Bees and Cannabis

Image result for honey bees and cannabis

Very little research appears in the literature about how honey bees (Apis mellifera) interact with Cannabis plants which contain levels of tetrahydrocannabinol (THC) and cannabidiol (CBD) appropriate for recreational or medical use (only one scholarly article about the interaction between Cannabis plants and bees can be found). So what are the biologic and physiological relationships between Cannabis and Apis mellifera? In 2016, Sharon Schmidt, who holds a doctoral degree in Clinical Psychology, is a Psychiatric Nurse Practitioner, beekeeper and a volunteer Director for the Oregon (US) Honey Festival, located some bee hives on a property that had beautiful land resources; organic plants and flowers in the summer and a clean, continuously flowing stream in the vicinity of the hives. Facing south-east with a big thicket of tall, mature plants on the north side of the hives to protect against winter winds, there were pigs in a neighbouring field that would stir up and loll in puddles of muck and sometimes the bees seemed attracted to the puddles. Community gardens, visible from the property, interested the bees greatly. The setting was idyllic and the bees proved to be good pollinators. 

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There was no warning the bees would eventually be in the middle of a Cannabis grow. However, on the day Oregon law changed to allow citizens to grow Cannabis, an odour some described as ‘heavenly’ and others referred to as ‘skunk-like’ emanated from the fields. When told the bees had access to Cannabis, people would ask whether the bees were ‘buzzed’ and whether their honey would make people ‘high’ (euphoric). This was a fascinating question! Would the bees (quite unintentionally) produce neuro-active honey? This began a line of inquiry by Sharon to determine whether bees are interested in Cannabis, what they might glean from it nutritionally and the effects of Cannabis on bees and bee products. Her observation of the bees revealed there was apparently no interaction in spite of the abundance of Cannabis plants in close proximity to the hives. Why not? One hypothesis was that the bees were not attracted to the aroma of Cannabis plants.  

Bees have an exquisite olfactory sense that they use to detect pheromones of other bees and to find nectar. They are also attracted to colours and these two appeals to the senses are like neon billboards for finding food and mating opportunities. Cannabis does not have these attributes. It does not produce a smell that would attract bees, nor is it colourful and finally, and most importantly, it is unable to provide a reward in the form of floral nectar.  As those familiar with Apis mellifera know, it is nectar and not pollen that is required by bees to make honey. There are other reasons bees would not find Cannabis attractive. However, an apparently contradictory piece of video footage turned up on social media in 2015. The video showed seemingly excited honey bees buzzing around and alighting upon a Cannabis plant from which they appeared to be feeding. Many viewers seeing that footage probably believe the bees derived some chemical excitement from their contact with the plant. However this is very unlikely because bees have no neuro-receptors that would allow them to apprehend the neuro-active elements present in Cannabis. Image result for Nicholas Trainerbee

In a 2001 article, Cannabinoid receptors are absent in insects, the authors revealed insects do not produce arachidonic acid (polyunsaturated Omega 6 fatty acid) which is a precursor of necessary ligands (molecules that bind to other, usually larger molecules). It is thought that the cannabinoid (CB) receptor was lost in insects over the course of evolution. The authors also noted the CB receptor appears to be the only known neuro-receptor present in mammals and absent in insects. Because of its documented absence, bees are unable to experience Cannabis the same way humans do. Apparently the story circulating behind the bee video footage was that middle-aged French bee-keeper ‘Nicolas Trainerbees’ (a pseudonym), freely admitted to spraying ‘sugar water’ on female Cannabis flowers to entice the bees. He was trying to ‘train’ them to harvest the resin of the Cannabis plant to make propolis, a special gum which the bees use everywhere in the hive. As to his purported ‘Canna Honey’, the female Cannabis flowers produce tiny, resinous, crystal like structures called trichomes. These sticky structures help pollen to stick to the flower for pollination and within these trichomes are the cannabinoids.

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However, trichomes are oil-soluble, not water-soluble and honey is water-based. The next often asked question is whether honey made by bees having access to Cannabis plants contains THC and whether it exerts a neuro-active effect on those consuming it. The Cannabis plant is dioecious, meaning male and female flowers are produced by different individuals, male and female plants. The Cannabis plant is also anemophilious, wind pollinated (mostly), and therefore has not evolved to attract bees, except perhaps in extreme dearth situations. Male flowers, which produce pollen, do not contain any cannabinoids, however, so lack the active ingredients which are what give the desired ‘effects’. The existing scholarly article, Cannabis sativa – an important subsistence pollen source for apis mellifera, on the topic notes that Cannabis pollen seems to be a food of last resort for bees. The author notes that bees (in India) turned to Cannabis plants as a source of protein but only visited male plants during times of dehiscence (spontaneous bursting open) when the male plant’s reproductive organs released pollen and that bees were only interested in that pollen during a pollen dearth. 

Bees and male marijuana

The Abstract of Cannabis sativa – an important subsistence pollen source for apis mellifera, states:

Cannabis sativa is an important source of pollen for Apis mellifera during the period of floral scarcity (May and June) when major flora is absent. Foraging of bees on the herb under experiment took place during morning and evening hours, while during rest of the day activity remained totally ceased. All the foraging bees were pollen gatherers as the plant provides pollen only. Maximum foraging took place during  morning, however pollen was also collected thoroughly by specific sweeping activity and scrabbling behaviour during evening hours. Foraging frequency of bees was more during morning as compared to that at evening. Average pollen load observed was 4 mg / bee. Abundance, Foraging behaviour and pollen loads indicated that this annual herb is a good source of pollen during dearth period in summer”.

So how do we account for reports of persons who say they have seen bees congregating and apparently foraging on female plants or of images available on social media? Sharon approached Norman Carreck (Science and Senior Director of the Journal of the Apiculture Research) who suggested the possible source of the female plant’s attractiveness to bees could be ‘extra floral nectaries’ documented as an attribute of the Cannabis plant by John Free (1970) in his book, Insect Pollination of Crops. Extra floral nectaries include glands residing outside the calyx producing both water and sugars. There are no formal reports of extra floral nectaries in Cannabis plants other than the one referenced by Mr Free. However, if Cannabis plants are shown to have these, they could serve a defensive purpose by attracting ants which protect the plant from herbivores, or they might serve to attract bees. However, Cannabis is known to have glandular trichomes (plant hairs that secrete fluid), which could also be a plant feature interesting to bees suggested Dr Marjorie Weber, Postdoctoral Fellow, Centre for Population Biology, University of California Davis, in January 2016.

Image result for capitate-stalked trichomes

In Cannabis plants, bulbous type trichomes are the smallest at 15-30 microns and barely visible. Capitate-sessile trichomes measure from 25-100 microns across and capitate-stalked trichomes measure from 150-500 microns and are the most abundant. The latter contain the majority of the neuro-active cannabinoids (THC, THCV, CBN) and the effects of use are at least partly mediated by how much degradation is allowed prior to harvest. It appears that trichomes may have evolved for the purpose of making a plant less tasty to animals and insects, making the idea that bees are feeding from trichomes less plausible and more likely that they might be collecting resin from them. In a discussion with noted entomologist, Dr Dewey Caron, more ideas were advanced. First, that another naturally occurring source of interest for bees called ‘honeydew’ is often the object of their interest. Honeydew is simply the waste product of scale or other sucking insects which Cannabis is likely to host. These tiny insects probably concentrate their feeding (and excretion) at the tender surfaces of new plant growth and produce tasty waste products that bees might feed on.

Honey bees and cannabis

Second is the possibility that bees might be collecting resins for purposes of making propolis (a sticky bee product used to sanitise, reinforce and weatherproof the hive) and third, that bees demonstrating activity on Cannabis plants might even be seeking moisture from irrigation, as suggested by Dr Caron. Presently, it seems that some aspects of the relationship between bees and Cannabis are not yet verified. Judging from statements occurring in public discourse, misinformation about bees, Cannabis and honey based upon legend and lore exists among some of the public. Much may yet be discovered, but some hypotheses are more likely true than others: First, it appears that bees cannot experience altered neuro-physiology as a result of exposure to Cannabis given they have no neuro-receptors for the chemical it contains. Second, the literature suggests they do not prefer Cannabis pollen but will resort to visiting male plants and collecting pollen from them mostly during a floral dearth. Third, if bees congregate and appear to be feeding upon female plants it is not to collect floral nectar because Cannabis does not produce flowers containing nectar; there is no known reason for the plant to produce nectar to attract pollinators due to the fact that it has evolved as a wind pollinated plant. 

Image result for Cannabis bees propolis

However the plant may produce water and sugars if extra floral nectaries are proved to be present, which could account for observations and anecdotes about bees congregating. Fourth, it is possible that an extra floral plant exudate might be used by bees to make honey and one can speculate about the presence of the precursors of neuro-active chemicals. It seems unlikely though unless the bees are actually foraging on trichomes. Trichomes have evolved to protect the plant from the predatory interests of animals and insects so the idea of bees foraging from them seems unlikely. The common use of the term ‘sugar’ to describe the frosty looking trichomes which have become opaque may further cloud the issue, bringing some to equate trichomes with sweetness. In fact, people who advocate juicing Cannabis reference the need to mix it with other vegetable juice to cut the bitter taste. Generally bees do not seem to seek out bitter fluids. Fifth, even if the resulting honey did contain such alkaloids, bee products would not be neuro-active without heat being applied for the purpose of converting alkaloids from an inactive to an active state (decarboxylation). 

Image result for cannabis honeyThus persons reporting euphoria after eating raw honey made by bees with access to Cannabis are much more likely to be reporting a psychological phenomenon rather than a physiological one. Bees also have an affinity for honeydew (waste products of scale and other insects that inhabit and forage in Cannabis plants) therefore any interest bees demonstrate toward this plant could be based on the presence of honeydew, or even due to bees’ interest in collecting moisture or resin. A final possibility is that bees might be ‘trained’ to collect whatever substances are available from the plant as a result of experiencing a conditioning paradigm. Under such circumstances they might learn to associate the plant odour with a reward (sugar water) which could account for the enthusiasm they appear to be showing in the above-referenced video. Future observation will likely yield more information about Cannabis and how bees interact with this plant. Not known is the composition of contents of the guts of bees appearing to forage on Cannabis or even the composition of their propolis. No micro observation of their interaction with the plant is readily available either. Given the expansion of legal Cannabis growing in some American states it seems likely there will be more interest and opportunity for systematic observation and research allowing anecdotal reports and scientific data to be accurately reconciled. 

The Benefits Of Cannabis-Infused Honey

Elizabeth Vernon, known as “Queen Bee” in her home state of New Jersey in the US, is an apiarist and certified massage therapist with a degree in Eastern Medicine. She combines her two passions, healing and beekeeping, by infusing botanicals like Cannabis into honey with her Magical Butter machine. Adding Cannabis to honey creates a powerful and healthy natural remedy, since both are known to have healing anti-bacterial and anti-inflammatory properties. Cannabis-infused honey can be used topically or ingested, depending on the desired effects. Infusing honey has been practiced for over 3,000 years. Honey is an extremely versatile base with a large number of healing properties. Adding different herbs and blends of herbs can create a powerful combination that can prevent and fight illness and disease. There are many different methods and the best practice with crafting anything is to find your own balance, do research and figure out what works best for you.

Image result for bees on cannabis flowers

There are so many different variables to consider; Working with fresh ingredients or dry? Planning a cold infusion or warm infusion? What season is it? Honey is always best to work with when the temperature is warmer and using a Magical Butter machine (or similar) saves time and energy. As honey can’t bind to Cannabis, and honey can’t be made into Cannabis-infused honey by bees themselves, the best way is to make a tincture and to add it to the honey. But without any fat, the herb has nothing to bind to, so adding infused coconut oil with the tincture works amazingly well, as without binding the THC to a fat molecule in the likes of coconut oil, most of the effect will be lost. Coconut oil is a saturated fat, allowing maximum absorption of cannabinoids and is much more healthful for you than saturated animal fat; definitely the best option for vegans and those concerned about health. Tinctures are, without a doubt, the oldest mass-market way of extracting and consuming cannabinoids and terpenes found in the trichomes of the Cannabis plant. During the majority of the 19th century, physicians from North America, the United Kingdom and Europe dispensed, recommended and prescribed Cannabis tinctures for a wide variety of common ailments. 

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Adapted from Bees and Cannabis with The Benefits Of Cannabis-Infused Honey

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Therapeutic and Medicinal Uses of Six Cannabinoids

Cannabinoids are a diverse class of chemical compounds produced in plants like Cannabis, endogenously in many animals and, synthetically. Those produced in plants are known as phytocannabinoids, the most well-known source of which is the Cannabis plant. They are able to illicit physiological effects chiefly via their ability to act on receptors in the human Endocannabinoid System (ECS), primarily by their interactions with the CB1 and CB2 receptors. To date, 113 cannabinoids have been  isolated from the Cannabis plant, many of which have been linked to potential medicinal benefits, from killing cancer cells to reducing pain and anxiety. Cannabis contains a treasure trove of compounds with potential medical uses. Highlighted here are the medicinal uses of six of the more studied cannabinoids, offering a glimpse into the incredible potential of the Cannabis plant.


THC – Tetrahydrocannabinol

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  • The FDA has approved THC for the treatment of: anorexia in AIDS patients, nausea and vomiting in cancer chemotherapy patients, muscular spasticity in multiple sclerosis (when combined with cannabidiol)
  • Clinical evidence supports the potential use of THC for the treatment of: muscular spasticity following spinal injury, fibromyalgia, peripheral neuropathic pain, glaucoma, post-traumatic stress disorder (PTSD)
  • Preclinical evidence supports the potential use of THC for the treatment of: multiple cancers, sleep disorders, opiate addiction, depression

CBD – Cannabidiol

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  • Clinical evidence supports the potential use of CBD for the treatment of: Epilepsy, Parkinson’s disease, pain, anxiety, inflammatory bowel disease (IBD), Crohn’s disease, schizophrenia, muscular spasticity in multiple sclerosis, glioblastoma (when combined with THC)
  • Preclinical evidence supports the potential use of CBD for the treatment of: Alzheimer’s disease, Huntington’s disease, hypoxic-ischemic injury, depression, multiple cancers, nausea, inflammatory diseases, rheumatoid arthritis, antibiotic-resistant bacterial  infection, cardiovascular disease, diabetes-related complications

THCV – Tetrahydrocannabivarin

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  • Preclinical evidence supports the potential use of THCV for the treatment of: Obesity, Type 2 diabetes, Alzheimer’s disease, osteoporosis, Parkinson’s disease, epilepsy, anxiety, PTSD

CBN – Cannabinol

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  • Clinical evidence supports the potential use of CBN for the treatment of: Sleep disorders
  • Preclinical evidence supports the potential use of CBN for the treatment of: Antibiotic-resistant bacterial infection, pain, allergic airway diseases, Crohn’s disease, rheumatoid arthritis, appetite loss, seizures

CBG – Cannabigerol

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  • Clinical evidence supports the potential use of CBG for the treatment of: Psoriasis, eczema
  • Preclinical evidence supports the potential use of CBG for the treatment of: Glaucoma, neuropathic pain, antibiotic-resistant bacterial
  • infection, IBD, ulcerative colitis, Crohn’s disease, multiple sclerosis, multiple cancers, autoimmune encephalomyelitis, appetite loss

CBC – Cannabichromene

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  • Preclinical evidence supports the potential use of CBC for the treatment of: Multiple cancers, osteoarthritis, inflammation (when combined with THC), acne, depression (when combined with THC and CBD)

References
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33. Brierley, D. I., Samuels, J., Duncan, M., Whalley, B. J., & Williams, C. M. (2016). Cannabigerol is a novel, well-tolerated appetite stimulant in pre-satiated rats. Psychopharmacology, 233(19-20), 3603-3613.
34. Ligresti, A., Moriello, A. S., Starowicz, K., Matias, I., Pisanti, S., De Petrocellis, L., … & Di Marzo, V. (2006). Antitumor activity of plant cannabinoids with emphasis on the effect of cannabidiol on human breast carcinoma. Journal of Pharmacology and Experimental Therapeutics, 318(3), 1375-1387.
35. Maione, S., Piscitelli, F., Gatta, L., Vita, D., De Petrocellis, L., Palazzo, E., … & Di Marzo, V. (2011). Non‐psychoactive cannabinoids modulate the descending pathway of antinociception in anaesthetized rats through several mechanisms of action. British journal of pharmacology, 162(3), 584-596.
36. DeLong, G. T., Wolf, C. E., Poklis, A., & Lichtman, A. H. (2010). Pharmacological evaluation of the natural constituent of Cannabis sativa, cannabichromene and its modulation by 9-tetrahydrocannabinol. Drug & Alcohol Dependence, 112(1), 126-133.
37. Oláh, A., Markovics, A., Szabó‐Papp, J., Szabó, P. T., Stott, C., Zouboulis, C. C., & Bíró, T. (2016). Differential effectiveness of selected non‐psychotropic phytocannabinoids on human sebocyte functions implicates their introduction in dry/seborrhoeic skin and acne treatment. Experimental dermatology, 25(9), 701-707.
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Decriminalisation versus Legalisation, of Cannabis

 

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Decriminalisation refers to a reduction of legal penalties imposed for personal Cannabis use, either by changing them to civil penalties such as fines, or by diverting Cannabis users away from a criminal conviction and into education or treatment options (known as ‘diversion’). Cannabis possession for personal use and use itself would still be legally prohibited, but violations of those prohibitions would be deemed to be exclusively administrative violations, removed completely from the criminal realm. Decriminalisation largely applies to use and possession offences, not to sale or supply. The idea is to provide users with a more humane and sensible response to their use. Decriminalisation has the potential to reduce the burden on police and the criminal justice system. Essentially, under decriminalisation, law enforcement is instructed to ‘look the other way’ when it comes to possession of small amounts of Cannabis for personal use only. Under decriminalisation, both production and sale of Cannabis remains unregulated by the State. Decriminalisation does not address the black market nor criminal networks and relies on the ‘discretion’ of law enforcement. 

Image result for cannabis decriminalisationAs an example in Jamaica, according to The Economist:

“Decriminalisation is only half the answer. As long as supplying ‘drugs’ remains illegal, the business will remain a criminal monopoly. Jamaica’s gangsters will continue to enjoy total control over the ganja market. They will go on corrupting police, murdering their rivals and pushing their products to children. People who buy cocaine in Portugal face no criminal consequences, but their euros still end up paying the wages of the thugs who saw off heads in Latin America. For the producer countries, going easy on ‘drug’-users while insisting that the product remain illegal is the worst of all worlds”.

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Legalisation, on the other hand, is the lifting or abolishing of laws banning possession  and personal use of Cannabis. Legalisation would eliminate, or significantly reduce, the illegal black market and criminal networks as criminals do not profit in a legal market.  Legalisation allows government to regulate and tax Cannabis use and sales, accruing taxation revenue as they currently do from gambling, alcohol and tobacco. Moving the issue away from police and the criminal justice system and concentrating responses within health would save big taxpayer dollars and remove the negative consequences (including stigma) associated with criminal convictions for Cannabis use. Finally, use figures post legalisation in most jurisdictions show either no change or a drop in use numbers, along with a reduction in crime and overdose deaths from all other drugs.

Currently legal drugs, such as alcohol and tobacco, are widely consumed and associated with an extensive economic burden to society – including hospital admissions, alcoholism treatment programs and public nuisance.

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We should all be concerned about laws on substances deemed drugs (as Cannabis, for example, is a herb) because they affect all of us: people who use; who have family members using; health professionals seeing people for related problems; ambulance and police officers; and all who pay high insurance premiums because drug-related crime is extensive. Drug-related offences also take up the lion’s share of the work of police, courts and prisons. The moral argument against legalisation suggests the use of illegal drugs is somehow amoral, anti-social and otherwise unacceptable in today’s society. The concern is legalisation would ‘send the wrong message’. The moral argument also applies to decriminalisation, as lesser penalties may suggest society approves of drug use. Many countries, including Australia, have decriminalised Cannabis use to some degree: measures include providing diversion programs (all Australian states and territories) and moving from criminal penalties to civil penalties (such as fines in South Australia, Australian Capital Territory and the Northern Territory). 

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Research on Portugal suggests previously illegal drug use rates didn’t rise under decriminalisation, with measurable savings to the criminal justice system. The Portuguese government had been waging the ‘war on drugs since the 1980’s, but it wasn’t working (and hasn’t worked anywhere). Around 1% of the population was addicted to heroin in 1999 with the highest number of drug-related AIDS deaths in the European Union. In 2001 they took the unprecedented step of decriminalising all illicit substances deemed as ‘drugs’, from Cannabis to crystal methamphetamine to heroin. The Portuguese drug policy has been lauded by ultra-conservative and quasi-judicial, International Narcotics Control Board (INCB), which deemed it exemplary in December 2015. A decreasing trend in the total number of notifications of human immuno-deficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) cases has continued to be registered since the early 2000’s. In 2016, a total of 1,030 new HIV-positive individuals and 261 new AIDS cases were reported for all risk groups; 14.3% of drug users who had ever injected and tested at outpatient treatment services were HIV positive, indicating an overall downward trend since 2013; and, Portugal’s drug-induced death rate sat at three per million residents, five times lower than the European average.

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A person caught using or possessing a small quantity of drugs in Portugal for personal use (by law, should not exceed quantity required or average individual consumption over a period of 10 days), where there is no suspicion of involvement in trafficking, will be evaluated by a local Commission for the Dissuasion of Drug Addiction (CDT), composed of a lawyer, a doctor and a social worker. Punitive sanctions can be applied, but the objective is to explore the need for treatment and to promote healthy recovery. Trafficking may incur a sentence of 1-5 or 4-12 years’ imprisonment, depending on specific criteria, such as the nature of the substance supplied. The penalty is reduced for users who sell to finance their own consumption. Decriminalisation seems to have taken some pressure off the Portuguese criminal justice system. In 2000, approximately 14,000 people were arrested for drug-related crimes. This number dropped to an average of 5,000-5,500 people per year after decriminalisation. However, the number of people the police have cited for administrative drug use offences has also remained constant at about 6,000 per year. 

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Uruguay legalised Cannabis use in December 2013 under President Jose Mujica, known for donating 90% of his wages to the needy. The goal was to stamp out the black market, controlled mainly by Paraguayan smugglers, without encouraging consumption. Other considerations were to assist health problems, battle ‘drug’ related crime by controlling growing, importing and distribution of Cannabis and lowering the profit organised crime rings would gain by trafficking etc. Three separate surveys were conducted early 2014, late 2015 and mid‐2017 with national representative samples of adults. 60.7% of respondents in 2014 were against legalisation; in 2017, 54.1% remained opposed. In 2015, half those interviewed (49.9%) supported access through self‐cultivation, while 38.6% favoured Cannabis clubs and 33.1% agreed with retail sales in pharmacies. Support for medical Cannabis was high in 2015, with 74.5% favouring it. The surveys evidenced a change in public opinion toward legalisation. 

Registered Uruguayan citizens (not visitors) are able to get Cannabis in one of three ways: grow up to six plants at home; join a club (45 members can cultivate up to 99 plants); or buy in pharmacies. Consumers are restricted to 40 grams (1.4 ounces) a month. About 10% of adult Uruguayans smoke at least once a year and more than 6,600 people initially registered to grow at home, with 51 clubs opened. Cannabis Clubs can grow a wide variety of plants, more than pharmacies are allowed to sell, with no limits on THC. “It’s the equivalent of comparing a bottle of wine with a box of wine” says Marco Algorta, grower at the 420 Cannabis Club in Montevideo. His worry is 99 plants are not enough to supply members with their full entitlement and he wants permission to grow more. 

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Even then, clubs and home growers will only cater to a niche market and pharmacies’ business will build, slowly (it’s only been five years since legalisation, this coming December). Thirty pharmacies initially signed up to cover much of the country, but their corporate suppliers are allowed to grow only four tonnes a year, 15% of what Uruguayans smoke. In June 2017, Uruguay’s envoy to Ottawa, Canada, Ambassador Martin Vidal, said his country’s goal had not been to change the minds of other countries about Cannabis, but to get them to accept that there are other ways to approach ‘drug’ control. “Some other countries have joined us in this discussion and others in the future, maybe Canada will be one of them, will find it’s not that the path is already clear, but we have facilitated a lot because we worked very hard in the last years to introduce this perspective” said Vidal, whose country is home to about 3.4 million people, about one-tenth Canada’s population.

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There hasn’t been a rise in Cannabis use rates in Australia, despite states and territories introducing civil penalties for users. Research has noted a negative side effect to the way in which decriminalisation operates in Australia; ‘net widening’, whereby more people are swept into the criminal justice system than would have been otherwise under full prohibition because discretion by police is less likely and/or they do not meet their obligations. Despite the largely supportive evidence base, politicians appear reluctant to proceed along the decriminalisation path, let alone legalisation, due somewhat to vested interests (mostly pharmaceutical interests). But public opinion is largely in support of decriminalisation and even legalisation where it concerns Cannabis. In a national survey in 2015, more than nine out of 10 Australians (91%) believed the use of Cannabis for medicinal purposes should be made legal, according to a special survey conducted 20-22 October. Only 7% were against legalisation and 2% couldn’t say.

“Prohibition has failed. As a drug and alcohol doctor, I’ve seen that the ‘tough on drugs’ approach causes enormous harm. It drives people away from getting help when they need it and exposes them to a dangerous black market”, Richard Di Natale

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In April 2018, Richard Di Natale, Leader of The Australian Greens said: “The Greens see ‘drug’ use as a health issue, not a criminal issue. Our plan to create a legal market for Cannabis production and sale will reduce the risks, bust the business model of criminal dealers and syndicates and protect young people from unfair criminal prosecutions”. He said in a poll in 2017, 55% of Australians believed Cannabis should be taxed and regulated like alcohol and tobacco. The plan would be expected to raise “hundreds of millions” of dollars for the budget. In May 2018, Senator David Leyonhjelm, Liberal Democrat from New South Wales, put forward a private member’s bill, ‘Criminal Code and Other Legislation Amendment (Removing Commonwealth Restrictions on Cannabis) Bill 2018’, which would amend five Acts and the Criminal Code Regulations 2002 to remove barriers in Commonwealth legislation to the legalisation and regulation of Cannabis for recreational, medicinal, industrial and other purposes.

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“Adults should be free to make their own choices, as long as they do not harm others”, he told Parliament House in Canberra. The NSW minor-party Senator has been a long-time supporter of recreational Cannabis as a libertarian who champions free speech, lower taxes and unwinding gun control. Senator Leyonhjelm previously supported the Greens’ plan to make the herb legal in the face of bans in every state and territory. In March, a Victorian parliamentary Inquiry Into Drug Law Reform called for recreational use to be legalised, after MP’s visited Colorado and California, where it is legal to use Cannabis, recreationally. They argued a sales tax could be levied on Cannabis if it was legalised and explored how Cannabis could be regulated with child-proof packaging, only available for sale to adults. 

reefermadnessOpponents of legalisation are concerned it will increase use, increase crime, increase risk of car accidents and reduce public health, including mental health. None of which has happened in any jurisdiction under legalisation (in fact mostly the opposite has been shown to be true). The current incarnation of the Australian Federal Health Minister, the misogynistic Greg Hunt, actually said in April 2018, “marijuana is a gateway drug”. Hunt graduated in Law from Melbourne University and won a full scholarship for his Masters in International Relations via Yale University. Great qualifications for a health portfolio; a lawyer who spruiks ‘reefer madness’ rubbish, as the ‘gateway drug’ hypothesis was well and truly discounted decades ago. The majority of people who use Cannabis do not go on to use other drugs. In addition, alcohol, tobacco and pharmaceuticals usually precede Cannabis use, which if the theory were correct would make those drugs the ‘gateway’. There is also no evidence legalisation increases use

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Australia’s official drug strategy is purportedly based on a platform of harm minimisation, including supply reduction, demand reduction (prevention and treatment) and harm reduction. Arguably, policies should therefore have a net reduction in harm.  But some of the major harms from using illicit drugs are precisely because they are illegal. A significant harm is having a criminal record for possessing drugs for personal use. This can negatively impact a person’s future, including careers and travel. A large proportion of the work of the justice system (police, courts and prisons) is spent on drug-related offences. Yet, as Mick Palmer, former AFP Commissioner, noted “drug law enforcement has had little impact on the Australian drug market”. Decriminalisation may reduce the burden on the justice system, but not as much as full legalisation because police and court resources would still be used for cautioning, issuing fines, or diversion to education or treatment. 

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Legalising for recreational use would boost the budget by up to $1.8 billion a year, the Parliamentary Budget Office revealed. The independent costing of the policy submitted by the Greens shows a tobacco-style 25% per cent excise on each sale with a 10% Goods and Services Tax and a reduction in law enforcement would net $3.5 billion by 2020-21. Tourists travelling to Australia would add up to “10% of total sales”, earning $130 million in revenue by 2020. The boost would be used to fund drug education and treatment programs. The PBO said the policy would allow the Australian Federal Police to “re-allocate a proportion of the resources currently directed at Cannabis to strengthen the law enforcement of other illicit substances”, such as ice, methamphetamines and heroin.  There would also be minimal costs for the Australian Taxation Office and the Department of Home Affairs to administer the taxes, the PBO found, as that could be done through established systems and processes. 

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Many see Cannabis prohibition as an infringement on civil rights, citing the limited to non-existent harms associated with Cannabis use. This includes the exceptionally low rate of so-called ‘dependence’ (it can certainly be habit-forming) and impossibility of overdosing on Cannabis, as well as incredibly low to non-existent risk of harms to people using, or others. Many activities that are legal are potentially harmful: driving a car, drinking alcohol, bungee jumping. Rather than making them illegal, there are guidelines, laws and education to make them safer that creates a balance between civil liberties and safety. Legalisation of Cannabis is relatively recent in most jurisdictions so longer-term benefits of legalisation are not yet known. But one study found little effect of legalisation on ‘drug’ use or other outcomes and other studies have shown no increase in use, even among teens

Related imageIn Australia there is a lack of clarity about the issues with poor understanding of the different models of decriminalisation and some basic confusion existing between what decriminalisation and legalisation actually constitute. Many people equate decriminalisation with legalisation, but as detailed, they are very different in policy, intent, action and outcome. Decriminalisation is also sometimes incorrectly confused with harm reduction services, such as safe injecting centres. In order for the debate to progress, we need clarity of terms and dispassionate presentation of what evidence we have, not more ‘reefer madness’ from unqualified and ignorant, in their lack of education regarding actual Cannabis, elected officials, politicians, senior so-called ‘medical professionals’ and self-serving academics. Three words leap to mind, ‘Cranial Rectal Inversion’.
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Adapted from Decriminalisation or legalisation: injecting evidence in the drug law reform debate with Portugal’s Experience of Drug DecriminalisationThe status of support for cannabis regulation in Uruguay 4 years after reform: Evidence from public opinion surveysUruguayan pharmacies will start selling cannabisGreens want cannabis to be made legalDrug War Facts – Region – PortugalCriminal Offences in Portugal 2012, by Type of ‘Drug’Drug harms in Portugal 2018, Uruguay sets path for Canada on marijuana legalization within international treatiesLegal highs: arguments for and against legalising cannabis in Australia$3.5 billion budget boost from legalising marijuana, costing shows and Australia: Senator introduces bill to allow the use of recreational cannabis 

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Mad About Saffron

spices that interact with the endocannabinoid system

Modern science is starting to catch on to the wisdom of our ancestors, who knew a lot about using aromatic herbs and spices for medicinal purposes. The use of spices for cooking, healing and dyeing fabric has shaped much of human history. In ancient times these highly precious commodities were traded along well-travelled spice routes throughout Asia, the Middle East, Northern Africa and Europe. Some spices were literally worth their weight in gold. Yet, it’s only recently that scientists have discovered the bio-active constituents and molecular mechanisms of several common kitchen spices, shown to reduce oxidative stress and inflammation while modulating multiple healing pathways simultaneously. A number of scientific studies confirm the health-promoting properties of various spices are mediated by the same receptors in the human brain and body that respond pharmacologically to Cannabis.

Saffron: Nerve Tonic

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A 2013 report in Pharmacognosy Review  examined the neuro-protective effects of Saffron extracts, which inhibited the build-up of beta-amyloid plaque in the brain in animal models of Alzheimer’s. The same article noted that Saffron extracts could “prevent retinal damage and age-related macular degeneration”. An Italian research team subsequently showed Saffron can counteract effects of continuous bright light exposure in lab rats by enhancing retinal blood flow. Saffron “engages” both the CB1 and the CB2 cannabinoid receptors “in order to afford retinal protection” the Italian scientists concluded. Described as “the most expensive cultivated herb in the world” Saffron (Crocus sativus) is a much-revered food seasoning and a natural colourant.

Cultivated originally in Persia and Asia Minor, this legendary spice comes from a light purple flower with thread-like red-orange stigma that contains 150 bioactive components, including carotenoids, flavonoids and other potent polyphenols. A rich source of riboflavin (vitamin B-2) and free-radical scavengers, saffron has a long history of use as a folk medicine for treating cancer, convulsions, headaches, skin conditions, asthma, ulcers, premenstrual distress and other diseases. The Ebers papyrus (1550 BC) refers to Saffron as a “cheering cardiac medicament” and a cure for kidney problems. Scientific studies indicate Saffron improves learning and memory by inhibiting the breakdown of acetylcholine. Saffron also enhances the functioning of the GABA receptor, which explains in part its efficacy as a relaxant and nerve tonic. Clinical trials evaluated the anti-depressant properties of Saffron and concluded it was more effective than a placebo and equivalent to Prozac.

Turmeric: Holy Powder

ImageTurmeric (Curcuma longa), a perennial plant of the Ginger family, has a safe 6,000-year track record as a medicinal herb, a culinary spice and a dye for fabric and food. The fleshy rhizome of this all-star botanical is ground into a deep orange-yellow powder and used to season South Asian cuisine. It is a significant ingredient in most commercial curries, as well as a staple of Ayurvedic medical practice, which utilises Turmeric (typically in combination with other herbs) to treat indigestion, throat infections, metabolic dysfunction, common colds and many other ailments. Known as “the holy powder of India”, Turmeric is also applied topically as an antibacterial and anti-fungal remedy for skin sores and to clean wounds. The United States Food and Drug Administration (US FDA), perennial handmaiden of Big Pharma, recognises Turmeric as a food-colouring agent but not as a therapeutic substance, despite more than 5,600 peer-reviewed studies of Turmeric and its main polyphenolic component, Curcumin, that document numerous healing attributes. There is more evidence-based scientific literature (1,500 science articles) supporting the use of Curcumin against cancer than any other nutrient, including vitamin D.

Much like Saffron, Curcumin is a potent antioxidant that confers neuro-protective effects through multiple molecular channels. Turmeric protects against alcohol-induced brain damage, improves insulin sensitivity and cardiovascular function, inhibits platelet aggregation and facilitates the clearing of beta-amyloid plaque associated with Alzheimer’s dementia. It’s worth noting the incidence of Alzheimer’s and other neuro-degenerative diseases among people living in the Asian subcontinent, where Turmeric is ubiquitous, is significantly lower than in North America. Turmeric’s versatility as a medicinal herb derives in part from its interaction with the endocannabinoid system, which regulates numerous physiological processes. In May 2012, Neurochemical Research Identified the CB1 cannabinoid receptor as a mediator of Curcumin’s antidepressant effect: “treatment with Curcumin”, the report notes, “results in the sustained elevation … of endocannabinoids”. In December 2013, the European Journal of Pharmacology disclosed that Curcumin reduces liver fibrosis by modulating cannabinoid receptor transmission.

Peppercorn: Black Gold

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Employed since antiquity as both a food seasoning and a folk cure, Black Pepper (Piper nigrum) is the world’s most traded spice. Touted as “black gold”, the dried fruit of this woody vine, the peppercorn, was considered such a valuable commodity, it served as a substitute for money in business transactions. During the Middle Ages in Europe, Black Pepper was a luxury item only the wealthy could afford. Today, it is one of most commonly used spices on the planet. The manifold therapeutic properties of Black Pepper have been validated by modern science. Essential oil of Black Pepper reduces nicotine cravings and eases withdrawal symptoms. An anti-spasmodic and anti-convulsant, it can also lower blood pressure and relieve digestive distress. Piperine, Black Pepper’s principal bioactive constituent (an alkaloid), has been shown to inhibit cancer cell proliferation in animal models of osteosarcoma, and also potentiates anti-tumoural and apoptotic effects of Turmeric by enhancing the bioavailability of Curcumin. When co-administered, Piperine and Curcumin interact synergistically to confer a stronger antidepressant effect than either compound delivers on its own.

In addition to Piperine, Black Pepper contains vitamin K, iron and manganese along with a robust array of aromatic terpenes, which should be familiar to Cannabis connoisseurs: Pinene, Limonene, Linalool … Black Pepper is particularly well endowed with the sesquiterpene Beta-caryophyllene, an important medicinal component of many Cannabis strains. Beta-caryophyllene is the only terpene known to bind directly to CB2, the cannabinoid receptor that regulates immune function, peripheral nervous system, metabolic tissue activity and other physiological processes. Black Pepper’s potent anti-inflammatory effect is mediated by the CB2 receptor. THC binds directly to the CB2 receptor, although this is not what causes a person to experience euphoria when he or she consumes Cannabis. That’s because CB2 receptors are not present to a significant degree in the brain and central nervous system. Beta-caryophyllene is a significant component of several other common kitchen spices, including Clove, Cinnamon and Oregano.

Nutmeg: Cannabinoid Booster

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Nutmeg (the dried kernel of Myristica fragrans) does not directly activate the CB1 cannabinoid receptor in the brain or the CB2 cannabinoid receptor in immune cells. This commonly used kitchen spice can have a powerful impact on the endocannabinoid system as a 2016 study in Pharmaceutical Biology reported, Nutmeg interacts with the endocannabinoid system by inhibiting certain key enzymes that catabolise (break down) the two main endocannabinoids, anandamide and 2AG. Likened to the brain’s own Cannabis, these short-lived endogenous cannabinoid compounds bind to CB1 and CB2 receptors. This triggers a signalling cascade on a cellular level that protects neurons against toxic insults (stress) and promotes neurogenesis (creation of new stem cells in adult mammals). Two catabolic enzymes, fatty acid amide hydrolase (FAAH) and monoglycerol lipase (MAGL), are involved in the breakdown of anandamide and 2AG, respectively.

Simply put, less FAAH  and MAGL means more anandamide and 2AG. So by inhibiting these catabolic enzymes, Nutmeg raises the level of anandamide and 2AG in the brain and boosts cannabinoid receptor signalling throughout the body. FAAH and MAGL  inhibition has proven to be beneficial for easing pain, anxiety, hypertension and various inflammatory conditions in preclinical research, which lends credence to traditional medical uses of Nutmeg. Ayurvedic healers in India utilise Nutmeg as an anxiolytic or anxiety-reducing agent. But there are conflicting accounts of Nutmeg’s effect on anxiety and depression; higher doses cause a biphasic response, exacerbating mood disorders and triggering hallucinations. Nutmeg has long been known for its central nervous system activity. In an article in Nature (1966), Alexander Shulgin identified “myristicin as a psychotropic substance”.  Many prison inmates, including Malcolm X before his conversion to Islam, sniffed and swallowed Nutmeg to ‘get high’. Now we know how and why Nutmeg has a neuro-active effect; it stimulates cannabinoid receptor transmission by suppressing the enzymes that break down the brain’s own Cannabis.

Ecological medicine

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Herbs and spices are ecological medicines that 75-90% of the world’s rural people still rely on as their primary mode of healthcare. Numerous plants, not just Cannabis, are endowed with compounds that interact directly or indirectly with the endocannabinoid system. The health benefits of many common kitchen spices are mediated by the same cannabinoid receptors in the human brain and body that Cannabis activates. Scientific research into Cannabis’ effects on the brain has opened the door to whole new vistas of understanding human biology and physiology. As we welcome Cannabis back into the pantheon of approved medicinal herbs, perhaps we should rethink our ideas about the endocannabinoid system, so named after the plant that led to its discovery, and stretch its boundaries to encompass an abundance of botanicals.

Adapted from an article by MARTIN A. LEE, Director, Project CBD, author Smoke Signals: A Social History of Marijuana — Medical, Recreational and Scientific

  • Akhonzadeh S, et al, “Saffron in the treatment of patients with mild to moderate Alzheimer’s disease,” J Clini Parm Ther, 2010 Oct.
  • Bhutani, MK, et al, “Anti-depressant effect of curcumin and its combination with piperine in unpredictable chronic stress-induced behavioral, biochemical and neurochemical changes,” Pharmocol Biochem Behav, 2009 March.
  • Cordell, Barbara  and Buckle, Jane, “The effects of aromatherapy on nicotine craving on a U.S. campus: a small comparison study.” J Altern Complement Med. 2013 July 31.
  • El-Alfy, Abir T, et al, “Indirect modulation of the endocannabinoid system by specific fractions of nutmeg total extract,” Pharmaceutical Biology, 2016.
  • Gertsch, J, et al, “Beta-caryophyllene is a dietary cannabinoid,” Proc Natl Acad Sci USA, 2008 July.
  • Gohari, Ahmad Reza, et al, “An overview on saffron, phytochemicals, and medicinal properties,” Pharmacogn Rev, 2013 Jan-Jun.
  • Hassan M, et al, “Pharmacological basis for the medicinal use of black pepper and piperine in gastrointestinal disorders,” Anticancer Res. 2009 Dec 01.
  • Hassanzadeh P, et al, “The CB1 receptor-mediated endocannabinoid signaling and NGF: the novel targets of curcumin,” Neurochemical Research, 2012 May.
  • Javadi, B, et al, “A Survey of Saffron in Major Islamic Traditional Medicine Books,” Iranian Journal of Basic Medical Sciences, 2013.
  • Ji, Sayer, “600 Reasons Turmeric May Be the World’s Most Important Herb,” GreenMedInfo.com, July 10, 2013.
  • Ji, Sayer, “Better than Chemo: Turmeric Kills Cancer Not Patients,” GreenMedInfo.com, Sept. 12, 2015.
  • Kannappan, Ramaswamy, et al, “Neuroprotection by Spice-Derived Nutraceuticals,” Molecular Neurobiology, 2011 October.
  • Kazem M, et al, “Antispasmodic effect of Piper nigrum fruit hot water extract on rat ileum,” Pak J Biol Sci, 2008 Jun 01.
  • Khazdair, Mohammad Reza, et al, “The effects of Crocus sativus (saffron) and its constituents on nervous system: A review,” Avicenna Journal of Phytomedicine, Sept-Oct 2015.
  • Khorasany, AR, et al, “Therapeutic effects of saffron (Crocus sativus L.) in digestive disorders: a review,” Iranian Journal of Basic Medical Sciences, 2016.
  • Mishra A, et al, “Anticonvulsant mechanisms of piperine, a piperidine alkaloid,” Channels (Austin). 2015 Sep 02.
  • Natoli, R, et al, “Gene and noncoding RNA regulation underlying photoreceptor protection: microarray study of dietary antioxidant saffron and photobiomodulation in rat retina,” Molecular Vision, 2016.
  • Patil, Vaishali M, et al, “Quantum Chemical and Docking Insights Into Bioavailability Enhancement of Curcumin by Piperine in Pepper,” J Phys Chem A, 2016 May 26.
  • Rapino, Cinzia, et al, “Type-1 and Type-2 Cannabinoid Receptor Signaling is Involved in the Neuroprotective Effect of Saffron of Rat Retina,” poster at International Cannabinoid Research Society conference, 2016 June.
  • Rose, J E and Behm FM, “Inhalation of vapor from black pepper extract reduces smoking withdrawal symptoms,” Drug Alcohol Depend. 1994 Feb 01.
  • Samarghandian, Saeed, et al, “Anticarcinogenic effect of saffron (crocus sativus L.) and its ingredients,” Pharmacognosy Res, 2014 Apr-Jun.
  • Zhang J, et al, “Piperine inhibits proliferation of human osteosarcoma cells via G2/M phase arrest and metastasis by suppressing MMP-2/-9 expression,” Int Immunopharmacol. 2014 Dec 31.
  • Zhang Z, et al, “Curcumin modulates cannabinoid receptors in liver fibrosis in vivo and inhibits extracellular matrix expression in hepatic stellate cells by suppressing cannabinoid receptor type-1 in vitro,” European Journal of Pharmacology, 2013 Dec 5.

Is the Government Removing ‘Medical Cannabis’ Competition?

This man was arrested for giving patients Cannabis medicine for free. Despite purported legalisation, it remains extremely difficult to access ‘medical Cannabis’ in Australia. 

Prominent Cannabis Grower Tony Bower Is Arrested For Gifting Cannabis Oil To Patients
Tony Bower – If You Can, Please Support His Legal Fund

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On 28th March 2018, police arrested prolific Australian Cannabis grower and founder of Mullaways Medical Cannabis (company registered 21 October, 2008), Tony Bower. His company develops Cannabis-based medicines to treat a variety of illnesses and conditions, including chronic pain, epilepsy (particularly intractable paediatric forms), cancer/s and the likes of multiple sclerosis. As a result of his arrest, over 150 individuals who rely on his Cannabis-based treatments will need to look elsewhere, at least in the short term. Tony’s wife, Julie, said the couple had only a relatively small amount of Cannabis oil left in stock at the time of Tony’s arrest. 

“A 62-year-old Crescent Head man remains in custody following his latest appearance in court on three drug-related charges. Police executed a raid on a property near Kempsey. Anthony Bower was charged by police from the Mid North Coast Police District after they executed a search warrant with assistance of the Dog Unit. Police facts allege they located a large amount of cash, Cannabis leaf and 280 plants. Bower was arrested and charged with cultivating prohibited plant, deal in proceeds of crime, possess prohibited drug and supply prohibited drug. He was refused bail and remains in custody. His next court appearance is on 20 June”.

Tony waits in the Mid North Coast Correctional Centre for a June bail hearing after bail was refused in Local Court as he was deemed a high risk of ‘re-offending’. Anyone who knows, or has heard of, Tony, ‘Mullaway’, knows he is anything but criminal. To even suggest such seems, in effect, criminal, as laws based on lies are ‘pretend laws’ after all! However, the authorities have been trying to stop him and his important, life-saving work for years. Tony’s first time in court for growing and supplying Cannabis was in 1998, charged for cultivation. In 2013, he was charged with possession. Sentenced to one year’s incarceration, he appealed and was released after only six weeks. The following year, caught with more Cannabis plants, he was charged once again.

“A pretend law, made in excess of power, is not and never has been a law at all. Anyone in the country is entitled to disregard it”, Chief Justice Sir John Latham, 1942, South Australia v Commonwealth.

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Tony has long experimented with plant breeding to cultivate safe cannabinoid medicines. From Mullaways’ website;

“The Research by Mullaways Medical Cannabis has made it possible for the first time to; Design, Cultivate, Trial and Evaluate Cannabinoid Treatments using SAFE Doses of Cannabinoids / THCA / THC. While the rest of the Medical Cannabis Research world tries to genetically engineer Cannabis without any THC or tries to produce a rich Blend of Cannabinoids / THC from low THC Cannabis Mullaway’s Research has already produced the Jewel in the Crown of Medical Cannabis Research”.

However, Tony’s plans have been put on hold as he once again sits behind bars. In February 2016, Australia officially legalised ‘medical Cannabis’. Since then, government has signalled its intention to expand its ‘medical Cannabis’ operations, stating it would approve exports, becoming the fourth country in the world to do so. The country’s health minister said his government aims “to give farmers and producers the best shot at being the world’s number one exporter of medicinal Cannabis”.

Mullaways

Without legal permits, Tony was an easy target for law enforcement. But many in the community see Mullaways’ independent operation as a necessary alternative to the government-run, overly bureaucratic program. Many patients report accessing ‘medical Cannabis’ in Australia remains difficult. According to some estimates, only roughly one in ten users has been granted permission to access Cannabis legally, regardless of the government streamlining the current convoluted process.


Support Tony Bower with Legal Fees

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Thank you for your interest.

Adapted from Prominent Cannabis Grower Tony Bower is Arrested For Gifting Cannabis Oil to Patients with Man remains in custody on cannabis charges, Patient Access to Medicinal Cannabis Products in Australia

Cannabis and Psychosis; Correlation Still Does Not Imply Causation

Image result for Dr Charles Ksir WyomingImage result for Dr Charles Ksir WyomingIn the United States during the first quarter of 2016, Professor’s Charles Ksir (University of Wyoming, Psychology) and Carl L. Hart (Columbia University, New York, Psychology) read with intense interest the meta-analysis by Tabea Schoeler (Kings College, London, United Kingdom) and colleagues, on continued Cannabis use in patients with psychosis. They applauded the authors for covering this timely, important issue, commending them for attempting to provide empirical evidence to inform public policy. However, their enthusiasm was dampened because the interpretation extended beyond the available data.

Large image of Figure 1.

Meta-Analysis Study Selection

They noted that it is of utmost importance to remember the meta-analysis was based on correlational studies. Each study pointed out causation has not been shown; however, a strong tendency exists to accept Cannabis use as a so-called component cause of psychosis, which then leads to the conclusion it is imperative to reduce Cannabis use in patients with, or at risk, for psychosis. Although the Professor’s understood this impulse is motivated by a concern for public health, they agreed it should not allow the consistency of these correlational findings to substitute for actual evidence of causality. In 2016, Professor’s Ksir and Hart published a critical review of the scientific literature on Cannabis and psychosis and concluded that the literature supports the hypothesis that both psychosis and Cannabis use are more likely in individuals with a shared vulnerability to misuse of various substances and increased risk for various mental disorders. In other words, the correlation between Cannabis use and psychosis is not specific, either with regard to the chemicals found in Cannabis or to psychosis as opposed to other disorders.Image result for no clear evidence causal relation Cannabis and psychosis

Schoeler and colleagues stated that rates of Cannabis use in patients with psychosis are “higher than … those of people with other psychiatric diagnoses”. To support this statement the authors cited an article by Agosti and colleagues, even though Agosti and colleagues clearly concluded, “Alcohol dependence, antisocial personality disorder and conduct disorder had the strongest associations with Cannabis ‘dependence’, followed by anxiety and mood disorders”. They did not report any association between Cannabis and psychosis, presumably because of the low frequency of psychosis in the participants studied. In their own review, Professor’s Ksir and Hart included seven studies published between 2013 and 2016 that provided information on the issue of specificity. After reviewing the scientific literature they found evidence that bipolar disorder, anxiety disorder and mood disorder have all been correlated with Cannabis use and reported that psychosis has been correlated with heavy tobacco smoking, heavy alcohol use, stimulant misuse and sedative misuse. They found no clear evidence for a causal relation between Cannabis and psychosis.Image result for no clear evidence causal relation Cannabis and psychosis

The Professors’ reviewed research reports on Cannabis and psychosis, giving particular attention to how each report provided evidence relating to two hypotheses:
1) Cannabis as a contributing cause, and
2) shared vulnerability.
Two primary kinds of data are brought to bear on this issue: studies done with schizophrenic patients and studies of first-episode psychosis. Evidence reviewed suggests that Cannabis does not in itself cause a psychosis disorder. Rather, the evidence leads to the conclusion that both early use and heavy use of Cannabis are more likely in individuals with a vulnerability to psychosis. The role of early and heavy Cannabis use as a prodromal sign (early symptom that may mark onset of a disease) merits further examination, along with a variety of other problem behaviours (e.g., early or heavy use of cigarettes or alcohol and poor school performance).

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According to their shared vulnerability hypothesis, in a given group of Cannabis users who have had psychotic episodes, the individuals with the greatest degree of the shared vulnerability would be the most likely to continue Cannabis use rather than to discontinue and they would be the most likely to have recurring episodes of psychosis and require more hospital treatment. As such, these two outcomes should be correlated, even if neither is a cause of the other. As to whether a public health benefit can be obtained from efforts to reduce Cannabis use in patients with psychosis, two randomised controlled trials, published in 2013, comparing treatment as usual with treatment as usual plus motivational interviewing and cognitive behaviour therapy that concentrated on Cannabis use, found no beneficial effect of either intervention on either psychotic symptoms or amount of Cannabis use.

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Interest in the relationship between Cannabis use and psychosis has increased dramatically in recent years, in part because of concerns related to the growing availability of Cannabis and potential risks to health and human functioning. There now exists a plethora of scientific articles addressing this issue, but few provide a clear verdict about the causal nature of the Cannabis-psychosis association. The Professors’ greatest concern is not that someone might be advised to stop using Cannabis. They are concerned that a misunderstanding of the relation between Cannabis use and psychotic behaviour leads to an oversimplification of the complex developmental nature of substance use and mental disorders. Furthermore, they proposed that future studies that limit their data collection to focus exclusively on the Cannabis-psychosis association only will do little to enhance understanding of the complexity of this comorbidity. Research studies of this ilk will therefore be of little value in the quest to better understand psychosis and how and why it occurs.

“I have to make sure I don’t engage in conversations with
people who don’t abide by the rules of evidence”, 
Carl Hart

 


Adapted from Correspondence in the Lancet, Psychiatry, May 2016, and 
Cannabis and Psychosis: a Critical Overview of the Relationship

Cannabis Health Effects – A Brief Summary

The most common physiologic effects of Cannabis on:

Cancer

Cannabinoids have been shown to target and affect cancer cells differently than normal, healthy cells. In various types of cancer, cannabinoids have been shown to prevent tumour growth, trigger cell death (apoptosis), prevent the formation of blood vessels that feed the tumour and inhibit the metastasis of cancer from one part of the body to another. It is well-established that Cannabis can help with the symptoms of cancer and the side effects of cancer treatment and can be used to enhance the anticancer effects of conventional treatments.

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Cardiovascular system

Cannabis exerts bidirectional effects on the cardiovascular system, as it can increase or decrease both heart rate and blood pressure. Typical doses of Cannabis slightly decrease blood pressure and increase heart rate. Cannabinoids can dilate blood vessels and improve blood flow while animal studies suggest some cannabinoids could prevent or reduce atherosclerosis (hardening of the arteries). Ultra-low doses of THC have been shown to limit the damage of heart attack while preserving cardiac function and promoting faster healing. In general, therapeutic doses of Cannabis have a cardioprotective effect


Digestive System

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Cannabis has broad effects in the digestive system, including increasing appetite, reducing nausea and vomiting, inhibiting acid secretion, relaxing smooth muscle, decreasing pain, decreasing inflammation and decreasing motility, thereby relieving cramps and diarrhoea. Cannabinoids are active in the liver and can modulate inflammation and scarring. Cannabis decreases saliva production, resulting in dry mouth and enhances the perception of flavours.


Eyes and Ears

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Cannabis can lower pressure in the eye, the cause of the “red eye” side effect of use. Cannabinoids can protect the optic nerve in glaucoma and other diseases of the eye. Cannabis has also been shown to acutely improve night vision. There are reports of Cannabis relieving tinnitus (ringing in the ears) and cannabinoids may also have a role in the development and treatment of inner ear disorders that cause dizziness and vertigo.


Immune System

The immune system is partially controlled by the body’s own cannabinoids (endocannabinoids) and using Cannabis can certainly affect immune function in complex ways, often suppressing certain aspects of the immune system while stimulating others. Overall, cannabinoids have anti-inflammatory properties and have shown benefit in inflammatory conditions such as Crohn’s disease and multiple sclerosis (MS). Cannabinoids, terpenes and other substances in the plant also have antibacterial properties, including potent activity against antibiotic resistant infections like Methicillin-resistant Staphylococcus aureus (MRSA).Immune System


Metabolism

Cannabinoids influence the hormones that control appetite and fat metabolism. Despite increasing appetite, several studies have now shown Cannabis users are less likely to be obese and diabetic than their non-Cannabis using counterparts. Underweight patients with chronic disease use Cannabis to gain weight, as in other bodily systems, cannabinoids have the potential to bidirectionally restore balance, potentially helping both overweight and underweight individuals.


Nervous System

Cannabinoids have been shown to reduce the intensity of pain, including inflammatory pain, neuropathic pain and cancer pain. Cannabinoids reduce spasticity and the pain associated with muscle spasm. Beyond decreasing the intensity of pain, many patients report Cannabis changes the nature of the pain, making it more bearable and less distracting. Cannabinoids have neuroprotective effects, protecting the nerves from acute injuries like head trauma, stroke and conditions that cause chronic injury, such as Alzheimer’s disease. Cannabinoids also have anticonvulsant effects and in some circumstances, antipsychotic effects.Image result for cannabis and the nervous system

Cannabinoids also affect consciousness via the nervous system. Depending on the strain or preparation, cannabinoids can be awakening or sedating. Cannabinoids can slow reaction time and cause other changes in sensory perception. Many patients report positive mood, relaxation, laughter, social comfort, time distortion and intensification of ordinary experiences (e.g., eating, sex, listening to music) after using Cannabis. Cannabis can cause both a dissociative effect (awareness detaching from the physical body and one’s environment) and, conversely, an integrating effect (greater awareness of self and environment).


Reproductive System

Most human male and female reproductive tissues, such as uterus and testis, manufacture and degrade endocannabinoids to control hormones, fertility, implantation and development of the embryo and inflammation. The plant cannabinoids (phyto-cannabinoids) interact with this same cellular machinery and have the potential to both enhance or inhibit optimal function of these systems. Cannabis use by pregnant women is difficult to study. Studies in Jamaican women, who traditionally use Cannabis as a tonic during pregnancy and to aid in childbirth, found their offspring to have more resilience to stress, better sleep-wake organisation and improved socialisation early in life, but found no differences at age five years.

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Maternal stress and malnutrition are well known to increase the likelihood of adverse outcomes in pregnancy and in some situations a healthcare provider may determine the potential benefits of using Cannabis to treat pain, Post Traumatic Stress Disorder (PTSD), seizures, or vomiting in pregnancy far outweigh any perceived or purported risk. No-smoking! Healthy delivery methods should always be used to avoid exposing the mother and foetus to carcinogens and other products of combustion. The cannabinoids, terpenoids and flavonoids in Cannabis all can affect hormone levels, especially when taken acutely.

Related imageLong-term Cannabis users, however, have normal hormone levels when compared with non-users. Many women report Cannabis can bring balance to their menstrual cycle and relieve many premenstrual and menstrual symptoms. One study found women with more severe menstrual symptoms had lower levels of endocannabinoids, a case for administering additional cannabinoids from a plant source (phytocannabinoids) to help with this potential “deficiency”.

Cannabis can affect sexual function, often helping relieve stress, enhance erection and increase the enjoyment of sexual activity. It can dry vaginal secretions, like it does in the mouth, so Cannabis users may benefit from added lubrication. From a practical standpoint, Cannabis can enhance one’s sex-life if used correctly. Dosage is important, a small dose can be stimulating, while high doses may be too sedating to promote good sex. Human studies also point to differences among genders, with females more consistently stimulated by cannabinoids and males sometimes stimulated and sometimes inhibited.

Cannabis and sex


Respiratory System

Cannabis can dry upper respiratory secretions, similar to its action on saliva and vaginal secretions, which may be of benefit to individuals with a runny nose or severely-ill patients at risk of choking on secretions. Cannabis has been shown to dilate (open) the airways in the lungs, potentially improving oxygen intake. It can act as an expectorant, helping clear phlegm. Patients have reported using vaporised Cannabis to help with asthma and Chronic Obstructive Pulmonary Disease (COPD). Cannabis smoke is clearly irritating to the respiratory system.Related image

The heat can destroy tiny hairs on the respiratory tissue whose job is to help remove phlegm and trapped particles and some of the smoke’s components can likely cause irritation and inflammation. While even long term, heavy Cannabis smokers do not have an increased risk of lung cancer, they do tend to have more respiratory symptoms like cough, phlegm, and wheeze. Smoking both tobacco and Cannabis synergistically increase the risk of respiratory symptoms and COPD. Patients with respiratory symptoms should avoid Cannabis smoke and consider using alternative delivery methods.


Soft Tissue and Joints

Cannabinoids can modulate bone remodelling, promoting bone growth and inhibiting bone resorption and some are currently being studied for prevention and treatment of osteoporosis. Our bodies increase the number of cannabinoid receptors present in tissues that are injured or inflamed, indicating a role for cannabinoids in healing. Several cannabinoids have in fact, been shown to prevent cartilage breakdown in joints, protect connective tissue from injury due to lack of oxygen and speed the repair process in damaged skeletal muscle. Extensive research has shown cannabinoids are excellent for reducing muscle spasm and associated symptoms, even in refractory cases of MS or spinal cord injury. Patients often report improved flexibility and enhanced recovery following exercise when using Cannabis.


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Adapted from The Health Effects of Cannabis by Dustin Sulak, DO, links compliments of Granny Storm Crow’s List, video Pregnancy and Cannabis: Dr Melanie Dreher, 2013

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