Cannabidiol, or CBD, is now available in the UK in everything from skin creams to beers. Meanwhile a new generation of cannabis medicines has shown great and uses THC and CBD to treat spasticity in multiple sclerosis. are: a sense of calm and focus; relief from everyday stresses; help in. Marijuana (cannabis) remains a controversial drug in the twenty-first century. . The cannabinoids of the C. sativa plant include cannabidiol (CBD), . in adults with multiple sclerosis as well as relieve nausea, and emesis in HIV or Fattore L, Fratta W. Beyond THC: the new generation of cannabinoid designer drugs. Heart Failure · High Cholesterol · Multiple Sclerosis · Psoriasis · Psoriatic Arthritis Phillip Sutton (left) uses THC cream for his osteoarthritis pain. A June study review in the Journal of the American Medical Other diets that may help with arthritis symptoms include vegan or gluten-free plans.
Incorporate Cannabis Everyday into A Health Medicine: Multi-generational How to Your
If you are suffering under the weight of a mental health problem and marijuana addiction, you need comprehensive treatment. These combined factors can create chronic and problematic situations due to persistent symptoms, such as:. These symptoms significantly contribute to poor life outcomes and poor life satisfaction. Poor educational achievement --teen marijuana use is associated with lower grades and test scores, less likelihood of attending college and higher high school dropout.
Cognitive impairments --a decline in IQ has been found in chronic users who began use in their teens and continued into adulthood. An average loss of eight IQ points from childhood to midlife has been reported. Addiction --onset of marijuana use in the teens has been linked to later addiction to marijuana and other substances.
Psychiatric problems -- teen use of marijuana is associated with higher rates of psychosis in adult life. For those seeking addiction treatment for themselves or a loved one, the MentalHelp. Our helpline is offered at no cost to you and with no obligation to enter into treatment.
With that in mind, would you like to learn about some of the best options for treatment in the country? Marie Monroe Doutaz, M. Marijuana use is prevalent and has the potential for causing both physical and psychological dependence.
In , approximately 20 million people over the age of 12 used marijuana in the U. We naturally produce substances that bind to these receptors , called endocannabinoids. Marijuana contains a chemical called tetrahydrocannabinol THC which exogenously i. This leads to the psychological experience of being "high," along with the drug's action on other mood-regulating neurotransmitters, like dopamine. Those who are sensitive to higher levels of the neurotransmitter dopamine, or already have higher levels, can experience: Negative life outcomes associated with l ow educational achievement, unemployment, and low incomes have been associated with the chronic use of marijuana.
Chronic social problems can be caused by both marijuana use and chronic mental health symptoms. Sex-dependent differences have also been noted with respect to cannabinoid metabolism. Pre-clinical studies in females report increased metabolism of THC to hydroxy-THC compared to males where THC was also biotransformed to at least three different, less active metabolites Reference There is also evidence to suggest that effects of cannabinoids vary as a function of fluctuations in reproductive hormones Reference Reference Together, these findings suggest that the neurobiological mechanism underlying the sex-dependent effects of cannabinoids may arise from sexual dimorphism in the ECS and THC metabolism, but also from the effects of fluctuations in hormone levels on the ECS Reference Reference There is also evidence to suggest sex-dependent differences in subjective effects and development of dependence, withdrawal symptoms, relapse and incidence of mood disorders.
Data combined from four double-blind, within-subject studies measuring the effects of smoked "active" cannabis 3. These findings suggest that, at least among near-daily cannabis users, women may be more sensitive to the subjective effects of cannabis, especially effects related to cannabis abuse liability compared to men.
Another study demonstrated dose-dependent sex differences in subjective responses to orally administered THC Reference In this study, women showed greater subjective effects at the lowest dose 5 mg , whereas men showed greater subjective responses at the highest 15 mg dose. Together, these studies suggest that while women may be more sensitive to the subjective effects of THC at lower doses, they may develop tolerance to these effects at higher doses, which could, for example, have implications for the development of dependence.
For example, while cannabis use among men is more prevalent and men appear to be more likely than women to become dependent on cannabis, women tend to have shorter intervals between the onset of use and regular use or development of dependence commonly referred to as the "telescoping effect" Reference In addition, women abstaining from cannabis use reported more withdrawal symptoms, with some being more severe, than those seen in men and which have been linked to relapse Reference Reference Women with CUD also present with higher rates of certain comorbid health problems such as mood and anxiety disorders Reference Reference Reference The College of Family Physicians of Canada, along with other provincial medical regulatory colleges, has issued a guidance document in for authorizing the use of cannabis for medical purposes.
Please consult these and any other official guidance documents, as applicable, for additional information regarding dosing and other matters associated with authorizing cannabis for medical purposes.
Cannabis has many variables that do not fit well with the typical medical model for drug prescribing Reference While precise dosages have not been established, some "rough" dosing guidelines for smoked or vapourized cannabis have been published see below. Besides smoking and vapourization, cannabis is known to be consumed in baked goods such as cookies or brownies, or drunk as teas or infusions.
However, absorption of these products by the oral route is slow and erratic, varies with the ingested matrix e. Other forms of preparation reported in the lay literature include cannabis-based butters, candies, edibles, oils, compresses, creams, ointments, and tinctures Reference 80 Reference - Reference but again, limited dosing information exists here with much of the information being anecdotal in nature.
Dosing remains highly individualized and relies largely on titration Reference Patients with no prior experience with cannabis and initiating cannabis therapy for the first time are cautioned to begin at the very lowest dose and to stop therapy if unacceptable or undesirable side effects occur. Subsequent dose escalation should be done slowly, once experience with the subjective effects is fully appreciated, to effect or tolerability. If intolerable adverse effects appear without significant benefit, dosing should be tapered and stopped.
Tapering guidelines have not been published, but the existence of a withdrawal syndrome see Section 2. Clinical studies of cannabis and cannabis-based products for therapeutic purposes are limited to studies carried out with dried cannabis that was smoked or vapourized and with synthetic or natural cannabis-based products that have received market authorization i. As such, providing precise dosing guidelines for such products is not possible although existing sources of information can be used as a reference point see below.
Naturally, dosing will vary according to the underlying disorder and the many other variables mentioned above. Average daily dose of dronabinol is 20 mg and maximal recommended daily dose is 40 mg Reference Doses less than 1 mg of THC per dosing session may further avoid incidence and risks of adverse effects. Various surveys published in the peer-reviewed literature have suggested that the majority of people using smoked or orally ingested cannabis for medical purposes reported using between 10 and 20 g of cannabis per week or approximately 1 to 3 g of cannabis per day Reference Reference Reference An international, web-based, cross-sectional survey examining patients' experiences with different methods of cannabis intake reported that from among a group of self-selected participants, from 31 countries, the vast majority preferred inhalation over other means of administration e.
Mean daily doses with smoked or vapourized cannabis were 3. Information regarding cannabinoid potencies of cannabis products i. Daily frequency of use for smoking was six times per day, whereas with vapourizing it was five times per day. First onset of effects for smoking were noted on average around 7 min after start of smoking, 6.
Other data suggests that those patients who use cannabis for medical purposes use up to one gram or less per day. For example, data from the Netherlands suggests the average daily dose of dried cannabis for medical purposes stood at 0. Canadian market data collected from licensed producers under the Access to Cannabis for Medical Purposes Regulations ACMPRs showed that, from April to March , clients had been authorized by their healthcare practitioners to use, monthly, an average of 2.
However, since this data is collected per licensed producer, it does not include cases where clients split their authorization into two or more authorizations in order to register with more than one licensed producer at a time or personal production registrations with Health Canada Reference To fulfill orders for oils, licensed producers equate oil to dried cannabis based on the formulation of their oil products.
On average, licensed producers equate 1 g of dried cannabis to 6. Using this average conversion factor, healthcare practitioners have authorized an equivalent average of Satisfaction ratings for criteria such as onset of effects and ease of dose finding were reported to be higher for smoking and vapourizing i.
However, prescription cannabinoid medications e. Satisfaction ratings in terms of side-effects were higher for non-prescription unregulated cannabis products, with the inhaled route rated best, although the survey did not ask specific questions about the types of side effects.
Satisfaction ratings were only slightly higher for orally ingested cannabis products for criteria such as duration of effects. The majority of survey participants had indicated having used cannabis products prior to onset of their medical condition. A prospective, open-label, longitudinal study of patients with treatment resistant chronic pain reported that patients titrate their cannabis dose starting with one puff or one drop of cannabis oil per day, increasing in increments of one puff or one drop of oil per dose, three times per day until satisfactory pain relief was achieved or side effects appeared Reference Mean monthly prescribed amount of cannabis was 43 g or 1.
Data from randomized, double-blind, placebo-controlled clinical studies of smoked or vapourized cannabis used a daily dose of up to 3.
In contrast to the gram amounts of cannabis used with smoked, vapourized, and oral routes of administration, the mean daily amounts for prescription cannabinoids such as dronabinol were 30 mg, for nabilone 4.
With respect to the relationship between dosing and psychotropic effects , it has been estimated that an inhaled dose of 0. Furthermore, it has been estimated that between one and three puffs of higher potency cannabis would be sufficient to produce significant psychoactive effects Reference One study has shown that while cannabis smokers titrate their dose of THC by inhaling lower volumes of smoke when smoking "strong" joints i.
For oral administration, a dose of 0. Other provincial bodies may also provide guidelines on monitoring Reference The College of Family Physicians of Canada has recently published a simplified guideline for prescribing medical cannabinoids in primary care Reference The recommendations are as follows:.
The majority of clinical trials with smoked cannabis for medical purposes have used joints of dried cannabis weighing between and mg. Estimates that are more recent suggest the mean weight of cannabis in a joint is mg Reference In addition, expectation of drug reward can also influence smoking dynamics Reference Little reliable information exists regarding conversion of a "smoked dose" of THC to an equivalent oral dose.
It is also important to emphasize that this "conversion factor" appears to relate mostly to psychoactive effects e. Further rigorous comparative pharmacology studies are required. In addition, no comparative studies have been done with vaping. In addition, this theoretical conversion factor may or may not apply for therapeutic effects.
Indeed, it is important to highlight that two studies reported that individuals using cannabis for therapeutic purposes indicated they used approximately similar gram amounts of cannabis regardless of route of administration Reference Reference A single-dose, open-label, clinical trial of patients with neuropathic pain and using very low doses of inhaled THC reported a statistically significant improvement in neuropathic pain with minimal adverse effects Reference THC administration was associated with a statistically significant reduction in baseline VAS for pain intensity of 3.
These above-mentioned studies suggest that, at least in the case of chronic neuropathic pain, psychoactive effects can be separated from therapeutic effects and that very low doses of THC may actually be sufficient to produce analgesia while keeping psychoactive effects to a minimum.
A review of U. Product has been discontinued by the manufacturer post-market; as of February ; not for safety reasons. Newfoundland and Labrador; NS: Prince Edward Island; QC: The pharmacokinetic information described in Section 2. Tea prepared from Cannabis flowering tops and leaves has been documented, but no data are available regarding efficacy Reference On the other hand, to reduce or prevent CINV, a dosage of 5 mg t.
In either case, the dose should be carefully titrated to avoid the manifestation of adverse effects. The second dose is usually administered 1 to 3 h before chemotherapy. If required, the administration of nabilone can be continued up to 24 h after the chemotherapeutic agent is given. The maximum recommended daily dose is 6 mg in divided doses. Dose adjustment titration may be required in order to attain the desired response, or to improve tolerability. More recent clinical trials report starting doses of nabilone of 0.
Data from an open-label longitudinal study of cannabis oil for patients with treatment-resistant chronic non-cancer pain reported that patients titrated their cannabis oil dose starting with one drop of cannabis oil per day, increasing in increments of one drop of oil per dose, three times per day, until satisfactory analgesia was achieved or until side effects appeared Reference Maximum daily dose was 5 mg b. On subsequent days, the number of sprays can be increased by one spray per day, as needed and tolerated.
A fifteen-minute time gap should be allowed between sprays. During the initial titration, sprays should be evenly spread out over the day. If at any time unacceptable adverse reactions such as dizziness or other CNS-type reactions develop, dosing should be suspended or reduced or the dosing schedule changed to increase the time intervals between doses.
According to the drug product monograph, the average dose of nabiximols is five sprays per day i. The majority of patients appear to require 12 sprays or less; dosage should be adjusted as needed and tolerated. Administration of four sprays to healthy volunteers total The Dutch Office of Medicinal Cannabis has published "rough" guidelines on the use of vapourizers Reference Although the amount of cannabis used per day needs to be determined on an individual basis, the initial dosage should be low and may be increased slowly as symptoms indicate.
The amount of cannabis to be placed in the vapourizer may vary depending on the type of vapourizer used. The levels of cannabinoids released into the vapour phase increased with the temperature of vapourization Reference Participants inhaled as much of the mg dose of dried cannabis 3.
In another study, patients followed a similar "cued-puff" procedure and inhaled 4 puffs, followed by an additional round of between 4 and 8 puffs 2 h later for a total of between 8 and 12 puffs over a 2 h period Reference Subjects inhaled 4 puffs at the beginning of the testing session, followed by an additional round of between 4 and 8 puffs 3 h later for a total of between 8 and 12 puffs over a 3 h period.
While there are countless anecdotal reports concerning the therapeutic uses of cannabis, clinical studies supporting the safety and efficacy of cannabis for therapeutic purposes in a variety of disorders are limited, but slowly increasing in number. Furthermore, the current level of evidence for the safety and efficacy of cannabis for medical purposes does not meet the requirements of the Food and Drugs Act and its Regulations except for those products that have received a notice of compliance and market authorization from Health Canada.
It has been repeatedly noted that the psychotropic side effects associated with the use of psychoactive cannabinoids have been found to limit their therapeutic utility Reference 23 Reference 55 Reference 57 Reference Reference A comprehensive review of 72 controlled clinical studies evaluating the therapeutic effects of cannabinoids mainly orally administered THC, nabilone, nabiximols, or an oral extract of cannabis up to the year reported that cannabinoids present an interesting therapeutic potential as anti-emetics, appetite stimulants in debilitating diseases cancer and AIDS , analgesics, and in the treatment of MS, SCIs, Tourette's syndrome TS , epilepsy, and glaucoma Reference However, a more recent systematic review and meta-analysis of randomized clinical trials of cannabinoids i.
Compared with placebo, cannabinoids were associated with a greater average number of patients showing a complete improvement in nausea and vomiting, reduction in pain, a greater average reduction in numerical rating scale pain assessment, and average reduction in the Ashworth spasticity scale Reference There was also an increased risk of short-term adverse events with cannabinoids.
Commonly reported adverse events included dizziness, dry mouth, fatigue, somnolence, euphoria, vomiting, disorientation, drowsiness, confusion, loss of balance and hallucinations Reference Overall, the review and meta-analysis conducted using the Grading of Recommendations, Assessment, Development and Evaluation GRADE approach suggested that there was moderate-quality evidence to support the use of cannabinoids for the treatment of chronic neuropathic or cancer pain as well as MS-associated spasticity, but low-quality evidence to support use for CINV, weight gain in HIV infection, sleep disorders, and TS Reference The review and meta-analysis only included only one study with smoked cannabis and all other included clinical studies were with oral or oro-mucosal administration of cannabinoid-based medicines e.
This comprehensive report includes information on the therapeutic effects of cannabis and the cannabinoids but also other health effects such as cancer, cardiometabolic risks, respiratory disease, immunity, injury and death, prenatal, perinatal and neonatal effects, psychosocial and mental health effects.
It also discusses challenges and barriers in conducting cannabis research as well as recommendations to support and improve cannabis research. Much of the evidence included in the report came from systematic reviews and meta-analyses and selected high quality primary research. Evidence gathered from in vitro or in vivo animal studies was not included. It was available for sale in Canada in capsules containing 2.
The drug is no longer sold in Canada post-market discontinuation of the drug product as of February ; not for safety reasons. It is available as capsules 0. It is also marketed with conditions as an adjunctive treatment for the symptomatic relief of neuropathic pain in adults with MS and with conditions as an adjunctive analgesic in adult patients with advanced cancer who experience moderate to severe pain during the highest tolerated dose of strong opioid therapy for persistent background pain Reference The existing scientific and clinical evidence for cannabis and certain cannabinoids in treating various symptoms associated with various medical conditions is summarized in the following sections beginning on the next page.
Among the goals of palliative care described by the WHO are relief from pain and other distressing symptoms, and the enhancement of quality of life QoL Reference While integration of cannabis into mainstream medical use can be characterized as extremely cautious, its use appears to be gaining some ground in palliative care settings where the focus is on individual choice, patient autonomy, empowerment, comfort and especially QoL Reference Nevertheless, establishing the effectiveness of cannabis as a viable treatment option in a palliative care context requires a careful assessment of its effects in a wide range of conditions; such evidence is not yet abundant and further research is needed Reference Certain patient populations e.
A prospective, non-randomized, and unblinded observational case-series study assessing the effectiveness of adjuvant nabilone therapy in managing pain and symptoms experienced by advanced cancer patients in a palliative care setting reported that those patients using nabilone had a lower rate of starting NSAIDs, tricyclic anti-depressants, gabapentin, dexamethasone, metoclopramide, and ondansetron and a greater tendency to discontinue these drugs Reference Treated patients were started on 0.
At follow-up, the majority of patients were on a 2 mg daily nabilone dose with a mean daily dose of 1. The two primary outcomes of the study, pain and opioid use in the form of total morphine sulfate equivalents were reduced significantly in treated patients compared to untreated patients.
Side effects from nabilone consisted mainly of dizziness, confusion, drowsiness, and dry mouth. Patients also demonstrated less tendency to initiate additional new medications and could reduce or discontinue baseline medications. One observational study that examined over self-reported cannabis-using patients in a cancer palliative care setting reported significant improvement in a variety of cancer and anti-cancer treatment-related symptoms including nausea, vomiting, mood disorders, fatigue, weight loss, anorexia, constipation, sexual function, sleep disorders, itching, and pain Reference The reported decrease in memory among a proportion of the study sample could be a function of cannabis use along with the use of other medications such as opioids, anti-depressants, or even vary with age.
Improvements in symptom and distress scores were also noted. Limitations of the study included its observational nature, the lack of an appropriate control group, and the reliance on self-report. Another observational study looking at the patterns of cannabis use among adult Israeli advanced cancer patients reported that of approximately 17, cancer patients monitored at a single Israeli healthcare institution, patients were authorized to use cannabis for medical purposes; among these, the median age of patients was 60 years range: In most patients, cannabis was requested for multiple indications.
Eighty-three percent of patients rated the overall efficacy of cannabis as being high. A handful of clinical studies have used standardized QoL instruments to measure whether the use of cannabis or prescription cannabinoids e. The evidence from these studies is summarized below. A two-centre, phase II, randomized, double-blind, placebo-controlled day pilot study carried out in adult patients suffering from chemosensory alterations i.
Statistically significant improvements were also noted for quality of sleep and relaxation with dronabinol treatment compared to placebo. According to the study authors, negative psychoactive effects were minimized by starting patients at a low dose 2. A multi-centre, phase III, randomized, double-blind, placebo-controlled, three-arm, parallel study in adult patients with advanced incurable cancer and suffering from cancer-related anorexia-cachexia syndrome concluded that neither cannabis extract 2.
A randomized, double-blind, placebo-controlled trial of nabilone in patients suffering from fibromyalgia reported that adjuvant nabilone therapy four weeks; maximum dose in the final week of treatment: An enriched-enrolment, randomized withdrawal, flexible-dose, double-blind, placebo-controlled, parallel-assignment efficacy study of nabilone as an adjuvant in the treatment of long-standing diabetic peripheral neuropathic pain reported statistically significant improvements in measures of QoL Composite EuroQoL five dimensions questionnaire, EQ-5D, Index Score and overall patient status compared to placebo Reference A seven-week, randomized, placebo-controlled study comparing the effects of nabilone to placebo on QoL and side effects during radiotherapy for head and neck carcinomas reported that at the dosage used 0.
There was also no statistically significant difference in the occurrence of adverse effects between the nabilone and placebo groups. A twelve-week, double-blind, randomized, placebo-controlled, parallel-group, enriched enrolment study of nabiximols as add-on therapy for patients with refractory spasticity concluded that there was no significant difference between active treatment and placebo on measures of QoL EQ-5D Health State Index, EQ-5D Health Status VAS, SF Reference A five-week, multi-centre, randomized, double-blind, placebo-controlled, parallel-group, graded-dose study evaluated the analgesic efficacy and safety of nabiximols in three dose ranges in opioid-treated cancer patients with poorly-controlled chronic pain Reference The study reported the lack of any positive treatment effects on overall QoL in this study population even at the highest doses of nabiximols 11 - 16 sprays per day.
A randomized, double-blind, placebo-controlled, four-period, cross-over trial of smoked cannabis in the treatment of chronic neuropathic pain chronic post-traumatic or post-surgical etiology concluded that inhalation of smoked cannabis 25 mg of cannabis containing 2. In contrast, a cross-sectional survey examining the benefits associated with cannabis use in patients with fibromyalgia reported a statistically significant benefit in the mental health component summary score of the SF QoL questionnaire in patients who used cannabis compared to non-users Reference However, no significant differences between cannabis and non-cannabis users were found in the other SF domains, in the Fibromyalgia Impact Questionnaire, or the Pittsburgh Sleep Quality Index.
A preliminary observational, open-label, prospective, single-arm trial in a group of 13 patients suffering from Crohn's disease or ulcerative colitis reported that treatment with inhaled cannabis over a three-month period improved subjects' QoL, caused a statistically significant increase in subjects' weight, and improved the clinical disease activity index in patients with Crohn's disease Reference Patients reported a statistically significant improvement in their perception of their general health status, their ability to perform daily activities, and their ability to maintain a social life.
Patients also reported a statistically significant reduction in physical pain as well as improvement in mental distress. The authors attributed the null findings to the heterogeneity of study characteristics, and the limitation in which HRQoL were secondary and not primary outcomes in most studies. However, the studies showing a positive relationship between cannabinoids and HRQoL were more likely to be from pain-related symptoms neuropathic pain, multiple sclerosis, headaches, inflammatory bowel disease , while negative relationships were observed mostly in HIV patients who reported significant reductions in physical and mental HRQoL Reference CINV is one of the most distressing and common adverse events associated with cancer treatment Reference Once a patient experiences nausea, it tends to persist throughout treatment and make subsequent episodes of nausea more severe Reference Post-treatment nausea is also associated with impaired patient functioning, increased anxiety, depression, and reduced QoL which can all negatively impact treatment adherence or even cause discontinuation of treatment entirely Reference While nausea typically occurs before vomiting, the two have distinct neural circuitries and can be separated behaviourally Reference Furthermore, while the central mechanisms of vomiting are well-known, those responsible for nausea remain less well understood Reference Nevertheless, scientific studies point to the insular cortex as the seat of sensations such as nausea and disgust, with other central regions e.
Non-specific anti-anxiety treatments e. It is important to note that excessive use of cannabis has been reported to paradoxically trigger a chronic cyclic vomiting syndrome i. Patient claims that smoked cannabis relieves CINV are widely recognized, and increasing evidence suggests a role for the ECS in the regulation of nausea and vomiting Reference Reference Reference Reference - Reference CB 1 and CB 2 receptors have been found in areas of the brainstem associated with emetogenic control Reference Reference , and results from animal studies suggest the anti-nausea and anti-emetic properties of certain cannabinoids e.
Levels of 2-AG are increased in the visceral insular cortex during an acute episode of nausea in rats and localized blockade of 2-AG through targeted MAGL inhibition in the insular cortex reduces acute nausea Reference Similarly, infusion of 2-AG into the insular cortex dose-dependently blocks anticipatory nausea, while infusion of anandamide was without effect Reference These findings suggest that 2-AG, but not anandamide, drives acute and anticipatory nausea.
Elsewhere, elevation of endocannabinoids such as anandamide and 2-AG by inhibition of the endocannabinoid degradative enzymes FAAH and MAGL, has been shown to suppress acute and anticipatory nausea in animal models Reference Reference and localized infusion of a peripherally-restricted CB 1 receptor agonist into the visceral insular cortex suppressed nausea-like behaviour in rats, whereas systemic administration had no effect Reference Additional work has revealed novel and important roles for cannabinoid acids i.
In one study, when administered alone, a very low dose 0. In addition, the effective dose of CBDA that attenuated acute nausea was approximately 1 times lower than the effective dose for CBD Reference THCA at doses of 0.
In this study, CBDA 0. Treatment with CBDA was not associated with any effects on locomotor activity at any tested dose whereas chlordiazepoxide significantly reduced locomotor activity. Co-administration of subthreshold doses of CBDA 0. Further research is needed to resolve the conflicting evidence around the mechanism of action, if any, of THCA at the CB 1 receptor.
Additional animal studies have shown that administration of subthreshold doses of THC 0. In contrast to the effect seen for acute nausea, combined subthreshold doses of THC and CBDA did not suppress anticipatory nausea in animals Reference Higher doses of either THC 1. The study showed that 2. Singular administration of either 2. CBDA was not associated with any suppression of acute nausea and vomiting. Furthermore, certain subthreshold combinations of some of these cannabinoids can produce synergistic anti-nausea and vomiting effects compared to when used alone.
While prescription cannabinoids present clear advantages over placebo in the control of CINV, the evidence from randomized clinical trials shows cannabinoids to be clinically only slightly better than conventional dopamine D2-receptor antagonist anti-emetics Reference Reference In some cases, patients appeared to prefer the cannabinoids to these conventional therapies despite the increased incidence of adverse effects such as drowsiness, dizziness, dysphoria, depression, hallucinations, paranoia, and arterial hypotension.
This may be explained in part by the notion that for certain patients a degree of sedation and euphoria may be perceived as beneficial during chemotherapy. While no peer-reviewed clinical trials of smoked cannabis for the treatment of CINV exist, Musty and Rossi have published a review of U.
In all cases, patients were admitted only after they failed treatment with standard phenothiazine anti-emetics. Few, if any, clinical trials directly comparing cannabinoids to newer anti-emetics such as 5-HT 3 Ondansetron, Granisetron or NK-1 receptor antagonists have been reported to date Reference Reference A small clinical trial comparing smoked cannabis 2. Furthermore, only cannabis produced changes in mood and subjective state. In another clinical study with a small sample size, ondansetron and dronabinol 2.
More research is required to determine if combination therapy provides added benefits above those observed with newer standard treatments. A retrospective chart review of dronabinol use for CINV in an adolescent oncology population i.
The most commonly prescribed dose of dronabinol in this study was 2. Sixty percent of the pediatric patients in this study were reported to have had a "good" response to dronabinol. Limitations of this study include retrospective design, lack of a comparison group, lack of chemotherapy standardization, and lack of standardized anti-emetic regimens. The use of cannabinoids whether administered orally or by smoking cannabis is currently considered a fourth-line adjunctive therapy in CINV when conventional anti-emetic therapies have failed Reference Reference - Reference Nabilone may be administered orally every 12 h at dosages ranging from 1 - 2 mg, whereas dronabinol may be administered every 6 - 8 h orally, rectally, or sub-lingually at doses ranging from 5 - 10 mg Reference Reference The ability of acute cannabis exposure to increase appetite has been recognized anecdotally for many years Reference In addition, results from epidemiological studies suggest that people actively using cannabis have higher intakes of energy and nutrients than non-users Reference Studies showing a high concentration of CB 1 receptors in brain areas associated with control of food intake and satiety lend further support to the link between cannabis consumption and appetite regulation Reference - Reference These include all areas of the industry including business, agriculture, research, etc.
This panel will talk about what courses are currently available for students and what still needs to be offered as well as how higher education can translate their findings into commercial services and products the industry can use to advance itself.
This panel of hemp, CBD, and edible experts will cover extraction, consistency, product development, and the future of medical cannabis in pharmaceuticals. Learn how to protect your business and avoid lawsuits in the cannabis industry. Attendees will receive comprehensive information on how to reduce taxes, protect their license, and run their business without fear. The number of Veterans that commit suicide or die from overdosing in this country is alarming.
Leading doctor and researcher in the industry will discuss current research, initial results, Veteran access, and the difficulties they face. Cannabis legalization is quickly increasing on a global scale. This panel will focus on the budding market landscape in the U.
Leading entrepreneurs will provide insight on how canna-preneurs may benefit from global legalization initiatives. This panel will cover the effective tools for building an opioid-free life, both to conquer opiates, and also to manage the underlying pain which caused the need for opiates. Legal cannabis is one of the fastest growing industries in the country. Last year, the industry employed , people in the U.
S, a number estimated to double by Compassionate Certification Centers will discuss medical cannabis and its impact on the future of healthcare in the U. Our CBD products are not for use by or sale to persons under the age of 18 and should not be used if you are pregnant or nursing. Consult with a physician before use if you have a serious medical condition or use prescription medications.
The information on our website and any other communication regarding legality which you may receive from any representative of Compassionate Certification Centers is for informational purposes only and not for the purpose of providing legal advice.
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How to Cook Cannabutter Time: Captain Kirk , Michael Hensel Cannabis infused edibles are becoming increasingly popular for many consumers and patients who want a healthier and more discreet way to consume their cannabis. Bryan Doner For decades cannabis consumers have been portrayed as everything from depraved addicts to lazy do-nothings. Ed Sulkowski Cannabis continues to be a hot topic in the world of professional sports, but what are its benefits for daily fitness regimens and overall wellness?
Sven Hosford This panel will discuss how businesses can better serve the patient community in both medical and adult-use markets.
An Introduction to CBDs: Juana Career Readiness Workshop Time: Founder of the First Cannabis Dispensary Time: Alex Abellan Meet Canadian film and television actor Alex Abellan who left his on-screen career to pursue a new kind of venture in cannabis. The Fundamentals of Testing: Andrew Rosenstein Steep Hill was Founded in CA in and is a science and technology firm that has become the industry leader in cannabis testing and analytics in the United States, and internationally.
A History of Cannabis Time: Wirtshafter Don E Wirtshafter has collected the history of the medical use of Cannabis for over 40 years. Cryptocurrency Concerns for the Cannabis Industry Time: Catia Kossovsky Join the discussion surrounding whether cryptocurrency provides practical solutions to most immediate and relevant concerns of marijuana related business in conducting financial transactions.
Cannabis Career Fair Time: Exhibit Hall C Discover what companies are hiring locally, regionally, and nationally. Overview of Cannabis Testing Cannabis Extractions with United Chemical Technologies 2: Cannabis Analyzer for Potency and Hands on Workshop 3: A Day in the Life of a Cannabis Sample. Law Update and Business Impact Time: Inspiring the Next Generation Time: Living Life on the Offense: Brain Health Initiatives in Time: From Cultivation Site to Dispensary Showroom: Seed2Sale Operational Technologies Time: Jeff Kiehn Learn how to utilize industry-specific technology and create a strong foundation for your cannabusiness.
Nadeem Al-Hasan The infused-product sector of the cannabis industry is a booming market, both recreationally and medically. Theresa Nightingale When they were younger, many hid their cannabis use from their parents.
Lilach Mazor Power Tools and tips on increasing sales without upselling to patients and how to keep yourself and your company laser focused with so many opportunities. Mowgli Holmes As cannabis becomes more mainstream, the need for safe, clean and reliable cannabis is at an all time high. Hemp Oil or Cannabis Oil? Brian Mackay , Megan Rideout This informative panel will cover how to effectively market and brand technology for both recreational and medical markets.
Opioid Epidemic and Natural Solutions Time: Cannabis Appraisal and Financial Management: Hot and Emerging Issues Time: The Suit Against Sessions Time: Bryan Doner Even as cannabis becomes increasingly popular, there is still much to discover. David Hodes Now that more than half of the adult population in the U. Cyril Wecht Renowned forensic scientist Dr. Patrick Nightingale What is the Supremacy Clause and how can it undo literally decades of state level reform?
Eric Schlissel After winning a license, the real work begins. Jim McAlpine Athletes For CARE is a not-for-profit organization dedicated to raising awareness for important issues facing professional athletes and the public at large, including addiction, chronic pain, access to alternative medicines, mental health, CTE and traumatic brain injury.
Jill Christensen Best-selling author and consultant Jill Christensen will share her global Fortune Executive-level experience and examine the current cannabis recruiting landscape. Michael Sampson Learn about the market for insurance in the medical cannabis industry, the types of coverages industry participants should consider, insurance coverage in the event of a disaster, the enforceability of insurance contracts as a result of federalism and public policy issues , and claims-handling best practices.
Diana Briggs In states that prohibit delivery services for medical cannabis patients, caregivers play a even more important role in the ecosystem. Dispensary Retailing Time: Jeffrey Adkins , Alexander Fetterman In this presentation we will focus on the application of modern retail principles relative to the dispensary environment.
Journey to Compassion Time: Diversity in Cannabis Time: Aaron Epstein Learn how to develop and expand your cannabusiness and rise above the competition. Entrepreneurial Opportunities in the Cannabis Industry Time: Ewart The cannabis industry is set to create more jobs than established industries like manufacturing by Snowden Bishop This panel of hemp, CBD, and edible experts will cover extraction, consistency, product development, and the future of medical cannabis in pharmaceuticals.
Daniel McNeff Learn how to protect your business and avoid lawsuits in the cannabis industry.
Marijuana Addiction & Mental Health Problems
A Multi-generational Medicine: How to Incorporate Cannabis into Your Everyday Health. Time: AM – PM Where: Main Stage Speakers: Dr. Joseph. Thus, many individuals with a mental health disorder might also be using marijuana. What is a Marijuana acts primarily on cannabinoid receptors in the brain. The cannabis industry's fixation on millennials risks overlooking older consumers who have more money to spend and more health issues to address. They, along with the upcoming Gen Zers, are the generation more likely to noticed more seniors asking questions about medical cannabis in the past.