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POTENTIAL CBD’s IMMENSE
CB1 receptors are responsible for effects of euphoria and contribute to appetite stimulation as well as pain reduction. On the other hand, CB2 receptors are concentrated in immune cells and work to reduce inflammation . The human body has naturally occurring cannabinoids such as anandamide that interact with the ECS, and this same system is responsible for the effects experienced from cannabinoids found in the cannabis plant.
Researchers have so far identified five primary components of the cannabis plant that have demonstrated immense potential in helping patients treat their symptoms. THCA is a non-psychoactive cannabinoid found in a raw unheated cannabis plant.
While there remains much research to be done on the effects of THCA, preclinical studies have found this cannabinoid to have beneficial effects on the endocannabinoid system, some of which include anti-spasmodic effects, anticonvulsant effects, anti-insomnia effects .
One of the most predominant and most well-known components found in the cannabis plant is THC. In the in vivo portion of their study, neuroblastoma tumors were induced in non-obese diabetic immunodeficient mice and the mice were then treated for 14 days with either THC, CBD, pure ethanol control , or were untreated.
While the exact mechanisms for how these drugs produced the observed effects is yet to be fully understood, the authors understandably suggested larger, more in-depth studies in the future to further explore this potential Fisher, et al.
According to the NCI, a small pilot study investigating intratumoral injections of THC in nine patients with recurrent glioblastoma multiforme GBM showed no clinical benefit but a good safety profile.
A trial in Israel testing oral CBD in patients with recurrent solid tumors has no published results yet. Due to the presence of CB1 receptors in the gastrointestinal tract, certain GI effects have been credited to and therapeutically tested in cannabinoids. As previously mentioned, both nabilone and dronabinol are currently approved for the treatment of nausea and vomiting related to chemotherapy treatments.
The evidence was rated as low quality but did show evidence of benefit from both of these medications for their respective approved uses. The four studies reviewed for appetite stimulation and weight gain included participants and compared dronabinol with placebo 3 of 4 or megestrol acetate Megace 1 of 4. One study also compared with cannabis. Trials all showed improved weight gain with dronabinol or cannabis versus placebo, but the study comparing megestrol acetate found less weight gain with dronabinol.
Combining dronabinol with megestrol did not seem to have additive benefit Whiting, et al. According to Health Canada, the cannabinoid products performed at least as well and sometimes better than ondansetron, but with higher rates of adverse effects.
Two trials evaluated THC in postoperative nausea and vomiting and found no significant difference compared to placebo and unacceptable adverse effects reported. In patients diagnosed with inflammatory bowel disease IBD , self-medicating users reported decreased abdominal pain, nausea, diarrhea, and joint pain and increased appetite with cannabis use, but there is a lack of reliable clinical evidence as these are the results of self-report observations and not a clinical trial.
Potential adverse effects of cannabinoids vary greatly depending on the composition of the product being evaluated. Chronic use also carried with it risk for memory and cognitive deficits, psychosis, respiratory and immune system effects that increased the risk for infections, airway inflammation and bronchitis, social dysfunction, difficulty in school for adolescents, decreased job performance, increased unemployment, decreased income levels and decreased satisfaction with life.
The meta-analysis in JAMA reviewed acute adverse effects published in 62 studies and corroborated the aforementioned effects, as well as complaints of euphoria, paranoia, and seizures Whiting, et al.
According to the multiple large studies, there does not appear to exist a clear epidemiological link between marijuana and lung cancer, such as that seen with tobacco users. It remains inconclusive and a topic for further exploration, as cannabis may carry some increased risk of testicular, prostate, or squamous cell carcinomas NCI, As with any treatment plan in medicine, especially one that may include a medication that carries with it risk of adverse effects, full disclosure to the patient and extensive patient counseling and screening is key to positive outcomes.
When considering whether cannabinoid treatment is appropriate for a particular patient, the following patient characteristics should be taken into consideration:. Regarding the counseling of patients within states that allow recreational use of cannabis for adults, the American Journal of Public Health developed some evidence-based recommendations for safe cannabis use.
These are identified as the Lower-Risk Cannabis Use Guidelines LRCUG and could be studied and utilized by medical care providers as a framework for counseling patients who elect to use cannabis recreationally. Their 10 major recommendations are as follows:. These guidelines are intended to reduce the overall risk of adverse effects from cannabis use and are not a guarantee against adverse effects in any particular patient.
Hopefully, these recommendations can help inform patients who may be willing to modify their use so as to reduce some of the health risks Fischer, et al. In , a federal farm bill legalized the study of hemp, and many have elected to interpret this as a legalization of products containing CBD, which is a hemp derivative.
Despite warnings that the FDA has issued stating that CBD should not be contained in food or supplement products sold between states, the purchase and shipping of these products between states does occur.
Regarding CBD specifically, the DEA has stated that while it is still illegal, it is not currently an enforcement priority. National retailers Target and Wal-Mart previously sold products that contained CBD and have pulled those products from their stores and websites Chaker, California was the first to legalize medical marijuana use with Proposition in Currently, there exist comprehensive medical marijuana access laws in 31 states as well as Washington DC, Guam, and Puerto Rico.
Cannabis is currently legal for adult use in Canada as well as parts of Europe. Regarding the future of cannabis and cannabinoid use in medicine, many researchers feel that the future of cannabis in medicine is not likely with cannabis as a whole, but instead in distilling and purifying the most therapeutic components to ensure a reliable, pure, and consistent product that has the ability to stand up to strict standards put forth by the FDA.
This may include products containing CBD that may function as antipsychotics, antiepileptics, or treatments for addiction. Other suggestions for future research include a CB1 antagonist for obesity or addiction treatment, a synthetic CB2 agonist as an anti-inflammatory in the treatment of scleroderma, or a mixture of cannabinoids for the treatment of diabetes or metabolic syndrome. The general consensus amongst the medical community is that the use of cannabinoids and the manipulation of the endocannabinoid system holds immense medical potential, but at the current time additional research is needed to confirm in whom and how exactly this should be carried out for optimal benefit and minimal risk.
Amanda Chicago Lewis , investigative reporter for Rolling Stone. She has reported extensively on the marijuana industry. Author of " Marijuana: It really started to hit the mainstream in when Sanjay Gupta talked about it in his famous documentary 'Weed' that aired on CNN, and the demand based on that documentary led to a spread in the seeds , and explosion in the growth, especially beginning in after it became a little bit easier to grow hemp in the United States.
And so I think that after enough harvests passed and enough people became familiar with it and wanted to start their own CBD companies, now you see it everywhere. On understanding cannabis as "a drug development toolkit". You could see a chihuahua and you could also see a husky, and both of those are dogs. So someone described cannabis recently to me as less of a drug and more of a drug development toolkit, and I liked that phrasing a lot, because it helps talk about the fact that what we think of as marijuana — one thing that gets you high, always the same plant — is in fact sort of a black box of compounds that you could breed in and out.
I mean, it's an extremely promising compound but we really need to be clear about where the level of research is. So there is a difference between pre-clinical and animal research, and randomized clinical trials where thousands of patients have used a medicine so it can be studied properly.
So with cannabidoil, CBD, we really only have very very strong evidence for a couple of conditions, whereas unfortunately we've got people using it for myriad conditions at this point.
There are many conditions for which there is strong pre-clinical evidence, and that leads the way to additional clinical trials. But, importantly, there are things that we don't know about it.
We don't know the chronic effects of cannabidol used, we don't know the interactions it may have with other drugs that people may be taking, and so there's a dire need for research. I think it's critical for people who are profiting from the cannabis industry to bear some of this responsibility for funding.
Marijuana and CBD: Effective Treatment and Use
The purpose of the current review is to determine CBD's potential as a of any mental disorder, and constitute an immense social and economic burden [5, 6]. The global potential for the CBD market is immense and largely untapped. around the immense potential of the industrial hemp-based CBD. While it's easy to zero in on CBD's immense potential, it's also important to remember that CBD research is relatively new and medical studies.