Oh, the Irony! Of course, in the naturally occurring and naturally growing, non-engineered cannabis plant (which no longer exists on the planet - other than perhaps in regions not yet traversed by humans) Cannabidiol (CBD) is the naturally occurring agonist to the psychosis inducing THC compound in cannabis. Naturally growing cannabis historically had around 2% THC, with naturally occurring CBD ‘tempering’ the psychoactive properties of THC.
This investigation into this particular therapeutic potential, is just that, only a potential. However, with the growing research on the negatives of CBD, this may also prove ‘one step forward and two back?’
Great business model! Especially for the addition for profit industry that is.
What action negates this entire mess? Not using in the first place! But apparently that is not an option in our public and mental health ‘advancing’, yet drug permitting culture?
…. of the same health concerns raised decades ago about using marijuana therapeutically are still unresolved, even as the potency of the plant’s intoxicating ingredient, tetrahydrocannabinol, best known as THC, has increased fivefold. Furthermore, exclusive medical use is uncommon; in a Canadian study of 709 medical users, 80.6 percent also reported using marijuana recreationally.
“People are using a medical excuse for their recreational marijuana habit,” said Dr. Kenneth Finn, a pain management specialist in Colorado Springs and editor of a new, 554-page professional book on the subject, “Cannabis in Medicine: An Evidence-Based Approach.”
The evidence — or lack thereof — of health benefits that can be reliably attributed to smoking, vaping or ingesting marijuana, even in its purest form, is described in great detail in Dr. Finn’s book. “Components of the cannabis plant can help in various conditions, but that’s not what people are buying in stores,” he said in an interview. “Let’s do the research on purified, natural, noncontaminated cannabinoids,” as the various potentially therapeutic chemicals in marijuana are called.
Three such substances have been approved by the Food and Drug Administration. One, Epidiolex, a cannabidiol-based liquid medication, is approved to treat two forms of severe childhood epilepsy. The others, dronabinol (Marinol, Syndros) and nabilone (Cesamet), are pills used to curb nausea in cancer patients undergoing chemotherapy and to stimulate appetite in AIDS patients with wasting syndrome.
Another marijuana-based drug, nabiximols (Sativex), is available in Canada and several European countries to treat spasticity and nerve pain in patients with multiple sclerosis.
Medicinal cannabis is hardly a new therapeutic agent. It was widely used as a patent medicine in the United States during the 19th and early 20th centuries and was listed in the United States Pharmacopoeia until passage of the Marijuana Tax Act in 1937 rendered it illegal.
Then a federal law in 1970 made it a Schedule 1 controlled substance, which greatly restricted access to marijuana for legitimate research. Also complicating attempts to establish medical usefulness is that plants like marijuana contain hundreds of active chemicals, the amounts of which can vary greatly from batch to batch. Unless researchers can study purified substances in known quantities, conclusions about benefits and risks are highly unreliable.
That said, as recounted in Dr. Finn’s book, here are some conclusions reached by experts about the role of medical marijuana in their respective fields:
Pain Management: People using marijuana for pain relief do not reduce their dependence on opioids. In fact, Dr. Finn said, “patients on narcotics who also use marijuana for pain still report their pain level to be 10 on a scale of 1 to 10.” Authors of the chapter on pain, Dr. Peter R. Wilson, pain specialist at the Mayo Clinic in Rochester, Minn., and Dr. Sanjog Pangarkar of the Greater Los Angeles V.A. Healthcare Service, concluded, “Cannabis itself does not produce analgesia and paradoxically might interfere with opioid analgesia.” A 2019 study of 450 adults in the Journal of Addiction Medicine found that medical marijuana not only failed to relieve patients’ pain, it increased their risk of anxiety, depression and substance abuse.
Multiple Sclerosis: Dr. Allen C. Bowling, neurologist at the NeuroHealth Institute in Englewood, Colo., noted that while marijuana has been extensively studied as a treatment for multiple sclerosis, the results of randomized clinical trials have been inconsistent. The trials overall showed some but limited effectiveness, and in one of the largest and longest trials, the placebo performed better in treating spasticity, pain and bladder dysfunction, Dr. Bowling wrote. Most trials used pharmaceutical-grade cannabis that is not available in dispensaries.
Glaucoma: The study suggesting marijuana could reduce the risk of glaucoma dates back to 1970. Indeed, THC does lower damaging pressure inside the eye, but as Drs. Finny T. John and Jean R. Hausheer, ophthalmologists at the University of Oklahoma Health Sciences Center, wrote, “to achieve therapeutic levels of marijuana in the bloodstream to treat glaucoma, an individual would need to smoke approximately six to eight times a day,” at which point the person “would likely be physically and mentally unable to perform tasks requiring attention and focus,” like working and driving. The major eye care medical societies have put thumbs down on marijuana to treat glaucoma.
Mental Health: Allison Karst, a psychiatric pharmacy specialist at the V.A. Tennessee Valley Healthcare System, who reviewed the benefits and risks of medical marijuana, concluded that marijuana can have “a negative effect on mental health and neurological function,” including worsening symptoms of PTSD and bipolar disorder.
Dr. Karst also cited one study showing that only 17 percent of edible cannabis products were accurately labeled. In an email she wrote that the lack of regulation “leads to difficulty extrapolating available evidence to various products on the consumer market given the differences in chemical composition and purity.” She cautioned the public to weigh “both potential benefits and risks,” to which I would add caveat emptor — buyer beware.
A Review of Cases of Marijuana and Violence - Research (March 2020)
Abstract: Marijuana is the most consumed illicit drug in the world, with over 192 million users. Due to the current legalization push of marijuana in the United States, there has been a lack of oversight regarding its public health policies, as marijuana advocates downplay the drug’s negative effects. This paper’s approach is from a public health perspective, focusing specifically on the cases of violence amongst some marijuana users.
Here, we present 14 cases of violence with chronic marijuana users that highlight reoccurring consequences of: marijuana induced paranoia (exaggerated, unfounded distrust) and marijuana induced psychosis (radical personality change, loss of contact with reality). When individuals suffering from pre-existing medical conditions use marijuana in an attempt to alleviate their symptoms, ultimately this worsens their conditions over time. Although marijuana effects depend on the individual’s endocannabinoid receptors (which control behavioral functions, like aggression) and the potency level of tetrahydrocannabinol (THC) in the drug, scientifically documented links between certain marijuana users and violence do exist. Wider public awareness of the risks and side effects of marijuana, as well as a more prudent health policy, and government agency monitoring of the drug’s composition, creation, and distribution, are needed and recommended.
Introduction: In the United States, ten states have legalized the recreational use of marijuana and over 20 states have decriminalized the recreational use of it. Recent reports suggest, however, that the increase of the recreational use of marijuana is causing detrimental effects to individuals, as well as the society as a whole [1,2,3].
These effects include, but are not limited to, the increase of violence, the increase of thriving underground marijuana markets, and increase in car accident claims after the legalization of marijuana where the recreational use of marijuana was legalized [1,2,3]. This is caused by lack of oversight. Marijuana is being legally sold with high THC concentration levels without taking into account its addictive qualities and adverse effects. On the other hand, and contrary to popular belief, marijuana is still illegal in the Netherlands and it is decriminalized. However, the consumption and storage of marijuana are limited by law and the approach taken by the Netherlands is to decriminalize the drug in order to be able to help individuals struggling with marijuana use. This prudent oversight has resulted in a decreased in violence and people are able to get the care they need to deal with addiction and become less prone to violence [1,2,3].
Furthermore, the consumption of marijuana is associated with an increase in violent behavior over the course of an individual’s lifespan, a high risk of psychosis for frequent users, an increase of cardiovascular diseases, and deterioration in health for individuals who have pre-existing mental health issues such as Post Traumatic Stress Disorder, social anxiety, and depression [4,5,6].
According to research studies, marijuana use causes aggressive behavior, causes or exacerbates psychosis, and produces paranoia. These effects have been illustrated through case studies of highly publicized incidents and heightened political profiles.
These cases contain examples of repeated illustrations of aggression, psychosis and paranoia by marijuana users and intoxication. Ultimately, without the use and intoxication of marijuana, the poor judgment and misperceptions displayed by these individuals would not have been present, reducing the risk for actions that result in senseless deaths.
EU drug agency flags CBD market issues in report on low-THC cannabis products
The European Union’s drug agency has signaled that it is mulling the legal and commercial status of CBD and cannabis-based products in Europe in a new report.
The Lisbon-based European Monitoring Centre for Drugs and Drug Addiction published the report on Monday, detailing the results of a study that kicked off in 2018 and aimed to provide insight into the open sale of low-THC products in Europe.
“The specific objectives were to identify and further explore the types of product available and the range of sales outlets, user profiles, associated harms and responses taken in different EU countries,” the authors wrote.
The Centre took note of several glaring issues with the marketing and promotion of some CBD products across Europe, including:
As of February, 1st this year “low-dose cannabidiol (CBD)” has been available in the now lesser regulated ‘OTC’ (over the counter) space.
The TGA had been ‘dancing’ with the ‘vote for medicine’ campaign, and whilst not fully endorsing it, has ushered in a sub-set of classification and rescheduled this particular cannabinoid. Now, this new line certainly opens the door to significantly greater promotion and use of a substance still not fully understood – and a product certainly with clouds over both efficacy and safety – regardless of ‘anecdotal testimony’
Australia’s Therapeutic Goods Administration (TGA) announced their down-scheduling of “low-dose cannabidiol (CBD)” from a Schedule 4 substance to a Schedule 3 substance in mid-December of last year, a decision that just went into effect this Monday, February 1.
This particular jump is a monumental one for Australian CBD producers and customers alike, since it marks the divide between prescription-only (Schedule 4) and over-the-counter (Schedule 3) status.
In order to qualify for this down-scheduling, CBD products have to meet Schedule 3 criteria, chief among which is the requirement on pharmacists to adhere to the newly increased 150mg/day maximum daily dose.
Once a product is approved by the TGA, it is placed in the Australian Register of Therapeutic Goods (ARTG), and can thereafter be sold over the counter.
Of course, cannabis derived formulations have no curative properties of any kind, and formulations for useful ‘medical application’ are very sparce despite, the now decade long thorough investigation, and at very best current preparations may only alleviate some conditions, but not without potential harmful and/or long-term side-effects. The placebo effect of cannabis-based therapeutics is widely known, and whilst a placebo that does no other harms, can be very beneficial on a subjective level, ones that do have detrimental potential are only emerging, and the trade off of one alleviated symptom for another is not good medicine – particularly when net health outcome may be worse.
Whilst we are all excited about, and look forward to, advances in science and medicine that truly benefit our health, not just alleviate a symptom (or worse simply a ‘felt need’) we want to ensure that best-practice science, not market-driven greed and hype (historically a source of many pharmaceutical catastrophe’s) are what drive health-care compassion.
It’s important all consumers keep across all the research – the good, bad and ugly, and make wise beneficial decisions for both short and long-term.
