Kannuhbiss Grows Bud KahLd (Marijuana=Mehrihwahnuh), Heer A.K.A. Kush Bud.

Medical Marijuana In FuhnehTik Inglish Yeeng Voiss Sownd Chahrz

Kannuhbinnoeedz

Frum: WemMD Medical Marijuana FAQ

How does it help?

Cannabinoids — the active chemicals in medical marijuana — are similar to chemicals the body makes that are involved in appetite, memory, movement, and pain.

Research suggests cannabinoids might:

Reduce anxiety
Reduce inflammation and relieve pain
Control nausea and vomiting caused by cancer chemotherapy
Kill cancer cells and slow tumor growth
Relax tight muscles in people with MS
Stimulate appetite and improve weight gain in people with cancer and AIDS

Can medical marijuana help with seizure disorders?

Medical marijuana received a lot of attention a few years ago when parents said that a special form of the drug helped control seizures in their children. So far, research hasn't proved it works. But some epilepsy centers are testing a drug called Epidiolex, which is made from CBD, as a therapy for people with very severe or hard-to-treat seizures. In studies, some people had a dramatic drop in seizures after taking this drug.

Kannuhbinnoeedz

Frum: WemMD Medical Marijuana FAQ

How does it help?

Cannabinoids — the active chemicals in medical marijuana — are similar to chemicals the body makes that are involved in appetite, memory, movement, and pain.

Research suggests cannabinoids might:

Reduce anxiety
Reduce inflammation and relieve pain
Control nausea and vomiting caused by cancer chemotherapy
Kill cancer cells and slow tumor growth
Relax tight muscles in people with MS
Stimulate appetite and improve weight gain in people with cancer and AIDS

Can medical marijuana help with seizure disorders?

Medical marijuana received a lot of attention a few years ago when parents said that a special form of the drug helped control seizures in their children. So far, research hasn't proved it works. But some epilepsy centers are testing a drug called Epidiolex, which is made from CBD, as a therapy for people with very severe or hard-to-treat seizures. In studies, some people had a dramatic drop in seizures after taking this drug.


Mehriwahnuh Nachropathik Eeuuss Kyndz

Table of Contents

Thuh NekST TekST Wuhz Fruhm:

Medical Cannabis and Naturopathy

By Qingping Zheng, M.Sc, ND, Clinic Supervisor & Research Faculty,

  • Canadian College of Naturopathic Medicine on October 16, 2018

The genus Cannabis, commonly known as marihuana or marijuana, refers to a flowering plant of which

there are 3 main species, Cannabis sativa, Cannabis indica and Cannabis ruderalis.

It has received a lot of public and media attention since the announcement of legalization for recreational use in Canada.

Medical cannabis refers to using cannabis or cannabinoids as a medical therapy to treat disease or alleviate symptoms.

In addition to requiring prescription and oversight from a healthcare provider with knowledge, skills, scope and competency, this may also differ from recreational use due to differences in product quality and consistituents.

Despite the fact that the

herb Cannabis has been used for more than 3,000 years for the treatment and management of pain, digestive issues and psychological disorders

  • by various cultures, many healthcare providers are somewhat familiar or experience discomfort with appropriate medicinal usage. A recent survey (1) of Canadian physicians revealed that dosing and the need for safe, effective treatment monitoring places were at the forefront of educational needs. This may be in part due to stigma, as well as significant changes in the volume and quality of both evidence and high quality products as well as the regulatory and legal policies surrounding its use (2). Although the list of conditions for approved medical use has been growing, the research to support many of these treatments is limited. To help further understand this plant, a brief review of the available evidence on its pharmacology and medical uses, along with the safety issue from the perspective of naturopathic medicine, is provided to help address gaps in knowledge or understanding.

Chemical Composition Uhv Hemp

Hemp grows throughout temperate and tropical climates but originated from central Asia or in the foothills of the Himalayas (3).

++The leaves and flowering tops of cannabis plants
+++contain at least 489 distinct compounds known as cannabinoids distributed among 18 different chemical classes,
+++and harbor more than 70 different phytocannabinoids (4).

Many of these compounds interact with our bodies via the endocannabinoid system (5),

where their actions are mainly

mediated by their interaction with two closely related receptors, CB1 and CB2,

  • first chemically identified in the 1940s (6,7). Potential for these receptor-mediated interactions are high, particularly throughout the central nervous system (CNS), with

CB1 receptor being expressed in neurons and

CB2 receptors being localized primarily on cells of the immune system.

Δ9-THC is by far the best studied phytocannabinoid, and is responsible for the psychoactive effects of cannabis through its actions at the CB1 receptor (8). It is the major psychoactive constituent and also has the largest association with tolerance and withdrawal effects. THC is regularly used to measure the herb’s potency. Typical concentrations of THC are less than 0.5% for inactive hemp, 2% to 3% for marijuana leaf, and up to 4-8% for higher-grade seedless, or sinsemilla buds. Higher concentrations can be found in extracts, tonics, and hashish (concentrated cannabisresin).

THC displays complex psychoactive effects, analgesic, cognitive, muscle relaxant, anti-inflammatory, appetite stimulant and antiemetic activity (9).

Cannabidiol (CBD) is the main non-psychoactive phytocannabinoid in the cannabis plant

  • that has drawn more attention in recent years. It does not have the intoxicating effects of THC, and
  • [ Cannabidiol (CBD) ] does not develop tolerance and withdrawal effects (10).

Despite its weak affinity for the CB1 and CB2 receptors, CBD seems to antagonize CB1/CB2 receptor agonists in CB1 and CB2 expressing cells and tissues (11).

Animal studies have demonstrated
[ Cannabidiol (CBD) ] has neuroprotective (12,13), anti-inflammatory, antioxidant properties (14), anticonvulsant, analgesic, anti-anxiety, antiemetic, immune-modulating and anti-tumorigenic properties.

Preliminary clinical trials suggest that

high-dose oral CBD (150–600 mg/d) may exert a therapeutic effect for social anxiety disorder, insomnia and epilepsy,

  • but it may also cause mental sedation (15).

There is considerable variation in the consistency of constituents amongst Cannabis plants and species. In general, cannabis products (recreational and medicinal) derived from

Cannabis sativa exhibit a higher CBD/THC ratio than products derived from Cannabis indica.

Administering different ratios of THC and CBD leads to diverse outcomes. Experimental studies indicate CBD attenuates effects of ∆9-THC requiring at least 8 : 1 (±11.1) ratio of CBD to THC; whereas CBD appears to potentiate some of the effects associated with THC when the CBD to THC ratio is around 2 : 1 (±1.4) (16).

** Use of Medical Cannabis:

Cannabis is a potent antiemetic with…Cancer chemotherapy:

Nausea and vomiting associated with cancer chemotherapy is one of the most familiar and well-established uses of cannabis in modern medicine. Cannabis is a potent antiemetic with therapeutic potential in cancer care(17). A systematic review and meta analysis of medicinal cannabis (18) found all studies suggested a greater benefit of cannabinoids compared to both active comparators and placebo, however no single study reached statistical significance. It is also important to note that paradoxically at excessive doses, Cannabis can precipitate cannabis hyperemesis syndrome (CHS) (19). This is relatively infrequent, but significant adverse reaction is characterized by severe nausea and vomiting followed by a period of deep sleep. For patients undergoing chemotherapy and radiation, THC is known to increase appetite, and subsequently weight, as an additional benefit.

effectiveness of cannabis in treating Chronic pain:

The systematic reviews on the efficacy and safety of cannabis-based medicine for chronic pain conditions have yielded diverse conclusions. A recent systematic review (20) supported the effectiveness of cannabis in treating chronic pain, primarily for neuropathic pain patients. However, Häuser W et al (21), didn’t come to a conclusion of the effectiveness of cannabis based on the quality of the clinical trial, most critical challenge being the small size and short term of research design. A 2014 statement issued by The Canadian Pain Society (22) recommended cannabis-based medicines as a potential third-line treatment for chronic neuropathic pain; while the Canadian Agency for Drugs and Technologies in Health (23) (2016) reviewed clinical safety and effectiveness of cannabinoid buccal spray for chronic non-cancer or neuropathic pain and suggested there was insufficient evidence to make well-founded conclusions about the clinical advantage and use of cannabis-based medicines for the management of cancer and non-cancer pain.

Cannabinoids typically lowers intraocular pressure (IOP) by up to 30% [ with ] Glaucoma:

Ocular (as well as systemic) administration of cannabinoids typically lowers intraocular pressure (IOP) by up to 30% although the mechanism is not well elucidated (24). A small but well-controlled pilot study of 6 patients with ocular hypertension or early primary open-angle glaucoma reported that two hours after sublingual administration of a single 5 mg Δ9-THC reduced the IOP significantly and was well tolerated by most patients. Sublingual 20 mg of CBD did not reduce IOP ( intraocular pressure ), while 40 mg of CBD increased IOP at four hours after administration (25).

clinical use of CBD for spasticity and pain in Multiple sclerosis:

The various needs and symptom profiles of patients with multiple sclerosis (MS) present with make it difficult to assess the observed and potential effectiveness of cannabis. Pharmaceutical CBD have been investigated for its effectiveness and safety in treating MS. A recent systematic review (26)supports the clinical use of CBD for spasticity and pain in multiple sclerosis, while it is not inconclusive on use to treat other common symptoms like bladder control, ataxia and tremor. Adverse effects including dizziness, dry mouth, euphoria, diarrhea, and difficulty concentrating were most frequently described as “mild” to “moderate”. Some researchers argued that a risk/benefit decision may be needed in the management of CBD used by MS patients. According to another study (27), the benefitsof CBD were generally observed within the first 4 weeks; thus a trial of 4-6 weeks is recommended to determined whether patients will receive clinical benefit.

CBD has been drawing more attention in treating most of Anxiety disorder:

Compared with THC, that has been found to induce anxiety in healthy subjects (28), CBD has been drawing more attention in treating most of anxiety due to its anxiolytic property (29) without impairing cognitive performance (30). Increasing doses of CBD leads to a linear reduction in anxiety, compared with the biphasic anxiolytic/anxiogenic effect of THC use (31). A double-blind randomized design study (32) on 24 patients with generalized social anxiety disorder (SAD) demonstrated that 600mg orally pretreatment with CBD significantly reduced anxiety, cognitive impairment and discomfort in their speech performance, compared with the placebo group. A fMRI study on fifteen healthy men found that oral administration of 600mg CBD and 10mg D-9-THC presented opposite neurophysiological effects when performing different cognitive task; while the following behavioral experiment on six healthy volunteers, after pretreatments of 5mg CBD intravenously (IV) followed by 1.25 mg IV D-9-THC prevented the acute induction of psychotic symptoms, thus might lessen the anxiogenic effects of THC (33).

CBD…shows a promising anticonvulsant profile [ for ] Epilepsy:

Cannabis preparations have reported to be beneficial in treatment of epilepsy and other seizure disorders, particularly drug refractory childhood epilepsies. Cannabis products with moderate to high THC content are generally unsuitable for this condition, considering the potential risk of seizure aggravation (34) and undesired side effects such as psychiatric disorders, addiction liability, cognitive and motor impairment in the childhood population. CBD, on the other hand, shows a promising anticonvulsant profile in the recent high quality RCT trials. The efficacy of CBD as add-on therapy for patients with Dravet syndrome (35) and drop seizure in patients with Lennox-Gastaut syndrome (36) were investigated. The results of these studies demonstrate that, at a dosage of 20 mg/kg/day, add-on CBD was efficacious in reducing the frequency of convulsive seizures. The CBD group was had higher adverse events such as diarrhoea, somnolence, pyrexia, decreased appetite, and vomiting, but generally well tolerant. As seen in other disorders, this case illustrates that the risk: benefit profile of cannabinoids needs to be weighed and discussed with patients prior to initiating therapy. Current best practices do not suggest CBD as stand-alone monotherapy in seizure disorders.
Sleep disorder:

According to the studies, different doses of THC yields mixed results.

A low dose of THC (less than 5 mg) seems to increase the quality of sleep

  • and reduce the frequency of nightmares (37) while administration of

larger dose [ of THC ] (15mg) decreased sleep latency on the following morning,

  • and disturbed both mood and memory on the next day. Novel studies investigating cannabinoids and obstructive sleep apnea suggest that synthetic cannabinoids such as nabilone and dronabinol may have short-term benefit for sleep apnea due to their modulatory effects on serotonin-mediated apneas. CBD may hold promise for REM sleep behavior disorder and excessive daytime sleepiness, while nabilone may reduce nightmares associated with Post-traumatic stress disorder (PTSD) and may improve sleep among patients with chronic pain.

Chronic cannabis use is associated with negative subjective effects on sleep that are manifested most prominently during withdrawal. Symptoms reported include sleep difficulties such as strange dreams, insomnia, and poor sleep quality.

These results are consistent with one interpretation that cannabis is typically not beneficial to sleep except among medicinal cannabis users who are identified by the presence of pre-existing sleep interrupting symptoms such as pain. As such, cannabis may be thought to improve sleep via the mediating improvement of these confounding symptoms.

Methods for using Cannabis:

Cannabis can typically be administered by inhalation, oral ingestion, and topical application.

Each delivery method has its advantages and disadvantages. The effects of cannabis are felt fastest when it is inhaled (i.e. liquid aerosol, nebulized or ‘smoked’). Inhalation is the most common way with the advantages of quick action, ease of monitoring the amount ingested, convenience, and short-term duration of effect. Side effects often include increasing risk of bronchitis and potential link to cancers of the respiratory tract, particularly when smoked.

Vaporizing (liquid aerosol) has been considered safer than smoking

  • because there are less by products since a lower temperature is used in the vaporizer and is thus a healthy alternative to smoking, however these statements deserve further investigation and evaluation.

Cannabis oils and tinctures are examples of concentrates of cannabis taken orally.

Compared to smoking, oral administration results in slower onset of action, lower blood levels of cannabinoids, and a longer duration of pharmacodynamic effects (38), though there is some indication that different oral forms (sublingual, food-product, ‘extended-release’) will have differing pharmacokinetic profiles.

Topicals are one of the lesser known forms of medicinal cannabison the market,

  • but they have significant potential to benefit people with inflammation and pain. The low THC content make them particularly attractive to consider for cannabis-naïve or cannabis-hesitant users. The other topical application is suppositories which can sometimes have some psychoactive effect depending on the product constituents.

Prescribed cannabis or cannabidiol approved by Health Canada

  • includes Nabilone (commercial name of Cesamet®) and Dronabinol (commercial name of Marinol®) which are the orally administered synthetic structural analogues of Δ9-THC. The latter was discontinued in the Canadian market in 2012. Cesamet® is sold as capsules (0.25, 0.5, 1 mg) and is indicated for the treatment of the nausea and vomiting associated with cancer chemotherapy (39). Nabiximols (commercial name of Sativex®) is from a whole-plant extract of two different, but standardized, strains of Cannabis sativa containing approximately equivalent amounts of Δ9-THC (27 mg/mL) and CBD (25 mg/mL), and other cannabinoids. It is marketed as an adjunctive treatment for the symptomatic relief of spasticity and neuropathic pain in adults with multiple sclerosis and as an adjunctive analgesic in adult patients with advanced cancer who experience moderate to severe pain (40).

[ Cannabis ] Safety

1: [ Cannabis ] Toxicity:

* To date there has been no documented fatal overdose from isolated Cannabis use.**

These statistics are impressive if compared with other commonly used recreational drugs. Globally, alcohol was linked to over 3 million deaths per year in 2012, and tobacco is reportedly linked to the deaths of more than 6 million people each year (41). Although several toxicology studies (42,43) with THC in animals suggested that THC was considered a safe drug both in acute and long-term exposure, toxicity of the commercial synthetic cannabinoids was found to be increased compared with Cannabis itself (44).

[ Cannabis use ] side effects typically include:

dizziness/light-headedness, sedation, confusion, ataxia, a feeling of intoxication, euphoria (“high”), xerostomia, dysgeusia, and hunger (20).

2: [ Cannabis ] Tolerance:

Ina residential laboratory study (45,46) on twelve daily marijuana smokers, the development of tolerance was evaluated after four-day period administration in two different groups including the oral THC pills group and the smoked marijuana group. Each pills contained 30 mg of THC and smoked marijuana dose consisted of 3.1% THC, and they were administrated four times a day in each group. Both groups became tolerant to subjective effects of THC such as feeling “high” and “good drug effect” but not to its effects on food intake or social behavior. The tolerance was disappears rapidly following cessation of administration (47). In addition, the dynamics of tolerance vary with respect to the different constituents and effects (48). However, some long-term studies reported the absence of pharmacological tolerance (49, 50)– this suggests that dosing straetgies may help alleviate or prevent issues of tolerance.

3: [ Cannabis ] Addiction: Cannabis is considered to be also far less addictive

There is evidence that cannabis dependence (physical and psychological) occurs especially with chronic, heavy use (51). However, Cannabis is considered to be also far less addictive than alcohol, nicotine, cocaine, opiates and other psychoactive drugs. In the 1970’s, recreational cannabis became known as “the gateway drug,” but facts do not support this statement. In fact, studies suggest medical cannabis is a safer alternative rather than prescriptions of some pharmaceuticals with well-known potential for addiction (52).

4: [ Cannabis ] Exacerbations: smoked Cannabis is not recommended in patients with respiratory insufficiency

Cannabis does have the potential to exacerbate symptoms of underlying conditions, such as severe cardiopulmonary disease because of occasional hypotension, possible hypertension, syncope, or tachycardia (53); Studies showed that although Cannabis smokers have minimal changes in pulmonary function studies as compared to tobacco smokers, they may develop bullous disease and spontaneous pneumothorax. The relationship between Cannabis smoking and lung cancer remains unclear due to design limitations of the studies published so far. Therefore, Health Canada stated in 2013, “smoked Cannabis is not recommended in patients with respiratory insufficiency__ such as asthma or chronic obstructive pulmonary disease (COPD)__” (54).

5: [ THC impairs Tho CBD Improves ] Cognitive function:

Evidence has demonstrated that high THC/low CBD Cannabis (55) lead to greater cognitive impairments, in particular memory function, attention and emotional processing in individuals. On the other hand, research showed CBD seems to antagonize THC-induced impairments and improve cognition in multiple preclinical models of cognitive impairment, including models of neuropsychiatric (schizophrenia), neurodegenerative (Alzheimer’s disease), neuro-inflammatory (meningitis, sepsis and cerebral malaria) and neurological disorders (hepatic encephalopathy and brain ischemia) (56). However it is unclear whether at specific concentrations CBD might outweigh any harmful effects of THC on cognition.

6: Uncertainty of risks [in] mental health…during…Brain development:

The regular (mis)use of cannabis during developing childhood and adolescence is of particular concern and the question of whether Cannabis is harmful remains the subject of heated debate. Although multiple studies have reported the adverse effects of Cannabis use on mental health are greater during development, particularly during adolescence, than in adulthood (57), others studies (58) have not made definite conclusions as to whether cannabis use alone has a negative impact on the human adolescent brain (59). Given the uncertainty of potentially risks, “Cannabis should not be used in any person under the age of 18, and physicians in Ontario “are not allowed to prescribe Cannabis to patients under the age of 25 unless all other conventional therapeutic options have been attempted and have failed to alleviate the patient’s symptoms” (60).

7: Mental health: cannabis should not be used in patients with schizophrenia

Whether the use of Cannabis might precipitate mental illness in some patients is a long standing concern. Cannabis has been linked to episodes of acute psychosis (61) and can exacerbate the symptoms of existing psychotic illness like schizophrenia (62, 63). However, some studies report the opposite results—CBD seems to represent a mechanistically different and less side-effect prone antipsychotic compound for the treatment of schizophrenia, even though the underlying pharmacological mechanisms are still debated (64). Given the uncertainty of results, Health Canada suggests “medicinal cannabis should not be used in patients with a personal history of psychiatric disorders (especially schizophrenia)” (65). In other conditions like anxiety disorders, the anxiolytic effects of Cannabis in clinical populations are inconsistent (65).


Thuh NekST TekST Wuhz Fruhm:

By Christopher G. Fichtner, MD, And Howard B. Moss, MD

Perceived benefits of medical cannabis

Regardless of the legal status of cannabis, many patients with psychiatric disorders use cannabis and report improvement in their symptoms. Patients use cannabis for symptoms of PTSD, anxiety disorders, depression, ADHD, bipolar disorder, chronic pain, insomnia, opiate dependence, and even schizophrenia. In addition, patients use cannabis for neurological conditions such as the spasticity of multiple sclerosis, agitation in dementia, and specific seizure disorders that are unresponsive to standard therapies. Patients also use cannabis to reduce the nausea and anorexia of cancer chemotherapies and to improve their mood and outlook—frequently with their oncologist’s approval…


Thuh NekST TekST Wuhz Fruhm:

By Christopher G. Fichtner, MD, And Howard B. Moss, MD

Schizophrenia, CBD, and THC

Molecular CBD has been shown to treat symptoms of schizophrenia

  • under controlled clinical trial conditions, with results comparable to those of treatment with an approved antipsychotic medication, and with a favorable adverse-effect profile.4 Other studies support the view that

CBD may have therapeutic potential as an antipsychotic

  • and may counter or offset psychotomimetic effects of THC. Differences between THC and CBD notwithstanding, in a small case series, 6 patients with schizophrenia and a history of symptom relief with cannabis use were treated with the addition of low-dose prescription THC to regimens that included clozapine in some cases or multiple antipsychotics in 1 patient.5 Four of the 6 patients showed improvement with the addition of THC to their regimen, and in 3 of the 4 patients a specific antipsychotic effect was evident. As with the anxiogenic potential of THC, dosage may be important in the relationship between THC and psychosis.

Cannabis and cognition

The National Academy report also acknowledged that there is moderate evidence of a statistical association between cannabis use and better cognitive performance among individuals with psychotic disorders and a history of cannabis use. It has been speculated that this could represent a less cognitively vulnerable subgroup of patients who would not have developed psychosis in the absence of exposure to cannabis, but this is not known. More generally, there is moderate evidence of a statistical association between acute cannabis use and impairment in the cognitive domains of learning, memory, and attention. However, results have been mixed on the question of longer-term and residual cognitive impairment. A recent report indicates neuropsychological decline in persistent long-term users with cannabis use disorders, although an earlier meta-analysis found no residual impairment.6,7 Evidence of impaired academic achievement and educational outcomes was judged to be limited according to the National Academy report. Again, with cognitive functioning as with the risk of psychosis, dosage may be an important factor, since the findings of impairment relate primarily to heavy long-term use and even more specifically to those patients with cannabis use disorders.


Thuh NekST TekST Wuhz Fruhm:

By Christopher G. Fichtner, MD, And Howard B. Moss, MD

Cannabis and PTSD

Evidence that cannabis or cannabinoids are effective for improving symptoms of PTSD

  • is considered limited by the National Academy report, but clinical reports and case series excluded under its research quality criteria are more positive for the benefits of cannabis for PTSD symptoms.

A growing number of states have included PTSD as one of the acceptable indications for recommending or approving medicinal use of cannabis.

Clinicians who have written large numbers of medical cannabis recommendations have documented that a sizeable minority have been for psychiatric indications, with PTSD being perhaps the most common.10

Greer and colleagues11 reported on 80 patients with PTSD who were approved for medicinal use of cannabis through the New Mexico Medical Cannabis program. As a retrospective assessment, the study’s methodology limits the scientific conclusions that can be drawn. However, the authors reported decreases of 75% overall and separately in each of the 3 respective (DSM-IV) symptom clusters: re-experiencing, hyperarousal, and avoidance, as measured by current versus retrospective baseline Clinician Administered PTSD Scale (CAPS) scores, with and without cannabis use, respectively. The study was not included in the National Academy report, but it was reviewed by Walsh and colleagues,1 who noted that most studies on the therapeutic use of cannabis by persons with mental health conditions are not of methodologically high quality.

The beneficial effects of cannabinoid medicines for PTSD are consistent with what is known about the psychobiology of PTSD and the emerging research on the endocannabinoid system.12 Components of the endocannabinoid system include cannabinoid (CB1 and CB2) receptors; endogenous ligands anandamide, 2-arachidonoylglycerol (2-AG), and others; and enzymes that regulate endocannabinoid ligand production. Endocannabinoid signaling occurs in retrograde fashion, with postsynaptic release of ligands that bind to presynaptic cannabinoid receptors and inhibit presynaptic neurotransmitter release. This contrasts with the classic monoaminergic neurotransmitter systems that have shaped much of our thinking in psychopharmacology, and represents a potential alternative strategy for psychopharmacologic intervention (Figure).

CB1 receptors are widespread throughout the brain. Based on animal and human studies, the endocannabinoid system appears to be involved in the extinction of aversive memories, and both THC and CBD have been shown individually in separate studies to facilitate extinction of the conditioned fear response.13,14 Recent neuroimaging studies have found increased CB1 receptor availability in multiple brain regions in PTSD, including the amygdala-hippocampal-cortico-striatal circuit implicated in its pathophysiology.15

The National Academy report also found limited evidence of an association between cannabis use and increased severity of symptoms among individuals with PTSD, but the cause-and-effect relationships are unclear. Individuals with more severely symptomatic PTSD may be more likely to self-medicate with cannabis. The possibility of symptom exacerbation with cannabis use must be weighed against reported therapeutic benefit in individual cases. Other psychiatric diagnoses for which the National Academy report found limited evidence for effectiveness include Tourette syndrome and social anxiety disorders.

Thuh NekST TekST Wuhz Fruhm:

MORE ABOUT Christopher G. Fichtner, MD

Dr. Fichtner is a Clinical Professor of Psychiatry at the University of California, Riverside School of Medicine, and a staff psychiatrist with the Riverside University Health System—Behavioral Health. He received his medical degree from The University of Chicago Pritzker School of Medicine (1987). Dr. Fichtner is a diplomate of the American Board of Psychiatry and Neurology and a Fellow of the American Psychiatric Association, with specialty certification in administrative psychiatry. In addition, he is a Fellow of the American Association for Physician Leadership and a past President of the American Association of Psychiatric Administrators…

Dr. Fichtner and Dr. Moss are Clinical Professors of Psychiatry at the University of California, Riverside School of Medicine.


Thiss Iz Thuh Last Lyn Uhv Tekst Uhv Thuh Paeej Naeemd Mehriwahnuh Nachropathik Eeuuss Kyndz.



RecreaTional Drug SafeTy Uhv RecreaTional Drug Owners ConsTiTuTional RighTs

{ Lrning And Teecheeng } KumpleeT ImporTanT ( Med FacTs And Mohr Saeef Use OpTs And Their EarTh CiTizen RighTs Uhv Thuh Earth ConsTiTuTion ) ReeGahrdeeng ( Eech RecreaTional Drug Wich ( SeLf Ohr Sum Wun Known ) Iz InTresTed In Eewzeeng ) Ahr Needed Tu Inform ( Now And Possibbul New ) RecreaTional Drug Eewzrz UhbowT Thuh PoTenchuL ( Risks And BenneffiTs ) Uhv Eewzeeng ThaT RecreaTional Drug.

RecreaTional Drug Owners ConsTiTuTional RighTs Uhv Legalize All Drugs And End the drug war

BaeesT On: EarTh CiTizen RighTs Uhv Thuh Earth ConsTiTuTion

Eech ( NaTional And Municipal And Local ) Law Code Should GeT { ChekT And If Nehsehsehree FixT } So ThaT In Ehvree Jrisdikshuhn Uhv Thuh RTh Thuh Law Code Ther { ReespekTs Eech Uhv Thuh Following ConsTiTTpooshuhnul RyTs Uhv Eech Recreational Drug Ownr } And { Maeeks It Illegal For Kops Tu AkT AgainsT Ehnee RecreaTional Drug Ownr Tu Koz ThaT Prsuhn Tu BeKum A VicTim Uhv Ehnee Uhv Thuh Following ViolaTion Krymz } }.

1: Eech Recreational Drug Ownr Haz Thuh ConsTiTuTional RyT Tu "Prohibition against physical or psychological duress or torture during any period of investigation, arrest, detention or imprisonment, and against cruel or unusual punishment."

2: Kuz Uhv ThaT, Eech Cop ShouLd Nevr KuhmiT a ( physical durress ohr cruel ) assulT krym violation againsT Ehnee RecreaTional Drug ( Ownr And|Ohr Eewzr ).

3: Recreational Drug Ownrz Hav Thuh ConsTiTuTional RyT Tu "Safety of person from arbitrary or unreasonable arrest, detention, exile, search or seizure; requirement of warrants for searches and arrests."

4: Kuz Uhv ThaT, Eech Cop ShouLd Nevr KuhmiT ThefT Violation UhgensT Ehnee RecreaTional Drug Ownr Without A WarrrenT Uhledjeeng That Thuh RecreaTional Drug Ownr Had { { STole ( Sum Ohr AhL ) Uhv Thuh RecreaTional Drug(z) They Hav } And|Ohr { Endaeendjrd Ohr Violated Anyone's Bod WiTh Their RecreaTional Drug Property } }.

5: AhLsoh Kuz Uhv 3, If Ther'z No WarrenT Legalizing Thuh arresT Then ThaT Iz A ConsTiTuTionally ( rong and illegal ) arresT that MyT Also ProbbabLee InkLood unNehsehsehree And ConsTiTuTionally ( rong and illegal ) { imprisonment uhv wrists in handcuffs Then Cop Car imprisonment And jail Imprisonment } violations AgainsT Thuh RyTs Uhv A RecreaTional Drug Ownr ( InnuhsenT = NoT gilTee ) Uhv Ehnee Uhv THuh Following Real True violation krymz.

6: If Ehnee RecreaTional Drug Ownr Iz InnuhsenT Uhv ( ( Thuh Real True violation krym Uhv UhsuLT ) And ( Real True ProprTee violation krym, Fohr EgzampuL ( ThefT Ohr ( Vandalism Such Az UnauThorized Damaging Uhv A Dif Prsuhn'z ProprTee ) ), Then Tu arresT ThaT Prsuhn WouLd Bee TrooLee ReaLLee ( rong and unJusT ). Thuh rongful arresT MyT Hav Ben Dun Kuz Uhv At LeesT Wun ( Rong And unJusT ) Law ThaT ShouLd MohsT LykLee GeT Chaeendjd Ohr { Reemoovd Fruhm Thuh Lahz Uhv At LeesT ThaT Jrisdikshuhn And Hohpfully Ehnee UhThr Jrisdikshuhn ThaT Haz ( ThaT Ohr A SimmiLr ) ProbbabLee ( Rong And unJusT ) Law }.

Legalize All Drugs And End the drug war


Table of Contents

Drug DeTox NooTrishuhn

EnhansT NexT TexT Fruhm http://www.heretohelp.bc.ca/vision-alcohol-vol2/role-nutrition-recovery-alcohol-and-drug-addiction

A diet for recovery should include:

Complex carbohydrates (50% to 55% of the calories you consume),

  • which means plenty of grains, fruits and vegetable

Dairy products or other foods rich in calcium

Moderate protein (15% to 20% of calories):

  • two to four ounces twice a day of meat or fish (or another high-protein food such as tofu [ Or Milk ])

Fat choices (30% of calories), preferably good oils (EssenTial Fatty Acids)


NachruL DeTox

NexT TexT Frum: https://www.leaf.tv/articles/how-to-naturally-detox-from-drugs-at-home/

Drink lots of fluids

A daily intake of eight to 12 glasses of fluids each day flushes out the toxins and chemicals. All healthy fluids water, fruit juices, vegetable juices and herbal teas are a good way to clean the body internally. The wastes, impurities and drug residues are washed out of the cells, tissues and organs.

Lose fat by exercising.

Even if you aren't overweight, losing fat will help with detoxification from drugs. Most chemicals and toxins that enter the body are stored in the fat cell. By losing excess fat, a person also loses toxins. To lose the fat, do aerobic exercise. Swimming, running, dancing and cycling are good cardiovascular exercises that help to burn calories and fat. During a high-impact workout, a person also builds up a sweat. Toxins are released through the sweat glands. Building muscle with weights or resistance training also burns fat. In time, the muscles replace the fat deposits. Breathing deeply during any type of exercise helps to expel toxic carbon dioxide from the lungs. On inhalation, more oxygen enters the body.

Have a healthy diet.

Eating fruits and vegetables gives the body the nutrients it needs to repair itself

  • and carry out its many functions.

Organic foods are more expensive, but they are better for the body,

  • because they contain fewer chemicals like preservatives and pesticides.

Adding fiber to the diet helps in moving wastes & debris through the intestines & out the body.

DeTox NooTrishuhn

See:

ReComMendEd, Common, NuTrishuhnuL Drinks DeTox, Eezee Tu GeT AT A Corner STore Drinks Include:

ION4 Advanced ELECTROLYTE SysTem POWERADE MounTain Berry BlasT

* SporTs Drink WiTh VITAMINS B3, B6, & B12
* MounTain Berry BlasT With Mixed Berry Flavored + OThr NaTural Flavors

GLACEAU ViTamin WaTer Energy Tropical Citrus Flavored

* WiTh ViTamins: C ViTamin, b5, B6, B12
* With Electrolytes And 50 mg Caffein
* NuTrienT enhanced WaTer beverage

V8 Energy Protein

V8 Original 100% VegeTable Juice WiTh 2g Uhv [ProTein

SOBE ELIXIR GREEN TEA WiTh AddEd Green Tea Spice

See ALso:



SaTiva In FuhnehTik IngLish Yeeng Voiss Sownd Chahrz Iz SuhTeevuh

marijuana-cannabis-sativa-buds-BEC2T4.jpg
Frum: https://www.alamy.com/stock-photo-marijuana-cannabis-sativa-buds-26081220.html

See:

Marijuana Indica iz thuh SanskriT Simp Lang Bhang

Bhang Pronunciation
(US) IPA: /bæŋ/

Etimolluhjee bhang (n.)

"dried leaves of Cannabis Indica," 1590s, from Hindi bhang "narcotic from hemp," from Sanskrit bhangah "hemp," which is perhaps cognate with Russian penika "hemp." The word first appears in Western Europe in Portuguese (1560s). It also was borrowed into Persian (bang) and Arabic (banj).
Sum Incica Bud Haz Noh CBDz

Fruhm: https://cannabis.net/blog/strains/the-difference-between-indica-and-sativa-marijuana
3744_Oos4_indica_vs_sativa.png

Included page "ruderalis" does not exist (create it now)

See:

Iz Mehrihwahnuh Smohk ohvrdohss lethal???

NexT TexT Fruhm: Here's how much marijuana it would take to kill you

"With more people lighting up than ever…it's important to remember how many fatally overdose on the drug:

"Zero. That's according to the Centers for Disease Control and Prevention which collects data on a range of other substances, both legal and illicit, and the Drug Enforcement Administration…

"It's pretty impossible to ingest a lethal dose of marijuana...

"Cannabinoid receptors are not found in the brainstem areas that control breathing. Thus, 'lethal overdoses from cannabis and cannabinoids do not occur,' The National Cancer Institute explains…

"[W]hile there are no recorded cases of deaths from marijuana overdose, one bong rip too many can make users feel incredibly uncomfortable. Their heart starts to race, hands tremble, and anxiety strikes. There are things they can do to mitigate a 'What I have done?' high…

"Drink some water to stay hydrated and eat a snack — preferably one that is ready-to-eat and does not require operating a stove — to boost your blood sugar…"

See: Human Essential Nutrition

"…The good news is, as reported in The British Journal of Psychiatry, cannabis is safe in overdose. In other words, it is physically impossible for a human to die as a direct result of a cannabis overdose. Having said that, this guide will be helpful to medical marijuana patients who find themselves smoking or ingesting too much of their favorite plant…What are the signs and symptoms of a cannabis overdose?…"
* Fruhm: https://www.medicaljane.com/2015/11/05/can-you-overdose-on-marijuana-survival-tips-for-greening-out/

"Non-tobacco smoking was associated with chronic cough (OR=1.73), chronic phlegm (OR=1.53) and wheeze.,.There was no significant difference in lung function measurements between marijuana-only smokers and non-smokers…Marijuana use was significantly associated with chronic bronchitis symptoms, coughing on most days, phlegm production, wheezing and chest sounds without a cold…"

Definitions of chronic

If you smoke a cigarette once, you've simply made a bad choice. But if you're a chronic smoker, you've been smoking for a long time and will have a hard time stopping.

The word chronic is used to describe things that occur over a long period of time and, in fact, comes from the Greek word for time, khronos. If you have chronic asthma, it is a recurring health issue for you. No one likes a chronic liar!

"If it gets to an advanced stage, chronic bronchitis can lead to a life-threatening illness. When the bronchial tubes and lungs become weak enough, it becomes more likely that you will experience respiratory failure, develop lung cancer or a heart or lung disease. You also have a heightened risk for pneumonia. About one percent of people with a chronic obstructive pulmonary disease like chronic bronchitis die from their condition every year…

"Chronic bronchitis symptoms include mucus, cough, wheezing and inflammation or irritation of the lining of bronchial tubes. You may also have chills and fever with chronic bronchitis. Smoking is a common cause, but not the only cause. Air pollution may also be a cause. When bronchitis symptoms last a long time, the condition is serious.

Antibiotics, inhalers, and cough medicines are all used to help treat chronic bronchitis. Sometimes a course of respiratory therapy is also used."



Tu Tohk Iz Tu DeeLibrayTLee BreeTh In a PsychoAcTive Gas, EspeshuLLee Wood-Lyk Mehrihwahnuh Rb BrnT Tu Kush Smohk.



[[include Tohk]]]



Smohkeeng Iz AiThr:
1: Brneeng ( Wood Ohr An UhThr FlammabuL Rb PahrT ) Tu Smohk, Or
2: BreeTheeng ( In Then Out ) Smohk Frum A Kush Rb Such Az Tobacco Or [[[Mehrihwahnuh]].

Ehnee UhThr PoTenchuLLee PsychoAcTive Kemz Non ( Grown In Rb ), such az Sum Typs Uhv Solid Kush Jemz, Wen CookT Tu Gaz, Heer KahLd Kush Vaypr, And BreeThd Iz Too OfT Also KahLd Smohkeeng.

Vapor In FuhnehTik IngLish Yeeng Voiss Sownd Chahrz Iz Vaypr

vapour (US), vapor
1. particles of moisture or other substance suspended in air and visible as clouds, smoke, etc

Cooking Kemz Tu Gaz Iz KahLd ( Vaypryzeeng = Making Vaypr ).

Tu BreeTh Kush Vaypr Iz Heer AhLsoh KahLd Tu Tohk


  • Tohkeeng Kush Smohk Haz A High Risk Tu Koz loud rude devil kof suhfreeng. ThaT Loudness Shood GeT KuhnsidraTLee KrTeeuhsLee Kuhvrd WiTh A CLoTh Kof MuhfLr, Lyk A KiTchen CLoTh Ohr PahrT Uhv A ShrT. ThaT Kof CloTh ShouLd Be PuT Neer In A Handy PLayss, Lyk RyT Undr THuh Hand That U Plan Tu HohLd Thuh Tohrch. Then Wen U STahrT Tu Brn Your Mehrihwahnuh Wood Tu Kush Smohk And STahrT Tu ( Tohk = DeeLibrayTLee BreeTh In Gaz WiTh Kemz ThaT Koz A SykuhTropik EefekT ), Thuh Kush Smohk, NohrmuLee In UhbowT 3 Sekuhnds, Thuh Rdj ThaT SignuLz Kof PuLss Iz FelT Thuh Soon Your Kof CloTh MyT Bee Handy Eenuf Tu Grab Then MuffLeen gThuh MohsT RrLee Kof Az PossibuL,KwikLee STahrT Tu (MuhfuL = Mayk KwyeTr ) Then AhL Following Kof Pulsez Az PossibuL WuhT MyT Have Ben Mohr Loud Sowndz.

Kannuh bud Can AhLTrnuhTivLee Bee hand-grynded intu green Spyss wich kan get spreengkLd on or in a fwd or drink (lyk tea) and then mixt ohr shook in and then kunswmd.


Included page "kannabbinnoeedz" does not exist (create it now)

Kannabbinnoeedz

THC Vrsuhs CBD

Fruhm: CBD vs. THC: Medical benefits

CBD and THC have many of the same medical benefits. They can provide relief from several of the same conditions. However, CBD doesn’t cause the euphoric effects that occur with THC. Some people may prefer to use CBD because of the lack of this side effect.

In June 2018, the U.S. Food and Drug Administration approved Epidiolex, the first prescription medication to contain CBD. It’s used to treat rare, difficult-to-control forms of epilepsy.

CBD is used to help with other various conditions, such as:

seizures
inflammation
pain
psychosis or mental disorders
inflammatory bowel disease
nausea
migraines
depression
anxiety
THC is used to help with conditions such as:

pain
muscle spasticity
glaucoma
insomnia
low appetite
nausea
anxiety

include


Mehriwahnuh Nachropathik Eeuuss Kyndz

Table of Contents

Thuh NekST TekST Wuhz Fruhm:

Medical Cannabis and Naturopathy

By Qingping Zheng, M.Sc, ND, Clinic Supervisor & Research Faculty,

  • Canadian College of Naturopathic Medicine on October 16, 2018

The genus Cannabis, commonly known as marihuana or marijuana, refers to a flowering plant of which

there are 3 main species, Cannabis sativa, Cannabis indica and Cannabis ruderalis.

It has received a lot of public and media attention since the announcement of legalization for recreational use in Canada.

Medical cannabis refers to using cannabis or cannabinoids as a medical therapy to treat disease or alleviate symptoms.

In addition to requiring prescription and oversight from a healthcare provider with knowledge, skills, scope and competency, this may also differ from recreational use due to differences in product quality and consistituents.

Despite the fact that the

herb Cannabis has been used for more than 3,000 years for the treatment and management of pain, digestive issues and psychological disorders

  • by various cultures, many healthcare providers are somewhat familiar or experience discomfort with appropriate medicinal usage. A recent survey (1) of Canadian physicians revealed that dosing and the need for safe, effective treatment monitoring places were at the forefront of educational needs. This may be in part due to stigma, as well as significant changes in the volume and quality of both evidence and high quality products as well as the regulatory and legal policies surrounding its use (2). Although the list of conditions for approved medical use has been growing, the research to support many of these treatments is limited. To help further understand this plant, a brief review of the available evidence on its pharmacology and medical uses, along with the safety issue from the perspective of naturopathic medicine, is provided to help address gaps in knowledge or understanding.

Chemical Composition Uhv Hemp

Hemp grows throughout temperate and tropical climates but originated from central Asia or in the foothills of the Himalayas (3).

++The leaves and flowering tops of cannabis plants
+++contain at least 489 distinct compounds known as cannabinoids distributed among 18 different chemical classes,
+++and harbor more than 70 different phytocannabinoids (4).

Many of these compounds interact with our bodies via the endocannabinoid system (5),

where their actions are mainly

mediated by their interaction with two closely related receptors, CB1 and CB2,

  • first chemically identified in the 1940s (6,7). Potential for these receptor-mediated interactions are high, particularly throughout the central nervous system (CNS), with

CB1 receptor being expressed in neurons and

CB2 receptors being localized primarily on cells of the immune system.

Δ9-THC is by far the best studied phytocannabinoid, and is responsible for the psychoactive effects of cannabis through its actions at the CB1 receptor (8). It is the major psychoactive constituent and also has the largest association with tolerance and withdrawal effects. THC is regularly used to measure the herb’s potency. Typical concentrations of THC are less than 0.5% for inactive hemp, 2% to 3% for marijuana leaf, and up to 4-8% for higher-grade seedless, or sinsemilla buds. Higher concentrations can be found in extracts, tonics, and hashish (concentrated cannabisresin).

THC displays complex psychoactive effects, analgesic, cognitive, muscle relaxant, anti-inflammatory, appetite stimulant and antiemetic activity (9).

Cannabidiol (CBD) is the main non-psychoactive phytocannabinoid in the cannabis plant

  • that has drawn more attention in recent years. It does not have the intoxicating effects of THC, and
  • [ Cannabidiol (CBD) ] does not develop tolerance and withdrawal effects (10).

Despite its weak affinity for the CB1 and CB2 receptors, CBD seems to antagonize CB1/CB2 receptor agonists in CB1 and CB2 expressing cells and tissues (11).

Animal studies have demonstrated
[ Cannabidiol (CBD) ] has neuroprotective (12,13), anti-inflammatory, antioxidant properties (14), anticonvulsant, analgesic, anti-anxiety, antiemetic, immune-modulating and anti-tumorigenic properties.

Preliminary clinical trials suggest that

high-dose oral CBD (150–600 mg/d) may exert a therapeutic effect for social anxiety disorder, insomnia and epilepsy,

  • but it may also cause mental sedation (15).

There is considerable variation in the consistency of constituents amongst Cannabis plants and species. In general, cannabis products (recreational and medicinal) derived from

Cannabis sativa exhibit a higher CBD/THC ratio than products derived from Cannabis indica.

Administering different ratios of THC and CBD leads to diverse outcomes. Experimental studies indicate CBD attenuates effects of ∆9-THC requiring at least 8 : 1 (±11.1) ratio of CBD to THC; whereas CBD appears to potentiate some of the effects associated with THC when the CBD to THC ratio is around 2 : 1 (±1.4) (16).

** Use of Medical Cannabis:

Cannabis is a potent antiemetic with…Cancer chemotherapy:

Nausea and vomiting associated with cancer chemotherapy is one of the most familiar and well-established uses of cannabis in modern medicine. Cannabis is a potent antiemetic with therapeutic potential in cancer care(17). A systematic review and meta analysis of medicinal cannabis (18) found all studies suggested a greater benefit of cannabinoids compared to both active comparators and placebo, however no single study reached statistical significance. It is also important to note that paradoxically at excessive doses, Cannabis can precipitate cannabis hyperemesis syndrome (CHS) (19). This is relatively infrequent, but significant adverse reaction is characterized by severe nausea and vomiting followed by a period of deep sleep. For patients undergoing chemotherapy and radiation, THC is known to increase appetite, and subsequently weight, as an additional benefit.

effectiveness of cannabis in treating Chronic pain:

The systematic reviews on the efficacy and safety of cannabis-based medicine for chronic pain conditions have yielded diverse conclusions. A recent systematic review (20) supported the effectiveness of cannabis in treating chronic pain, primarily for neuropathic pain patients. However, Häuser W et al (21), didn’t come to a conclusion of the effectiveness of cannabis based on the quality of the clinical trial, most critical challenge being the small size and short term of research design. A 2014 statement issued by The Canadian Pain Society (22) recommended cannabis-based medicines as a potential third-line treatment for chronic neuropathic pain; while the Canadian Agency for Drugs and Technologies in Health (23) (2016) reviewed clinical safety and effectiveness of cannabinoid buccal spray for chronic non-cancer or neuropathic pain and suggested there was insufficient evidence to make well-founded conclusions about the clinical advantage and use of cannabis-based medicines for the management of cancer and non-cancer pain.

Cannabinoids typically lowers intraocular pressure (IOP) by up to 30% [ with ] Glaucoma:

Ocular (as well as systemic) administration of cannabinoids typically lowers intraocular pressure (IOP) by up to 30% although the mechanism is not well elucidated (24). A small but well-controlled pilot study of 6 patients with ocular hypertension or early primary open-angle glaucoma reported that two hours after sublingual administration of a single 5 mg Δ9-THC reduced the IOP significantly and was well tolerated by most patients. Sublingual 20 mg of CBD did not reduce IOP ( intraocular pressure ), while 40 mg of CBD increased IOP at four hours after administration (25).

clinical use of CBD for spasticity and pain in Multiple sclerosis:

The various needs and symptom profiles of patients with multiple sclerosis (MS) present with make it difficult to assess the observed and potential effectiveness of cannabis. Pharmaceutical CBD have been investigated for its effectiveness and safety in treating MS. A recent systematic review (26)supports the clinical use of CBD for spasticity and pain in multiple sclerosis, while it is not inconclusive on use to treat other common symptoms like bladder control, ataxia and tremor. Adverse effects including dizziness, dry mouth, euphoria, diarrhea, and difficulty concentrating were most frequently described as “mild” to “moderate”. Some researchers argued that a risk/benefit decision may be needed in the management of CBD used by MS patients. According to another study (27), the benefitsof CBD were generally observed within the first 4 weeks; thus a trial of 4-6 weeks is recommended to determined whether patients will receive clinical benefit.

CBD has been drawing more attention in treating most of Anxiety disorder:

Compared with THC, that has been found to induce anxiety in healthy subjects (28), CBD has been drawing more attention in treating most of anxiety due to its anxiolytic property (29) without impairing cognitive performance (30). Increasing doses of CBD leads to a linear reduction in anxiety, compared with the biphasic anxiolytic/anxiogenic effect of THC use (31). A double-blind randomized design study (32) on 24 patients with generalized social anxiety disorder (SAD) demonstrated that 600mg orally pretreatment with CBD significantly reduced anxiety, cognitive impairment and discomfort in their speech performance, compared with the placebo group. A fMRI study on fifteen healthy men found that oral administration of 600mg CBD and 10mg D-9-THC presented opposite neurophysiological effects when performing different cognitive task; while the following behavioral experiment on six healthy volunteers, after pretreatments of 5mg CBD intravenously (IV) followed by 1.25 mg IV D-9-THC prevented the acute induction of psychotic symptoms, thus might lessen the anxiogenic effects of THC (33).

CBD…shows a promising anticonvulsant profile [ for ] Epilepsy:

Cannabis preparations have reported to be beneficial in treatment of epilepsy and other seizure disorders, particularly drug refractory childhood epilepsies. Cannabis products with moderate to high THC content are generally unsuitable for this condition, considering the potential risk of seizure aggravation (34) and undesired side effects such as psychiatric disorders, addiction liability, cognitive and motor impairment in the childhood population. CBD, on the other hand, shows a promising anticonvulsant profile in the recent high quality RCT trials. The efficacy of CBD as add-on therapy for patients with Dravet syndrome (35) and drop seizure in patients with Lennox-Gastaut syndrome (36) were investigated. The results of these studies demonstrate that, at a dosage of 20 mg/kg/day, add-on CBD was efficacious in reducing the frequency of convulsive seizures. The CBD group was had higher adverse events such as diarrhoea, somnolence, pyrexia, decreased appetite, and vomiting, but generally well tolerant. As seen in other disorders, this case illustrates that the risk: benefit profile of cannabinoids needs to be weighed and discussed with patients prior to initiating therapy. Current best practices do not suggest CBD as stand-alone monotherapy in seizure disorders.
Sleep disorder:

According to the studies, different doses of THC yields mixed results.

A low dose of THC (less than 5 mg) seems to increase the quality of sleep

  • and reduce the frequency of nightmares (37) while administration of

larger dose [ of THC ] (15mg) decreased sleep latency on the following morning,

  • and disturbed both mood and memory on the next day. Novel studies investigating cannabinoids and obstructive sleep apnea suggest that synthetic cannabinoids such as nabilone and dronabinol may have short-term benefit for sleep apnea due to their modulatory effects on serotonin-mediated apneas. CBD may hold promise for REM sleep behavior disorder and excessive daytime sleepiness, while nabilone may reduce nightmares associated with Post-traumatic stress disorder (PTSD) and may improve sleep among patients with chronic pain.

Chronic cannabis use is associated with negative subjective effects on sleep that are manifested most prominently during withdrawal. Symptoms reported include sleep difficulties such as strange dreams, insomnia, and poor sleep quality.

These results are consistent with one interpretation that cannabis is typically not beneficial to sleep except among medicinal cannabis users who are identified by the presence of pre-existing sleep interrupting symptoms such as pain. As such, cannabis may be thought to improve sleep via the mediating improvement of these confounding symptoms.

Methods for using Cannabis:

Cannabis can typically be administered by inhalation, oral ingestion, and topical application.

Each delivery method has its advantages and disadvantages. The effects of cannabis are felt fastest when it is inhaled (i.e. liquid aerosol, nebulized or ‘smoked’). Inhalation is the most common way with the advantages of quick action, ease of monitoring the amount ingested, convenience, and short-term duration of effect. Side effects often include increasing risk of bronchitis and potential link to cancers of the respiratory tract, particularly when smoked.

Vaporizing (liquid aerosol) has been considered safer than smoking

  • because there are less by products since a lower temperature is used in the vaporizer and is thus a healthy alternative to smoking, however these statements deserve further investigation and evaluation.

Cannabis oils and tinctures are examples of concentrates of cannabis taken orally.

Compared to smoking, oral administration results in slower onset of action, lower blood levels of cannabinoids, and a longer duration of pharmacodynamic effects (38), though there is some indication that different oral forms (sublingual, food-product, ‘extended-release’) will have differing pharmacokinetic profiles.

Topicals are one of the lesser known forms of medicinal cannabison the market,

  • but they have significant potential to benefit people with inflammation and pain. The low THC content make them particularly attractive to consider for cannabis-naïve or cannabis-hesitant users. The other topical application is suppositories which can sometimes have some psychoactive effect depending on the product constituents.

Prescribed cannabis or cannabidiol approved by Health Canada

  • includes Nabilone (commercial name of Cesamet®) and Dronabinol (commercial name of Marinol®) which are the orally administered synthetic structural analogues of Δ9-THC. The latter was discontinued in the Canadian market in 2012. Cesamet® is sold as capsules (0.25, 0.5, 1 mg) and is indicated for the treatment of the nausea and vomiting associated with cancer chemotherapy (39). Nabiximols (commercial name of Sativex®) is from a whole-plant extract of two different, but standardized, strains of Cannabis sativa containing approximately equivalent amounts of Δ9-THC (27 mg/mL) and CBD (25 mg/mL), and other cannabinoids. It is marketed as an adjunctive treatment for the symptomatic relief of spasticity and neuropathic pain in adults with multiple sclerosis and as an adjunctive analgesic in adult patients with advanced cancer who experience moderate to severe pain (40).

[ Cannabis ] Safety

1: [ Cannabis ] Toxicity:

* To date there has been no documented fatal overdose from isolated Cannabis use.**

These statistics are impressive if compared with other commonly used recreational drugs. Globally, alcohol was linked to over 3 million deaths per year in 2012, and tobacco is reportedly linked to the deaths of more than 6 million people each year (41). Although several toxicology studies (42,43) with THC in animals suggested that THC was considered a safe drug both in acute and long-term exposure, toxicity of the commercial synthetic cannabinoids was found to be increased compared with Cannabis itself (44).

[ Cannabis use ] side effects typically include:

dizziness/light-headedness, sedation, confusion, ataxia, a feeling of intoxication, euphoria (“high”), xerostomia, dysgeusia, and hunger (20).

2: [ Cannabis ] Tolerance:

Ina residential laboratory study (45,46) on twelve daily marijuana smokers, the development of tolerance was evaluated after four-day period administration in two different groups including the oral THC pills group and the smoked marijuana group. Each pills contained 30 mg of THC and smoked marijuana dose consisted of 3.1% THC, and they were administrated four times a day in each group. Both groups became tolerant to subjective effects of THC such as feeling “high” and “good drug effect” but not to its effects on food intake or social behavior. The tolerance was disappears rapidly following cessation of administration (47). In addition, the dynamics of tolerance vary with respect to the different constituents and effects (48). However, some long-term studies reported the absence of pharmacological tolerance (49, 50)– this suggests that dosing straetgies may help alleviate or prevent issues of tolerance.

3: [ Cannabis ] Addiction: Cannabis is considered to be also far less addictive

There is evidence that cannabis dependence (physical and psychological) occurs especially with chronic, heavy use (51). However, Cannabis is considered to be also far less addictive than alcohol, nicotine, cocaine, opiates and other psychoactive drugs. In the 1970’s, recreational cannabis became known as “the gateway drug,” but facts do not support this statement. In fact, studies suggest medical cannabis is a safer alternative rather than prescriptions of some pharmaceuticals with well-known potential for addiction (52).

4: [ Cannabis ] Exacerbations: smoked Cannabis is not recommended in patients with respiratory insufficiency

Cannabis does have the potential to exacerbate symptoms of underlying conditions, such as severe cardiopulmonary disease because of occasional hypotension, possible hypertension, syncope, or tachycardia (53); Studies showed that although Cannabis smokers have minimal changes in pulmonary function studies as compared to tobacco smokers, they may develop bullous disease and spontaneous pneumothorax. The relationship between Cannabis smoking and lung cancer remains unclear due to design limitations of the studies published so far. Therefore, Health Canada stated in 2013, “smoked Cannabis is not recommended in patients with respiratory insufficiency__ such as asthma or chronic obstructive pulmonary disease (COPD)__” (54).

5: [ THC impairs Tho CBD Improves ] Cognitive function:

Evidence has demonstrated that high THC/low CBD Cannabis (55) lead to greater cognitive impairments, in particular memory function, attention and emotional processing in individuals. On the other hand, research showed CBD seems to antagonize THC-induced impairments and improve cognition in multiple preclinical models of cognitive impairment, including models of neuropsychiatric (schizophrenia), neurodegenerative (Alzheimer’s disease), neuro-inflammatory (meningitis, sepsis and cerebral malaria) and neurological disorders (hepatic encephalopathy and brain ischemia) (56). However it is unclear whether at specific concentrations CBD might outweigh any harmful effects of THC on cognition.

6: Uncertainty of risks [in] mental health…during…Brain development:

The regular (mis)use of cannabis during developing childhood and adolescence is of particular concern and the question of whether Cannabis is harmful remains the subject of heated debate. Although multiple studies have reported the adverse effects of Cannabis use on mental health are greater during development, particularly during adolescence, than in adulthood (57), others studies (58) have not made definite conclusions as to whether cannabis use alone has a negative impact on the human adolescent brain (59). Given the uncertainty of potentially risks, “Cannabis should not be used in any person under the age of 18, and physicians in Ontario “are not allowed to prescribe Cannabis to patients under the age of 25 unless all other conventional therapeutic options have been attempted and have failed to alleviate the patient’s symptoms” (60).

7: Mental health: cannabis should not be used in patients with schizophrenia

Whether the use of Cannabis might precipitate mental illness in some patients is a long standing concern. Cannabis has been linked to episodes of acute psychosis (61) and can exacerbate the symptoms of existing psychotic illness like schizophrenia (62, 63). However, some studies report the opposite results—CBD seems to represent a mechanistically different and less side-effect prone antipsychotic compound for the treatment of schizophrenia, even though the underlying pharmacological mechanisms are still debated (64). Given the uncertainty of results, Health Canada suggests “medicinal cannabis should not be used in patients with a personal history of psychiatric disorders (especially schizophrenia)” (65). In other conditions like anxiety disorders, the anxiolytic effects of Cannabis in clinical populations are inconsistent (65).


Thuh NekST TekST Wuhz Fruhm:

By Christopher G. Fichtner, MD, And Howard B. Moss, MD

Perceived benefits of medical cannabis

Regardless of the legal status of cannabis, many patients with psychiatric disorders use cannabis and report improvement in their symptoms. Patients use cannabis for symptoms of PTSD, anxiety disorders, depression, ADHD, bipolar disorder, chronic pain, insomnia, opiate dependence, and even schizophrenia. In addition, patients use cannabis for neurological conditions such as the spasticity of multiple sclerosis, agitation in dementia, and specific seizure disorders that are unresponsive to standard therapies. Patients also use cannabis to reduce the nausea and anorexia of cancer chemotherapies and to improve their mood and outlook—frequently with their oncologist’s approval…


Thuh NekST TekST Wuhz Fruhm:

By Christopher G. Fichtner, MD, And Howard B. Moss, MD

Schizophrenia, CBD, and THC

Molecular CBD has been shown to treat symptoms of schizophrenia

  • under controlled clinical trial conditions, with results comparable to those of treatment with an approved antipsychotic medication, and with a favorable adverse-effect profile.4 Other studies support the view that

CBD may have therapeutic potential as an antipsychotic

  • and may counter or offset psychotomimetic effects of THC. Differences between THC and CBD notwithstanding, in a small case series, 6 patients with schizophrenia and a history of symptom relief with cannabis use were treated with the addition of low-dose prescription THC to regimens that included clozapine in some cases or multiple antipsychotics in 1 patient.5 Four of the 6 patients showed improvement with the addition of THC to their regimen, and in 3 of the 4 patients a specific antipsychotic effect was evident. As with the anxiogenic potential of THC, dosage may be important in the relationship between THC and psychosis.

Cannabis and cognition

The National Academy report also acknowledged that there is moderate evidence of a statistical association between cannabis use and better cognitive performance among individuals with psychotic disorders and a history of cannabis use. It has been speculated that this could represent a less cognitively vulnerable subgroup of patients who would not have developed psychosis in the absence of exposure to cannabis, but this is not known. More generally, there is moderate evidence of a statistical association between acute cannabis use and impairment in the cognitive domains of learning, memory, and attention. However, results have been mixed on the question of longer-term and residual cognitive impairment. A recent report indicates neuropsychological decline in persistent long-term users with cannabis use disorders, although an earlier meta-analysis found no residual impairment.6,7 Evidence of impaired academic achievement and educational outcomes was judged to be limited according to the National Academy report. Again, with cognitive functioning as with the risk of psychosis, dosage may be an important factor, since the findings of impairment relate primarily to heavy long-term use and even more specifically to those patients with cannabis use disorders.


Thuh NekST TekST Wuhz Fruhm:

By Christopher G. Fichtner, MD, And Howard B. Moss, MD

Cannabis and PTSD

Evidence that cannabis or cannabinoids are effective for improving symptoms of PTSD

  • is considered limited by the National Academy report, but clinical reports and case series excluded under its research quality criteria are more positive for the benefits of cannabis for PTSD symptoms.

A growing number of states have included PTSD as one of the acceptable indications for recommending or approving medicinal use of cannabis.

Clinicians who have written large numbers of medical cannabis recommendations have documented that a sizeable minority have been for psychiatric indications, with PTSD being perhaps the most common.10

Greer and colleagues11 reported on 80 patients with PTSD who were approved for medicinal use of cannabis through the New Mexico Medical Cannabis program. As a retrospective assessment, the study’s methodology limits the scientific conclusions that can be drawn. However, the authors reported decreases of 75% overall and separately in each of the 3 respective (DSM-IV) symptom clusters: re-experiencing, hyperarousal, and avoidance, as measured by current versus retrospective baseline Clinician Administered PTSD Scale (CAPS) scores, with and without cannabis use, respectively. The study was not included in the National Academy report, but it was reviewed by Walsh and colleagues,1 who noted that most studies on the therapeutic use of cannabis by persons with mental health conditions are not of methodologically high quality.

The beneficial effects of cannabinoid medicines for PTSD are consistent with what is known about the psychobiology of PTSD and the emerging research on the endocannabinoid system.12 Components of the endocannabinoid system include cannabinoid (CB1 and CB2) receptors; endogenous ligands anandamide, 2-arachidonoylglycerol (2-AG), and others; and enzymes that regulate endocannabinoid ligand production. Endocannabinoid signaling occurs in retrograde fashion, with postsynaptic release of ligands that bind to presynaptic cannabinoid receptors and inhibit presynaptic neurotransmitter release. This contrasts with the classic monoaminergic neurotransmitter systems that have shaped much of our thinking in psychopharmacology, and represents a potential alternative strategy for psychopharmacologic intervention (Figure).

CB1 receptors are widespread throughout the brain. Based on animal and human studies, the endocannabinoid system appears to be involved in the extinction of aversive memories, and both THC and CBD have been shown individually in separate studies to facilitate extinction of the conditioned fear response.13,14 Recent neuroimaging studies have found increased CB1 receptor availability in multiple brain regions in PTSD, including the amygdala-hippocampal-cortico-striatal circuit implicated in its pathophysiology.15

The National Academy report also found limited evidence of an association between cannabis use and increased severity of symptoms among individuals with PTSD, but the cause-and-effect relationships are unclear. Individuals with more severely symptomatic PTSD may be more likely to self-medicate with cannabis. The possibility of symptom exacerbation with cannabis use must be weighed against reported therapeutic benefit in individual cases. Other psychiatric diagnoses for which the National Academy report found limited evidence for effectiveness include Tourette syndrome and social anxiety disorders.

Thuh NekST TekST Wuhz Fruhm:

MORE ABOUT Christopher G. Fichtner, MD

Dr. Fichtner is a Clinical Professor of Psychiatry at the University of California, Riverside School of Medicine, and a staff psychiatrist with the Riverside University Health System—Behavioral Health. He received his medical degree from The University of Chicago Pritzker School of Medicine (1987). Dr. Fichtner is a diplomate of the American Board of Psychiatry and Neurology and a Fellow of the American Psychiatric Association, with specialty certification in administrative psychiatry. In addition, he is a Fellow of the American Association for Physician Leadership and a past President of the American Association of Psychiatric Administrators…

Dr. Fichtner and Dr. Moss are Clinical Professors of Psychiatry at the University of California, Riverside School of Medicine.


Thiss Iz Thuh Last Lyn Uhv Tekst Uhv Thuh Paeej Naeemd Mehriwahnuh Nachropathik Eeuuss Kyndz.



See Also: Marijuana And The Bible

RecreaTional Drug Owners ConsTiTuTional RighTs Uhv Legalize All Drugs And End the drug war

BaeesT On: EarTh CiTizen RighTs Uhv Thuh Earth ConsTiTuTion

Eech ( NaTional And Municipal And Local ) Law Code Should GeT { ChekT And If Nehsehsehree FixT } So ThaT In Ehvree Jrisdikshuhn Uhv Thuh RTh Thuh Law Code Ther { ReespekTs Eech Uhv Thuh Following ConsTiTTpooshuhnul RyTs Uhv Eech Recreational Drug Ownr } And { Maeeks It Illegal For Kops Tu AkT AgainsT Ehnee RecreaTional Drug Ownr Tu Koz ThaT Prsuhn Tu BeKum A VicTim Uhv Ehnee Uhv Thuh Following ViolaTion Krymz } }.

1: Eech Recreational Drug Ownr Haz Thuh ConsTiTuTional RyT Tu "Prohibition against physical or psychological duress or torture during any period of investigation, arrest, detention or imprisonment, and against cruel or unusual punishment."

2: Kuz Uhv ThaT, Eech Cop ShouLd Nevr KuhmiT a ( physical durress ohr cruel ) assulT krym violation againsT Ehnee RecreaTional Drug ( Ownr And|Ohr Eewzr ).

3: Recreational Drug Ownrz Hav Thuh ConsTiTuTional RyT Tu "Safety of person from arbitrary or unreasonable arrest, detention, exile, search or seizure; requirement of warrants for searches and arrests."

4: Kuz Uhv ThaT, Eech Cop ShouLd Nevr KuhmiT ThefT Violation UhgensT Ehnee RecreaTional Drug Ownr Without A WarrrenT Uhledjeeng That Thuh RecreaTional Drug Ownr Had { { STole ( Sum Ohr AhL ) Uhv Thuh RecreaTional Drug(z) They Hav } And|Ohr { Endaeendjrd Ohr Violated Anyone's Bod WiTh Their RecreaTional Drug Property } }.

5: AhLsoh Kuz Uhv 3, If Ther'z No WarrenT Legalizing Thuh arresT Then ThaT Iz A ConsTiTuTionally ( rong and illegal ) arresT that MyT Also ProbbabLee InkLood unNehsehsehree And ConsTiTuTionally ( rong and illegal ) { imprisonment uhv wrists in handcuffs Then Cop Car imprisonment And jail Imprisonment } violations AgainsT Thuh RyTs Uhv A RecreaTional Drug Ownr ( InnuhsenT = NoT gilTee ) Uhv Ehnee Uhv THuh Following Real True violation krymz.

6: If Ehnee RecreaTional Drug Ownr Iz InnuhsenT Uhv ( ( Thuh Real True violation krym Uhv UhsuLT ) And ( Real True ProprTee violation krym, Fohr EgzampuL ( ThefT Ohr ( Vandalism Such Az UnauThorized Damaging Uhv A Dif Prsuhn'z ProprTee ) ), Then Tu arresT ThaT Prsuhn WouLd Bee TrooLee ReaLLee ( rong and unJusT ). Thuh rongful arresT MyT Hav Ben Dun Kuz Uhv At LeesT Wun ( Rong And unJusT ) Law ThaT ShouLd MohsT LykLee GeT Chaeendjd Ohr { Reemoovd Fruhm Thuh Lahz Uhv At LeesT ThaT Jrisdikshuhn And Hohpfully Ehnee UhThr Jrisdikshuhn ThaT Haz ( ThaT Ohr A SimmiLr ) ProbbabLee ( Rong And unJusT ) Law }.

Legalize All Drugs And End the drug war