Australian Legal ‘Medicinal Cannabis’, Overpriced and Difficult to Obtain

It is estimated that close to a million patients are now seeking access to ‘medicinal Cannabis’ in Australia. Australian government figures show around 20,000 patients now have approvals for access to legal ‘medicinal Cannabis’ products. The Medical Cannabis Users Association of Australia Inc. (MCUA) reports many patients are still having to turn to the ‘black’ market or are self supplying because, access to and cost of, the majority of legal ‘medicinal Cannabis’ products is way beyond their financial reach. This is happening in Queensland, for example, partly because public hospital policy does not permit its doctors to prescribe Cannabis-based products.

The MCUA states the rate of approvals has increased substantially with a mushrooming of corporate clinics set up to move products that had been languishing on warehouse shelves because General Practitioners (GP’s) were refusing to prescribe ‘medical Cannabis’. These clinics have the sole purpose of prescribing corporate ‘Cannabis’-based products and have become the gateway to moving these over-priced, often longitudinally untested pharmaceuticals off the shelves. It appears these clinics are given ‘special treatment’ in this highly regulated environment as the MCUA noted when CEO of ‘medical Cannabis’ company, THC, David Radford said on Sky News;

“… We are working with individual state governments to get their approvals (for clinics) … not the same as a health clinic that you go through so we are not expecting the same regulatory hurdles …”.

The current modus operandi of the clinics when communicating with ‘patients’ is an offering of either/or teleconferencing and face to face consultations with doctors who it is being alleged have no prior experience using or prescribing ‘Cannabis’-based medicine in a clinical situation and who also have had limited training via educational videos and ‘medical Cannabis’ company backup. Some patients have said to the MCUA that consultation processes have been amateur in approach. In some cases, no medical history of the patient was recorded and prospective patients weren’t even asked about current medications or allergies they might have. As to consultation fees the MCUA report these can vary enormously between clinics.

The majority of ‘medical Cannabis’ patients do not receive a Medicare rebate and on average, patients are charged fees by third parties of around $200 to apply to the Therapeutic Goods Administration (TGA) online (a process for which there is no fee attached if one registers directly). Other costs,  it is reported, vary from <$100 to >$1,000 for an initial consultation and an application for ‘medical Cannabis’. Due to the increasing number of complaints about these clinics the MCUA is conducting a patient satisfaction survey asking about patient experiences overall with the delivery model set up by the Australian Federal Government. Responses to their survey have been consistent throughout with +45% of patients saying they are paying up to $500-$1,000 a month for products.Image result for australian medical cannabis products

Most survey respondents are on Centrelink payments because of their illness and some have got themselves into debt with family or friends to enable them to purchase the medicine. Almost half of the prescriptions written have not been filled. Peter Crock, CEO of the Cann Group and Chairman of Medicinal Cannabis Industry Australia reinforces this scenario.  He said on ABC radio that, “All medicinal Cannabis is being imported … that is what is keeping prices high … and people are taking the opportunity to make super profits on the way through”. Many survey respondents say they have had more than one approval with 20% saying they have had more than five approvals. The dissatisfaction rate with the delivery system is consistently 86% .

Patient experiences gathered via the survey include the following;

  • One MCUA member reported being charged $700.00 in consultation fees and product for her fathers palliative medicine. The product was delivered in November 2019, a six week supply of Cannabis oil with an expiry date of October 2019. They were told the family GP would need to sign off on the prescription and treatment would not begin until the Clinic doctor saw the GP because the state owned aged-care facility could not give out-of-date medicine. The woman’s dying father was denied medicine to make his passing easier. 
  • Another wrote they were worried their Cannabis clinic was ‘taking them for a ride’. Their first prescribed medicine was bought as two 25 ml bottles to avoid an extra $50 for shipping. The first script cost $633.30, the next $330.30 due to the distributor lowering the cost. After three months the ‘patient’ had to pay the clinic to write a new script, which needed to be approved again by the TGA. When the clinic couldn’t get the same product they had to re-apply for TGA approval and supplied a different product altogether at a cost of $540.00 for two bottles (50 ml). The cost to use on a daily basis was initially (February 2019) an average of $15.20. When the price dropped it reduced the daily cost to $7.92 and now the ‘patient’ is paying $16.20 daily. 
  • One said she recently applied for the ‘legal version’, knowing full well it was beyond what she could afford after the initial appointment cost $200.00. Subsequent scripts, she was told, would cost $59.00. It would be $80.00 for a follow-up appointment and $59.00 whenever there was an adjustment to dose or product. Requiring two products, one at $660.00 a month and the other at $300.00 a month, needless to say, she could not afford to fill the scripts and believes this circumstance to be discriminatory against people on low incomes. 
  • And one, with Multiple Sclerosis (MS), Fibromyalgia, Rheumatoid Arthritis (RA), degenerative spinal conditions (previous high impact crush injury – L5/4/3), a dislocated neck (C4/3), Scheuermann’s Kyphosis Scoliosis, Complex Regional Pain Syndrome (CRPS), high blood pressure, diabetes, Sarcoidosis, Chronic Obstructive Pulmonary Disease (COPD), is going blind because of the MS. This 36 year old, on a Total and Permanent Disability (TPD) Pension, 18 months ago was looking at being an invalid, possibly under palliative care but that simply was not an option as they had children. They researched and made Full Extract Cannabis Oil (FECO). According to them it was the only reason they did not become wheelchair-bound and paralysed. For $350.00/ounce of black-market Cannabis they could make 250 ml of oil. They used 50 ml ($70.00 worth) a month. Image result for FECO cannabis productsBefore the illegal oil, they took 19 ‘pills’ every morning, 20 at night and another ten throughout the day. They no longer take opioids or other pain-killers except the Cannabis oil which healed the broken back and dislocated neck, when they were told they’d never walk again. They sought approval for legal supply through a prescription, because they go to hospital regularly due to lung and kidney issues, but the hospital won’t let them use their oil because it’s not ‘legal’. They now have a script for legal supply but the bottle of oil is waiting at the pharmacy as they cannot afford it. It’s a THC/CBD blend, 25 ml for $300.00. The doctor said that was the dose for one month. With no way to maintain that cost the ‘patient’ has no option but to continue to make their own oil and run the risk of being raided and prosecuted. Which they were; arrested and charged when caught by police for sending a bottle of home-made medicine to a fellow sufferer. 
  • Another paid $110.00 for two consultations, first with a nurse to see if they met the criteria and second with a doctor to go through the application. They were told they would hear back within a week. After four weeks, they emailed the clinic and got no response. They called the mobile numbers and found they were disconnected, so they wrote a bad review online and looked into reporting the clinic as a scam. The clinic contacted them and asked them to remove the review. In exchange the clinic said they would pay for half the prescription. The full cost was beyond the ‘patient’, so they agreed and drove 1½ hours (round trip) to collect it. The ‘patient’ very quickly worked their way to the maximum dose, without any noticeable impact and was not prepared to spend $385.00 every five days on something that did not work. They were told they would have ongoing follow up care from the team, that they were not going to have to go through the process alone, the entire team was behind them. They never heard from the clinic again. 
  • And yet another at a popular access clinic felt badly treated after commenting about the high cost of the consultations and product. The clinic pharmacist said if they couldn’t afford it to go back to their GP! The ‘patient’ complained to the practice manager and got nowhere. Left without any oil since June, the clinic didn’t care they were not coping, in extreme pain and couldn’t afford to keep paying for consultations, approval applications and the outrageous cost of the oil which they felt was very diluted and not effective at the low dose prescribed. They repeatedly told the clinic they couldn’t afford $450.00 every three weeks on a Disability Pension. They noted that the system is not working and nobody seems to want to help.

Image result for australian medical cannabis productsThis is a small sample. There are many such ‘horror’ stories and MCUA has witnessed firsthand how the system has failed the ill and suffering. There needs to be a review with public input and recommendations made to facilitate a quicker more affordable delivery system. MCUA President, Deb Lynch, is currently waiting for a trial date after being arrested and charged for self-supply following many attempts to acquire a prescription through Queensland (Qld) Health, whose doctors have been advised not to prescribe Cannabis under public hospital policy. Being on a disability pension, there is no way she can afford the costs involved in getting a script from one of these corporate Cannabis clinics.

The MCUA is still seeking patients who have been through the legal process to fill in their Medical Cannabis Access – Patient Satisfaction Survey (2019) which will be forwarded to the Federal Senate, via the Australian Labor Party (ALP) Senator Anne Urquhart, along with their current petition asking for a full review of the delivery system put in place by the Liberal/National Party (LNP). Cannabis is a herbal remedy and trying to squeeze it into the pharmaceutical delivery model will mean that the hold-ups will continue and prices will remain high as companies who have spent millions to get into the market are not turning a profit. The MCUA is asking anyone with an opinion to comment on their petition asking for this review.

The MCUA is contactable via their website.

Image result for australian medical cannabis productsAdapted from Australian Medical Marijuana Patients Find It Difficult To Get and Medical Cannabis Rip Offs result in patients charged with self supply

top

It’s Past Time to Remove False Claims About Cannabis

In 2017, the United States (US) Drug Enforcement Administration (DEA) removed some false claims about Cannabis from their website. The nonprofit advocacy group, Americans for Safe Access, used government policy against the DEA, filing a petition that stated they had violated the Information Quality Act (Data Quality Act), meant to ensure objective, fact-based information is supplied on government websites and literature meant to educate the public. The group cited at least 25 misleading statements found on the DEA’s website and in a report from the agency titled, “The Dangers and Consequences of Marijuana Abuse”, that not only contradicted commonly accepted facts about Cannabis backed by science and research, but also the DEA’s own statements from 2016 when then-US Attorney General Loretta Lynch said Cannabis is not, in fact, a gateway drug’. “We usually … are talking about individuals that started out with a prescription drug problem”, she said.

Image result for cannabis is not a gateway drug

Image result for ban the deaAmong the other misinformation the DEA was passing off as purported fact was that marijuana’ induces psychosis and causes long-term brain damage. “We are pleased that in the face of our request the DEA withdrew some of the damaging misinformation from its website”,  said Vickie Feeman of law firm Orrick, Herrington & Sutcliffe“We are hopeful the DEA will also remove the remaining statements rather than continue to mislead the public in the face of the scientifically proven benefits of ‘medical Cannabis’”, she said. “However, the DEA continues to disseminate many damaging facts about the health risks of ‘medical Cannabis’, and patients across the country face ongoing harm as a result of these alternative facts’”. In 2019, there are still concerning statements on the DEA website that contradict accepted facts about Cannabis.

The Australian Government’s Department of Health (DoH) website states the following:

… ‘drugs’ can be categorised by the way in which they affect our bodies;

  • depressants — slow down the function of the central nervous system
  • hallucinogens — affect your senses and change the way you see, hear, taste, smell or feel things
  • stimulants — speed up the function of the central nervous system

Some ‘drugs’ affect the body in many ways and can fall into more than one category. For example, Cannabis appears in all three categories.

Image result for alcohol and drug foundation

The links to individual substances listed on the DoH website lead you to the Australian Alcohol and Drug Foundation (ADF) website for the purported facts (to use the term, facts, extremely loosely). On Cannabis it notes the effects include anxiety, blurred vision, clumsiness, dry mouth, excitement, fast heart rate, feeling sleepy, increased appetite, low blood pressure, paranoia, quiet mood, reflective mood, relaxation, slower reflexes, spontaneous laughter … and calls it a cannabinoid drug’, contradicting the DoH, using an adapted Drug Wheel (from the United Kingdom).

DrugWheel

Checking the references of the ADF article on Cannabis there are no surprises as to the misinformation, on the short list of names there are several of the usual culprits; high-profile Australian prohibitionists who profit from pushing propaganda with scant regard for actual science or the truth (many ‘brought to us’ by the pharmaceutical industry, among others with vested interests).


Australian Cannabis statistics from the Alcohol and Drug FoundationRelated image
Australians Nationally

34.8%, 14 years and over, have used Cannabis once or more in their life,
10.4%, 14 years and over have used Cannabis in the previous 12 months,
Young People in Australia
• Most do not use Cannabis – 68.7% of 12-17 year olds have never tried it.


Image result for Cannabis and those pernicious substances, the drugs, are wholly unalikeThe therapeutic index (larger the TI, the safer) of Cannabis is estimated to be between 4,000:1 to 40,000:1. Nobody really knows because no one has ever died from an overdose of natural Cannabis. This is because there are few or no CB1 receptors in the brain stem so there is NO respiratory depression from cannabinoids. Respiratory depression can be caused by many psychoactive drugs such as benzodiazepines, alcohol, anti-depressants and opiates. As most people who have tried Cannabis (estimated to be more than one-hundred million US citizens alone) know, the effects can often be quite pleasant and the side effects, such as they are, are mild and less often seen in people with serious medical conditions. Like all therapeutic agents, Cannabis can cause side effects for some, which may include anxiety, paranoia, dysphoria and cognitive impairment. These side effects appear to be dose related, tend to occur in naïve users and are entirely temporary. Due to this (in 1988), US Judge Francis Young, DEA’s Chief Administrative Law Judge, after a two-year rescheduling hearing, recommended rescheduling Cannabis to Schedule II, adding,  “Cannabis was one of the safest therapeutic agents known to man”.cannapharmaco

 


The reality is clear: Cannabis and those pernicious substances, the drugs, are wholly unalike. As the word ‘drug’ is wrong and inapplicable to Cannabis, it is necessary to establish a correct word, veracious vocabulary, which is fitting. “Because Cannabis has been loosely, widely and incorrectly referred to in the past as a ‘drug’ does not mean that this basic untruth can become acceptable. On the contrary, since the introduction of Prohibition the legal situation compels veracity and clarity more than ever, for not to articulate the truth accurately involves perjury. Yet truthful language, the truth, exposes the mendacious basis to the crime that is this prohibition of Cannabis”. 

From The Report of the Family Council on Drug Awareness (FCDA) (Europe, 2000)


Anti-weed activists say violent crimes have increased in states like Colorado. Picture: AP Photo/Dave Zalubowski

Image result for addiction to cannabis less than coffeeThe US Federal Government’s Independent New Drug (IND) program, instituted in 1978,  showed there are no troubling chronic effects from regular long-term use of Cannabis. A 2004 study by Dr Ethan Russo and Mary Lynn Mathre, RN, performed a battery of tests and physical exams on several IND patients supplied with government-grown Cannabis for over 25 years. They found these Cannabis patients to have had no adverse health effects from decades-long respiratory consumption of 7.5-9 lbs (3.4-4+kg) per year. There is plenty of data to demonstrate the safety of Cannabis. Not only the US Government’s IND program but also epidemiology studies demonstrate there are no proven long­-term adverse effects of Cannabis use. Prohibitionistic propagandists will say Cannabis is addictive. However, Cannabis addiction does not exist (except as an oxymoron). It is a misunderstanding of the definition of addiction alongside a lack of knowledge of the action of cannabinoids on the human Endocannabinoid System (ECS). Of course there is a dependency risk to Cannabis, one shared with other medications and/or recreational substances. As substance abuse experts Drs Hennigfield and Benowitz pointed out decades ago, the dependency risk of Cannabis is less than coffee. The 1972 report of the Nixon Marijuana Commission also debunked the idea that Cannabis is addictive.

Image result for cognition iq cannabis use

Another common fallacy is the possibility Cannabis use is linked to adverse cognitive effects. Studies that purport to show these effects are poorly done. A prime example is they do not control for important variables such as use of drugs, traumatic brain injury, PTSD, other medical conditions, growing up in a dysfunctional family, and/or environmental factors. One study cited to support the bogus claim found a reduction in IQ of 8 points in long-time users. This has not been replicated. Several studies including a twin study done by University of California, Los Angeles (UCLA) and University of Minnesota showed this adverse IQ was not true. In fact, Cannabis has helped many with ADD and ADHD pay better attention and raise their academic scores from C’s and D’s to A’s and B’s. One of the most egregious allegations is that Cannabis can change brain structure. Those trying to make the case point to effects in the hippocampus, amygdala and prefrontal cortex. Of course, there are effects on this part of the brain, because it is where many CBl receptors are located. This is why Cannabis has such beneficial effects on treating anxiety, depression and impulse control.

Image result for cannabis bipolar schizophrenia

Another canard (unfounded rumour or story) is that regular Cannabis use is linked to an increased risk of psychotic symptoms. This too is untrue. If it were true, epidemiology would show an increased incidence of psychotic behaviour in the 1970’s or 1980’s because of the pervasive use of Cannabis. There was no such increase. Over the past 60 years the incidence of psychosis has stayed flat or slightly declined. Instead, Cannabis has been shown to be beneficial in the treatment of bipolar disorder and schizophrenia.  Then there are those who insist Cannabis is linked to lower educational attainment. This too is untrue. The work of Dr Melanie Dreher with children exposed to Cannabis in utero and in breastmilk demonstrated that these children did better in school and reached their developmental landmarks sooner than those children whose mothers did not use Cannabis in pregnancy. And the lies continue to percolate wherever it is politically and economically advantageous to those in power in so many jurisdictions, worldwide.

Image result for cannabis use in utero

The International Drug Policy Consortium (IDPC) recommended that, beyond 2019, United Nations (UN) member states should end punitive ‘drug’ control approaches and put people and communities first. The IDPC’s Shadow Report, ‘Taking stock: A decade of drug policy’ evaluates the impacts of policies implemented across the world over the past decade, using UN data, complemented with peer-reviewed academic research and grey literature reports from civil society. Image result for IDPC LOGOThe important role of civil society in the design, implementation, monitoring and evaluation of global policies is recognised in the 2009 Political Declaration and Plan of Action on drugs, as well as in the Outcome Document of the 2016 United Nations General Assembly Special Session (UNGASS). It is in this spirit the IDPC produced the Shadow Report, to contribute constructively to high-level discussions on the next decade in global drug policy. The Shadow Report concluded that member states should identify more meaningful policy goals and targets in line with the 2030 Agenda for Sustainable Development, the UNGASS Outcome Document and international human rights commitments.


IDPC’s Shadow Report, ‘Taking stock: A decade of drug policy’ – Key Conclusions

• Data from the Shadow Report show targets and commitments made in the 2009 Political Declaration and Plan of Action have not been achieved, and in many cases have resulted in counterproductive policies.
• The Shadow Report highlights the urgent need to conduct more comprehensive and balanced research and evaluations on the impacts of drug policies worldwide, taking into account government data, but also academic research and civil society findings.
• The Shadow Report concludes member states should identify more meaningful drug policy goals and targets in line with the 2030 Agenda for Sustainable Development, UNGASS Outcome Document and international human rights commitments.


Crossing out Lies and writing Truth on a blackboard.Image result for cannabis is not a drug

 

 

 

 

 

 

The right to the truth is a human right. Cannabis is a herb, not a drug, and should be removed from all the various drug conventions, worldwide; then it could be provided to all in need, just as ‘Mother Nature’ intended. In the interim, how about the whole, organic truth about the Cannabis sativa plant; it might just set us all free.

 

Adapted from DEA Removes False Claims About Cannabis from Their WebsiteDEA Finally Removes Misinformation about Pot from WebsiteLIES USED TO JUSTIFY RESTRICTIVE CANNABIS POLICIES, Illegally HealedDEA Drops Inaccurate Cannabis Claims From WebsiteWhat You Should Know About MARIJUANAGranny Storm Crow’s List and CANNABIS IS NOT A DRUG.

top

Cannabis is a Significant Non-Toxic Substitute for Dangerously Addictive Pharmaceuticals

Image result for Cannabis as an alternative to traditional pharmaceuticals
Giving patients legal access to Cannabis will influence a significant portion of them to use Cannabis as an alternative to traditional pharmaceuticals, two 2019 studies found. In the first, published in the Journal of Pain, researchers analysed data from online surveys submitted by 1,321 adult Cannabis consumers in legalised states throughout the United States. It found that +80% of respondents had used Cannabis as a substitute for pharmaceuticals, primarily opioid painkillers. Seventy-two percent of those who reported substitution said they had completely ceased opioid use, 68% stopped taking benzodiazepines and 80% eliminated SSRI anti-depression medication. The participants were asked why they chose Cannabis over pharmaceuticals. The top reasons given included that Cannabis had fewer adverse side effects and was more successful in managing symptoms. Almost 90% of respondents said their pain improved after using Cannabis and 71% said their health improved overall. “The current study and the consistent nature of the observational findings provide additional nuance to the ongoing debate about Cannabis’ analgesic value for chronic pain, as well as a potential substitute for opioids or other drugs”, researchers wrote. The second study, published in the Harm Reduction Journal in January 2019 surveyed  +2,000 Canadian adult medical Cannabis patients registered with federally authorised manufacturer Tilray. They completed online questionnaires about why they use Cannabis and whether they’ve used it as a substitute for other medications and substances. The exhaustive survey included 239 questions.

Image result for 2,000 Canadian adult medical Cannabis patients registered with the federally authorised manufacturer Tilray

About 70% said they used Cannabis as a substitute for prescription drugs, 35% for opioids, 11% for anti-depressants, 8% for anti-seizure medications, 4% for sleeping pills and muscle relaxants and 4% for benzodiazepines. A significant fraction of those who used Cannabis as an opioid substitute reported complete cessation: 59%. About 20% said they reduced their opioid usage by at least 75%. Like the US survey, the researchers asked the Canadian patients about the reasons behind their decision to substitute. Fifty-one percent said it was because they felt Cannabis was safer than pharmaceuticals they were prescribed, 40% said Cannabis had fewer adverse side effects and 20% reported better symptom management with Cannabis. Additionally, 44% of respondents said they used Cannabis to partially or completely stop using alcohol and 31% cut out tobacco. “This study offers a unique perspective by focusing on the use of a standardised, government-regulated source of medical Cannabis by patients registered in Canada’s federal medical cannabis program”, researchers wrote. “The findings provide a granular view of patient patterns of medical Cannabis use, and the subsequent self-reported impacts on the use of opioids, alcohol, and other substances, adding to a growing body of academic research suggesting that increased regulated access to medical and recreational Cannabis can result in a reduction in the use of and subsequent harms associated with opioids, alcohol, tobacco, and other substances”. Nearly half of patients using Cannabis to help with their respective medical conditions stopped taking prescribed benzodiazepines, another study, published in the journal Cannabis and Cannabinoid Research, reported.

Image result for Cannabis helped stop taking prescribed benzodiazepines

“Within a cohort of 146 patients initiated on medical Cannabis therapy, 45.2% successfully discontinued their pre-existing benzodiazepine therapy”, authors wrote. “This observation merits further investigation into the risks and benefits of the therapeutic use of medical Cannabis and its role relating to benzodiazepine use”. While much research has been dedicated to understanding how medical Cannabis could potentially replace opioids for patients who deal with chronic pain and other ailments, the study suggests patients who take Valium, Xanax and other popular tranquilisers for neurological conditions (anxiety, insomnia, seizures etc) may find relief through Cannabis. Researchers in Canada conducted a retrospective analysis of data collected from a group of patients who had been referred to the Canabo Medical Clinic for medical Cannabis to treat a variety of conditions. They identified 146 patients who reported taking benzodiazepines regularly at the start of their Cannabis therapy. According to their findings, 44 patients (30%) had discontinued benzodiazepines by their first follow-up visit. Another 21 had stopped by their second follow-up visit and one more person reported doing so at the third visit. Sixty-six patients, or 45%, stopped taking benzodiazepines after starting a medical Cannabis regimen. “Patients initiated on medical Cannabis therapy showed significant benzodiazepine discontinuation rates after their first follow-up visit to their medical Cannabis prescriber, and continued to show significant discontinuation rates thereafter” the study stated. “Discontinuation was not associated with any measured demographic characteristic. Patients also reported decreased daily distress due to their medical condition(s) following prescription cannabinoids”.

Image result for prescription cannabinoids

The amount of CBD and THC content did not appear to play a role in who continued to discontinue taking the tranquilisers. “The study results are encouraging and this work is concurrent with growing public interest in a rapidly developing Canadian Cannabis market”, said the lead author, Chad Purcell. The study also served as an opportunity to draw more attention to the potential risks associated with benzodiazepines, Purcell said. “I was interested in this project because it presented an opportunity to address benzodiazepines and Cannabis use, both of which are becoming increasingly socially relevant. Benzodiazepines can be effective in treating many medical conditions but unlike opioids, there seems to be little public awareness of the risks associated with these commonly used prescription medications”. According to the US Centres for Disease Control and Prevention, overdose deaths related to benzodiazepines rose 830% between 1999 and 2017. Another study (August 2018) showed how Cannabis could be an effective treatment option for both pain relief and insomnia, for those looking to avoid prescription and over-the-counter pain and sleep medications – including opioids. The study, published in the Journal of Psychoactive Drugs, looked at 1,000 people taking legalised Cannabis in an American state and found among the 65% taking Cannabis for pain, 80% found it was very or extremely helpful. This led to 82% of these people being able to reduce, or stop taking over-the-counter pain medications and 88% being able to stop taking opioid painkillers. 74% of the 1,000 bought it to help them sleep – 84% of whom said Cannabis had helped and over 83% said they had since reduced or stopped taking over-the-counter or prescription sleep aids.

Image result for prescription cannabinoids

The study suggests Cannabis could lower opioid use. However, researchers caution more needs to be done to understand potential therapeutic benefits of Cannabis. “Twenty percent of American adults suffer from chronic pain, and one in three adults do not get enough sleep”, said Dr Gwen Wurm, Assistant Professor, University of Miami Miller School of Medicine. Traditional over-the-counter medications and painkillers can help, however they may have serious side effects. Opioids depress the respiratory system, meaning that overdoses may be fatal. “People develop tolerance to opioids, which means they require higher doses to achieve the same effect”, said Dr Julia Arnsten, Professor of Medicine, Albert Einstein College of Medicine. “This means that chronic pain patients often increase their dose of opioid medications over time, which in turn increases their risk of overdose”. Although less common, sleeping pills can lead to dependence and cause grogginess the next day, interfering with people’s work and social lives. As a consequence, some people are looking to Cannabis to help. To find out more about these users, Wurm and her colleagues used survey data from people who purchased Cannabis from two retail stores in Colorado, US, where it is legal for both medical and recreational use – meaning any adult over 21 with a valid government ID may purchase product. “In states where adult use of Cannabis is legal, our research suggests that many individuals bypass the medical Cannabis route (which requires registering with the state) and are instead opting for the privacy of a legal adult use dispensary”, said Wurm.

Related image

Although the survey was conducted among customers willing to participate (meaning the results may not reflect the overall population of dispensary customers) other national survey data and data from medical patients at medical Cannabis dispensaries, demonstrates that people who use Cannabis to treat symptoms both decrease and stop their use of prescription medications. The study adds weight to the theory that widening access to Cannabis for medicinal purposes could lower the use of prescription painkillers, allowing more people to manage and treat pain without relying on opioid prescription drugs that have dangerous side effects. This is backed up with other research that shows US states with medical Cannabis laws have a 6.38% lower rate of opioid prescribing and that Colorado’s adult-use Cannabis law is associated with a relative reduction in opioid overdose death rate from 1999 to 2010. Wurm added, “Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen cause GI bleeding or kidney damage with chronic use. Paracetamol (Acetaminophen) toxicity is the second most common cause of liver transplantation worldwide and is responsible for 56,000 ER visits, 2,600 hospitalisations, and 500 deaths per year in the US”. Again, however, researchers caution more research is needed to understand the health benefits and side effects of Cannabis. “The challenge is that health providers are far behind in knowing which Cannabis products work and which do not. Until there is more research into which Cannabis products work for which symptoms, patients will do their own ‘trial and error’, experiments, getting advice from friends, social media and dispensary employees”, said Wurm.

Related image


Adapted from Patients Are Substituting Marijuana For Addictive Pharmaceutical Drugs, Two New Studies ShowA ‘Significant’ Number Of Patients Stopped Taking Benzodiazepines After Starting Medical MarijuanaCould marijuana be an effective pain alternative to prescription medications?

Bioavailability of Cannabis Oils and Optimal Dosing

Most Cannabidiol (CBD) and Δ-9-Tetrahydrocannabinol (THC) oil goes to waste in the body. Amid the current frenzy in many North American jurisdictions surrounding legal Cannabis and its therapeutic benefits, it’s easy to gloss over the bioavailability of Cannabis products. Bioavailability refers to the degree and rate at which a substance is absorbed into the bloodstream to be used where needed. Physiological processes and consumption methods can affect Cannabis absorption, rendering its effects somewhat hit-and-miss. It’s critical to understand bioavailability in order to maximise the medicinal potency of Cannabis. The more bioavailable the Cannabis is, the lesser quantity of plant is required to reap all the benefits. The surge in Cannabis popularity in legal jurisdictions around the world can in part be attributed to the range of consumption methods available.

Edibles and tinctures can have less of the traditional stigma attached to them than the likes of joints, for example. However, when cannabinoids such as CBD and THC are ingested in oil form—oil is also used to make edibles—their bioavailability becomes compromised. CBD and THC oils resist absorption into the bloodstream because the human body is up to 60% water. Basic science dictates that oil and water do not mix and the same is true for Cannabis oil and the human body. “Cannabinoids are fat-loving molecules and have to traverse a cellular environment that is aqueous or watery”, explained Dr Patricia Frye, member of the Society of Cannabis Clinicians and current chief medical officer at Hello MD (US). When Cannabis is consumed as an oil, the onset of effects can become delayed and bioavailability limited.

Image result for oil-based Cannabis extracts
Another phenomenon that limits oil-based Cannabis extracts from reaching the bloodstream is the first-pass effect. When Cannabis is ingested orally, it is absorbed in the gastrointestinal tract and transported via the portal vein to the liver, where it is metabolised. As a result of this process, only a limited quantity reaches the circulatory system. Since Cannabis oil is often taken orally, its efficacy can be hindered. 
There has been some investigation into CBD, THC, and less into cannabinol, or CBN. Studies have shown the bioavailability of cannabinoids depends on the method of delivery. When applied as a topical ointment or transdermal patch, CBD can penetrate the tissue ten times more effectively than THC. The same is true of CBN. THC, however, is more bioavailable than CBD when administered orally or delivered via the lungs.

Image result for cannabis bioavailability

clinical study found concentrations of THC in the bloodstream appeared 30-50% higher than CBD following oral delivery as a sublingual spray. However, bioavailability of THC is still limited and when consumed orally, averaged 4-12%. When smoked or vaped, the bioavailability of THC leaps to an average of 30%Some of the most common and convenient Cannabis products available across much of North America, such as capsules, soft gels, tinctures and edibles, limit bioavailability due to the first pass through the liver. “With edibles, absorption is slow, unpredictable and highly variable”, said Frye. “Only about 6% of the dose is absorbed. The onset of action can be as long as 6 hours; it’s very easy to take too much, and the effects can last as long as 20 hours”.

Image result for cannabis oral administration

Oral administration lasts longer than smoking, eliminating the need for frequent dosing and avoids irritation to the airways and risk of malignancies associated with smoking, for example. That said, inhaling Cannabis guarantees increased bioavailability because molecules are transported by vapour particles directly to the alveoli in the lungs. This allows cannabinoids to rapidly enter the bloodstream without being metabolised by the liver. Another lesser known method of administration is intranasal delivery, which enables cannabinoids to be easily absorbed with a rapid onset of ten minutes or less. “Intranasal methods are highly bioavailable at 34-46%”, said Frye. “It’s a particularly helpful mode of delivery for patients who are having a seizure or for patients trying to abort an impending seizure or migraine”.

Related image

Transdermal patches can be super effective at targeting localised or systemic pain. They allow for a steady infusion of active ingredients to the delivery site, so the patient is unlikely to experience spikes of THC in the bloodstream. One method that boosts the absorption of edibles is to combine the Cannabis product with fats. Frye recommends combining edibles or tinctures with healthy fats such as guacamole, hummus, or dark chocolate. The same goes for alcohol-based tinctures. For those who smoke or vape, bioavailability can be enhanced by minimising sidestream loss and increasing the number of puffs. “Using a desktop or handheld vaporiser with flower will eliminate sidestream losses”, Frye advised. If you think you get more bang for your buck by holding your breath, think again. “There is no evidence supporting holding one’s breath for more than 10 seconds”, said Frye. 

Image result for cannabis desktop or handheld vaporiser

For those looking to optimise Cannabis bioavailability, Dr Fyre said: “The most cost-effective way to use Cannabis is not to use more than you need. Less is more”. Due to its biphasic nature, excessive dosing may exacerbate symptoms. Therapeutic Cannabis products consumed as oils or liquid capsules are more slowly absorbed with effects generally delayed for 30-90 minutes. Bioavailability of oral cannabinoids is low (10-20%) because of intestinal and first pass liver metabolism. Peak effects can occur two to four hours after consumption. Given the longer time frame, it is important to allow at least three hours between administration of single oral doses. Effects can last eight hours and as long as 24 hours. Given the slower onset and longer duration, taking therapeutic Cannabis products orally would be more useful for medical conditions or symptoms where control over longer periods of time is sought – similar to use of slow release medications.


Coconut Oil Canna Capsules

Cannabis oil capsules, infused/mixed with coconut oil, are an alternative way to therapeutically use Cannabis without having to inhale it via smoking or vaporising. Coconut oil is used due to its high amount of medium chain triglycerides (MCT) which makes it a good binding agent for the cannabinoids, not to mention its amazing health properties. Half the fat in coconut oil is comprised of lauric acid, a fat not frequently found in nature. Lauric acid has been called a ‘miracle’ ingredient due to its health promoting capabilities. Present in mother’s milk, it can be found in only three dietary sources – small amounts in butterfat and larger amounts in palm kernel and coconut oil. In the body, lauric acid is converted to monolaurin, a potent antiviral, antibacterial and anti-protozoal substance. Monolaurin, being a monoglyceride, can destroy lipid-coated viruses including measles, influenza, HIV, herpes and a number of pathogenic bacteria. Although it ‘targets’ the liver and gets processed there (metabolism), you can avoid this happening with your infusion/blend, and the ensuing metabolism of the cannabinoids (e.g. Δ-9-THC metabolises into Δ-11-THC in the liver), by a process commonly known as ‘pre-loading’. Consuming a large spoonful of coconut oil around half an hour before dosing with capsules occupies the metabolising enzymes and allows cannabinoids to enter the bloodstream and go about their business, as they are meant to, before going back to the liver.

Hempy Honeytongue,
Cannabis as Medicine and More – Its Your Life


 

According to Dr Dustin Sulak, dosage is the key factor in achieving the most benefits from Cannabis. After following thousands of patients using Cannabis therapeutically for eight years, he observed that dosing Cannabis is unlike any therapeutic agent to which he was exposed during medical training. A basic understanding of the key characteristics of Cannabis dosing can empower one to make the most of this incredibly versatile, safe and effective herb, Dr Sulak said. Some patients effectively use tiny amounts of Cannabis, while others use incredibly high doses. Dr Sulak has seen adult patients achieve therapeutic effects at 1 mg of total cannabinoids daily, while others consume over 2,000 mg daily. And while a 2000-fold dosing range is unusual for a medication, researchers have failed to kill monkeys at doses even 300 times higher than the highest dose Dr Sulak observed in the clinic.

Related image

Within this unusually broad dosing range, Cannabis exhibits an unusual relationship between the dose and the expected response.  For most medications, a higher dose will result in a stronger therapeutic effect and a higher likelihood of adverse effects; this is described as a monophasic dose-response relationship. Cannabis simply does not follow this pattern. For most Cannabis consumers, gradually increasing their dose will at first result in stronger effects; but after a certain point (unique to each individual), subsequent dosage increases can result in weaker and weaker therapeutic effects.  Consumers who continue to increase their dosage to very high levels can often reclaim some or all of the previously lost benefit, and sometimes find additional therapeutic effects not achieved at the lower doses. Of course, ultra-high doses are much more expensive and can produce some unwanted side effects.

Most patients do much better at the lowest effective dose. For many Cannabis users, this means that less can be more. In a study of 263 opioid-treated cancer patients with poorly controlled pain, the group receiving 21 mg of combined THC and CBD each day experienced significant improvements in pain levels, more so than the group that received 52 mg daily. The group that received 83 mg daily reduced their pain no better than placebo, but experienced more adverse effects. How is this possible? The Endocannabinoid System (ECS) is a sensitive, highly tuned physiologic infrastructure designed to maintain balance at a cellular level. When the cannabinoid receptors become overstimulated by high doses of Cannabis, the cells pull the receptors inside, where they are either recycled or degraded. As cannabinoid receptor levels diminish, the effects of Cannabis will diminish as well, even (or especially) in the face of dose escalation.

Image result for cannabis endocannabinoid system

This is known as tolerance-building, something that many regular Cannabis users have experienced. The term therapeutic window describes the range between the lowest effective dose and the dose that produces unwanted or intolerable side effects. People who have little or no experience using Cannabis typically have a very narrow therapeutic window, while regular users develop a wider therapeutic window. This is due to the fact that individuals build tolerance to the various effects of Cannabis at different rates and most build tolerance to unwanted effects faster than desired effects. Cannabis also has the ability to produce opposite (or bidirectional) effects in different people, with different strains, and at different dosages. For example, anxious people who take Cannabis may relax while non-anxious people who take the same dose can become anxious.

Image result for two different varieties of cannabis

The same dose of two different varieties of Cannabis can cause opposite effects – one might be an awakening strain and the other might put you to sleep. CBD and THC have many overlapping therapeutic qualities, including relief of pain, anxiety, seizures and nausea, although they work via different mechanisms of action. When combined, CBD and THC can enhance each other’s benefits while reducing unwanted effects. By adding CBD to THC, the therapeutic window becomes even wider. Consumers should know, however, that the total dose of cannabinoids needed to treat a symptom or condition will also likely increase. For example, in a study of 177 patients with cancer pain, one group received an oral spray of THC, while another group received an oral spray of combined THC and CBD at an approximate 1:1 ratio. Both groups were allowed to gradually increase their dose until they experienced satisfactory relief.

Image result for thc oral spray

The THC group ended up using an average of 27 mg daily, while the CBD+THC group used close to 60 total mg daily, but the CBD+THC group had a superior reduction in pain. Some patients do well with ultra-high doses (hundreds or thousands of milligrams daily). THC consumers have to slowly work up to these high doses, but many patients can quickly reach high doses of CBD without adverse effects. On the other hand, ultra-low doses can be extremely effective, sometimes even more so than the other extreme. Most people are surprised to learn that the therapeutic effects of THC-dominant Cannabis can be achieved at dosages lower than those required to produce euphoria. Cannabis microdosing, taking a dose for the purpose of improving heath and productivity, has been gaining popularity across many legal jurisdictions.

Image result for cannabis microdosing

People report better mood, reduced anxiety, improved focus, enhanced resilience to stress, less pain (and/or less bothersome pain) and other benefits without any adverse effects. Most consumers find 1-5 mg works well. Some emerging evidence even suggests a practice like this could be protective against damage of a heart attack or brain injury. For new Cannabis users, Dr Sulak abides by an old adage: “Start low, go slow, and don’t be afraid to go all the way”. Dr Sulak has  developed an easy- to-follow program to help find the optimal dose, along with other useful resources available on Healer.com. If you’ve not tried non-inhaled delivery methods such as tinctures or sprays, and haven’t experimented with the combination of CBD and THC, Dr Sulak suggests both endeavours will help you continue to unlock the full power of this incredible herb.

Adapted from Most THC and CBD oil goes to waste in your body—here’s whyA Physician’s Perspective on Optimal Cannabis Dosing with Guidance for the use of medicinal cannabis in Australia: Overview and Granny Storm Crow’s List Phytocannabinoids 2015-2019 

top

Cannabis to Treat Opioid Addiction

Medical Cannabis

In the United States in 2011, the Centers for Disease Control and Prevention declared an ‘opioid epidemic’. This announcement came on the heels of two decades of medical over-prescribing practices, leading to opioid misuse and abuse, resulting in soaring rates of overdoses across the US. Too little, too late? Addiction isn’t a new problem. The human body is inherently vulnerable to addiction through the action of dopamine in the brain. Dopamine, a prominent chemical messenger, is released in response to rewarding and pleasurable events. Its role is to reinforce biologically relevant and necessary behaviours, including eating, sleeping and sex.

However, humans and other animals are at risk of becoming dependent on the dopamine ‘rush’ and can, therefore, develop an addiction to these behaviours whereby their body becomes dependent on the increased dopamine to function at baseline. Just like food or sex, substances like alcohol and opioids can lead to dopamine release. Opioids are derived from the poppy plant and are a key component of illicit drugs (like heroin) and pain medications (like oxycodone). While opioid medications have been used for many years to treat pain, a few crucial factors converged in the late 1990’s and early 2000’s that led to an opioid-addicted US.

Image result for new york medcan for opioid addiction

In 1996, healthcare professionals were urged to pay closer attention to the pain reported by their patients – a recommendation bordering on being a requirement, prompting recognition of pain as the ‘fifth vital sign’. The Joint Commission on Accreditation of Healthcare Organisation heightened the urgency to treat pain in their published guidelines and US Congress declared the first decade of the 21st century to be the “Decade of Pain Control and Research”. These events and associated policy changes sent a jolting ripple effect through the medical community that resulted in greatly increased prescriptions for pain medications.

Concurrently, Purdue Pharmaceuticals, the manufacturer of OxyContin®, began aggressively marketing their prescription opioids, spending $200 million on advertising. Their tactics included down-playing the potential risk of addiction and dependency caused by opioid medications. As a result, OxyContin® sales soared from $48 million in 1996 to almost $1.1 billion in 2000. While Purdue eventually faced criminal and civil charges, by then, the damage to America had already been done. In 2017 there were 47,600 opioid-related deaths in the US. While prescription opioids certainly contributed to these statistics, many of these deaths involved heroin; those who take opioid medications are at significantly higher risk of using heroin, due to its lower cost and easier access.

In fact, the nature of the opioid epidemic fundamentally shifted the way addiction is viewed in the US. Government initiatives have invested in strategies to reduce access to prescription opioid medications but this does nothing to help patients with chronic pain who need treatment, nor those recovering from addiction. Fortunately, there is an overwhelming amount of data supporting Cannabis as both an effective agent for pain relief and an aide in helping people recover from opioid addiction. The idea of using Cannabis to treat pain is not new – in fact, ancient Chinese civilisations used Cannabis for joint pain and inflammation before it came to the West (Cannabis is one of the ancient Chinese ‘50 Fundamental Herbs’).

Opioids, derived from the poppy plant, have also been historically used for pain control; however, unlike Cannabis, those who used opioids quickly learned of the risk of addiction. Cannabis shares some physiological similarities to opioids, as short-term use increases dopamine to relieve pain. However, Cannabis increases dopamine via cannabinoid receptors, while opioids increase it via opioid receptors. Additionally, the increase in dopamine levels from Cannabis does not persist over time and, therefore, the risk of possible dependence is significantly lower.

Image result for cannabis for pain and opioid addiction

The effects of Cannabis on pain have been demonstrated across many studies. A meta-analysis of 28 clinical trials conducted on Cannabis and pain ranging from 1948-2015 reported positive findings, concluding Cannabis is effective in treating pain with a reasonable safety profile. Cannabis has therefore been approved to treat chronic pain in the majority of US states where its use is legalised. But, what about treating opioid addiction and not just pain? US states with legalised medical’ Cannabis have significantly lower levels of opioid use and opioid-related deaths.

A study in 2016 found a 64% reduction in opioid use in American patients who used Cannabis for their chronic pain. Studies have shown Cannabis may be effective in reducing craving for opioids and easing withdrawal symptoms. Based on this evidence and the unrelenting opioid crisis, New Jersey and Pennsylvania added opioid addiction as a qualifying condition for ‘medical’ Cannabis and other states like New Mexico, Maryland, Connecticut and Ohio are drafting similar policies. New York and Illinois allow patients prescribed opioids to receive ‘medical’ Cannabis instead.

Image result for cannabis for pain and opioid addiction

These policies certainly represent tremendous progress toward helping patients use ‘medical’ Cannabis to treat their pain and potentially aid them in recovery as they transition off opioids. However, Cannabis still remains a Schedule I substance at the federal level in the US, which restricts patients’ access to it and continues to slow critical research. Despite growing awareness and recognition of the potential for Cannabis in alleviating the epidemic caused by opioid addiction, ending prohibition entirely is the only way to further progress and alleviate the opioid crisis in the United States.

Adapted from Medical Cannabis for Opioid Addiction: A Two-Pronged Approach, Part 1 and Medical Cannabis for Opioid Addiction: A Two-Pronged Approach, Part 2

top

Cannabis Tinctures

In many states of the United States and across Canada, dispensaries and health food stores have shelves lined with little amber or blue glass dropper bottles. Easy to purchase and use, tinctures offer a tried-and-true mode of Cannabis consumption that has been around since long before the days of legalisation. A dropper or two of a liquid tincture placed under the tongue is a solid sub-lingual delivery mechanism that can lead to quick absorption and lasting effects. But what exactly is in a tincture? Tinctures have been used in ancient and modern herbalism for centuries and are, at a basic level, an alcohol extract of an herb.

The two necessary ingredients to any tincture are thus alcohol and an amount of the botanical from which to derive an extract. In the case of Cannabis tinctures, this means the most basic ingredients are alcohol and Cannabis. Ethanol, or grain alcohol, is the most common base for a tincture, but the extract can also be done by soaking plant material in oil or in vegetable glycerine under normal ambient conditions. A saturated MCT oil, such as coconut oil, is a common carrier for this type of tincture. A vegetable glycerine tincture is the least common due to the availability of glycerine and the fact it can lead to a less potent tincture.

cannabis-tinctures

Cannabis tinctures are made by soaking Cannabis flowers (buds) in alcohol (leaf trim, hash and kief can also be used). The alcohol extracts the terpenes, cannabinoids and other compounds from the Cannabis (for the full ‘Entourage Effect’), into a liquid that contains a high concentration of active compounds. Alcohol preserves the compounds, which is important since it takes longer to consume tinctures as opposed to other forms of Cannabis. A DIY or homemade tincture would involve soaking raw Cannabis in a strong grain-derived alcohol and leaving it to soak in a dark glass container for several weeks.

Tinctures are often darker than post-processed concentrates which have undergone clean-up steps like winterisation to remove undesirable plant molecules like waxes, lipids and chlorophyll that are soluble in the alcohol. A commercial application would involve a similar process while using laboratory equipment to adhere to standards and regulations for cleanliness and quantity. Cannabis should be decarboxylated prior to being placed in the alcohol (or oil/glycerine) solution if the intent is to consume the activated THC instead of the inactive THC-A. While a strict tincture only consists of the carrier liquid and herb base, many tinctures available for public consumption in North America contain other ingredients.

grapefruit-oil

Many additions are based on flavour and/or recipe desires and are not essential in the creation of a tincture. Honey, Mint, Lavender and many other herbs can be added to a Cannabis tincture and are often included to make a more proprietary blend that brands can use to distinguish themselves in the marketplace. Cannabis tinctures are usually stored in glass dropper bottles, which help preserve the tincture for longer by blocking out sunlight. One of the benefits of using tinctures is the alcohol allows the body to absorb the medicine faster. Most tinctures are taken by placing a few drops under the tongue, known as sublingual administration.

When you take a tincture sublingually, the cannabinoids are absorbed rapidly by the blood vessels lining the inner tissues of the mouth, resulting in a quick onset of effects. Tinctures can also be ingested orally, such as by swallowing or mixing it with food. If you consume a tincture orally, the cannabinoids must be absorbed through the stomach and gastrointestinal tract and through the liver (in particular) and take significantly longer to enter the bloodstream. Depending on whether the Cannabis is decarboxylated first, tinctures may contain tetrahydrocannabinol (THC) in its active form or non-active form (THCa). Most people choose to decarboxylate their Cannabis before making a tincture, allowing them to take full advantage of the medical benefits of THC. 

thcWhile medical uses of THC are still being researched, there is evidence it can be helpful in treating a wide range of conditions and disorders, including nausea, vomiting, poor appetite, pain, multiple sclerosis, cancer, Crohn’s disease, PTSD, anxiety, depression, Parkinson’s disease, Alzheimer’s disease, sleep apnoea, glaucoma, diabetes, cardiovascular disease and many others. However, if you do not decarboxylate your Cannabis, you will receive the benefits of tetrahydrocannabinolic acid, THC acid or THCa, found in the flowers, leaves and stems of young Cannabis plants.

Biosynthesised by the trichomes, THCa plays a critical role in protecting the trichomes, and thus the plants themselves, from insects and other predators. Furthermore, THCa is no more ‘psychoactive’ than CBD, thus allaying parental concerns about getting their children ‘high’ (an unfounded, prohibitionist-driven fear). THCa is one of the cannabinoids primarily found in fresh Cannabis, although in variable amounts, according to CannLabs. Once the Cannabis plant is exposed to heat, such as vaporising, THCa decarboxylates to THC. What happens on a molecular level is that the carbon dioxide in the Cannabis is released; as a carbon atom in the acid is lost, THCa is converted to neuro-active THC. THCa acts as a cannabinoid receptor agonist and in so doing, also provides neuro-protective (brain protection) effects.

North American Recipes

Australian Recipes (Nimbin HEMP Embassy)

(including Cold and Hot Methods, Glycerine and Oil-based Methods)Effects of Cannabis Tinctures

Tinctures can be felt as quickly as 15 minutes after dosing and the effects last for a shorter period of time compared to edibles. Tincture efficacy usually peaks about 90 minutes after consumption and can last 4 to 8 hours, depending on the dose. Because the effects can be felt so quickly, dosing with a tincture is easier than dosing with an edible. As with any form of Cannabis, you should start with a small dose to gauge your tolerance and to avoid any possible, initial, unwanted effects of ‘over-consuming’. If you’re taking a Cannabis tincture for the first time, start off with about 1 ml and adjust (upwards or downwards) as necessary. CBD-min-1-800x445

There are three ways to consume Cannabis tinctures: sublingually, orally or with food. To take a tincture sublingually, drop desired dose under the tongue and hold for 30 seconds before swallowing. This method will produce quicker, stronger effects because the tincture is absorbed into the bloodstream through the inner lining of the mouth. You can take Cannabis tinctures orally by adding a few drops to a beverage such as a smoothie, juice or even a ‘mocktail’. Alternatively, you can swallow the tincture on its own like any liquid medicine. When you take a tincture orally rather than sublingually, it must be absorbed through the digestive system, so it will take longer to feel the effects.

Tinctures taken orally have a similar effect to edibles and can take up to an hour to start Cannabis tinctureworking. Tinctures can also be combined with food to make a tincture edible. The difference between a tincture edible and a fat-based edible is the latter is harder to dose and can produce a longer, more intense effect (including euphoria). If you consume a tincture mixed with food, it will take the digestive system more time to absorb than if you took the tincture sublingually. Cannabis tinctures may be added to a variety of foods such as puddings, ice creams, dressings and sauces.

There are many advantages to taking Cannabis tinctures, with a major one being how easy they are to make at home. You can make your own Cannabis tincture (links above) and, while there are many different recipes, these are some of the most popular. When preparing a Cannabis tincture, you usually must decarboxylate (or ‘decarb’) your plant material. Decarboxylation is the process of heating Cannabis to activate the compounds in the plant. Specifically, this will convert THCa into THC and allow you to experience all the effects of whole-plant Cannabis. If you choose to skip this step, your tincture will mostly contain THCa.

Epsilon Apothecaries, (California, US) has a downloadable Extraction Basics Guide (pdf), the Epsilon Essentials Guide Series, comprises a novice approach to the creation of three special supplements: tincture extract of Cannabis, essential extract of Cannabis and supplemental extract of Cannabis. Readers can learn how to create therapeutic grade supplements at home, following in the footsteps of Epsilon’s decade-long track record of success in a variety of cases. The Epsilon Essentials Guide is free of charge, the company’s website says, “All we ask is your respect in return”.

Adapted from What’s in a Tincture? and Cannabis Tinctures: Uses, Effects and Recipes

top

Cannabis Topicals and How They Work

 

Tens of millions of Americans are afflicted with chronic pain and many are seeking safe, non-addictive solutions to ease their suffering. So too in Australia, where 67% or 11.1 million people aged 15 years and over reported experiencing bodily pain in the previous month (2012). Around one in ten (9%) experienced severe or very severe pain, and many adults experienced chronic pain. Research suggests Cannabis topicals could provide relief for sufferers of ailments ranging from sports injuries and migraines to skin conditions such as acne, eczema and psoriasis. Image result for cannabis topicals

Topicals represent one of the fastest-growing segments of the legal Cannabis marketplace in the United States. Scientific bodies confirm Cannabis has pain-relieving properties. But to fully understand how topicals can relieve pain and other ailments, we need to take a quick tour of the human Endocannabinoid System (ECS). The ECS is a vast network of receptors throughout the body. It’s responsible for modulating many physiological systems involving the brain, endocrine, immune and nervous systems. Researchers have found the ECS is essential for maintaining homoeostasis, or balance, in these various systems.

0000ECSandBodilySystems

There are two main types of receptors or ‘message receivers’ in the ECS, classified as CB1 and CB2 receptors. CB1 receptors are predominantly located in the brain and central nervous system; CB2 receptors are primarily in the peripheral nervous system. The messages these receptors receive are actually chemicals that bind to the receptor and either activate it or shut it down, producing a corresponding effect within the body. 

CB1-CB-2-receptors-1024x1024

The chemical compounds in Cannabis that interact with the ECS are called cannabinoids, with the most well-known being neuroactive delta-9-Tetrahydrocannabinol (THC), which activates CB1 receptors in the brain to create euphoria. More than 100 cannabinoids have been identified in the Cannabis plant including cannabidiol (CBD) and others like cannabinol (CBN), cannabigerol (CBG) and tetrahydrocannabivarin (THCv), whose various medicinal properties are under escalating scrutiny.

When you apply a Cannabis topical to your skin, the cannabinoids interact with CB2 receptors in your epidermis and muscles. In a 2016 report in Cellular and Molecular Life Sciences, researchers found when CB2 receptors were the targets, the result was reduced inflammation, an immune response that plays a role in many ailments including skin conditions and chronic pain. Unlike anti-inflammatory medications, Cannabis topicals can be used without risking unpleasant potential side effects or overdose. Image result for cannabis topicals

Some Cannabis topicals contain THC, but when applied to the skin, the cannabinoids don’t actually enter the bloodstream. Instead, THC interacts with the ECS receptors outside the blood-brain barrier. A research review in Molecular Pharmacology concluded, “activation of CB2 receptors does not appear to produce … psychotropic effects”. Topicals allow consumers to localise and directly target an afflicted area to reduce inflammation. People can and do ingest Cannabis via smoking, vaping or edibles for generalised pain relief, but many prefer to single out that aching knee or sore neck by applying a topical directly. Image result for cannabis topicals

Some research even indicates cannabinoids may accelerate our bodies’ natural healing process. A 2005 study on CB1 and CB2 receptors in the gastrointestinal system found that cannabinoids can promote the healing of epithelial wounds. Our skin is composed of epithelial cells, which also line the surfaces of our organs and blood vessels. So, Cannabis topicals may also promote a quicker healing response for skin conditions and injuries. Perhaps best of all, Cannabis topicals offer consumers a simple, safe and low-stakes entryway into exploring the wellness benefits of Cannabis.

Image result for elderly using cannabis topicals

Many people still harbour fears about Cannabis, but topicals are approachable and in many ways, the best ambassador for the Cannabis plant’s pain-relieving and healing capabilities. The emerging research is clear in showing the tangible ways Cannabis topicals work with our bodies. Just let that knowledge soak in.

Adapted from How Cannabis Topicals Actually Work: A Deep Dive into Your Body’s CB1 / CB2 Receptors (Author Dahlia Mertens is the founder and CEO of Mary Jane’s Medicinals)

top