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

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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.

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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.

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“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”.

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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.

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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.

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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.

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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?

THC-Free Might Not Mean Zero THC!

Image result for thc freeThere’s a buzzword alive-and-well in marketing hemp-based cannabidiol (CBD) rich products; Δ-9-Tetrahydrocannabinol (THC)-free. Industrial hemp is defined by its scant THC content, with the legal threshold in the United States being anywhere below 0.3%. The threshold set by the European Union is slightly lower at 0.2%. Switzerland says hemp should be <1% THC, Thailand says 0-3%, and wet, wild and wonderful West Virginia in the US boldly states <1% THC as well.

 

According to the Australian Government’s Office of Drug Control, hemp is a colloquial term used to describe any Cannabis plant cultivated for fibre and seed. It will generally contain very low levels of THC, but potentially high CBD. As ‘hemp seed oil’ is an extract of Cannabis seeds and does not contain any extracts from the Cannabis plant, by the Australian Government’s definition, ‘hemp seed oil’ is not a ‘drug’. 

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The Australian Government’s Office of Drug Control states ‘hemp oil is defined as an extract of Cannabis and, for the purpose of the Narcotic Drugs Act 1967 (the Act), an extract of Cannabis is any substance obtained by separation of components from a plant in the genus Cannabis. The Act implements the Single Convention on Narcotic Drugs of 1961 (Single Convention) which states an extract of Cannabis is a drug (wrongly described, however). But, by this incorrect definition, hemp oil is also a drug

The Single Convention and Australian law are silent on the levels of THC in Cannabis extracts and deems all extracts of Cannabis as drugs, regardless of specific cannabinoid levels. Therefore, in Australia, ‘hemp oil that is deemed a medicinal Cannabis product may only be accessed by prescription from a doctor granted Special Access Scheme Approval or has Authorised Prescriber status and may only be imported under a licence and permit to import. Image result for thc free

Related imageHistorically the international definition of hemp was developed by a Canadian researcher, Ernest Small, in 1971. His arbitrary 0.3% THC limit became standard around the world as the official limit for ‘legal’ hemp, after he published The Species Problem in Cannabis. In his book, Small discussed how “there is not any natural point at which the cannabinoid content can be used to distinguish strains of hemp and ‘marijuana’”. 

Despite this he continued to “draw an arbitrary line on the continuum of Cannabis types and decided that 0.3% THC in a sifted batch of Cannabis flowers was the difference between hemp and ‘marijuana’”, and this continues to add to the controversy and confusion as to what truly constitutes the difference between Cannabis and hemp.


Image result for botanical name of a plant consists of ‘Botanical Latin’ words, denoting a generic name (the genus) and the specific epithet (the species)A simple botany lesson shows the botanical name of a plant consists of ‘Botanical Latin’ words, denoting a generic name (genus) and the specific epithet (species, usually two words, can be three). Cannabis sativa L., is a member of the Cannabaceae  family.  Cannabis is the plant genus, sativa (Latin for ‘cultivated’) is the species (included in many plant species names, e.g., rice is Oryza sativa L.), and the ‘L’ (not always used) denotes the authority who first named the species, Carolus (Carl) Linnaeus, Swiss botanist considered the ‘Father of Taxonomy’. Cannabis sativa L., is;
– an annual,
– herbaceous – denoting or relating to herbs (in the botanical sense), 
– usually dioecious – either exclusively male or exclusively female,
– or monoecious – having the stamen (male, pollen-containing anther and filament) and the pistil (female, ovule-bearing) in the same plant (hermaphrodite).
Thus, as the Help End Marijuana Prohibition (HEMP) Party of Australia so rightly point out, Cannabis is a herb!


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Across the United States (and other jurisdictions where Cannabis use is legal) there are products that are technically legal to ship across state or country borders, depending on the THC potency. Perhaps to the chagrin of those seeking the entourage effect, many companies are opting for what they’re calling THC-free’, which, like caffeine-free, implies there is 0% of the substance. However, depending on how the product was created, THC-free might not really mean there’s no THC, just like caffeine-free and decaffeinated beverages are not the same. Decaf coffee still contains some caffeine.

A CBD product made with isolate might represent a true THC-free product. A broad-spectrum product that has lots of other phytomolecules like cannabinoids and terpenes requires THC removal, perhaps through a method like supercritical fluid chromatography. What’s important to know, though, is that in cases where the THC has been removed there still might be traces of it present. When a laboratory measures how much THC is in a given sample, they are limited in how low they can accurately quantify.

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Labs have limits of detection and quantitation for their methods, and these metrics can vary from lab-to-lab. Additionally, there are gradients in detection technology, such as the use of ultraviolet (UV) detector versus mass spectrometry. The sensitivity of the method changes depending on the sophistication of the detection technology. What this all means is that one lab may not detect THC, while another might employ a different method that does. And while all labs can ensure compliance through measuring the required limits of THC content mentioned above, to say that a product is 100% THC-free could be misleading. One fate of this could be in workplace drug testing.

There have been many stories across North America of prospective employees losing out on a job because they bought a CBD product and tested positive for THC when drug tested. One method used by laboratories performing urinalysis (in the US) typically measures down to 50 nanograms per millilitre (ng/ml). Other thresholds might be 5 to 100 ng/ml, but regardless, these are very small concentrations. Some will measure THC metabolites in hair samples and these tests can often get to even lower quantities such as 1 picogram per millilitre (a picogram is 1/1000 of a nanogram).

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Thus it’s important to differentiate between truly THC-free products and those products where the laboratory who provided the certificate of analysis (CoA) just didn’t detect the THC with their validated method on their instrumentation. So be careful when selecting CBD products and note that if you look at the CoA of a product and next to Δ-9-THC, it says n.d., that means not detected and not necessarily free.

Adapted from Free at Last, but is it Really Free?Myth and Reality: Cannabis and Hemp

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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.

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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.

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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”.

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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”.

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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. 

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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.

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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.

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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.

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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.

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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.

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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 

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Full Spectrum CBD is Superior to Single Isolate CBD

cannabis, recreational cannabis, medical cannabis, cannabinoids, CBD, THC, endocannabinoid system, research, legalization, scientific studies

There has been a lot of debate regarding the superiority of whole plant medicine versus extracts and the converse. For a long time it was believed tetrahydrocannabinol (THC) was the most beneficial part of the Cannabis plant (at least when it came to medicinal value) and that all of the other bits didn’t really matter. Now we know many parts of the plant, including the cannabinoids, flavonoids and terpenes have tremendous value in healing. Not only that, these parts work together, within full spectrum medicine, to amplify the pharmacological activity of the whole via the Entourage Effect. The Cannabis plant has over 140 different cannabinoids with medicinal value as they interact with the body’s Endocannabinoid System. This is a signalling system of receptors found on the surface of certain cells, critical for the control of many bodily functions, such as digestion, nervous control, pain, immune functioning and homoeostasis (balance). The most abundant cannabinoid is THC, followed by cannabidiol (CBD). Other significant cannabinoids include cannabichromene (CBC), cannabigerol (CBG) and cannabinol (CBN).

cannabis, cannabinoids, CBD, THC, CBG, endocannabinoid system, research, medical cannabis, recreational cannabis, health benefits

It takes a lot of effort to isolate CBD or THC from the Cannabis plant. Even though you are processing the plant, the isolate that comes out the other end is not synthetic; this is a common misconception. The plant is refined to a pure form of CBD, typically a white powder. It used to be an isolate was the gold standard of ‘cannabis medicine’. But, as further research was conducted on how CBD interacts with the human body, something strange was observed – patients that took high CBD strains tended to have faster healing and less pain than those that merely took the CBD isolate. For example, a study looking at the anxiety of public speakers noted that with the isolate, CBD followed a bell-shaped curve for therapeutic effectiveness. This means when the amount of CBD ingested exceeded a certain point, its therapeutic impact declined dramatically. Therapeutic effect was only observed when CBD was given within a very limited dose range, whereas no beneficial effect was achieved at either lower or higher doses. Following this interesting finding, further studies were conducted to determine how to overcome the bell-shaped dose response curve effect. 

cannabis, CBD, THC, CBG, anandamide, research, scientific studies, cannabinoids, endocannabinoid system, CBD isolate, bell-shape dose response

One notable Israeli study was Published in the journal Pharmacology & Pharmacy (February 2015) and was entitled “Overcoming the Bell-Shaped Dose-Response of Cannabidiol by Using Cannabis Extract Enriched in Cannabidiol”. It is important to note that one of the co-authors, Lumir Hanus, was instrumental in the discovery of the endogenous cannabinoid, anandamide. The Israeli team obtained a CBD-rich strain called “Avidekel” which has only trace amounts of THC and studied it against a CBD extract referred to as “clone 202”. Both forms of CBD were administered to lab rats and the therapeutic effects were clinically observed and charted. The pure CBD isolate, once again, revealed that single-molecule CBD administration produced a bell-shaped dose-response curve with a small therapeutic window. However, rather than showing a bell-shaped curve, the whole plant CBD-rich extract caused a direct, dose-dependent inhibition of pain. Moreover, the Israeli researchers discovered that a smaller amount of CBD was needed for significant pain relief compared to the much larger amount of CBD isolate required to achieve similar analgesic effect. RxLeaf

When the CBD isolate was delivered in excess of therapeutic dose, there was a decline in efficacy, but an excess of whole plant CBD-rich extract did not undermine its therapeutic potency. What happened when the full spectrum extract was given in excess is that the therapeutic effect reached a medicinal plateau phase and levelled off, rather than declined. These results have revolutionised how Cannabis’ therapeutic effects are understood. So much so we can confidently call this a landmark study in the Cannabis space. Subsequent studies have further proved this finding. The effect mentioned above is now referred to as the Entourage Effect, achieved when Cannabis is consumed as a whole plant, whether that be flower, oil, or tincture. Full spectrum CBD oil contains terpenes, cannabinoids and flavonoids. These compounds work synergistically to produce a more potent and longer-lasting effect than a single compound can achieve on its own.

 

Adapted from Full Spectrum CBD is Superior to CBD Isolate Because It Works For A Range of Doses

Cannabidiol (CBD) Is “Psychoactive”

Image result for cannabis budsPerhaps the biggest lie put forth by people in the Cannabis industry is that Cannabidiol (CBD) is a “non-psychoactive” cannabinoid. That’s patently false because CBD does affect the mind, part of what makes it so effective. It’s a question of how the word “psychoactive” is defined. While most people have been using the term “non-psychoactive” as a synonym for “non-intoxicating” when they describe CBD, they’re misusing the term. In truth, a psychoactive substance is something that will alter mental processes or behaviours, but doesn’t mean every psychoactive substance is going to get a user “high”. Typing CBD into a search engine returns almost all results declaring CBD to be “non-psychoactive”; they are wrong. CBD is one of many active compounds in the Cannabis plant, but unlike Tetrahydrocannabinol (THC), it does not impart upon the user the euphoric effects for which Cannabis is well known. CBD is associated with the opposite, with ameliorating THC’s effects and fighting anxietydepression and possibly even nicotine addiction. For these reasons, CBD is popularly known as “non-psychoactive”, the most-common descriptor applied to CBD, by numerous Cannabis-industry sources, as well as mainstream media accounts published in The New York Times, The Guardian and elsewhere (around the world). All of these sources are guilty of propagating misinformation.cbd

Dr_Ethan_RussoOf course, CBD is psychoactive, that’s the point. Dr Ethan Russo, a neurologist and Director of Research and Development for the International Cannabis and Cannabinoids Institute and longtime Cannabis researcher said“Very simply stated, what is clear about CBD is that it must be considered psychoactive because of its ability to act as an anti-anxiety agent and an anti-psychotic agent”. He’s been interested in CBD since the 1960’s, when its chemical structure was first identified. “The first misconception about Cannabidiol was that it was inactive”, he said. During early research on CBD and its euphoria-inducing cousin THC, “All the hubbub was about THC, because of it being the, quote ‘active ingredient’ unquote, but that’s a misconception, as well”. Research on CBD picked up in the 1990’s, Russo said, for which he largely credits Britain’s GW Pharmaceuticals for whom he worked, first as a consultant and then as a senior medical adviser, from 1998 to 2014. Very simply stated, what is clear about CBD is that it must be considered psychoactive because of its ability to act as an anti-anxiety agent and an anti-psychotic agent”, he said. Merriam-Webster’s dictionary defines the term “psychoactive” as “affecting the mind or body”. The Oxford English Dictionary defines “psychoactive” as something, especially a drug, that affects the mind. There’s no doubt CBD meets those definitions, but the misconception persists.

Image result for legal psychoactive substancesAccording to the World Health Organisation, “psychoactive substances” are “substances that, when taken in or administered into one’s system, affect mental processes, e.g. cognition or affect”. Under both these definitions, CBD is psychoactive because it is affecting mental processes when it mitigates the “high” from THC or when it helps with anxiety and depression. This means that it cannot be possible to say in the same breath that CBD is non-psychoactive and that it will help with anxiety and depression. For example, other psychoactive substances include ibuprofen, caffeine and wine. If they were no more efficacious than a glass of water or a deep breath of air, nobody would partake of them. Martin Lee, co-founder and director of Project CBD, an educational platform founded in 2010 that provides research and resources on Cannabis therapeutics recently said that Project CBD also used to refer to CBD as “non-psychoactive”“At least in the beginning, it was a way for us to emphasise that there was something else going on with the Cannabis plant, that we should look at it differently”, Lee said. “But I’m uncomfortable with that now. As things went along, the obvious fact started staring us in the face: If it changes one’s mood, even if you’re not getting ‘high’, it’s psychoactive”. Pharmacologically, THC and CBD act in similar ways. Both molecules interact with cannabinoid receptors, although at different sites and with different effects.

Image result for project cbdA misunderstanding of how the molecules work, based on old science, may be at the root of the grand CBD myth. Lee’s Project CBD has attempted to correct the record, but like many other rational and reasonable science-based efforts in our post-factual world, it is swimming upstream and working against bad-faith actors intent on marketing CBD in any way possible, to as many Cannabis newcomers as possible. At best, “non-psychoactive” is an honest mistake stemming from a well-intentioned misunderstanding. At worse, “non-psychoactive” is an adman’s trick, an intentional misdirection meant to deceive. The problem is some CBD products, derived from industrial hemp that’s much lower in CBD content than the grown-for-the-purpose Cannabis, might actually be non-psychoactive because there’s not enough CBD present. But that means the product is faulty, not the ingredient itself. Perhaps the most straightforward way to describe CBD is that it “doesn’t create an euphoric high”, said University of British Columbia, Canada, psychology professor Zach Walsh, who studies Cannabis and mental health. “It doesn’t create cognitive alterations that are obvious or overt”, he explained. Walsh thinks the ongoing confusion over whether CBD is psychoactive has to do, in part, with “people struggling with the destigmatisation of Cannabis”.
Image result for euphoric high
I see a lot of people come to me, usually Cannabis-naive people, often people from a generation where Cannabis was more highly stigmatised, and they’re like, ‘I heard there’s a new Cannabis that doesn’t get you high, can I try some?’ Because they’re ambivalent, they want to partake in the potential benefits (that they’ve heard about), but at the same time they don’t want to go insane in a ‘reefer madness’ kind of a way, or they don’t want to be incapacitated or altered in a way that they’ve come to associate with moral failings, or just inappropriate behaviour”, said Walsh. “They want to have the cake and eat it too … If there’s a Cannabis that’s not really Cannabis, I think that’s pretty appealing to some people”. Russo thinks educating the public about CBD requires an approach that’s both “top-down and bottom-up”. “What I mean by that is, there’s a woefully inadequate treatment of not only Cannabis and its pharmacology in medical schools, but also the Endocannabinoid System that underlies a lot of its activity. So we need better-educated doctors that are going to understand this”. Russo continues to see CBD improperly described as “non-psychoactive” not only in the media, but also in scientific publications he peer-reviews. “People like simple explanations, but anything about Cannabis deserves paragraphs, not single phrases”, he said. “So when you’re trying to distil the essence of these pharmacological concepts in single words, it’s easy to run afoul”.

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Adapted from CBD Is Psychoactive — And That’s OK and Have you heard that CBD is ‘non-psychoactive’? It’s not true

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