Mott Children’s Hospital recently published results from a poll on parents’ perceptions of treating children with CBD. The poll revealed parents demonstrated minimal knowledge of hemp-derived products and their effects on children. This issue is a challenge for pediatric medicine, and it highlights the need for better communication about CBD concerns between medical professionals and parents. Roughly 75% of parents believe that a doctor’s recommendation should be required to administer CBD to children, but only 63% felt the doctor’s recommendation was a strong factor in deciding to try CBD. Parents familiar with CBD use it to help their children manage a wide range of health complaints. Responses from 1,992 parents of children ages 3-18 identified the most common reasons parents give their children CBD. Main reasons include anxiety (51%), sleep problems (40%), attention deficit hyperactivity disorder (33%), muscle pain (20%), autism (19%), and general wellness (13%). Pediatric health professionals believe increasing research on CBD effects on children will help improve parents’ knowledge of CBD. Mott Poll co-director Sarah Clark explains that “there is very little data on how CBD may impact children’s developing brains and only certain types of situations when it’s considered for pediatric medical reasons. Still, CBD has become much more accessible and widely advertised, with some companies claiming benefits for kids.” Although the FDA cautions companies about making unsubstantiated claims about CBD’s effectiveness, such marketing claims further complicate parental understanding of cannabinoid therapy for children. Most parents (71%) have never used CBD. Many parents have concerns about side effects and safety that prevent them from giving CBD to their children. 35% of the parents considered CBD and cannabis the same, so many parents may be unaware that hemp does not cause psychotropic effects. Parents may also not know about Certificate of Analysis (COAs) requirements that ensure customer safety standards and how to find quality CBD. CBD is generally safe for children, but it is important for parents to inform the pediatrician if they are giving their child CBD and discuss an appropriate dosing plan. Sources: Eureka Science Alert, Mott Poll

Researchers in Israel are investigating the potential for cannabis-derived products to treat patients with COVID-19. So far, researchers in the country are investigating three treatment candidates. The first is by InnoCan Pharma’s Israel-based subsidiary InnoCan Pharma Ltd. of Herzliya. In collaboration with Tel Aviv University, they are creating a treatment for COVID-19 from cannabidiol (CBD) loaded exosomes, small structures attached to cells responsible for cell-to-cell communication and the delivery of macromolecules between cells. It is hoped that the anti-inflammatory effects of CBD may be able to aid in the recovery of infected lungs. During their study, the researchers will use their treatment against a variety of lung infections. Throughout, the CBD-loaded exosomes will be delivered to patients via an inhalation technique. The treatment comes after animal tests showing that CBD is able to reduce bodily inflammation. It has not yet been proven however to prevent and ease illness caused by COVID-19 or other respiratory viruses. Another study will combine CBD with steroids as a treatment for those with COVID-19. Over the course of a few weeks, researchers aim to trial the treatment on 10 patients with COVID-19 currently receiving steroid medication at Israel’s Rabin Medical Center. If the drug combination is successful, they say that the treatment option will be expanded to another 40 patients with COVID-19 under conditions set by FDA clinical trial regulations and guidelines. In a press release, they said, “steroid treatment is usually the first or second line of treatment of hospitalized patients. CBD enhances the therapeutic effect of steroid treatment and treats the bio-mechanism affected by the virus.” Meanwhile, the third study is led by Tel Aviv’s Ichilov Medical Center to understand whether cannabis’s anti-inflammatory properties may be used to slow down lung infections in those diagnosed with COVID-19. Trials of CBD-based treatments are being conducted in collaboration with several wards in the hospital. The researchers expect dozens of patients with moderate illness from COVID-19 to participate. Dr Barak Cohen, one of the researchers behind the study says, ““this is a novel approach to treating some of the symptoms, using a component of the cannabis plant that is considered safe and non-addictive.” Sources: Jewish Press, the Legal Examiner, Yahoo Finance, The Cannigma

With cannabis legislation becoming increasingly less restrictive over the past 20 years, consumers have found themselves in an era where cannabis products are widely available and easily accessible. Cannabis distillate and isolates containing the cannabinoids CBD, CBDV, CBC, CBG, CBGA, CBN, Δ8THC, Δ9THC, and THCV are commercially available for consumer purchase – with all of these products readily available for online purchase and shipment anywhere in the U.S. (except those containing the psychoactive compound, Δ9THC). Emerging research – albeit experimentally limited – on the synergistic effects potentially produced by certain combinations of different cannabis phytochemicals (the “entourage effect”) has been accompanied by a skyrocketing use of marketing strategies that advertise their products as containing the full range of cannabinoids. The public’s recent surge of interest in cannabis products has led to many sellers labeling cannabis products with slogans such as ‘full-spectrum', ‘broad-spectrum, or ‘whole plant’ to increase the product’s supposed therapeutic appeal. However, there is currently a lack of data-driven evidence to adequately support the supposed therapeutic effects associated with the entourage effect phenomenon. Due to their designation as dietary supplements, cannabis products are not regulated by the Federal Drug Administration (FDA). This leaves consumers without a standardized description of what comprises a cannabis product of evidenced quality. Furthermore, without regulation, various different processing methods are currently being employed for phytochemical extraction from cannabis cultivars. However, the influence these different extraction methods have on the phytochemical profile of – and hence the effects elicited by – the resultant product has remained unexplored thus far. So, does the method used for cannabinoid extraction have an impact on the extract’s phytochemical profile? According to a new study published in Nature’s Scientific Reports just over two weeks ago, it does – and quite more so than might have been previously thought. In the study, researchers sought to determine whether the chemical profile of extracts from a single cannabis cultivar would be altered based on the method used for phytochemical extraction. They assessed three commonly employed extraction methods in their studies: alcoholic extraction with ethanol (EtOH), alcoholic extraction with isopropanol (IPA), and supercritical fluid CO2­ extraction (divided into two groups, S1 and S2, based on the pressure setting used). The phytochemical profiles of extracts processed using each of the three methods (four groups of extracts total) were analyzed using several analytical techniques: gas chromatography-mass spectrometry (GC-MS), ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS), and inductively coupled plasma mass spectrometry (ICP-MS). As complementary approaches, their combined usage permits extensive chemical coverage. GC-MS detected 41 total annotated compounds. Principal component analysis was used to assess overall chemical profile variation between samples, which revealed significant variation between them depending on the extraction method used. 33 of the 41 annotated compounds differed significantly between at least two extract groups, which included various long chain fatty acids, polyols and carbohydrates, and different classes of terpenoids (di-, tri-, and sesquiterpenoids). Phytocannabinoid composition and abundance were evaluated using UPLC-MS/MS, which detected 15 phytocannabinoids – 14 of which were found to differ in abundance between the samples based on the extraction method used. The data revealed a common pattern of increased phytocannabinoid abundance (which included both CBD and Δ9THC) in the samples processed using alcohol extraction methods (EtOH and IPA), with the exception being CBDA (which was enriched in supercritical CO2 fractions). There were also marked differences observed in the abundance of minor phytocannabinoids (CBG, CBN, CBC) corresponding to the extraction method employed. Much of the variation observed in these analyses is likely to impact the therapeutic potential of the resultant product. From their experiments, this research group demonstrated significant differences between the chemical profiles of extracts based on which method was used for phytochemical extraction. By evaluating the most commonly employed phytochemical extraction methods, this research has extended its application towards consumer protection in today’s dynamic cannabis market. Sources: Nature’s Scientific Reports; Labroots

Vaping products are becoming increasingly popular, both the legal and knock-off options. These products are currently driving what the medical community is referring to as a public health crisis. The vaping industry is quickly becoming a billion-dollar industry that the FDA is having a hard time monitoring as it grows at such a rapid rate. According to health officials, there have been twelve reported deaths from mysterious lung illnesses linked to vape pens, and 805 individuals hospitalized across the United States after use. Dr. Melodi Pirzada, a pediatric pulmonologist at NYU Winthrop Hospital in Mineola, New York, is calling this is "a new epidemic." The Centers for Disease Control and Prevention stated that, at the time of hospitalization, most patients affected reported the use of vaping products containing THC, the psychoactive ingredient in the marijuana plant. Health officials believe that Vitamin E acetate, a solvent present in vape pens, could be responsible for the health issues that followed. Photo Source: Rollingstone.com However, no single substance is currently linked to all of the cases mentioned above. In a study funded by NBC News, one of the largest cannabis testing facilities in the United States tested THC cartridges from both legal dispensaries and those purchased on the black market. Their findings showed that the three products purchased from a licensed dispensary contained no heavy metals, pesticides, or Vitamin E. However, thirteen out of the fifteen products sold by unlicensed dealers contained Vitamin E. Ten of these unlicensed products also tested positive for pesticides. Photo Source: Pixabay.com What's even more concerning is that research found that all of the products contained myclobutanil, which when burned, can change into hydrogen cyanide. Hydrogen cyanide (AC) is a systemic chemical asphyxiant that interferes with the normal use of oxygen by just about every organ of the body. A chemical that no human would willfully ingest or inhale.

The FDA (Food and Drug Administration) approved the first oral cannabidiol solution called Epidiolex in June of 2018. This medicine was approved as a treatment for two forms of severe drug-resistant epilepsy. This is the first time that the federal government has approved a medication derived directly from the cannabis plant. LGS (Lennox-Gastaut Syndrome) and DS (Dravet Syndrome) are two rare and severe forms of epilepsy with onset in early childhood. "The syndromes are categorized as developmental and epileptic encephalopathies, in which the epileptic activity is thought to contribute to developmental delay and behavioral abnormalities beyond the pathology of the underlying disease," stated Teresa Buracchio, who is the Clinical Team Leader from the Division of Neurology Products at the FDA. These forms of refractory epilepsy syndromes are resistant to drugs that are typically used for the treatment of seizures. Buracchio further explains that "Both syndromes are associated with higher rates of mortality than in the general epilepsy population, primarily due to status epilepticus and sudden unexpected death in epilepsy patients." The FDA conducted three randomized, double-blind, placebo-controlled trials with patients who have LGS and DS. The results from the study performed with 225 patients with LGS showed significant improvement with the use of CBD, "The median number of "drop seizures" (which can cause falls) during a 28-day period fell from 85.5 to 44.9 in the high-dose group (a decrease of 49 percent), from 86.9 to 50 in the low-dose group (43 percent), and from 80.3 to 72.7 in the placebo group (21 percent)." In the study that was performed with 120 patients with DS also showed significant improvement with the use of CBD, "The median number of convulsive seizures over 28 days fell from 12.4 to 5.9 in the CBD group (a drop of 52 percent) and from 14.9 to 14.1 in the placebo group (5 percent)." Epidiolex contains CBD, which is a cannabinoid found within the marijuana plant. It is known that cannabinoids interact with a multitude of neurotransmitters and neuromodulator systems and have the ability to interact with cellular pathways. By acting as ligands, they are able to modulate a receptor's behavior and their downstream biological pathways. According to GW Pharmaceuticals (the company that created the drug), CBD produces an anticonvulsant effect, it does this by, "...modulating a number of endogenous systems including, but not limited to neuronal inhibition (synaptic and extrasynaptic GABA channels, modulation of intracellular calcium (TRPV, VDAC, GPR55), and possible anti-inflammatory effects." Both forms of seizures are difficult to control and with the treatment option of CBD for patients diagnosed it can dramatically improve their quality of life. The use of medical marijuana is approved in 30 states and Washington D.C., 25 out of these 30 states specifically recognize epilepsy as a qualifying condition. These states allow treatment of epilepsy with low dose THC or high dose CBD oil and are now making it easier to legally obtain the drug Epidiolex. The creation of this drug and its approval are a huge step in offering patients a safe, controlled, and tested medication. Sources: Reason, FDA Briefing Document, GWPharm Mechanism of Action

Ever since the FDA approved the first drug derived from cannabis last year pharmaceutical companies big and small are taking another look at the plant for therapeutic potential. According to an article published on the website axios.com by Sam Baker, scientists are looking at cannabis - and psychedelics - as potential avenues towards profitable new medications. This is due, at least in part, to the relaxing of opinions regarding marijuana use, especially for medical purposes, around the country. The interest in psychedelics comes from the latest results from drugs such as ketamine, which has been shown to provide quick relief from depressive symptoms. Photo source: UnSplash.com According to another article published on the website globalnews.ca by Laura Hensley, marijuana may be becoming "the new Oxycontin". Two years ago at the Family Medical Forum in 2017, the largest family medicine conference in Canada, medical marijuana companies lined the exhibitor's hall. They tried to convince attendees to take a look at their wares, promising treatments for "this and that", according to one physician who attended, a Dr. Sarah Giles. She continued to say that, "none of [these claims] was evidence-based" and that “Marijuana is the next OxyContin, where everyone’s like, ‘Oh, it’s not addictive, it’s harmless, it’s good,’ and people are kind of using it willy-nilly because you can get it prescribed and not prescribed.” Part of this hesitation towards medical marijuana comes from the fact that it is still not being taught in medical school. Furthermore, doctors tend to perceive a lack of evidence that it’s an effective treatment for things like pain, sleep disorders and anxiety. There are also concerns around dosing. Big Pharma companies could actually change that perception, as they do with all of their products. They hire sales representatives and medical science liaisons to provide educational materials and answer questions from clinicians regarding their latest pills. A few of the pharmaceutical companies interested in the medical marijuana market include Novartis subsidiary Sandoz, which has partnered with the Canadian marijuana company Tilray; GW Pharmaceuticals, who released the FDA-approved cannabis-derivative Epidiolex; and AbbVie, which is exploring cannabis medicine and what products can be derived from it. Will medical marijuana start to appear on the shelves? Photo source: UnSplash.com Even pharmacies are getting into the act. According to an article on CNBC.com, Walgreens is planning to sell cannabidiol (CBD) creams, patches, and sprays in nearly 1,500 stores in select states. CVS introduced CBD-containing topicals, including creams and salves, to stores in eight states earlier in March. Mind you, CBDs are not quite "medical marijuana" in the strictest sense, but it does highlight an interesting trend that is moving into our drugstores. According to Brian Sterz, portfolio manager of Miracle Mile Advisors, a private financial firm, "There's too much revenue to be made by states and the federal government (to not allow) cannabis-related drugs and products to become available." While medical marijuana is still in its infancy, and the potential medical uses of marijuana still being elucidated, this dive into the market may seem to be premature. However, sometimes you have to capitalize on the market and not the science. Hopefully, these pharmaceutical companies can make extraordinary drugs from the cannabis plant, and not lead us into another "opioid-style" epidemic. See the video below for more details. Video source: YouTube.com Source: LabRoots.com, www.axios.com, The Independent Institute, GlobalNews.ca, Medical Science Liaison Society, the-scientist.com, investigators.com, cnbc.com

Cannabidiol (CBD) oil has been reported to have amazing health effects, from inflammation to anxiety relief to even cancer prevention. However, in using any kind of supplement, it is always important to keep in mind a special population of potential users: pregnant women. Teratogenic (effects on the developing fetus) effects of some drugs and supplements can cause terrible birth defects. The Federal Drug Administration (FDA) requires several pieces of evidence about teratogenic effects in order to help determine whether a medication is safe for unborn infants. Source: AL Loriaux One of the most commonly asked questions on motherhood forums is the use or marijuana or CBD during or after pregnancy. For most mothers-to-be who use it, it is intended to ease morning sickness on the first trimester. They also use it to combat the pains and aches suffered during and pregnancy and after delivery. It is a natural alternative for medication. Research also shows that CBD is used to relieve the anxiety and pressure that comes with a newborn. That said, it would help to know the effects of using CBD during and after pregnancy before searching for a cbd vape pen near me dealer. The trouble with CBDs is that, because they are not classified as a drug but instead as a supplement, the FDA can only investigate adverse effects after the fact. Law states that dietary supplements are exempt from pre-testing and are not investigated by the FDA unless there is a complaint after the product hits the market. So, what does the evidence say about CBDs and pregnant women? Well, not much. A very recent report published by ZME Science highlights the need for more research, any research, into CBD use in pregnant women. That's right, according to the report "there is no study, peer-reviewed or otherwise, that has investigated the effects CBD oil might have on pregnant women or offspring." This is not entirely accurate due to a very recent study on zebrafish (which found developmental effects in newborn fish). Notwithstanding, the rise in use (the CBD market is projected to be a billion-dollar market in just three years, according to Forbes) could be a potential disaster waiting to happen if used in pregnant women. Another dire warning comes from Dr. James Lozada at Northwestern University Feinberg School of Medicine. "These [CBD] receptors help our brains develop normally... because of the uncertainty, I recommend not using these products during pregnancy." Nevertheless, the investigation of pregnant women using CBDs is still in its infancy, with different recommendations coming from different scientists studying this problem in their own labs. So as of yet, there is no real consensus in the field about the effects of CBDs in pregnant women. Photo Source: Pixabay.com On the other hand, there have been many studies looking at pregnant women's exposure to delta-9-tetrahydrocannabinol (THC), the psychoactive component of cannabis. These studies have had mixed results. Ethnographic studies in the West Indies found that THC exposure does not have any adverse effects on newborn babies, at least, not during the first five years of life. However, peer-reviewed analyses of several studies (i.e. metanalyses) have found that cannabis use can cause babies to have a higher chance of having low birth weights and admittance to the NICU than babies born to mothers who did not smoke cannabis while pregnant. Yet THC is not CBD. CBD plays a major role in neurological development, which is, unsurprisingly, critical for healthy newborns. In cannabis research today, we can only speculate what could happen to a developing fetus based on what we know about our own endocannabinoid system. While THC binds mainly to the receptors CB1 and CB2, CBD is a different beast. It also binds to CB1 and CB2, but it can bind to other receptors involved in prenatal development. The overall message is that, until CBD (and cannabis in general) has gone through clinical testing, there is no indication to say one way or the other that CBD oil is safe for unborn fetuses, or for the pregnant woman for that matter. One thing is for certain: it will not hurt to refrain from indulging in any form of cannabis, CBD oil or not, during pregnancy. Many women have gone without cannabis and have had healthy babies. The video below goes over the research on cannabis and pregnancy. Video Source: Youtube.com Sources: Journal of Psychopharmacology, www.fda.gov, www.zmescience.com, Toxicology Sciences, www.Forbes.com, The West Indian Medical Journal, BMJ Open, British Journal of Pharmacology

People with epilepsy report better well-being when they self-medicate with cannabidiol (CBD) according to a new study published in the journal Epilepsy & Behavior. CBD is available as an FDA-licensed prescription medicine called Epidiolex. But medical insurance usually only covers the substantial cost of this drug for those with rare and intractable epilepsy syndromes, such as Lennox-Gastaut syndrome and Dravet syndrome. On the other hand health stores and pharmacies are piled high with over-the-counter CBD oils and supplements, and it was the usage of these products (coined “artisanal CBD” products) by those with epilepsy that the researchers were interested in. The epilepsy patients were recruited using social media and Realm of Caring patient registries. Realm of Caring is a nonprofit foundation devoted to cannabinoid therapies, and is sponsored by companies that make CBD products. The investigators, who had various affiliations, including Johns Hopkins University and Realm of Caring, started out by analyzing 280 surveys returned by epilepsy patients who used CBD, and 138 patients who did not. Follow-up surveys were then sent and returned by 190 participants. The results found that epilepsy patients using CBD products reported a higher quality of life, including less anxiety and better sleep than patients who did not take the cannabinoid. CBD-using epilepsy patients also better tolerated their epilepsy medications, and used fewer prescription medications overall. However CBD did not have any significant impact on seizure control. This was hard to measure though, as both CBD and non-CBD groups included a high number of individuals who did not have seizures during the study period. “These findings further emphasize the need for controlled research to determine optimal CBD product types, doses, and concomitant use of other medications that maximize possible clinical benefit while minimizing potential risks,” the investigators reported. 1 in 5 of the survey participants (who were 74 percent white, 55 percent female and average age 21), reported adverse effects from CBD. These included drowsiness and apparent worsening of epilepsy symptoms . Parents also had concerns over the cost of CBD products and potential legality issues. Drawbacks to this study include the use of self-reported data, potential selection bias and a lack of control over CBD products used. Studies have regularly also highlighted concerns about CBD products not containing what they say on the label). Sources: Marijuana Moment, Epilepsy and Behavior

Clinical trials are a necessary part of the drug approval process. All drugs on the market, even the over-the-counter drugs, have gone through clinical trials. They ensure that the drug is safe and effective, and if that cannot be demonstrated then your company will not get the Food and Drug Administration's (FDA) stamp of approval to go ahead and market it. So, now that medical marijuana is becoming the real deal, when will this plant get its chance to go through the 10 to 15 year and highly expensive pipeline to make it to market approval? Photo Source: UnSplash.com Well, that simple-sounding question actually has a very complex answer. First of all, do you want to get the actual plant, Cannabis sativa or indica approved? Well, have you patented this 5,000-year-old herb? Probably not, however, growers have been applying for patents for certain strains that were created through selective breeding. Will those patents be granted? Well, according to a landmark 1980 opinion, then-U.S. Supreme Court Chief Justice Warren Burger wrote that "eligibility for patent protection does not depend on whether the substance is living or nonliving. Rather, the key question is whether the inventor has altered nature’s handiwork to the extent the resulting invention can be deemed a nonnaturally occurring substance." Okay, now we have a patented product that can (supposedly) continue down the path to market. And if you can patent and market your strain of marijuana, well then, you may be set for life...at least the life of the patent. But in between getting your intellectual property rights that come along with an official patent (which, in the United States, poses a specific set of problems due to the fact that Uncle Sam is still "saying no" to wacky tobaccy) and selling your dream strain as a medicinal product is a long series of nonclinical and clinical studies. If you have that entrepreneurial spirit (a necessary attribute for anyone starting up in this business, along with investors) then you might actually make it. For the sake of brevity, let us skip over the nonclinical toxicology and safety studies in animals required before testing your drug (in this case, your strain) in people. Remember, we are operating under the assumption that the FDA would even allow you to get this far. However, you are not alone, intrepid marijuana grower. Several organizations are crying out for clinical trials of marijuana, especially in patients with terminal illnesses. One of them is a group called "Patients Out of Time". Photo Source: UnSplash.com Patients Out of Time strongly advocates the use of double-blind placebo-controlled clinical trials for cannabis. And guess what? These trials are actually being conducted! The National Institutes of Health (NIH) ClinicalTrials.gov website listed 749 studies when the search term "cannabis" was used. These trials are taking place all over the nation in hospitals and universities. They are looking at a variety of different health issues and are using various forms of cannabis or synthesized cannabinoids. ClinicalTrials.gov is also a great way to get involved to get advanced medications out to the public. Are you willing to be a human guinea pig for medical marijuana? Sources: www.fda.gov, caselaw.findlaw.com, theconversation.com, www.medicalcannabis.com, ClinicalTrials.gov

According to Barrons, an online and print news outlet, marijuana is getting a second look by clinicians, pharmaceuticals, and consumers. In a piece written by Teresa Rivas, the industry is champing at the bit to get into the United States market. They are only waiting for the "inevitable" (their sentiment) federal legalization of marijuana (or at least medical marijuana) to start ramping up production of marijuana or marijuana-derived medical treatments. Photo source: Pixabay.com Any new medical treatment (e.g. anything that will be used to treat a specific disease) will have to get clearance from the Food and Drug Administration (FDA) to market any new product. As this newsletter has touched upon before (here, here and here), any new medications that will be used to "treat a particular disease" will have to show that it is "safe and effective". As long as the company can provide evidence that it is then the FDA is obligated to approve it. For example, as Amanda Khal published in September of last year, the medication Epidolex, which is derived from the cannabis plant, was approved to treat two rare forms of epilepsy. So regulation should not be a problem (legal-wise, at least). Big Pharma has shown a lot of interest in the growing market in the United States, as to be expected. However, smaller biotech firms are also in the game. For example, the biotech agriculture company Cellibre uses a unique process for producing compounds at a fast rate: producing molecules from cell cultures. This is a promising technology for marijuana because this technique can be used to grow a number of different cannabis-containing molecules. These include cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC). The level of specificity with this technique means that medical marijuana treatment could be designed based on the patient or the disease. Photo source: Pixabay.com Growing compounds from cell cultures is limited only by the rate of cell division and growth. Cells can be induced to divide, grow and produce substances (such as antibodies). Plant cell culture can yield a myriad of complex compounds. This presents a method for producing cannabis compounds on a commercial scale, at least, that is what Cellibre hopes. There are many benefits of producing specific compounds, especially for the health care industry. Many new cannabis-derived compounds, besides CBD and THC, can also be produced using this method. This could be a boon for modern medicine, as deriving these compounds using current procedures can be costly. Another benefit from this technique is that the compounds can be produced "without unnatural byproducts” says Cellibre executives (as quoted in the Barrons article). Big CBD companies like Wtphemp using techniques such as plant cell culture could potentially provide new medicinal marijuana formulations at a lower cost. Furthermore, these compounds could be made readily available as production is scaled up. Finally, specific compounds, new and old, can be used for a more individualized treatment approach. This could be the next revolution to hit health care. We will have to wait and see. Below is a detailed video describing the plant cell culture process. Video source: YouTube.com Sources: Barrons.com, LabRoots, www.fda.gov, www.cellibre.com, Molecular Biology of the Cell, BMP

Cannabis plants produce at least sixty different cannabinoid compounds, which have different effects. THC may be the most well-known because of its psychoactive properties, while cannabidiol is recognized for its medicinal effects. CBD has been approved by the Food and Drug Administration (FDA) for the treatment of epilepsy and may be useful in treating other neurological disorders. Limited research has also suggested that CBD has an antimicrobial impact. Now scientists have investigated further and determined that CBD can effectively fight Gram-positive bacteria, which include the pathogens that cause Staph infections and pneumonia (bacteria can be broadly classified as Gram-positive or -negative based on their cell walls). The potency of CBD was comparable to some approved antibiotics, like vancomycin and daptomycin. The findings have been reported at the annual meeting of the American Society for Microbiology. "Given cannabidiol's documented anti-inflammatory effects, existing safety data in humans, and potential for varied delivery routes, it is a promising new antibiotic worth further investigation," said the leader of the research Dr. Mark Blaskovich of The University of Queensland's Institute for Molecular Bioscience's Centre for Superbug Solutions. "The combination of inherent antimicrobial activity and potential to reduce damage caused by the inflammatory response to infections is particularly attractive." Dr. Blaskovich worked with Botanix Pharmaceuticals Ltd, a company that is trying to develop topical therapeutics that are based on synthetic cannabidiol. The investigators were interested in treating skin conditions and learned that CBD was good at destroying a wide range of Gram-positive bacteria, including drug-resistant microbes. The work suggested that CBD would not lose potency over time, either. That may be an important characteristic; drug-resistant pathogens are predicted to become more common, and clinicians have to look for new ways to treat infections. When CBD was tested under conditions in which microbes that developed resistance to vancomycin or daptomycin, the CBD was different - it remained useful. It was also able to disrupt tenacious bacterial biofilms, which can allow bacteria to survive through challenging conditions. Learn more about CBD from the video. Sources: AAAS/Eurekalert! via American Society for Microbiology

Cannabis is known for many things these days, such as helping users with relaxation, sleep, social skills, and alleviating nausea. But as more cannabinoids are discovered, the claims as to what cannabis can do increase. One of the latest claims is that weed can help you diet. This may seem counterintuitive because weed is long known for giving people the munchies. However, a compound called tetrahydrocannabivarin (THCV), a non-psychoactive cannabinoid found in the cannabis plant, is showing positive signs of curbing the appetite. How does this work? THCV blocks the CB1 receptor in our endocannabinoid system, preventing other cannabinoids from binding to it, in effect curbing the appetite. As a result, THCV increases that satisfied feeling you get when you’re full. According to research, it also boosts energy and the metabolic function. Another promising discovery is that THCV can help combat Type 2 diabetes in some patients. A study performed a few years ago showed that THCV significantly decreased fasting plasma glucose and improved pancreatic B-cell function. Furthermore, the cannabinoid was well tolerated in the volunteers who participated in the study. Researchers are hopeful that THCV could someday be a new therapy in helping to control blood glucose in people battling Type 2 Diabetes. While the research is promising and will most likely lead to effective products and remedies in the future, scientists caution potential buyers to beware. Cannabis products that are currently sold over the counter at dispensaries and other retail locations, claiming to cure obesity and/or diabetes, are preliminary at best and misleading at worst. The FDA has not yet approved any of these products, so they should be treated accordingly. Some scientists go so far as to say that some companies contort science to make money. So, consumers should be careful, do their due diligence, and always consult their doctor. Sources: New York Times, Nature, Journal of Cannabis Research, Diabetes Journals

The US Federal Government has marijuana listed as a Schedule 1 drug, in addition to heroin, lysergic acid diethylamide (LSD), and others considered to have a high potential for abuse and with no medical value (according to the federal government). This classification creates challenges for advancing medical research and use, and therefore increased data analysis of benefits and drawbacks, of medical cannabis in the United States. In addition, the Schedule 1 categorization prohibits the prescription, administration, or direct distribution of these drugs by any doctors in the United States. This categorization is applied regardless of the potency or varieties of low-THC substances or extracts. Despite complex factors at play, medical cannabis is becoming more widely accepted, or at least is being considered, as an alternative therapeutic agent for many medical conditions including neurodegenerative diseases, cancer, pain relief, epilepsy, and anxiety including post-traumatic stress disorder (PTSD). As was recently reported by National Public Radio, groups like military veterans are looking at medicinal cannabis as a replacement for the multitude of drugs they are using to treat their symptoms of pain, anxiety, etc. related to their service. Veterans Affairs has provided exiguous support for the exploration of alternative options to opioids and benzodiazepines. Their policy rhetoric continues to revolve around the federal restrictions for medically trained employees of the government prescribing medical marijuana, which veterans are becoming more vocal about trying as an alternative. The distinction is the term “prescription”. Authorized medical professionals (MDs, Dos, NPs, etc.) can only “recommend” medical cannabis to patients or “certify” that a patient has a qualifying condition as a First Amendment right. Wait… what? Yep. Our highly educated medical experts cannot prescribe medical marijuana. The last court to review the ruling was the Ninth Circuit court of Appeals in 2002. The resulting verdict being that doctors had a first amendment right to recommend a treatment for a patient but could not prescribe or provide marijuana because of its schedule 1 classification. This is not just for the VA but for all medical professionals. Penalties for physicians and other medical professionals who do not follow the laws for controlled substances are steep including loss of DEA registration, thereby losing ability to prescribe any controlled substances. The Controlled Substances Act (CSA) was enacted in 1970 as part of the Comprehensive Drug Abuse Prevention and Control Act. Per Section 201 of the Act (21 U.S.C. 811), changes to add, delete, or edit a substance on the schedule can be initiated by the Drug Enforcement Agency (DEA) Department of Health and Human Services (DHS), or by petition from an interested party. The drug is investigated by the DEA and collects necessary data; DHS provides scientific and medical evaluations to make a determination for changes in collaboration between the DEA, DHS, and FDA. The ultimate threshold is whether a drug or substance has the potential for abuse. The Act doesn’t define “potential for abuse” so it is up for interpretation by legislators and evaluators. For now, military veterans will be asked about their use of marijuana as part of their conversations with VA medical providers; however, veterans will need to seek an alternative provider outside of the VA for a recommendation for medical cannabis if it is legal in their state. Currently in the US, 29 states and the District of Columbia have legalized medical cannabis.

In the latest issue of Time Special Edition, "Marijuana Goes Mainstreet", Bruce Barcott, author of the book "Weed the People", takes an in-depth look at the current state of the marijuana business, and how far it needs to go to win over more than just "potheads". Photo credit: Pixabay.com In a country where multiple states are updating their marijuana laws, it seems like only a matter of time before marijuana may be at least decriminalized in all fifty states. However, for an industry to thrive it needs to be recognized as just that, an industry. Currently, dispensaries in states where recreational or medical marijuana is legal, such as Washington and Colorado, are acting in a rather haphazard state, at least business-wise. Most of these stores are mom-and-pop pot shops, growing their own product in their home garden. At the moment the legalization or illegalization is at the whim of state governments. The only regulations come from taxation, again, run by local governments. Not even the FDA is involved, as marijuana is still federally illegal. What this industry needs is a way to get off the government hook. What it needs is a proper business structure. This means investment. The only private investment firm, according to Barcott, Privateer Holdings, was daring enough to enter the weed industry, or as they like to call it "the cannabis space". Privateer Holdings is headed by Brendan Kennedy, Michael Blue, and Christian Groh. They saw an opportunity. To get an idea of how these marijuana companies were run, they headed to a meeting of 200+ of the industries leaders. They were the only ones in suits. "Most people thought we were DEA agents," Kennedy is quoted as saying in the piece. It seemed as if the industry needed a corporate overhaul. However, they were not able to find venture capital companies that were ready to take the plunge. To solve this, Privateer Holdings used a private-equity firm. A private-equity firm does not invest but instead purchase entire companies and manage them directly. The biggest challenge of entering this "cannabis space", however, is to convince the American public that this is a legitimate, family-friendly product. And the best way to do that, according to Barcott, was advertising. He points to an interesting case in point: the motorcycle. When companies wanted to take motorcycles mainstream they had a problem. Only hoodlums and criminals rode motorcycles. It took a clever ad campaign to convince middle America that motorcycles were friendly. One advertising company working for Honda came out with the slogan, "You meet the nicest people on a Honda". To make money in this business, you have to lose the bad image of marijuana. You have to rebrand marijuana as something that ordinary people use and why they use it. Privateer Holdings took this ad-campaign and ran with it, similar to the Honda motorcycle. Ads in magazines demonstrated ordinary people going about their day, such as jogging going home. Little text boxes explained why these people used marijuana-based products, to help battle cancer, to relieve MS symptoms. And the tagline, "What's your strain?", beautifully made the product seem much more inclusive. It was produced as a pharmaceutical ad, ordinary people using marijuana to address their health issues. The following video is an interview with the author Bruce Barcott. Note that this TIME Special Edition is a re-release from 2015. Video credit: YouTube.com

The Federal Drug Administration (FDA) in the United States very recently approved Epidiolex, the first phytocannabinoid based pharmaceutical using cannabidiol extracted from the Cannabis sativa plant, which was developed to treat intractable seizures in pediatric patients. The US is poised at a crossroads. The Drug Enforcement Agency (DEA) has until September 2018 to update the drug schedule status of the cannabidiol (CBD) in Epidiolex; it needs to be removed from the list of Schedule I drugs, the grouping which means that it has no medicinal value and is highly addictive, in order for US doctors to prescribe it. With this FDA approval the longstanding argument, that cannabis-based products like CBD have no medicinal value, is tenuous at best. Researchers are optimistic that CBD, as a category, will be moved from the Schedule I list to a lesser regulated list. This broad move would allow researchers to jump through fewer hoops to allow for easier study of this non-intoxicating compound. One article author in Nature Communications this month quoted a cannabis researcher who said, “At the very least, the DEA ought to grant researchers an exemption permitting them to study CBD”. Other areas in the world are not only producing cannabis and cannabinoids for medicinal use, they are genetically engineering cannabinoids using bacteria and yeast. One of the challenges of plant-based products in demand, is that the ability to extract the amounts needed becomes untenable. Some of these compounds, CBD or terpenes for example, are found in the plant at small levels. By creating genetically engineered CBD, there are some scientists in countries like Canada that are preparing for higher demand. Genetic engineering (GE) involves adding new DNA to an organism to imbue or enhance some component of the original, un-modified, entity. We have seen GE in agriculture, animals, and now perhaps plant-based medicine. It is a remarkable feat of science that humans have derived a way to do this but there are concerns. GE critics are troubled by the lack of inadequate testing for harmful effects on animals or the environment. There are specific GE concerns spanning allergy development, increases in mutagenesis, antibiotic resistance, environmental damage, and what is called genetic pollution. Once the engineered organisms or products enter the closest biome, they cannot be controlled or “cleaned up”. There are many non-genetically modified organism (non-GMO) based products because of these apprehensions. It raises some ethical questions also. Alternatives include advanced crossbreeding approaches to generate better progeny. To be sure, there are scientists in other countries preparing to forge ahead using biotechnological advances like this to help provide medicinal cannabinoids to consumers and researchers for further study. Sources: Nature Communications, Grace Communications Foundation, AgBiosafety, Biotechnology Letters, The Californian,

An Oregon State University research team found that hemp byproducts are a safe food source for lambs. The study was recently published in the Journal of Animal Science. The researchers fed male lambs two different amounts of spent hemp biomass (10% and 20% of total feed). They then did not feed the lambs hemp biomass again for four weeks. After this withdrawal period, researchers assessed the lambs’ weight gain, carcass characteristics, meat quality, and overall health. They found that spent hemp’s nutritional quality is similar to alfalfa, which is used to feed lambs. Spent hemp also presents lower palatability and better digestibility. Additionally, they found that feed intake was negatively affected by feeding 20% spent hemp biomass in the short term but not in the long term. Feeding 10% spent hemp biomass increased feed intake long-term with no observed weight gain. The researchers also found that spent hemp biomass did not negatively affect metabolism and improved the lambs’ antioxidant capacity. They did observe an increase in shrink and cook loss that potentially affects the tenderness. Spent hemp biomass did not affect other parameters related to carcass and meat quality. Biomass does not currently have any value for hemp farmers, but it could be sold as livestock feed if approved by the Food and Drug Association. Associate professor and study author Dr. Serkan Ates explains, “The findings are important for both hemp farmers and livestock producers because they provide evidence that this byproduct of hemp can be used in livestock diets. If the Food and Drug Administration approves its use as an animal feedstuff, hemp farmers could have a market for what is essentially a waste product and livestock producers may be able to save money by supplementing their feed with the spent hemp biomass.” If the FDA approves biomass as suitable livestock feed, it will provide farmers a significant future economic benefit. Sources: Journal of Animal Science, Oregon State University

The actual cost of e-cigarette usage continues to reveal itself as reports of lung injury cases and deaths continue to rise. Scientists are diligently working to determine the cause of the illnesses, officials are seeking to ban products, and some tobacco companies are reconsidering their popular products. The Centers for Disease Control and Prevention have dubbed the illness, “EVALI: e-cigarette, or vaping, product use associated lung injury.” Earlier this week, the CDC announced updated and confirmed numbers of EVALI cases and deaths. A total of 39 confirmed deaths have occurred in 24 U.S. states. Ages ranged from 17 to 75 years with a median age of 53. A total of 2,051 confirmed lung injury cases associated with the use of e-cigarette products have been reported by 49 states. Just this Friday (11/8), the CDC reported a significant breakthrough in its investigation into this public health crisis. According to a news release from the federal organization, laboratory testing of lung fluid from 29 patients with EVALI from 10 states discovered vitamin E acetate in all of the samples. The release states that “this is the first time that we have detected a potential chemical of concern in biologic samples from patients with these lung injuries.” Some point to THC or nicotine as a cause of EVALI. However, THC was only in 82% of the samples and nicotine in 62%. The CDC is confident that they now have direct evidence of vitamin E acetate as a critical cause of lung injury associated with e-cigarette use. The investigation is ongoing and may reveal additional culprits. Source: CDC, AP News (Video)

When science is restricted, pseudoscience is allowed to roam free. The same can be said of marijuana research. From academics, interested in our own endocannabinoid system, to pharmaceuticals, trying to gain access to an open market space, these institutions will always have their hands tied in the face of the current federal laws. Non-scientists or "alternative" clinicians, on the other hand, can take shelter in legalized states to make and sell products based on hype and unconfirmed claims of safety and efficacy. Photo source: Unsplash.com A brief review. Marijuana is the number one used illicitly used substance in the United States. It is also the most politicized. The legal landscape for this plant is a constant evolving patchwork of state laws legalizing various aspects of use: from full recreational use to restricted medicinal applications. The Drug Enforcement Agency (DEA) still classifies marijuana as Schedule I, which is the most restrictive level to place a drug. Heroin and LSD are also Schedule 1. Interesting tidbit, the DEA actually scheduled a cannabis-derived medication approved by the Food and Drug Administration (FDA) as Schedule V but left marijuana as a plant at Schedule I. Given all of these circumstances, it is anyone's guess what it means for public health. The legality of marijuana is not the main issue at stake. It is only a major contributing factor. The real problem is in the lack of credible preclinical and clinical research on the drug. This has long been a problem for basic scientists legitimately interested in studying the effects of marijuana on the body, however, there was little outcry outside of academia. That is, until now. Photo source: Unsplash.com These are pressing issues for public health. The state-by-state (and Canada, too) pattern in legalization has exposed novice users to pot for the first time. Companies are designing their products for your average pothead, but legalization has brought in customers curious about this drug that they used to say "no" to. This can lead to adverse consequences. These novice users are attracted to the hype these companies are putting out. However, there is still little evidence backing this hype. As Dr. Salomeh Keyhani of the University of California in San Francisco commented in a recent article in The Verge, “I think it’s very dangerous to be asserting that things are very beneficial without thinking about risks.” What are the risks? Well, we do not really know. With the regulatory issues regarding marijuana research, including restricted funding, DEA oversight, and government-provided marijuana (infamous for its low quality and low external validity), science is lagging behind the burgeoning marijuana-market which is providing a wide variety of cannabinoid-infused "health" products to the public. This, as stated in The Verge, is a recipe for disaster. Sources: www.theverge.com, Annals of Internal Medicine, www.leafly.com, www.labroots.com, www.theverge.com, www.statnow.com, National Academic Press, National Public Radio

It can be difficult to get real information on what CBD can really do for you, as the industry is projected to hit over $16 billion by 2025 in the U.S. alone. So, stakeholders have a vested interest in extolling the cannabinoid’s benefits as much as possible. But all hype aside, what do users have to gain by consuming it? CBD has become increasingly popular as a non-psychoactive relief solution for anxiety, depression, PTSD, and insomnia. While there is considerable debate in the scientific community as how much these claims hold true, there is enough supporting evidence available that the FDA has approved Epidiolex, a CBD extract used to treat seizures in patients 2 years or older. That said, some studies produce conflicting data. Some research indicates that CBD does reduce anxiety, while others show results pointing to CBD having no effects at all, especially when compared with that of placebos. For consumers who experience positive effects from CBD, it is important that they buy their CBD products from reputable manufacturer, typically available at a licensed dispensary in a legal cannabis state, as some CBD products can contain unwanted surprises. Studies have found everything from cough medicine to synthetic cannabinoids in some products claiming to contain only CBD. Other studies have found that many products on the market failed to contain the amount of CBD marketed. The effects from CBD have been proven valid, and supporting evidence will most likely grow in the coming years. That said, it is important that consumers not believe in exaggerated or magical claims as to what the cannabinoid can do. While CBD can be medicinal, it is not the cure all that some companies would have consumers believe. Sources: NY Times, FDA, Neuropsychopharmacology, Cannabis and Cannabinoid Research, Science Direct

Research suggests that Cannabis sativa-derived cannabinoids – such as cannabidiol (CBD), Δ9tetrahydrocannabivarin (THCV), and Δ9tetrahydrocannabinol (THC) – likely serve an immune-modulatory function in inflammation. Studies have implicated alteration of cytokine levels (i.e., the equilibrium between pro- and anti-inflammatory cytokines) and macrophage activity as probable candidate mechanisms used by cannabinoids to enact their immune-response-related roles. CBD, in particular, has recently received special attention within the research community for its potential therapeutic application as an anti-inflammatory accessory in the treatment of severe COVID-19 cases. Within the past year, experimental evidence has implicated a role for CBD in arthritic inflammation via reduction of interleukin (IL)-6 and IL-8 levels. As CBD is already approved by the Food and Drug Administration (FDA) as an anti-epileptic treatment, it is an especially appealing therapeutic target during such unprecedented times. However, aside from the major phytocannabinoids, the impact of various other Cannabis compounds – such as other phytocannabinoids, terpenes, and flavonoids – has been vastly understudied, especially in alveolar epithelial and immune cell inflammation. Immune cell inflammation of the alveolar epithelium is characteristic of COVID-19 disease progression, which can often be resolved within the adaptive first phase of the body’s immune response to infection. During this initial immune phase, alveolar macrophages promote phagocytosis-mediated eradication of respiratory viral pathogens. In extreme cases, the disease progresses to the second immune response phase, most often accompanied by cytokine storm syndrome. Increased production of cytokines – such as IL-6 and IL-8, tumor necrosis factor-alpha (TNFα), and C–C Motif Chemokine Ligand 2 (CCL2) – is a characteristic immune response marker of cytokine storm syndrome. If unresolved, this cytokine storm leads to respiratory failure due to acute respiratory distress syndrome (ARDS) – the leading effector driving COVID-19 mortality. Signs of macrophage activation syndrome (MAS) have also been observed during the second immune response phase. During MAS, macrophages release pro-inflammatory cytokines (i.e., IL-6, IL-8, and CCL2) that contribute to cytokine storm syndrome and further exacerbate disease progression. Thus, a balance between maintaining the anti-inflammatory activity (i.e., reducing pro-inflammatory IL-6 and IL-8 cytokine levels during phase two) within lung tissues, reducing the pro-inflammatory activity of macrophages (i.e. reducing pro-inflammatory IL production during phase 2), and increasing alveolar macrophage phagocytosis (often associated with macrophage polarization during phase 1) would need to be obtained to combat cytokine storm syndrome. Furthermore, previous studies have shown that IL-7 can increase low absolute lymphocyte counts in septic patients as well as provide protective immunity in CD4+ T-cell-deficient patients. Thus, it has also been proposed that increasing IL-7 levels in COVID-19 patients could be a potential therapeutic target for treatment. According to a new study published in Nature’s Scientific Reports, a cocktail of purified phytocannabinoids containing CBD, THCV, and cannabigerol (CBG) may have increased efficacy towards reducing COVID-19-related lung inflammation compared to crude cannabis-derived extracts and CBD extract alone. The study sought to assess the anti-inflammatory effects of in vitro treatment with cannabis compounds on COVID-19-related immune response markers. Specifically, they investigated the impact of various cannabis phytochemicals (alone and in combination) on immune responses in alveolar epithelial cells and macrophages during COVID-19-related inflammation in vitro. The purified cannabis compound formulation analyzed in this study consisted of phytocannabinoid standard combinations at concentrations based on the measured concentrations of these phytocannabinoids in inflorescence extracts from a high-CBD C. sativa strain, Arbel. Use of commercially available phytocannabinoid standards ensured the absence of terpenes in this formulation. Crude extract from the same strain (i.e. including terpenes) was also analyzed. The preparation of purified phytocannabinoids demonstrated anti-inflammatory activity in A549 alveolar epithelial cells in vitro, evidenced by an observed dose-dependent reduction in IL-6 and IL-8 levels. Treatment of the alveolar cells with either the crude extract (i.e., with terpenes) or the purified mixture (i.e., without terpenes) resulted in reduced expression of IL-7, CCL2, CCL7, and angiotensin I converting enzyme 2 (ACE2). The purified mixture, however, reduced IL-7 and ACE2 expression to a lesser degree than the crude extract. Treatment with CBD alone also reduced IL-6 and IL-8 levels but displayed a bell-shaped dose-response curve (which is associated with a relatively narrower therapeutic window than dose-dependent responses). The crude extract and the purified compound mixture exhibited pro-inflammatory activity in cultured macrophages. Treatment with the crude extract induced macrophage polarization and phagocytosis as well as upregulated expression of CD36, type II receptor for the Fc region of IgG (FcγRII), IL-6, and IL-8. However, treating the macrophages with the purified mixture reduced phagocytosis and IL secretion relative to the crude extract. From these results, the authors propose that treatment with either cannabis mixture (purified or crude) may potentially facilitate a reduction in inflammatory cytokine secretion and macrophage recruitment during cytokine storm syndrome. They also suggest that the difference between the crude extract and the purified formulation in their ability to downregulate IL-7 expression is most likely due to the respective presence/absence of terpenes. This data, as advocated by the authors, indicates that the purified phytocannabinoids (i.e., without terpenes) are likely to be more therapeutically advantageous for treating COVID-19-related inflammation compared to cannabis-derived fractions that contain terpenes. Moreover, the research team suggests that the dose-dependent response observed following treatment with the purified phytocannabinoid mixture possesses more therapeutic potential to be effective in clinical application than does CBD alone. However, as noted by the authors, the pro-inflammatory activity observed with both of these treatments poses the possibility of exacerbating the cytokine storm associated with severe cases of COVID-19 by increasing IL-6 and/or IL-8 secretion from macrophages. Although somewhat encouraging, the results of this study further substantiate the notion that much more extensive experimental research is needed to ensure the safety and efficacy of cannabis as a COVID-19 therapeutic. Sources: Cell Death & Disease; Pharmacological Research; Journal of Leukocyte Biology; Research and Regeneration; Nature’s Scientific Reports; Merriam-Webster Dictionary; The Lancet’s Respiratory Medicine; The Journal of Clinical Investigation

As the demand for hemp increases, researchers are exploring the possibility of using hemp leaf byproducts to feed livestock. Farmers remove a significant number of leaves when processing the raw hemp plant for CBD oil, and this hemp biomass byproduct might provide a nutritional alternative to alfalfa and other traditional forms of animal feed. The Food and Drug Administration has not yet approved the use of hemp for livestock feed, and the United States Department of Agriculture currently the United States Department of Agriculture currently prohibits meat products processed from animals fed hemp. At the same time, the USDA is preparing for potential changes in hemp cultivation policies and agricultural practices by funding university research projects that are analyzing hemp feed’s impact on livestock. Oregon State University recently received a $300,000 USDA grant to study substituting hemp for alfalfa when feeding lambs. Farmers have traditionally used alfalfa as a main source of feed; hemp is similar to alfalfa in appearance, chemical composition, and protein levels. Hemp is also rich in fiber and minerals. OSU researchers are examining cannabinoid absorption, animal growth and health and hope to replicate a model for feeding biomass to cattle. Using hemp spent biomass promotes sustainability in the cannabis industry, as no part of the plant goes unused. Processing typically creates a significant amount of leaf waste with little value, unless used for specific purposes such as animal feed. OSU Associate Professor Massimo Bionaz explained, “here in Oregon, the majority of hemp is cultivated for CBD extraction with a tremendous amount of post-extraction biomass that has not, at the moment, any market, and it is a nuisance for the hemp industry.” Using hemp biomass as feed offers farmers a way to avoid extra time, labor and expenses associated with leaf waste management. It also potentially creates an additional source of income or a reduction in feed costs for farmers once hemp feed is FDA approved. Hemp biomass has many benefits. It is an inexpensive source of nutritional value for livestock, and it promotes sustainability by reducing byproduct waste. Hemp market experts anticipate that the animal feed market is projected to grow to $415 billion by 2023, up from $336 billion in 2017. Sources: AAFCO, Hemp Industry Daily, Oregon Public Broadcasting

While the medical community is scrambling to find the proper medications for Sars-CoV-02 infection, a significant portion of citizens has turned to unreliable sources for remedy advice. Outrageous claims of therapeutic effects achieved by ingesting garlic, bleach, essential oils, vitamins, silver colloid, or cannabis products are ineffective at minimum, if not outright dangerous. The line between a hoax and potentially valid treatment gets more blurry, as certain experimental and approved medications have gone into clinical trials, or got prescribed off-label in some parts of the U.S. to treat COVID. In late March, an Arizona couple was poisoned after ingesting an aquarium cleaner, and later the husband was pronounced dead. The toxic compound contains chloroquine, a drug used in the prevention and treatment of malaria, in regions where the local malaria parasites remain sensitive to its effects. This should not come as a surprise: the president advocated for the use of chloroquine and a variant, hydroxychloroquine, as a preventative measure or treatment for COVID-19, even though both remain therapeutic candidates because their clinical evaluation is underway. The anti-malaria effect of the chloroquine-type compounds is linked to their lysosome-dwelling character. The single-celled malaria parasites travel into a patient's bloodstream from the mosquito's saliva, with a majority of them making their home inside red blood cells. Chloroquine concentrates in the parasite's food-processing lysosomes, which stops them from acquiring amino acid and energy. Due to the same reason, various chemical forms of the same compound are also used to treat and control microbial growth in aquariums, limiting infections caused by anemones, algae, and many protozoa. The couple who mistook the fish med for treatment suffered from a major side effect of chloroquine — electrocardiographic changes. (Not to mention the composition of the aquarium cleaner is quite different from human chloroquine medications). The medication can disrupt the heart's electrical system, therefore affecting heartbeat rate and rhythm. It can also harm the muscle tissues of the heart, causing irreversible cardiomyopathy. How an obscure drug became a coronavirus 'cure' | The Fact Checker (Washington Post) After the event, FDA issued a Letter to Stakeholders, titled "Do Not Use Chloroquine Phosphate Intended for Fish as Treatment for COVID-19 in Humans". To prevent similar incidents, in which desperate consumers self-medicate with animal drugs, the federnal agency said it would work with vendors to remove chloroquine intended for aquarium use. Sources: NPR/FDA

As cannabidiol (CBD) products become increasingly mainstream, more people are using them to manage symptoms for chronic illnesses including diabetes. But how effective is CBD for managing symptoms of diabetes? Diabetes affects a person’s ability to process and regulate their blood glucose levels. People with diabetes either don’t make enough insulin to regulate how much glucose enters the bloodstream or can not use the body’s insulin as well as they should. This causes a person’s ‘blood sugar’ to increase and can cause serious health complications including heart disease, blindness, kidney failure and amputations. There is currently little research on how CBD may impact diabetes. As such, the American Diabetes Association (ADA) says that the Food and Drug Administration (FDA) does not currently regulate CBD products for the condition. Nevertheless, some animal studies have been carried out to investigate the effects of CBD. A study from 2015 for example found that CBD reduced inflammation and neurotoxicity in rats with diabetes. The researchers thus said that CBD may be a promising candidate as an anti-inflammatory and neuroprotective therapy against diabetic retinopathy, a vascular condition among those with diabetes that leads to blindness. Meanwhile, a study from 2019 found that a 30-day CBD treatment improved memory performance and reduced nerve inflammation in rats with diabetes and chronic cerebral hypoperfusion, one of the causes of vascular dementia. Regarding other aspects of diabetes, the ADA says that CBD does not have a noticeable effect on blood sugar or insulin levels in people with type 2 diabetes. The organization also notes that while the compound is well tolerated by most, it can suppress the immune response, increase eye pressure (which may worsen glaucoma) and cause complications for those with cardiovascular conditions. As such, the organization recommends patients seek advice from their doctor before taking CBD products to manage their symptoms. Sources: CDC, ADA, Healthline

Palliative care describes a class of healthcare intended to enhance patients' quality of life with severe, life-threatening diseases, including cancer. Palliative care is not the same as hospice care, a different type of healthcare focusing on patients nearing the end of life who are no longer receiving medical treatments trying to cure or even slow the progression of their disease. So, while patients receiving palliative care may also receive medical treatments targeting their illness, those in hospice care only receive care to increase their comfort in the last days or months of their life. While an increasing number of states have legalized marijuana use in some form or another, understanding the impact it could have on various medical conditions or symptoms associated with diseases and disorders has come under focus. Marijuana describes dried flowers, leaves, stems, or seeds of a plant called cannabis. Composed of over 100 compounds known as cannabinoids, the cannabis plant holds a diverse array of potential medicinal benefits. Two of the most well-known cannabinoids include tetrahydrocannabinol (THC), which can impair function, alter brain signals, and cause a “high,” and cannabidiol (CBD), which has no psychoactive or intoxicating effects. CBD oil, generated when CBD is extracted from cannabis and emulsified into an oil, has emerged as a popular product claiming a wide range of medical benefits. The CBD industry has touched many products, including cosmetics, food, beverage, and supplements. In 2021, financial experts estimated CBD’s global market value at $5.8 billion. Moreover, CBD sales in the US may exceed $20 billion by 2024. Despite the steady increase of CBD products and the affiliated economic boosts, most of the medicinal claims associated with CBD remain anecdotal. Of note, the only FDA-approved use of CBD is in the form of an anti-seizure drug called Epidiolex. To test the potential benefits of CBD, a team of researchers investigated the effects of CBD oil in palliative care patients with advanced forms of cancer. The results of this study, recently published in The Journal of Clinical Oncology, found that CBD oil provided no added benefit to standard palliative care. The study included 144 patients with advanced cancer experiencing symptom distress as determined using a well-established scale known as the Edmonton Symptom Assessment Scale. Patients received CBD oil or placebo for 28 days. After 14 days of intervention, the analysis revealed no significant difference between the symptom distress between the CBD and placebo groups. Specifically, in this study, CBD had no impact on quality of life, depression, or anxiety. While 53% of patients in the CBD group reported feeling better or much better after 14 days of treatment, 65% of those in the placebo group said the same. After the full 28 days of treatment, 70% and 64% of patients felt better or much better in the CBD and placebo groups, respectively. The authors conclude that “despite widespread public belief in the benefits of cannabis, this study failed to demonstrate an improvement in symptom control from CBD oil in patients with advanced cancer over that obtained from palliative care alone.” The authors also note that using pure CBD could present a significant criticism of their study as combining CBD and THC could prove more beneficial. Sources: J Med Chem, J Clin Oncol, J Palliat Care

.body_content a{color: #175CA9;} .body_content a:hover{color: #1A4E75;text-decoration: underline;} .body_content{text-align: justify;font-size: 1.1em;line-height: 1.5em;} Almost one-third of epilepsy patients suffer from a treatment-resistant form. Their condition is associated with severe unhealthiness and an increased risk of death. The use of medical marijuana to treat epilepsy has generated a great deal of interest among epilepsy patients and their doctors. There is no lack of anecdotal evidence of the drug's benefits and widespread use of treating epilepsy. Some parents have turned to cannabis to treat their child's debilitating epilepsy and found it significantly reduced the presence of seizures. There is not, however, a significant amount of scientific literature of back up the claims. Neurosurgeon Orrin Devinsky wanted to know more about using cannabidiol to treat epilepsy. Cannabidiol is one of over 60 compounds found in marijuana. It is one of the two compounds found in the highest concentration in marijuana. Cannabidiol doesn’t get the user high. While this makes it a poor choice for recreational users, the medical field is drawn to it for its significant medicinal benefits and minimal side effects. Along with a team of researchers, Devinsky found that the medical marijuana derivative was well-tolerated, safe, and effective in reducing seizure frequency in children and young adults. Thus, the drug might have a sufficient safety profile in children and young adults with treatment-resistant epilepsy. The researchers recruited 214 patients with severe, unmanageable, childhood-onset, treatment-resistant epilepsy. The participants, aged 1 to 30-years old, were already receiving stable doses of anti-epileptic drugs. They were additionally enrolled in an expanded-access program at one of 11 epilepsy centers across the United States. Expanded-access programs allow patients to gain access to investigational drugs not yet approved by the FDA. Both the study participants' families and the researchers knew the patients were receiving cannabidiol. The researchers gave the patients a daily dose of an oral form of cannabidiol called Epidiolex. Participants initially took 2 to 5 mg/kg. Doctors increased the dose up to 25 mg/kg or 50 mg/kg per day depending on the study site. The study took place over a course of one year. They monitored 162 patients for at least 12 weeks. Of the 162 patients, the researchers included 137 patients in the drug effectiveness analysis. The results showed, on average, a 36.5 percent reduction in monthly motor seizures. The average number of monthly motor seizures fell from 30 at the study’s start to 15.8 over 12 weeks. The seizures were recorded by parents or caregivers in diaries that were reviewed by the study team at each visit. Lab screenings were conducted at the beginning of the study and after 4, 8, and 12 weeks of treatment. The cannabidiol proved to be adequately safe and was generally well-tolerated by patients. Adverse events were reported in 128 of the monitored 162 patients. Most of them were mild to moderate and lasted for only a short time. Still, 20 patients experienced serious adverse events. Of those 20, only five discontinued treatment There are over 40 types of seizures. The two types of seizures that were reduced the most were focal and atonic seizures. Focal seizures consist of impaired consciousness, altered senses, and repetitious behaviors such as blinks or twitches. Atonic seizures are characterized by a sudden and general loss of muscle tone, especially in the arms and legs, which often causes the patient to fall. Two patients were completely free of seizures of all types over the entire 12 weeks. These latest findings provide the first estimates of safety, tolerability and efficacy of prescription CBD in children and adults with severe, highly treatment-resistant epilepsy. "We are very encouraged by our trial results showing that [cannabinoid] was safe and well-tolerated for most patients, and that seizures dropped significantly," says Devinsky. "But before we raise hopes for families who regularly deal with the devastation of treatment-resistant epilepsy, more research, including further studies through our ongoing randomized controlled trial, are needed to definitively recommend CBD as a treatment to patients with uncontrolled seizures." "I empathize with parents who are looking for answers and will try anything to help their children suffering the devastating effects of intractable epilepsy. But we must let the science, and not anecdotal success stories and high media interest, lead this national discussion," cautions Devinsky. "Taking CBD in a controlled medical setting is vastly different from going to a state where medical marijuana is legal and experimenting with dosing and CBD strains.” Devinsky is now leading a randomized controlled trial where patients will be randomly assigned to a placebo group of a cannabinoid group. The trial will help determine the specifics effects of the drug and better eliminate research bias. The study was published in the December 23, 2015, issue of Lancet Neurology. Sources: study via The Lancet, press release via EurekAlert! and NYU Langone Medical Center, Epilepsy Foundation, Epilepsy Foundation of Colorado, CBDForSure

CBD is known for its healing qualities, popular for easing everything from anxiety to chronic aches to TMJ. But while it’s non-intoxicating, and seen as safe for consumption, there can be downsides that users should be aware of. Like anything else, CBD has potential side effects that may affect some people more than others. Some side effects to watch out for include diarrhea, fatigue, and fluctuations in weight. Others can include such as dry mouth, reduced appetite, drowsiness, and fatigue. CBD can also interact with other medications you're taking, such as blood thinners. According to the FDA, consuming too much CBD can also cause liver damage. If you take CBD regularly for sustained periods of time, you can experience withdrawal effects when you stop taking it, particularly for conditions such as insomnia. It’s also important to keep an eye out for the purity and dosage of the CBD products you’re buying, so that you get exactly what you’re expecting, with no unpleasant surprises. To ensure you buy the best-tested CBD sleep gummies, oil and other types of CBD products, consider checking the independent lab testing results. Independent laboratories analyze the phytochemical profile of the sample, like the potency of CBD and the entire cannabinoid and terpene content. It would be safer for you to choose products from reputable brands by checking the founders' background and hemp sourcing. As long as you’re aware of the potential risks, you may want to look into whether or not CBD is right for you, as it is reported to have the following benefits: Antipsychotic effects. Some studies suggest that CBD might help with schizophrenia and other mental health conditions by reducing symptoms of psychosis. Substance abuse treatment. CBD is associated with helping anxiety and depression and easing dependency on certain drugs such as heroin. Possibly helping ease certain types of cancer. Recent studies suggest a combination of CBD and THC may help extend the life of some people suffering from certain aggressive cancers. However, this research is limited and very preliminary. Possibly improving sleep. CBD might help improve sleep in people with certain sleep disorders or suffering from recurring insomnia. Sources: Health Digest, Mayo Clinic, FDA, Healthline

After a national survey in July confirmed that the vast majority of arthritis patients were either interested in using CBD for symptom relief or already using CBD, the Arthritis Foundation is on board. The organization now has a brief but official set of guidelines for arthritis patients looking to CBD for symptom relief. Summarized in three words? Proceed with caution. What is arthritis? Millions of Americans are affected by some form of arthritis, making it the country’s top cause of disability. 30.8 million American adults have osteoarthritis, and 1.5 million Americans - with the majority of them being women - have rheumatoid arthritis, an autoimmune disorder. What is CBD? Cannabidiol, or CBD, is one of more than 100 phytocannabinoids found in cannabis plants and their varieties, i.e. marijuana and hemp. Phytocannabinoids interact with cannabinoid receptors of the endocannabinoid system in the human body to produce various physiological responses. Like its partner in infamy, tetrahydrocannabinol (THC), CBD is known for certain effects on the body that occur after interacting with a cannabis product. However, unlike THC, CBD does not cause psychoactive effects (a “high”). 2,600 arthritis patients provided feedback through the July 2019 national survey from the Arthritis Foundation. A little over half of the respondents reported having osteoarthritis, and a little under half reported having rheumatoid arthritis. The majority of respondents had been living with either form of arthritis for more than a decade. 79% of respondents reported previously, currently, or considering using CBD product to relieve their arthritis symptoms, and well over half (67%) reported “improvement in physical function.” With the undeniable knowledge of arthritis patients’ interests in CBD confirmed through the survey, Arthritis Foundation officials set out to collaborate with leading CBD and arthritis pain experts to produce practical guidelines that answer the main questions arthritis patients are asking “It’s far better to give this guidance, even if preliminary, because otherwise people will have no guidance whatsoever,” said Daniel Clauw, MD. Less than half (46%) of the July survey respondents reported receiving information about CBD use from a health care professional. The Arthritis Foundation has always operated under the idea that “no single drug, supplement or therapy works for everyone,” and acknowledging CBD as an option for arthritic symptom relief is a predictable step toward continuing to promote that idea. “While CBD is controversial and its effectiveness inconclusive, people with arthritis aren’t waiting to try it to treat their pain,” said Cindy McDaniel, Arthritis Foundation senior vice president of consumer health and impact.” Here’s an overview of the guidelines published by the Arthritis Foundation. The overall message? Be cautious. Concrete clinical evidence neither supports nor opposes use of CBD to address arthritis symptoms; CBD has been associated with symptom relief, but start with a low dose No major safety issues have been found, but drug interactions are possible CBD should not replace drugs used in the context of inflammatory arthritis to prevent permanent joint damage Discuss CBD use with a health care professional Do your research; different companies selling CBD products have different processes for purity, potency, and safety In addition to the July 2019 national survey, the Arthritis Foundation published a formal statement to the United States Food and Drug Administration (FDA), “urging the agency to expedite the study and regulation of CBD products to help make them a safe option for the 54 million people with arthritis.” Sources: Arthritis Foundation, Bioorganic & Medicinal Chemistry

The evidence that the endocannabinoid system (ECS) is intimately involved in food intake has been steadily mounting. Thus, in attempts to treat obesity, several pharmaceutical agents have been created to manipulate the food intake properties of the ECS to decrease appetite in obese individuals. In 2006, rimonabant was introduced into the European market by French pharmaceutical Sanofi S.A. as an appetite suppressant to help treat obesity. However, after adverse psychological side effects were reported, rimonabant was removed from the European market in 2008. It was never approved by the FDA in the United States due to advisory panel arguing against it based on potential psychiatric side effects. Photo Source: unsplash.com A little pharmacodynamics review. Rimonabant is an inverse agonist at the cannabinoid 1 (CB1) receptor. Briefly, an inverse agonist is a pharmacological agent that binds to a receptor and keeps it active at physiologically low levels. That is to say, because it is bound to the CB1 receptor, rimonabant allows for a small amount of constant activation. However, because it is bound to the receptor, our ECS system cannot activate it naturally. Thus its effects are similar to an antagonist, which blocks the activation of the receptor completely. Blocking the ability of the ECS to activate CB1 receptors (and thereby contribute to hunger) seems to make a lot of sense...on paper. Animal trials used obese mice to test whether rimonabant was effective at decreasing body weight. It turned out that it was. Clinical trials soon started afterward, and the results looked promising. At least when the clinical endpoint was decreased weight. What manufacturers were unaware of was that rimonabant was causing anxiety, depression, and suicidal thoughts in their subjects. Photo Source: unsplash.com What might be the reason rimonabant causes psychiatric side effects? Well, remember that an inverse agonist means that the receptor, in this case, the CB1 receptor, is constitutively active (i.e. always on). If we take a look back at the cannabis literature, we find that some people who smoke marijuana report anxiety and paranoia. This is thought to be due to the main psychoactive component of marijuana, delta-9-tetrahydrocannabinol (THC). THC activates CB1 receptors, which are located throughout the brain. It could be that by consistently activating CB1 receptors (albeit at a low level of activity), rimonabant could have been mimicking, over time, the psychiatric effects more often seen acutely with THC use. In fact, if scientists went back to the obese mice and looked for indices of depression or anxiety then they would have spotted these adverse psychological effects before investing time and money into costly clinical trials. These effects are so easy to see (but only if you are looking for them) in mice that rimonabant-induced depression is now an accepted model of inducing mood disorders in rodents. The catastrophic failure of rimonabant illustrates that we need to better understand our ECS if we want to design appropriate drugs which target it. Sanofi S.A.'s stock price plummeted when it was pulled from the market and it was sued for $40 million on behalf of patients who suffered suicidal thoughts. The discovery of the ECS and its role in food intake meant a new avenue for anti-obesity therapeutics. Nevertheless, the ECS is a complex system of which we really know little about. Pharmaceutical companies need to tread lightly if they hope to benefit from ECS-targeting drugs. See the video below for more information. Video Source: YouTube.com Sources: Reference Module in Biomedical Sciences, Side Effects Drug Annual, Wikipedia.com - Rimonabant, YouTube.com, The Brazillian Journal of Psychiatry, News-Medical.net, Neurobiology of Disease, reuters.com