbes reports. In November 2019, the House Judiciary Committee approved the Marijuana Opportunity Reinvestment and Expungement Act of 2019, or MORE Act, which would decriminalize marijuana at the federal level. It passed 24-10 and now heads to the full House for a vote. Article Sources: FDA FTC Forbes Marijuana Moment CBS Twitter

Gavin Newson, the governor of California and the leading 2016 proponent of the recreational pot legalization initiative Proposition 64, signed a bill on Wednesday that will allow parents of students in some California school districts to bring cannabis to their children at K-12 campuses. The bill states that medical cannabis can be administered to students by parents on campus if approved by their school board. However, the law indicates that cannabis cannot be administered through vaping or smoking form. Senator Jerry Hill of San Mateo, California, emphasized the importance of the bill in allowing hundreds of students who suffer from illnesses, including epilepsy, to access their prescribed dosages of cannabis oils, pills, and creams. He also explained that for many of these youth, medical marijuana is the only medication that works. This bill will allow them to receive these cannabis products with as little disruption as possible during the school day. Photo Source: Forbes.com Parents will be required to obtain a doctor's note to administer to their students on campus. There is push back as to whether this bill will be beneficial or harmful to school-aged youth, as well as if it's even necessary to allow administration in the school environment. Scott Chipman of American Against Legalizing Marijuana called the bill "an unnecessary stunt." He notes that the FDA has approved a drug for epilepsy that is administered in the morning and evening. He argues that daily dosages can be taken in the hours before and after school. Most Republican lawmakers expressed concern that the passing of this bill could lead to drug abuse. California Police Chiefs Assn., also opposed the bill, saying that preventing "youth under the age of 21 from accessing all types of cannabis products" is one of their main priorities. Jackie Goldberg, a Los Angeles Unified School District board member, believes that "it ought to be available as a need if the student's family gets a prescription or a recommendation from a medical doctor for using it." Goldberg also clarifies that the medication allowed by the bill does not include THC; the part of the plant that produces a "high." The new law will take effect on January 1.

It’s estimated that the number of visits to emergency rooms because of cannabis overdose tripled between 2011 and 2019, a period of time when recreational and medical cannabis was legalized across many states. Heavy users may present with cannabis toxicity or cannabinoid hyperemesis syndrome, but so far there are no FDA approved drugs to treat acute overdoses of cannabis or synthetic cannabinoids like Spice and K2. There have been case reports of successful treatment of with a continuous naloxone infusion, but a new drug is needed for acute cannabis overdose (ACO) and the award of an $850,000 grant from the National Center for Advancing Translational Sciences (NCATS) to contract development and manufacturing organization IRISYS LLC may now see this come to fruition. San Diego-based IRISYS have been given the grant to develop an injectable form of a drug called drinabant, which binds to the same brain receptor as THC, blocking its activity. Drinabant is currently an investigational drug being developed by Opiant Pharmaceuticals, an NCATS collaborator, but orally ingested drinabant is absorbed too slowly to reverse the clinical manifestations of ACO. The hope is that an injectable form of the drug will act more quickly to reverse the symptoms of ACO rapidly, thus limiting the time spent in an emergency room. Symptoms of ACO include anxiety, feelings of paranoia, agitation, visual and auditory hallucinations, and nausea. The popularity of cannabis edibles is believed to be behind increasing reports of acute overdose as they often contain much higher amounts of THC than available through smoking a joint. Edibles are usually in the form of brownies, cookies and candies, so young children are especially vulnerable because these may be easily mistaken for treats. "The need to quickly and effectively reverse ACO symptoms, including in vulnerable populations like children, is a strong motivating factor pushing us at IRISYS every day to put in the effort needed to ensure that this drug is ready for clinical trials as soon as possible," stated Robert Giannini, Ph.D., IRISYS president and CSO/CTO. Sources: Marijuana Business Daily, PR Newswire

In the last months of the years, dozens of holidays are celebrated across cultures, which means lots of food and quality time spent with family and friends. And while the holiday season can be a joyous one, it can also be quite stressful for many. Family members and friends may ask about your work, your personal life, and, often, your health. And it may be easier to discuss these matters with people you are close with but it can be difficult when catching up with someone you haven’t seen in a while – or someone who has differing opinions or beliefs, someone perhaps who opposes use of cannabis, even for medicinal uses. If you are a new medical cannabis patient, this situation may represent unfamiliar and uncomfortable territory. And even if you choose to keep your cannabis use to yourself, it may be worth considering alternative ways to approach this conversation. We’ve compiled a list of suggestions aimed at de-stressing these holiday situations below: Share Your Personal Journey to Cannabis. How did you first become interested in medical cannabis? Did your state recently legalize its use? Had you heard anecdotal stories about its success for your condition? Did you read up on the research? Your loved one may better understand your situation if you are honest in explaining how you decided medical cannabis would be right for you. Dispel Some Common Myths about Cannabis. If your loved one is from a generation in which cannabis use was portrayed as “evil” or believes it makes you lazy or a burden to society, try to patiently dispel some of these myths. And that cannabis has proven medical benefits. It wouldn’t hurt to mention that a few cannabis-based products are actually FDA-approved and that additional therapies are closer than ever to getting onto pharmacy shelves. Explain the Legal Cannabis Industry. Those who are not familiar with the legalized cannabis industry may still think of marijuana that is sold in baggies on the street. And they may not know that there are different types of strains and phytocannabinoids that produce a wide range of effects. For example, explaining the difference between psychoactive THC and non-psychoactive CBD may be very helpful in dispelling the common myths of the “high.” Describe the Different Methods of Cannabis Consumption. A loved one who may be concerned about smoking (perhaps an ex-smoker) may try to point out that using cannabis can be harmful to your lungs (whether this is actually the case or not is probably not worth arguing). Even if you choose to consume cannabis through smoking, it might be helpful to explain that there are so many other ways to consume cannabis – topicals, tinctures, edibles, vaping, and the list goes on. If your loved one is interested in using medical cannabis, this may be very important for them to consider. Show Them the Research on Cannabis. For some people, you can talk until your blue in the face and they still won’t let up with the questioning. In these cases, it may be the most helpful to show them the research studies on medical cannabis. It will probably be best to summarize the results from clinical studies and mention supporting data from pre-clinical (animal model) work. It that still doesn’t satisfy their curiosity, point them to PubMed or ClinicalTrials.gov so they can do some research of their own. We hope these tips may be helpful for you. Watch this video for some additional advice and check out these free resources available from Americans for Safe Access:

A recent review published in Frontiers in Nutrition highlighted the terpene myrcene’s phytotherapeutic profile and its range of potential medical applications. Myrcene is one of the most common terpenes. It is found in over 200 plants including verbena, bay, lemongrass, mangos, hops, and cannabis. The review outlined key findings of myrcene’s anxiolytic, anti-inflammatory, antioxidant, and analgesic properties. It concluded that myrcene is generally non-allergenic and non-toxic if consumed in moderate levels, but more research studies involving human subjects are needed to determine the most effective and safest amount. Terpenes in cannabis are responsible for the aroma, taste, and therapeutic efficacy of a given strain. Terpenes are effective even at low concentrations when administered orally or topically. Myrcene, also known as beta-myrcene, is responsible for the sedating effect associated with indica strains, and it is often used as a muscle relaxant or sleep aid. It is also used as a flavoring agent in food and beverages, and is deemed Generally Recognized as Safe (GRAS) by the Food and Drug Administration (FDA). Strains with more myrcene tend to have sedative effects while those with less myrcene usually boost energy. Some myrcene-rich strains include indicas like OG Kush and Granddaddy Purple, while strains low in myrcene tend to be sativa-dominant. Interactions with other terpenes significantly determine myrcene’s effectiveness. Myrcene comprises roughly 50% of a cannabis plant’s terpene profile, but myrcene’s interactions with other terpenes has a powerful effect on therapeutic potency. A study of phytocannabinoid and terpenoid entourage effects, conducted by Dr. Ethan Russo, indicated that the synergistic effect of different terpenes working together is more powerful than one individual terpene. Another key finding of this study was that myrcene facilitates the movement of THC and CBD across the blood-brain barrier, highlighting how myrcene can modify the effects of a cannabinoid and in some cases act as a precursor to the production or activation of other terpenes. Sources: Frontiers in Nutrition, NIH, Strainpoint

A significant shift from using alcohol to cannabis is taking place among American adolescents. Adolescent alcohol abuse has decreased since 2000, while cannabis use has increased 245% over the same period. The review, published in the journal Clinical Toxicology, tracked intentional instances of abuse and misuse reported to the National Poison Data System (NPDS). Experts analyzing the data suspect edibles are a key factor in this increase. Cannabis use among youths has risen dramatically since 2017, when decriminalization and legislation became more widespread. Currently, adult recreational use is legal in 19 states, and 36 states have active medical cannabis programs. The review found 338,000 instances of intentional abuse or misuse of young people aged 6-18. More than 80% of all reported exposure cases occurred in young people aged 13 to 18, with most ingestions occurring in male youth (58.3%). 2000 saw the most significant number of alcohol abuse cases. Cannabis exposure cases remained relatively stable from 2000 to 2009, but incident rates increased after 2011 and accelerated from 2017 to 2020. The study suggests that adolescents are increasingly choosing vapes, tinctures, and edibles over smoking cannabis. These products can be used in more discrete and convenient ways, making detection by parents, teachers, and authorities more difficult. Consumption of all cannabis products increased, but edibles demonstrated the highest average monthly increase of product forms. A growing problem associated with edibles is the unanticipated duration and effect of a THC dose that is too high. Some youth may consume too many edibles at once, not realizing the effects intensify over time, peak after thirty or more minutes, and last several hours. According to study author Dr Adrienne Hughes, Assistant Professor of Emergency Medicine at Oregon Health & Science University, “Compared to smoking cannabis, which typically results in an immediate high, intoxication from edible forms of marijuana usually takes several hours, which may lead some individuals to consume greater amounts and experience unexpected and unpredictable highs.” Individuals can have a range of mild to extreme reactions due to misuse. Exceeding the recommended dosage and high potency cannabis poses a threat to teens who may experience mental symptoms such as paranoia and physical symptoms such as racing pulse and nausea. Sources: Clinical Toxicology, Eureka News Alert

It may be a federally legal crop, but the Sailors and Marines of the US Navy have been told they cannot use hemp in any form—even if it’s just a trace amount in cosmetic items such as shampoos, soap and lip salve. Ironically, the memo detailing the hemp ban was released just four days after the House of Representatives approved an amendment to a spending bill that would have theoretically allowed military service members to use hemp, or its derivatives, including cannabidiol (CBD). A number of times previously, various military branches have told serving members they cannot use CBD even though it is a legal and non-intoxicating part of the cannabis species. In February, the Department of Defense (DOD) backed this up with a blanket policy barring all active and reserve service members from using hemp products, though this did not go as far as mentioning products used externally. The new advice could be seen as excessively restrictive, but seems to come out of an abundance of caution. Any trace of THC in the urine of service personnel would be seen as substance misuse, and incompatible with military readiness. “The United States Food and Drug Adminstration (FDA) does not determine or certify the THC concentration of commercially available hemp products,” the Navy memo explains. “Accordingly, these products may contain appreciable levels of THC, yet omit any reference to THC on the product label and/or list an inaccurate THC concentration”. Some CBD products for oral use have been found to contain THC, occasionally in unacceptable levels, but products used topically haven’t previously been implicated. The new Navy ruling specifically mentions hemp-containing “shampoos, conditioners, lotions, lip balms, or soaps”. Any violations of the ban are subject to adverse administrative actions and/or disciplinary action under the Uniform Code of Military Justice, though if a service member could not reasonably have known a product was made or derived from hemp, allowances will be made. Use of cannabinoid formulations approved as drugs by the FDA for which the service member has a valid prescription, such as dronabinol (Marinol, Syndros) and cannabidiol (Epidiolex) will still be allowed by the Navy. Source: Marijuana Moment

Over the past few years, there’s been a renaissance in cannabis research. Though we still have a long way to go to figure out exactly how cannabis works in the brain and to understand how it affects the body, with each new study, we are getting closer and closer to answering those questions. Here we provide a summary of some of the year’s “greatest hits” in cannabis research: Cancer This year, the PDQ Integrative, Alternative, and Complementary Therapies Editorial Board published an updated overview on medical cannabis for cancer patients. This report provided a summary of pre-clinical studies, including the effects of cannabis compounds on liver, breast, and colon cancers. While most clinical trials conducted in patients have not yielded conclusive results in many of these cancers, pre-clinical studies, using either animal models or cell lines, continue to produce encouraging data. In one particular study published this year, researchers found that cannabis compounds can target leukemia cells and, in combination with current cancer therapies, can actually enhance their effect – essentially delivering a more powerful anti-cancer treatment. And while these results were conducted in cell lines and not in human patients, results such as these help us get closer to developing cannabis-based therapies that specifically target cancer cells, instead of just addressing cancer-related symptoms. In fact, Medicanja Limited’s cannabis-based compound called chrysoeriol that is under evaluation for the treatment of acute myeloid leukemia, a rare form of leukemia, received orphan drug designation from the FDA this year – that means, once its ready for submission, its approval will be accelerated so that it will get into patients’ hands sooner. And that’s very good news. Epilepsy Cannabis-based therapies for epilepsy, particularly pediatric epilepsy, are also building toward FDA approval. GW Pharmaceuticals has developed a cannabis-based therapy, Epidiolex, for different types of pediatric epilepsy, including Dravet syndrome, Lennox-Gastaut syndrome (LGS), Tuberous Sclerosis Complex, and Infantile Spasms. These rare and severe forms of epilepsy usually do not respond to current medications or cause a wide array of serious side effects. While some parents have been treating their children with cannabis, FDA approval would allow for more widespread use, especially in states where medical cannabis has not been legalized. This year, GW presented positive results from their Phase 3 trial on Epidiolex in patients with LGS. Justin Gover, CEO of GW, said in a press release, "Having recently completed our New Drug Application submission to the FDA, we are now focused on the goal of gaining approval for Epidiolex in mid-2018 and making this much-needed, first-in-class medicine available to the patients who need it." Check out Part II of this article to learn more about research news in 2017.

A growing number of states have legalized marijuana for medical and/or recreational purposes. Cannabis is a plant that produces resin-containing compounds called cannabinoids. Cannabinoids, also known as phytocannabinoids, are chemicals that impact various biological systems, including the central nervous system and the immune system. Delta-9-tetrahydrocannabinol (THC) is a psychoactive cannabinoid which means it has an impact on the brain. Cannabidiol (CBD), another cannabinoid, is not psychoactive but still maintains therapeutic potential. While cannabis isn’t used as a drug to directly treat cancer patients, there is significant interest in using cannabis to manage the side effects of cancer and cancer therapies, such as anxiety, depression, pain, and nausea. In 1975 study tested cannabis in a randomized trial finding that THC reduced vomiting caused by chemotherapy. Since 1985, three cannabis drugs have been FDA-approved to treat chemotherapy-induced nausea and vomiting. Two of these approved drugs have the active ingredient dronabinol (Marinol and Syndros), and one is comprised of a synthetic cannabinoid, nabilone (Cesamet). Recent studies continue to support the efficacy of these agents for managing these symptoms. A systemic review, including studies published up through August 2020, compared the use of cannabis to drugs established as antiemetics. The study considered oral use of dronabinol and nabilone along with intramuscular administration of levonantradol, a synthetic form of dronabinol. In total, the review considered over 1,300 patients from 30 separate studies. The authors concluded that cannabinoids were more effective at reducing chemotherapy-induced vomiting than non-cannabis drugs such as prochlorperazine and chlorpromazine. However, the study also found that side effects such as dizziness, depression, and arterial hypotension were more prominent in patients treated with cannabis agents. In 2020, a multicenter Phase II trial investigated a combined THC:CBD cannabis extract for chemotherapy-induced nausea. The study found that the THC:CBD combination was associated with reduced nausea and vomiting. Importantly, no additional side effects were observed in the patients receiving THC:CBD. The American Society for Clinical Oncology recommends using dronabinol or nabilone for cancer patients experiencing nausea. While many cancer patients experience reduced nausea and vomiting from treatment with cannabis agents, the side effects should be closely monitored to ensure they don’t outweigh the benefits. Sources: NEJM, BMJ, Am J Med, Annal Oncol, J Clin Oncol

As U.S. states continue to legalize the use of marijuana, so is the number of American women using cannabis before becoming pregnant and to treat morning sickness, anxiety, and lower back pain. Research has indicated that the use of marijuana, and its prenatal exposure, holds long term consequences on the development of a baby’s brain and can contribute to the increased risk of psychiatric disorders like schizophrenia. Now, researchers at the University of Maryland School of Medicine, found that the FDA-approved drug pregnenolone can reverse the negative effects of marijuana use on experimental animal models exposed prenatally to THC--the psychoactive component of cannabis. The drug is also being investigated for treating schizophrenia, autism, and bipolar disorder. "This is an exciting finding that suggests a therapeutic approach for children born to mothers who used cannabis during pregnancy," said Joseph Cheer, PhD, a Professor of Anatomy & Neurobiology and Psychiatry at the University of Maryland School of Medicine. "It also raises important questions that need to be addressed such as how does pregnenolone exert its effects and how can we improve its efficacy? Do these detrimental effects persist into adulthood, and if so, could they also be treated in a similar way?" The study provides insight on the importance of physicians cautioning their pregnant patients not only on alcohol and cocaine use but also on the potential negative consequences of using cannabis during pregnancy. Findings of the study were published in the journal Nature Neuroscience. Source: Science Daily

Fibromyalgia is a common disease impacting millions of adults in the United States. The condition can be extremely debilitating, causing pervasive bodily pain, trouble sleeping, and depression. Due to its poorly understood pathophysiology, the disease is challenging to treat and usually involves a combination of medication and lifestyle modifications. The Food and Drug Administration (FDA) has only approved a handful of drugs such as certain antidepressant and anticonvulsive medications for the treatment of fibromyalgia; however, they may not be particularly effective, and in fact, are not approved by the European Medicine Agency. Due to the mysterious nature of fibromyalgia, patients can go years and see multiple doctors before receiving a correct diagnosis. This can make the disease very costly from a financial perspective as well. One of the hypotheses regarding the pathophysiology of fibromyalgia involves the dysfunction of pain modulatory systems such as the endocannabinoid system. Although this theory is far from conclusive, it has led many to postulate that cannabis could be helpful for the treatment of fibromyalgia. In August 2021, a systematic review of available studies was published examining whether cannabis can help manage fibromyalgia. This review looked at 22 studies, including systematic reviews and randomized clinical trials. Although the results of selected studies were mixed, some demonstrated that cannabis could improve quality of life, promote better sleep, and reduce symptoms in those with fibromyalgia. Earlier studies have also shown the efficacy of cannabis for the treatment of fibromyalgia. In 2019, the results of a prospective cohort study involving 367 participants were published. The study demonstrated that cannabis significantly reduced pain intensity and improved quality of life for fibromyalgia patients after six months of cannabis treatment. This study was significant given the extended follow-up period and large cohort size, which controlled for major limitations of other trials investigating cannabis as a treatment for fibromyalgia. Although additional randomized controlled trials will be needed to clearly establish cannabis as an efficacious and safe treatment for fibromyalgia, the results of available studies are promising. Indeed, the COVID-19 pandemic has put an additional physical and mental strain on those suffering from this condition due to influences such as social isolation. Taken together, the lack of efficacious treatments for fibromyalgia, present life stressors we face, and promising results of available literature, the continued exploration of cannabis as a treatment for fibromyalgia is most certainly worthwhile. Sources: Cureus, Journal of Clinical Medicine

The research community has made incredible progress in developing medications to treat HIV/AIDs in the last 15-20 years. Although still a very serious condition, those with HIV/AIDs can now live longer and healthier lives. And with the advent of a drug that can now help stop the spread of the disease by preventing its transmission, we have greater potential to control disease acquisition. Despite this progress, there is no cure for HIV and patients with this condition will have it their entire lives, whether or not it progresses to AIDs. And while antiretroviral medications for HIV/AIDs are effective, they also cause significant side effects, such as anemia, vomiting, nausea, headache, fatigue, and diarrhea. Patients have therefore been turning to medical cannabis for many years to address some of these side effects. And HIV/AIDs is one of the most common conditions approved for medical cannabis in most states in the US where its use is legal. Numerous studies have confirmed that cannabis is effective in addressing side effects associated with antiretroviral medications. In fact, the FDA has approved a few cannabis-based therapies for weight loss associated with HIV. Additional research has shown that cannabis may also be effective in reducing neuropathic pain. Preliminary studies have even suggested that cannabis may impact immune system cells directly and could even stop virus replication – although these results have not been consistently reported across the literature. Recent Study Reveals a New Role for Cannabis in HIV In addition to the above-mentioned side effects associated with antiretroviral medications, those with HIV also experience a decline in cognitive function, a very challenging part of living with the condition over time. Some researchers believe that these cognitive difficulties may be linked to inflammation in the brain, which could result from over activation of the immune system. Norbert Kaminski, PhD, Director of the Institute for Integrative Toxicology at Michigan State University, began studying the effect of cannabis on the immune system in the 90s and made some important discoveries on how cannabis binds to proteins in the immune system. Recent work in his lab has revealed that HIV patients who use cannabis have significantly lower levels of inflammatory cells than patients who do not use cannabis. Thus, cannabis consumption could result in a reduction of inflammation-induced cognitive decline in those with HIV. The Future of Medical Cannabis Research and HIV In the wake of a cannabis research renaissance, larger-scale clinical trials are being initiated to get a bigger picture of how exactly cannabis affects patients over the long term. In fact, the most comprehensive study on cannabis and HIV is currently underway at the University of Florida (UF). “We have a shared vision of a day when people affected by alcohol, substance abuse, mental health and HIV can have the same quality of life and health outcomes as everyone else,” said Robert Cook, MD, MPH, the study’s lead investigator and a professor of epidemiology and medicine at UF, in a press release.

More than 5 million Americans are living with Alzheimer’s disease (AD) according to the Alzheimer’s Organization. When the situation gets bad for patients, doctors can prescribe a number of medications that include antipsychotics and sedatives. A recent case report in the Frontiers in Psychiatry journal focuses on the medical treatment of a female AD patient, aged 69, who was a patient at the Medical University of Innsbruck, Austria. The woman's symptoms on initial assessment included memory loss, poor spatial orientation, paranoia, and mild depression. Over time the patient’s physical and mental condition deteriorated, necessitating the use of a heavy cocktail of prescription medications to deal with seizures and psychotic behaviour. She also became increasingly uncommunicative and physically aggressive towards those caring for her. The doctors concluded that, in large part, the patient's distressing symptoms were due to the side effects of the heavyweight medications she was taking, and that these were seriously impacting her quality of life. They decided to see if a low dose of dronabinol, a lab-made form of the cannabis chemical THC might help. The drug was initially created to help treat nausea and lack of appetite associated with chemotherapy or AIDS and is FDA-approved under the brand name Marinol. The results were really encouraging—dronabinol treatment had a significantly positive effect, improving the patient's mental state and aggression, and alertness. So much so, doctors were able to cut her usage of six medications down to just three. Cannabinoids like THC have a distinct pharmacologic profile that may offer an alternative approach to antipsychotics and sedatives for treating neuropsychiatric symptoms. Of course this is just one patient—a limitation that the researchers readily acknowledge. Meanwhile the Alzheimer’s Society cautions that ‘speculation regarding cannabis and cannabis-derived products as an Alzheimer’s therapy has outpaced current scientific information’. Nevertheless there is added weight to this case report as there was a very long follow-up period of 11 years with a close and detailed recording of clinical data and medication history. 'Our report underpins the need for randomized, controlled trials to explore the effect of cannabinoid receptor agonists on behavioral and psychological symptoms in patients in different stages of AD', the researchers wrote. In Perth, Australia, investigators are already on the case, testing a medical cannabis spray in patients with milder demetia, while Denver recently issued its first license for medical marijuana research to company Med Pharm, who will also examine the effects of cannabis on Alzheimer’s disease. Sources: Merry Jane, Frontiers In

It’s hard to keep up with all of the cannabinoids that the science community is constantly discovering. There are over 100 known to date, and we can expect that number to increase over time. One of the latest getting attention lately is HHC, which is short for Hexahydrocannabinol. So, what is it? HHC occurs naturally in the hemp part of the cannabis plant and receives mixed feedback as to whether it actually gets the user high. Early reports indicate a pleasant, mellow high, one that is similar to that of Delta 8, which is not quite as strong as that of Delta 9, but stronger than that of CBD. HHC can also be synthesized in a lab by using CBD as a base, requiring the addition of hydrogen, and using a metal catalyst. Note that synthetization can be a dangerous process that a layperson should not try at home. Additionally, users should always be wary of ingesting anything synthesized because of potential byproducts and pollutants that might be in the product. Can it show up on a drug test? While early reports indicate that it does not, it’s probably not wise to bet your job on it or to risk a career opportunity prior to an interview. In terms of consumption methods, HHC can be ingested the same way you ingest other cannabinoids, via smoking, vaping, edibles, tinctures, etc. And in terms of health risks, no one really knows yet, and the cannabinoid is too new to the mainstream market in order for there to be any definitive, unbiased research to rely upon yet. Furthermore, for users looking for something that has a longer shelf life, HHC has an advantage over traditional THC. Due to HHC’s two extra hydrogens, the cannabinoid has a level of stability that gives it a longer life span. As always, users should do their research and due diligence before trying a new cannabinoid, and test in low doses for best results. Sources: WebMD, FDA, Leafly, Cannabis Business Times

With the legalization of the use of marijuana in medicine and FDA approving two cannabis-derived medications, more research is now conducted on other possible therapeutic applications of cannabis in different areas of medicine, one of which is mental disorders. Although some earlier studies showed that the chronic use of marijuana could lead to psychiatric disorders in a condition known as cannabis-induced psychosis (CIP), a new study published in the journal JAMA Psychiatry by researchers at King’s College London is showing the opposite. In a study comprising of 33 individuals at high clinical risk of psychosis and 19 healthy control individuals, they concluded that administration of a single dose of cannabidiol (CBD) could help reduce psychotic symptoms. These findings could lead to the rise of a new drug for psychosis in the future alternative to the currently used medications as Thorazine and Haldol which cause serious side effects. “The mainstay of current treatment for people with psychosis are drugs that were first discovered in the 1950s and unfortunately do not work for everyone,” .said lead researcher Dr. Sagnik Bhattacharyya, a reader in translational neuroscience and psychiatry at the King’s College London and the study’s lead researcher “Our results have started unraveling the brain mechanisms of a new drug that works in a completely different way to traditional antipsychotics. 16 participants received a single oral dose of 600 mg of CBD while the other 17 received a placebo. The control participants were not given any drug. A functional magnetic resonance imaging (fMRI) was used to study all the participants while performing a verbal learning task that engages the three regions of the brain that is known to be involved in psychosis. The results showed that participants who received CBD had less severe abnormal brain activity than those who received placebo, this is suggesting that CBD can help restore brain activity to normal levels. Other previous research from King’s College London showed that cannabidiol works oppositely to tetrahydrocannabinol (THC); which is the compound in cannabis that is found to be responsible for the high effect after smoking marijuana which is also linked to the development of psychosis. “Although it is still unclear exactly how CBD works, it acts in a different way to antipsychotic medication, and thus could represent a new class of treatment,” said Philip McGuire, Ph.D., a King’s College London professor and lead author of the 2017 study. “Moreover, CBD was not associated with significant side effects. This is also potentially important, as patients may be reluctant to take antipsychotic medication because of concerns about side effects,” he said. Dr. Bhattacharyya and his colleagues are now working on the first large-scale, multi-center trial to test if cannabidiol could prevent young people from developing psychosis. Source: Healthline, King's College London, JAMA Network

Johns Hopkins University’s Center for Psychedelic and Consciousness Research just received a $4.9 million grant to study how psychedelic treatment affects behavior, mood, cognition, brain function, and biological markers of health. This landmark grant will allow JHU researchers to conduct a multi-site -multi-year- study building on their previous research pointing to the effectiveness of psychedelic treatments for addiction and anxiety disorders. Several earlier research studies highlighted the effectiveness of psilocybin in managing addiction and anxiety. JHU’s 2014 pilot study examined the role psilocybin played in smoking cessation. Participants engaged in 15 weeks of intensive therapy and journaling about smoking addiction triggers prior to receiving the psilocybin. In supported conditions with proper screening, preparation, monitoring, and follow up care, participants experienced a reduction of nicotine craving after taking moderate psilocybin doses. JHU researchers believe that psilocybin is effective because it is a non-addictive way to treat the root cause of addiction and not just the symptoms associated with nicotine withdrawal. Some study participants claim they have not had a cigarette since the psilocybin treatment for smoking cessation. A 2016 study found that psilocybin alleviated the anxiety and depression experienced by cancer patients. Researchers noted patients sustained moderate to high improvements in mood for 6 months. JHU researchers believe that this efficacy is the result of psilocybin enabling “crosstalk” between different parts of the brain that helps minimize anxious thoughts. The effects of psychedelics and cannabis are both under-researched, but they are gaining widespread attention for their medicinal potential. A recent research study on cannabis use for mood disorders suggests that cannabis effectively reduces symptoms of anxiety and depression. The Drug Enforcement Agency (DEA) proposed increases in cannabis and psychedelic drug production for research purposes. The objective is to develop FDA approved treatments for several psycho-active plant materials currently classified as Schedule I controlled substances. Research on mixing psychoactive elements is critical for understanding how plant medicine can be optimized to treat mental disorders and additions. These key studies, increased access to federal funding, and the DEA’s proposal signify a turning point in support for research on cannabis and psychedelic treatments for mood disorders. Sources: Johns Hopkins University Medicine, Marijuana Moment, JHU research study on psilocybin reducing anxiety

Australia is quickly joining the ranks of countries beginning to more widely accept the use of cannabis for medical treatment purposes. Australian cultivation of medical marijuana has been legal since October 2016 but now, as medical demand grows, importing and exporting was approved in 2017. Multiple companies have begun making footholds in the market including the Cann Group Ltd., Canopy Growth, Lexaria Bioscience, GW Pharmaceuticals, Bod Australia, and AusCann to name a few. Each of the companies is investing in the cannabis marketplace for Australia, both in research and in distribution and/or production to meet demand. For example, Lexaria Bioscience received approval for their patented DehytraTech technology in Australia as a method for improving the rate of absorption and cannabinoid molecular action for the edible cannabis market. They hold a similar patent in the United States. Early last year (Feb 2017) the Cann Group Ltd. was the first organization granted a license in Australia to legally grow and research medical cannabis. In a media release, Cann Group Chairman Allan McAllam stated, “The licence allows us to apply for a permit to progress our research and development programs, which are particularly focused on the breeding, cultivation, extraction and characterisation of cannabinoids. It will also mean we can further discussions we have underway with a number of leading Australian research and technology organisations to access additional expertise and resources. We are putting in place the building blocks to ensure we have industry-leading research, cultivation and manufacturing capabilities. This will position us to eventually provide Australians with access to innovative and high quality medicinal cannabis treatments." Epidiolex is a cannabidiol based drug being studied for its benefits in reducing epileptic seizures in conditions where traditional anti-seizure medications have not proven effective. GW Pharmaceuticals, makers of Epidiolex, studied its efficacy through advanced clinical trials in Australia as far back as late 2015, far earlier than others entering the market today. GW Pharma’s cannabinoid product is currently focused on severe, orphan, treatment-resistant epilepsy; it is currently in FDA authorized clinical trials in the United States. Bod Australia, a skincare and cosmetics company in Australia, was granted an import license for medical cannabis products in New South Wales with intents on commencing clinical trials for a proprietary sublingual cannabis extract; according to AusCann, representatives have claimed they are the first organization in Australia to have procured all available licenses related to the production and distribution of medicinal cannabis products. It is noteworthy news that Australia is yet another country, along with parts of the US, Canada, Netherlands, France, and others, to accept and even legalize some or all uses of cannabis; however, I wonder what new countries (or states) will follow suit in legalizing one or both medical or recreational cannabis. I predict that 2018 will be a year of many cannabis science developments across the globe. I studied abroad in Australia and it is an incredible country; rich with culture, history, and now blooming growth in the areas of science and research of medicinal cannabis. It is with great interest that I will be watching this topic as it unfolds, in Australia and elsewhere.

A study from the University of Arkansas for Medical Science suggests that CBD may be damaging to our livers in the same way that alcohol and other drugs are. Using mice to test CBD hepatotoxicity, researchers found that people using CBD could be at an elevated risk for liver toxicity. Researchers utilized the recommended dosage, as well as safety recommendations, from the CBD-based drug known as Epidiolex – a drug that the U.S. Food and Drug Administration approved the use of when treating certain kinds of epilepsy in children. Epidiolex was the first cannabis-based medicine approved for national distribution in the United States. When examining the mice with various doses of CBD in their system, it appeared that mice that had consumed the higher doses of CBD showed signs of liver damage in as short as 24 hours. Within a few days, those in the sub-acute phase had either died or were near death. Igor Koturbash, Ph.D., told Nutra Ingredients USA that the Epidolex label "clearly states a warning for liver injury. It states that you have to monitor the liver enzyme levels of the patients. In clinical trials, 5% to 20% of the patients developed elevated liver enzymes." Essentially suggesting that Epidolex has the potential to lead to liver disease. Photo Credit: GETTY via Forbes Dr. Hardeep Singh, a gastroenterologist at St. Joseph Hospital, in Orange, California, told Healthline that research showed patients diagnosed with hepatitis C, that used cannabis, had more progression in their liver disease than those who didn't. It has been known, and proven, that the use of various substances like alcohol, drugs, and potentially some natural supplements can affect the liver and how it functions. However, few studies explore the effects of CBD on the liver. To date, the FDA has not approved any of the CBD products currently being sold across the U.S. except for Epidolex. Could this CBD-based medicine open doors to more research regarding CBD and its potential cause of liver damage or the FDAs decision to approve further CBD products?

As cannabis products have grown in popularity, the stigma around them is falling, while knowledge is increasing. CBD, the non-psychoactive ingredient in cannabis known for its relaxing effects, is particularly popular. And its usage is growing not just among humans- but their pets too. Proponents for CBD usage in pets say it is effective in treating a variety of health problems- from anxiety to various skin conditions. This may be the case as one study showed that dogs in particular have large numbers of cannabinoid receptors. Other studies have shown that CBD can also decrease pain from arthritis and control seizures in dogs. Despite this, however, there is still very limited peer-reviewed research looking at CBD for dogs and other animals, and the few that have been conducted have had small sample sizes. More than this, although an increasing number of CBD products targeting pets are available both in stores and online, they have yet to be approved by the Food and Drug Administration, meaning that veterinarians can not recommend them. As such, the chief veterinary officer for scientific affairs and public policy at the American Veterinary Medical Association, Gail Golab, asks pet owners to be cautious. “It’s not that we don’t see potential in these products because we do,” says Golab. “It’s that we want their potential to be demonstrated through FDA approval, and we want to make sure that owners can be confident that what they’re giving their animal is something that’s actually going to help them.” While some may report that CBD oil and other products seem to have relaxing effects on their pets, vets warn that dogs instinctively try to hide their pain. This comes especially as, in certain studies, Golab explains owners tend to observe more positive effects on their pets after they are given CBD than biological measures pick up. Sources: Washington Post, Research Gate, Pub Med

CBD has become wildly popular in recent years as a star in the wellness industry. Myriads of products are now sold containing the cannabinoid, promising everything from curing anxiety to overall better health. It’s not surprising, then, that some of these claims push the boundaries in terms of validity. But a surprising number of the product labels are flat out inaccurate. Why? According to researchers, much of the controversy has to do with product development outpacing the science. Regulatory agencies have simply been unable to keep up. What are some of the inaccuracies? Some products tested have been found to contain THC, in one study up to 60% of the products tested, even though products were labeled as THC-free. Other products do not contain as much CBD as they claim. Others contain much more. Furthermore, some products make therapeutic claims not FDA approved. Their misleading claims include relief from a wide range of ailments including pain and wrinkles. This is especially prevalent in topicals. Researchers also agree that more clinical studies need to be performed as to whether topical products with THC can produce psychoactive effects, get users high, or result in a positive drug test. It’s also important to note that only one product containing CBD has been approved by the FDA, to date. Epidiolex contains purified CBD, which has been approved for treating seizures associated with two syndromes as linked to severe forms of epilepsy. That said, not everyone can take the drug, as some patients have had to stop taking it due to liver problems. Furthermore, the FDA has stated that neither THC nor CBD can be marketed or sold as dietary supplements. Bottom line, anyone who is interested in taking cannabinoids for medical issues should always consult with their health care provider first. Sources: UPI, Health Day, JAMA Network, National Center for Complimentary and Integrative Health

For those who have been following the recent controversy unfolding between states’ rights to sell cannabis (THC-based products) when legalized and the federal government’s imposed jurisdiction, the status of CBD remains as much in limbo as ever. As we discussed in a previous article, no one in the US can really give a straight answer regarding this issue, mostly due to the federal language around legality for CBD-based hemp products. Therefore, many people have taken advantage of this foggy window by processing and selling CBD in states where cannabis has not been legalized – in fact, you can buy it from many different places online. But how much can you trust the quality of online-bought CBD? Are the CBD manufacturers legitimate? And – in those who have never used medical cannabis or CBD before – if that CBD does not affect you, does that mean CBD isn’t a good choice for you or that the product you bought may not be high-quality CBD at all? Why CBD over THC? Let’s rewind for a minute to talk about why patients may choose to use CBD instead of THC or CBD-THC products. As we’ve discussed previously, CBD offers some very helpful benefits, including anti-depressant and anti-inflammatory properties. And, unlike THC, CBD will not get you “high.” In fact, CBD oil is being studied in clinical trials to help treat certain types of pediatric epilepsy. Therefore, it may be a good choice for people who need to take medical cannabis during the day to manage their symptoms but do not want to be affected by the psychoactive properties of THC. Ordering CBD Online A quick online search of CBD will bring up thousands and thousands of results, perhaps leaving one a little overwhelmed if not confused by what to buy. Where do you start? How do you know which product is the best? How do you know is the product a company is selling is actually 100% pure CBD oil? Well, the bad news is that you can’t know what you’re buying online. Unlike a medical cannabis dispensary where you can talk to a budtender about the products, where they come from, and the process used to make them, there’s no way to know if any of the information provided on web sites is really true. And how do we know this? By looking to the data. Buyer Beware A recent article published in the Journal of the American Medical Association analyzed 84 CBD products from 31 different companies. They found that less than one-third of the products tested were accurately labeled with the correct amount of CBD contained. With CBD products costing upwards of $150, these results are quite disappointing, especially if you rely on CBD daily to manage symptoms. Unfortunately, this is not the first time that online CBD products have come under fire. In 2015, the FDA sent a warning letter to a company that overstated its claims for CBD without providing sufficient medical evidence. What Should You Do? IIf you are a medical cannabis patient who uses CBD, there are things you can do to become a more vigilant consumer: -Make sure the oil used to extract the CBD does not contains any harmful chemicals -Look for independent lab results that have proven the quality of the CBD product -Purchase products with very high CBD:THC ratios (most CBD products contain very small trace amounts of THC) -Buy a pure CBD product that has not been combined with another supplement As with any purchase, make sure you are completely comfortable with your decision. If anything looks “off” about the product description or company, make your purchase elsewhere.

Recreational marijuana is illegal in the US under federal law (with the exception of a few states); however, medical cannabis is currently legal in many states. While pre-clinical studies have proven cannabis to be effective for many conditions, each state specifies which conditions cannabis can be used to treat. So, if you happen to live in a state where medical cannabis is legal, take a look at our list below to see if you might be able to take medical cannabis for your condition. These are the most common conditions approved throughout 29 states (and the District of Columbia) where medical cannabis is legal:* Arthritis. This common condition causes painful inflammation in the connective tissue and joints. Medical cannabis can be used as a natural analgesic (pain killer); in fact, both THC and CBD may be effective for arthritis. If you live in Arkansas, California, Connecticut, Hawaii, Illinois, or New Mexico, you may be able to use medical cannabis for this condition. Cancer. Although cannabis has been shown to target cancer cells, this evidence is pre-clinical and remains inconclusive for patient use. However, medical cannabis can address other symptoms associated with cancer or side effects from treatment, including pain, nausea, and appetite suppression. Cancer is an approved condition in nearly every state where medical cannabis is legal. Even if you don't live in one of these states, the FDA has approved three drugs, Marinol, Syndros, and Cesamet, to address nausea and vomiting. Chronic Pain. Many people live with the burdensome symptoms of chronic pain every day, which can make even the most basic tasks very challenging. Medical cannabis may be a favorable treatment and good alternative to opioids by treating back and neck pain, fibromyalgia, headaches, and pain symptoms resulting from another condition. Most states with legalized medical cannabis include chronic pain as a qualifying condition, although specific conditions may differ. Crohn’s Disease. This chronic condition affects the intestinal tract, causing abdominal pain, weight loss, and overall gastric distress, and includes irritable bowel disease and ulcerative colitis. Medical cannabis can treat Crohn’s disease symptoms through its anti-inflammatory and pain-killing effects. Most states include Crohn’s disease as a qualifying condition. Epilepsy. This disorder of the nervous system is characterized by seizure events and, in severe cases, may cause patients to experience hundreds of seizures a day. Seizures can result in cognitive impairment, loss of consciousness, and loss of muscle control. Due to the unpredictability of these events, seizures can prove fatal if the patient is in an unsafe, although common, situation during a seizure, such as driving or taking a bath. CBD is particularly very effective in treating epilepsy, especially in pediatric patients. Most states have approved epilepsy as a qualifying condition, although some specify that the condition must be refractory (unresponsive to current treatment). Glaucoma. Perhaps the first well-known condition to be treated with medical cannabis, glaucoma is a disease of the optic nerve that causes problems with vision. Medical cannabis can help treat elevated levels of intraocular pressure that build up in the eye as a result of the condition. Since medical cannabis has been used to treat the disease for quite a while, its use is approved in most states. HIV/AIDS. While medical cannabis cannot directly target this immune disease, it is effective in treating some of its symptoms, including pain, nausea, and appetite. It can also be used to address some side effects associated with antiretroviral treatments, and is approved in most states. Multiple Sclerosis. This autoimmune disease affects the central nervous system and causes pain and difficulty with motor movements. Medical cannabis has been shown to positively impact inflammation, motor control, abdominal disturbances, and sleep. A roughly equal ratio of THC to CBD may be most effective in treating MS symptoms. Although MS is an approved condition in most states, if you happen to live outside the US, you may have access to Sativex, an oral spray derived from the Sativa plant approved for MS in the UK. *Current as of November 2017. Medical cannabis laws and policies are quickly changing every day, so please remember to check with your state to make sure you stay up to date.

According to a report from the Center for Disease Control and Prevention (CDC) in 2015, 3.4 million Americans have epilepsy, a neurological disorder that can cause hundreds of seizures a day in the most severe cases. Of this group of patients, 470,000 are children. Jacqueline French, MD, chief scientific officer at the Epilepsy Foundation, responded to the report in a press release: “These numbers show a substantial growth from previous data. One of the biggest challenges with epilepsy is that it is frequently under diagnosed and under recognized, in part because it is associated with many co-occurring conditions.” Challenges in Treating Pediatric Epilepsy While there are numerous medications available to treat adults with epilepsy (although different types of epilepsy may require more intensive therapy or additional interventions), pediatric patients, and their parents or caregivers, often struggle the most with controlling the condition. Younger patients may be more likely to experience safety side effects from anti-epileptic medications, which can be nearly as impairing as the disease itself. In fact, in many cases, parents or caregivers would rather their children not even take these medications to avoid these issues. In addition to side effects, very severe forms of pediatric epilepsy do not respond to current medications. Such rare disorders, which include infantile spasms, Lennox-Gastaut syndrome (LGS), and Dravet syndrome, can result in severe disabilities and significantly impair cognitive development. Faced with very sick children and medications that either do not stop the seizures or add a list of safety concerns, many parents have looked to cannabis as a way to potentially help their children. Turning to Medical Cannabis Many parents have based their decision to treat their children with medical cannabis on numerous accounts of anecdotal evidence pointing to its benefits. But what does the literature say? While initial research on cannabis and epilepsy was rather mixed, more recent evidence has added fuel to the cannabis-epilepsy fire. A clinical trial published in the New England Journal of Medicine evaluated the effects of a synthetic form of CBD on 120 children and young adults with Dravet syndrome and treatment-resistant seizures across 14 weeks. CBD treatment significantly reduced the number of seizure in these patients. GW Pharmaceuticals is the company that developed this synthetic form of CBD, called Epidiolex, and is currently testing its safety and efficacy in clinical trials for patients with Dravet syndrome or LGS. Hopefully, Epidiolex will soon proceed to the FDA submission process, on its way to becoming an approved therapeutic. But What Do We Do in the Meantime? Many parents or caregivers whose children need medical cannabis to control their epilepsy are not willing to wait until this product is approved for use – they need to help their children now. And while those who live in states where medical cannabis is legal are able to treat their child with cannabis, those who do not are taking significant legal risks by traveling to states where it is legal and even bringing it back home. Watch the video below to learn about one parent’s experience with cannabis and how current research is making strides toward a greater understanding of the effects of cannabis in children with epilepsy:

A recent study in the journal Pain from researchers out of McGill University may be the first attempt to determine appropriate dosages for cannabidiol (CBD) in treating chronic pain. This is of particular interest because, ever since CBDs have hit the market with claims to help everything from pain to sexual dysfunction, there have been no systematic studies on how much CBD should be ingested to relieve various ailments. Further complicating matters is that CBD is currently classified by the Food and Drug Administration (FDA) as a food supplement and not as a therapeutic. Because of this, CBD companies are actually prohibited to provide dosage information, for in FDA parlance that would be "misbranding", however, since it is considered a food supplement the label is required to provide a "suggesting serving size". Photo Source: UnSplash.com As far as THC content goes (there is almost always trace amounts of THC in CBD oil) the legal percentage of THC allowed ranges from 0.03% to 1%, depending on the country. For example, in the European Union (EU), the cultivation of certain cannabis varieties is granted provided the THC content does not exceed 0.2%. Because of the FDA label issues, if you want to get an idea of what "dose" or amount of CBD to ingest, you would have to rely on unauthorized websites and anecdotal evidence. Until CBD oil is seen as a therapeutic instead of a food supplement, this is essentially all the information we have to go on. The CBD oil industry does provide some dosage recommendations (albeit worded very carefully to not alert authorities). For instance, Highland Pharms, a manufacturer of CBD-based products based out of Washington state, has a page on their website called "How Much CBD Should I Take?" (Serving Size). While they cannot recommend a "dose" per se, they do point out that an average human dose is about 1/mg to 40/mg a day. Photo Source: A L Loriaux That is why the report out of McGill is so interesting. It was directed at finding the optimal dose for pain management in rodents. Because this is scientific research performed on animals the FDA has little if any jurisdiction here. What the report found was, at least for pain, a seven-day CBD injection at a dose of 5 mg/kg decreased measures of allodynia (i.e. pain sensitivity) in a rodent model of neuropathic pain. Another interesting finding, which really just adds to the complexity of our endocannabinoid system, is that CBD treatment affected serotonin levels. This effect could ultimately decrease anxiety, which was also seen in the rats. So, in an attempt to not step on the FDA's toes, if one were to use this "magic" dose found in rats to calculate how much CBD a human should be taking, I will leave it for you to do the math. I will end on two words, however: NOT RECOMMENDED! Sources: Pain, www.leafly.com, Medical Cannabis and Cannabinoids, European Union Commission, how-much-cbd-should-I-take.com, highlandpharms.com

A drug derived from marijuana has been the first to be approved by the U.S. Food and Drug Administration for the treatment epilepsy. The drug, which will be marketed under the name Epidiolex, will specifically seek to treat two serious forms of epilepsy: Lennox-Gastaut syndrome and Dravet syndrome. These syndromes are known to begin in childhood and persist in adulthood. Epidiolex is made from purified cannabidiol (CBD), a compound present in the cannabis plant. CBD is known to have medicinal effects, however, it does not exert the mind-altering high that results from THC, the primary psychoactive component of marijuana. "This approval serves as a reminder that advancing sound development programs that properly evaluate active ingredients contained in marijuana can lead to important medical therapies," explains FDA Commissioner Scott Gottlieb. A few states have approved CBD oil in the treatment of intractable epilepsy or seizure disorders. "Our biggest concerns with the artisanal [or supplement] versions of CBD were related to the consistency," Carson says. "We can't guarantee the consistency." Carson believes he will likely prescribe Epidiolex in the future. "I'm always excited about the potential for a new therapy that has been well-studied and has a great potential for benefit," says Carson. Multiple investigators are examining the efficacy of CBD in the treatment of psychiatric conditions. For example, a clinical study is now underway to examine whether CBD can effectively treat post-traumatic stress disorder and alcohol use disorder. Additionally, another clinical study will test whether CBD could be a potential treatment to help prevent relapse in opioid abusers. Such approval of Epidiolex will help open the doors to more studies on CBD, which will lift a regulatory hurdle. As of now, the Drug Enforcement Administration placed CBD in the heroin and LSD category as a Schedule 1 substance which mean that these drugs have no medical use potential and only a high abuse substance. According to Dr. Douglas Throckmorton, deputy director of regulatory programs at the FDA's Center for Drug Evaluation and Research , when CBD is approved as a medical use drug- the DEA will change its classification. "The DEA will need to make a different scheduling decision for CBD...because it now has an accepted medical use," explains Throckmorton.

Hemp is a form of the cannabis plant that was specially bred for its use in textiles. It contains very little of the psychoactive component tetrahydrocannabinol (THC). Hemp seeds are now the new diet craze and are touted to have many beneficial health effects. Specifically, the seeds of the hemp plant, and the oil produced from them, are said to be a great source of a number of nutrients such as essential fatty acids, gamma linoleic acid (an important essential fatty acid for cellular health) Vitamin E and a great source of chlorophyll (a substance that supposedly has anti-cancer effects). Scientific studies have shown that it is also good for your skin and is useful in treating atopic dermatitis. The market for hemp products has surged in recent years. There appear to be a variety of uses for hemp-based products such as shampoo, facial cream, all types of clothing, protein powders, hot dogs, beer and liquor, dog toys, and even, yes, sports cars. Many of these products do not need FDA clearance if they are sold as supplements. So are companies legitimately using the (small amount) of data on hemp and health to guide them in producing their products? Or is hemp the new snake oil? In 2007 a study was published in the Journal of American Medical Association (JAMA) which tested 84 hemp products and found that only 26 met their claims. The FDA also commissioned a study looking at 24 products and found only 2 out of 24 products met their claims. Other than these false claims, there are a few risks with hemp seeds, especially hemp seed oil. If you are at risk for heart attacks, the large number of fatty acids in hemp seeds could lead to cardiac problems if too much is ingested. Large amounts of hemp seed or oil can act as a laxative and cause diarrhea. Other problems include blood clots, an increased risk of prostate cancer, immune suppression, and problems with brain development. However, as the pharmacologist saying goes, "the dose determines the poison". If anything, you should consult your physician if you are thinking about making hemp seed a large part of your diet. Thus, just like any other "miracle cure" of the day, the hype seems to be based on testimonials rather than scientific evidence. This is not to say that there are no legitimate studies supporting hemp's benefits on health. But just be sure next time you go shopping to take the claims made on that bottle of hemp shampoo with a grain of salt. Sources: JAMA, Journal of Dermatological Treatment, Ministry of Hemp, Farmers' Almanac, Nutrition & Metabolism, StyleCraze.com

Consistent terminology and use leads to greater understanding across all genres of communication. This is the second part of our Medicinal Cannabis Commonly Used Terms Series. Terminology is as complex as anything else needing interpreting. Commonly used terms included in Part II: raw cannabis, herbal cannabis, hemp, hybrid strains, backcross, hydroponics, kief, extracts, synthetics, concentrates, hash, hash oil, and pharmaceutically developed products. Relevant terms are italicized. Botanical Raw cannabis refers to any part of the Cannabis plant. It is widely accepted that in terms of biological taxonomy, Cannabis is the genus and there are multiple species: indica, sativa, and ruderalis. Each of these differ from each other and will be examined in a separate article. Herbal cannabis can refer to any of the three aforementioned species. Hybrid marijuana strains are created by breeders and growers using genetic crossbreeding techniques for plants. Hybrid strains are created to generate crops that contain traits from both parental strains. This form of marijuana utilizes the plant leaves or parts of the plant for ingestion or inhalation. The cannabis plant produces resins which are concentrated with cannabinoids within the trichomes of the plant. The resins can form crystal-like structures on the plant leaves or flower and be separated from plant material by agitation. Synthetics Synthetic cannabinoid-like compounds made by humans and are typically created in the form of chemical extract and are either sprayed on previously dried plant material for smoking or provided in a liquid form for vaping. They are classified as new psychoactive substances (NPS). They are highly intoxicating and dangerous because they are legally sold as an alternative to natural cannabis compounds and are far more powerful than the natural cannabis plant compounds which work together with each other. Street names for synthetics include K2 or Spice. There are synthetic cannabinoids as outlined in the Pharmaceutical section of this article but those are highly regulated and tested for clinical utility; they are not characterized in the same way as street synthetics which are completely unregulated. Extracts Extracts, or concentrates, make up a significant part of the medicinal cannabis market these days but what are they exactly? Cannabis extracts are derived from the cannabis plant using solvents to bring out plant compounds, most commonly in the form of an oil. Additionally, the term magistral preparation may be used and describes any medicinal product prepared by a pharmacist to meet a specific medical prescription/recommendation for a patient. As already mentioned, extracts can be natural or synthetic but most often, when discussing extracts, individuals are referring to natural botanical products. Extraction involves removal of cannabinoids and terpenes from the plant matter. Plant extraction preparation can be done using multiple methodologies for small batch up to commercial extractions. The most common methods use ethanol, hexane, light hydrocarbons, or CO2 Supercritical equipment. Light hydrocarbon extraction uses either butane or propane (sometimes a mix of both) and works efficiently and cost effectively because the non-polar cannabinoids easily dissolve into a soluble form and then the solvents are separated from the final product. Dangers involve hydrocarbon combustibility, so extraction must take place in a highly controlled environment. CO2 supercritical extracts are created using differing phases of carbon dioxide which provides the environment for unique cannabis compounds to be removed from the plant based on their molecular composition. This method is the likely the cleanest and safest, but the equipment is expensive. Kief is a very rudimentary form of concentrate that is sometimes mistakenly referred to as marijuana pollen because it looks powdery and yellowish, similar to pollen grains. Kief is the collection of trichomes that have been separated from the plant matter through grinding and remains loose; trichomes contain a high percentage of cannabinoids so kief is potent. Hash is made through removal of trichomes and then under subsequent pressure forms a solid mass for consumption; kief is the foundation for hash or hashish. It can be produced chemically using a solvent and is then referred to as hash oil. Tinctures are an easy way to deliver cannabis compounds without the need for vaping or smoking. This is a common form of delivery of medicinal cannabis and is made using an alcohol extraction method resulting in a liquid form that can be dropped under the tongue. CBD oil can be made using the Supercritical CO2 method, but the limitations of equipment cost are still maintained. Ethanol methodologies can be utilized but there are challenges in the polarity differences between the alcohol, cannabinoids and chlorophyll; chlorophyll and cannabidiol (CBD) can co-extract (come out together) which results in a bitter taste and greenish coloring to the oil. Chlorophyll can be further filtered but this adds cost, time, and loss of efficiency. Olive oil can also be used to extract CBD and is a fairly simple procedure, but the product cannot be concentrated so there is a dilution factor that cannot be undone. Pharmaceuticals More recently, there are pharmaceutical companies working to create pharmaceutical grade products that can be prescribed by a medical provider just like any other regulated medicine. There are three cannabinoid-based medicines approved by the FDA: Nabiximol (Sativex), Nabilone (Cesamet or Canemes), and Dronabinol (Marinol). One other drug, Epidiolex, is an oral solution of pure plant-derived CBD and is the FDA clinical trial stages as an epilepsy drug with potential for more applications. Additionally, there are multiple drug companies in the active stages of creating new cannabinoid-based medicines. Nabiximol was developed by GW Pharmaceuticals, Plc. in England and is an oral spray containing real cannabis extract. THC and CBD are the main cannabinoids in a 1:1 ratio; additional cannabinoids and terpenes are also present but in low amounts. Of note, GW Pharmaceuticals is the creator of Epidiolex also. Nabilone is a synthetic cannabinoid that is comparable to THC. It comes in oral capsules and its main indication for use is chemotherapy related nausea and vomiting. Dronabinol is a cannabinoid solution containing synthetic delta-9-tetrahydrocannabinol. This medicine was approved mainly for loss of appetite and weight loss concerns in AIDS patients and chemotherapy related nausea and vomiting. The video below outlines some of the common forms of extracts and concentrates of cannabis. Sources: European Journal of Internal Medicine, NIH, NIH US National Library of Medicine-Nabilone, NIH US National Library of Medicine-Dronabinol, GW Pharmaceuticals-Sativex, Trends in Pharmacological Sciences, British Journal of Pharmacology, MedicalJane.com, HempMeds,

Labroots hosted its 5th annual Cannabis Science Virtual Event on March 23, 2022. The speaker roster for this free conference featured 17 experts from across industry and academia. The topics covered advancements in cultivation and extraction methods, updates on medical cannabis research, the regulatory landscape, analytical testing and automation, and hot topics like psychedelics and solutions for THC quantitation. This virtual event will be available on demand for two years. The conference featured a poster hall with 6 downloadable posters. The posters exhibited focused on the different cannabinoids, their effects on symptom management, and regulatory and retail cannabis issues. Titles included: Prenatal Cannabis Exposure on Intelligence of 5-year-old with Autism Traits Sheow (presented by Yun Sie, Priyanka Priyanka Alluri, Donato DeIngeniis & Yoko Nomura) The Importance of Data Integrity (presented by Kara Eliadis, MCR Labs) The Science of Marijuana-How THC Affects the Brain (presented by Livia Marian) Δ8-THC or “Diet-Δ9”: Δ9’s “Legal” Younger Sibling (presented by Chad Johnson & Andrew Coop) Establishing a Consumer Technical Model for Consumer Cannabis (presented by Martha Bajec, Michelle Niedziela, Aja Allison & Allison Gutkowski HCD Research, Inc.) Cannabis For Medicinal Use In Patients With Rare Diseases (presented by Jekaterina Parovincaka) Dr. Dustin Sulak delivered the keynote presentation entitled Acidic Cannabinoids: Inactive Precursors or Powerful Therapeutics? He presented evidence that acidic cannabinoids THCA and CBDA have powerful physiologic effects and high bioavailability. THCA and CBDA were previously considered inactive precursors to THC and CBD, but research indicates that these two cannabinoids have a powerful effect on other cannabinoids. Conference Highlights and & Themes The conference identified priority topics for future research in the areas of cultivation, extraction, policy, and other areas. Several presentations provided valuable insight into the current research on cultivation and extraction methods. The finding that cannabinoids play more than just the role of precursor compound to THC warrants a closer look at the role all minor and major cannabinoids play individually and collectively. Understanding the synergetic effects of cannabinoids such as THCA and CBDA will help identify the most effective processing methods for treating different symptoms. Some studies have found that whole plant spectrum products offer superior effects to individual cannabinoid compounds. One recurring theme of several presentations was the need to research the most effective doses. For example, THCA appears to be more effective taken in lower doses. Research on optimal levels of decarboxylation for individual terpenes and compounds as well as the entourage effect will greatly advance medical cannabis research. Several presentations covered recent research and best practices regarding the cannabis growing environment. Outdoor grows tend to develop more complicated secondary metabolites while indoor grows have simpler metabolite profiles. Evaluations showed higher terpene potencies in outdoor grown plants and higher THCa potencies in most outdoor grown plants. Measurable heavy metal content was detectable in indoor grown plants. These results have implications for cultivating cannabis for novel and customized therapeutic applications as well as the relative efficient cannabis cultivation strategies. Current research highlights the beneficial nature of symbiotic relationships between plant hosts and their microbial community. Effective sterilization methods and management of living soil systems are critical to cannabis plant health. Medical Cannabis Therapeutic Updates: Researching different physiological responses to individual strains/chemovars or products is critical. The complexity of one’s metabolism and the complexity of cannabinoids and terpenes make it challenging to find the most effective products, but scientists are working towards a solution by combining genomics with biomarkers and measurable outcomes. There is some concern that CBD elevates the liver enzymes, so research on this possible correlation is a priority. Otherwise, CBD has a favorable safety profile. One of the most extreme side effects reported by some CBD consumers was gastrointestinal distress such as temporary nausea or diarrhea. Analytical Testing and Automation: Several presentations highlighted the importance of pesticide regulation, microbial regulations, and extraction efficiency metrics. Sample cross-contamination can be prevented with careful workflow design regarding sample intake and processing, and Laboratory Information Management System (LIMS) can further optimize workflow by maintaining data integrity. The Regulatory Landscape: Several presentations highlighted the need for more research on product quality and cannabinoid dosing in order to inform policy regulations and protect the safety of patients/consumers from mislabeling. The FDA’s hesitancy to regulate CBD and other cannabinoids hinders research advancements regarding cannabis. United States Department of Agriculture (USDA) guidelines for hemp testing effective March 22, 2021 explain the required sampling, test methods, measurement of uncertainty, disposal of hot hemp, and reporting of test results. The total THC threshold will remain at 0.3% in the USDA's final rule, and the “negligent violation” threshold has increased to 1% THC from .5% (hemp that tests above 0.3% THC but below 1% THC is legal). This event provided extensive information on the latest cannabis sciences. Please visit the Cannabis Sciences 2022 Virtual event website to see the full agenda and access the on-demand content.