Tag Archives: medical

Cannabidiol (CBD) as a Promising Anti-Cancer Drug

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cancers-logo“Recently, cannabinoids, such as cannabidiol (CBD) and Δ9 -tetrahydrocannabinol (THC), have been the subject of intensive research and heavy scrutiny. Cannabinoids encompass a wide array of organic molecules, including those that are physiologically produced in humans, synthesized in laboratories, and extracted primarily from the Cannabis sativa plant. These organic molecules share similarities in their chemical structures as well as in their protein binding profiles. However, pronounced differences do exist in their mechanisms of action and clinical applications, which will be briefly compared and contrasted in this review. The mechanism of action of CBD and its potential applications in cancer therapy will be the major focus of this review article.”

https://pubmed.ncbi.nlm.nih.gov/33143283/

“The use of cannabinoids containing plant extracts as herbal medicine can be traced back to as early as 500 BC. In recent years, the medical and health-related applications of one of the non-psychotic cannabinoids, cannabidiol or CBD, has garnered tremendous attention. In this review, we will discuss the most recent findings that strongly support the further development of CBD as a promising anti-cancer drug.”

https://www.mdpi.com/2072-6694/12/11/3203

Calling for Openness to the Study of Cannabis Use in Chronic Pelvic Pain

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JOGC (@JOGC_Social) | Twitter“Chronic pelvic pain affects women across all demographics. Its management is complex and requires a multimodal approach.

Cannabis has been legal for medical purposes for many years; however, its pharmacokinetics are just beginning to be understood, as are its analgesic effects and other benefits, such as improved sleep quality and reduced nausea and vomiting.

Given the recent Canada-wide legalization of cannabis for non-medical use, patients may be more willing to disclose cannabis use and use it for pain management. Given the complexity of chronic pain management, physicians must be open to cannabis as an analgesic option.

Cannabis use may decrease the need for opioids, a phenomenon that could reduce opioid dependency. Now is the ideal time to study patients’ use of and perspectives on cannabis for pain relief in order to establish its effectiveness and safety.

Cannabis shows potential to be a key player in a multimodal approach to chronic pelvic pain.”

https://pubmed.ncbi.nlm.nih.gov/33132057/

https://www.jogc.com/article/S1701-2163(20)30791-X/fulltext

Involvement of dopamine receptor in the actions of non-psychoactive phytocannabinoids

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Biochemical and Biophysical Research Communications “These data support the notion that CBD and CBDV act as functional partial agonists on dopamine D2-like receptors in vivo.

The discovery that dopamine receptor is involved in the actions of phytocannabinoids moves a significant step toward our understanding of the mechanisms for medical uses of cannabis in the treatment of neurological and psychiatric disorders.”

https://pubmed.ncbi.nlm.nih.gov/33097185/

https://www.sciencedirect.com/science/article/abs/pii/S0006291X20319306?via%3Dihub

Reductions in alcohol use following medical cannabis initiation: results from a large cross-sectional survey of medical cannabis patients in Canada

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 International Journal of Drug Policy“Evidence details how cannabis can influence the use of other psychoactive substances, including prescription medications, alcohol, tobacco and illicit drugs, but very little research has examined the factors associated with these changes in substance use patterns. This paper explores the self-reported use of cannabis as a substitute for alcohol among a Canadian medical cannabis patient population.

Results: Overall, 419 (44%) participants reported decreases in alcohol usage frequency over 30 days, 323 (34%) decreased the number of standard drinks they had per week, and 76 (8%) reported no alcohol use at all in the 30 days prior to the survey. Being below 55 years of age and reporting higher rates of alcohol use in the pre-period were both associated with greater odds of reducing alcohol use, and an intention to use medical cannabis to reduce alcohol consumption was associated with significantly greater odds of both reducing and ceasing alcohol use altogether.

Conclusions: Our findings suggest that medical cannabis initiation may be associated with self-reported reductions and cessation of alcohol use among medical cannabis patients. Since alcohol is the most prevalent recreational substance in North America, and its use results in significant rates of criminality, morbidity and mortality, these findings may result in improved health outcomes for medical cannabis patients, as well as overall improvements in public health and safety.”

https://pubmed.ncbi.nlm.nih.gov/33068830/

“Following medical cannabis initiation, 44% of participants reported decreases in alcohol use frequency over 30 days, and 34% decreased the number of standard drinks they had per week. Younger age (<55 years old) and higher rates of alcohol use prior to medical cannabis initiation were associated with greater odds of reducing alcohol. Specific intention to use medical cannabis to reduce alcohol consumption resulted in greater odds of reducing and/or ceasing use altogether.”

https://www.sciencedirect.com/science/article/abs/pii/S0955395920303017?via%3Dihub

Medical Marijuana Effects in Movement Disorders, Focus on Huntington Disease; A Literature Review

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“We aimed to comprehensively evaluate the effects of medical marijuana on symptoms that are relevant to movement disorders with a focus on Huntington disease (HD).

A systematic review by literature search through PubMed and EBSCO electronic databases was conducted for relevant studies reported after 2002 on the effects of medical marijuana or cannabis use on tremor, spasm, spasticity, chorea, sleep quality and HD-specific rating scales. Study selection, quality assessment and data extraction was performed by three reviewers. Outcome measures were changes in psychomotor, and sleep related symptoms. The methodological quality of the included studies was evaluated.

Results: A total of 22 studies were reviewed. There was strong evidence for significant improvement in the neurologic symptoms of spasms, tremors, spasticity, chorea, and quality of sleep following treatment with medical marijuana. Analysis of specific motor symptoms revealed significant improvement after treatment in tremors and rigidity. Furthermore, all pretreatment and post-treatment measures indicated a significant increase in average number of hours slept.

Conclusion: Larger scale studies are warranted to test the benefits of medical marijuana in HD patients. In the meanwhile, clinicians may consider prescribing medical marijuana as part of their strategy for better symptomatic treatment of patients with HD.”

https://pubmed.ncbi.nlm.nih.gov/33064979/

https://journals.library.ualberta.ca/jpps/index.php/JPPS/article/view/30967

Medical Cannabis Treatment for Chronic Pain: Outcomes and Prediction of Response

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“Although studied in a few randomized controlled trials (RCTs), the efficacy of medical cannabis (MC) for chronic pain remains controversial. Using an alternative approach, this multicenter, questionnaire-based prospective cohort was aimed to assess the long-term effects of MC on chronic pain of various etiologies and to identify predictors for MC treatment success.

Results: 1045 patients completed the baseline questionnaires and initiated MC treatment, and 551 completed the 12 month follow-up. At one year, average pain intensity declined from baseline by 20% [-1.97 points (95%CI= -2.13 to -1.81; p<0.001)]. All other parameters improved by 10-30% (p<0.001). A significant decrease of 42% [reduction of 27mg; (95%CI= -34.89 to -18.56, p<0.001)] from baseline in morphine equivalent daily dosage of opioids was also observed. Reported adverse effects were common but mostly non-serious. Presence of normal to long sleep duration, lower body mass index (BMI) and lower depression score predicted relatively higher treatment success, whereas presence of neuropathic pain predicted the opposite.

Conclusions: This prospective study provides further evidence for the effects of MC on chronic pain and related symptoms, demonstrating an overall mild to modest long-term improvement of the tested measures and identifying possible predictors for treatment success.

Significance: This “real world” paper shows that MC mildly to modestly attenuates chronic pain and related symptoms. MC treatment can also cause frequent, but mostly non-serious adverse effects, although central nervous system (CNS)-related AEs that can impair the ability to drive vehicles are not uncommon. This study is novel in identifying possible predictors for treatment success, including normal to long sleep duration, lower BMI and lower depression scores. In contrast to current beliefs the diagnosis of neuropathic pain predicts a less favorable outcome. These findings provide physicians with new data to support decision making on recommendations for MC treatment.”

https://pubmed.ncbi.nlm.nih.gov/33065768/

https://onlinelibrary.wiley.com/doi/10.1002/ejp.1675

The impact of cannabinoid type 2 receptors (CB2Rs) in neuroprotection against neurological disorders

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 Acta Pharmacologica Sinica“Cannabinoids have long been used for their psychotropic and possible medical properties of symptom relief. In the past few years, a vast literature shows that cannabinoids are neuroprotective under different pathological situations.

Most of the effects of cannabinoids are mediated by the well-characterized cannabinoid receptors, the cannabinoid type 1 receptor (CB1R) and cannabinoid type 2 receptor (CB2R). Even though CB1Rs are highly expressed in the central nervous system (CNS), the adverse central side effects and the development of tolerance resulting from CB1R activation may ultimately limit the clinical utility of CB1R agonists. In contrast to the ubiquitous presence of CB1Rs, CB2Rs are less commonly expressed in the healthy CNS but highly upregulated in glial cells under neuropathological conditions.

Experimental studies have provided robust evidence that CB2Rs seem to be involved in the modulation of different neurological disorders. In this paper, we summarize the current knowledge regarding the protective effects of CB2R activation against the development of neurological diseases and provide a perspective on the future of this field. A better understanding of the fundamental pharmacology of CB2R activation is essential for the development of clinical applications and the design of novel therapeutic strategies.”

https://pubmed.ncbi.nlm.nih.gov/33024239/

https://www.nature.com/articles/s41401-020-00530-2

Cannabis: An Emerging Treatment for Common Symptoms in Older Adults

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Journal of the American Geriatrics Society “Background/objectives: Use of cannabis is increasing in a variety of populations in the United States; however, few investigations about how and for what reasons cannabis is used in older populations exist.

Design: Anonymous survey.

Setting: Geriatrics clinic.

Participants: A total of 568 adults 65 years and older.

Intervention: Not applicable.

Measurements: Survey assessing characteristics of cannabis use.

Results: Approximately 15% (N = 83) of survey responders reported using cannabis within the past 3 years. Half (53%) reported using cannabis regularly on a daily or weekly basis, and reported using cannabidiol-only products (46%).

The majority (78%) used cannabis for medical purposes only, with the most common targeted conditions/symptoms being pain/arthritis (73%), sleep disturbance (29%), anxiety (24%), and depression (17%). Just over three-quarters reported cannabis “somewhat” or “extremely” helpful in managing one of these conditions, with few adverse effects.

Just over half obtained cannabis via a dispensary, and lotions (35%), tinctures (35%), and smoking (30%) were the most common administration forms. Most indicated family members (94%) knew about their cannabis use, about half reported their friends knew, and 41% reported their healthcare provider knowing. Sixty-one percent used cannabis for the first time as older adults (aged ≥61 years), and these users overall engaged in less risky use patterns (e.g., more likely to use for medical purposes, less likely to consume via smoking).

Conclusion: Most older adults in the sample initiated cannabis use after the age of 60 years and used it primarily for medical purposes to treat pain, sleep disturbance, anxiety, and/or depression. Cannabis use by older adults is likely to increase due to medical need, favorable legalization, and attitudes.”

https://pubmed.ncbi.nlm.nih.gov/33026117/

https://onlinelibrary.wiley.com/doi/10.1111/jgs.16833

“Study Finds Older Adults Using Cannabis to Treat Common Health Conditions”  https://health.ucsd.edu/news/releases/Pages/2020-10-07-study-finds-older-adults-using-cannabis-to-treat-common-health-conditions.aspx

Medical cannabis and cognitive performance in middle to old adults treated for chronic pain

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“Cannabis exposure is becoming more common in older age but little is known about how it is associated with brain health in this population.

This study assesses the relationship between long-term medical cannabis (MC) use and cognitive function in a sample of middle-aged and old chronic pain patients.

Results: Mean age was 63 ± 6 and 60 ± 5 years in the non-exposed and MC patients, respectively. Groups did not significantly differ in terms of cognitive performance measures. Furthermore, none of the MC use patterns were associated with cognitive performance.

Discussion and conclusions: These results suggest that use of whole plant MC does not have a widespread impact on cognition in older chronic pain patients. Considering the increasing use of MC in older populations, this study could be a first step towards a better risk-benefit assessment of MC treatment in this population. Future studies are urgently needed to further clarify the implications of late-life cannabis use for brain health.”

https://pubmed.ncbi.nlm.nih.gov/32964502/

https://onlinelibrary.wiley.com/doi/10.1111/dar.13171

“No Ill Effects for Older Adults Using Medical Marijuana for Pain, Study Says. A study looking at older adults with chronic pain found no no significant difference in cognitive performance when comparing them with matched patients who did not use medical marijuana.” https://www.ajmc.com/view/no-ill-effects-for-older-adults-using-medical-marijuana-for-pain-study-says

The Impact of Medical Cannabis on Intermittent and Chronic Opioid Users with Back Pain: How Cannabis Diminished Prescription Opioid Usage

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View details for Cannabis and Cannabinoid Research cover image“To determine if cannabis may be used as an alternative or adjunct treatment for intermittent and chronic prescription opioid users.

Results: There were no between-group differences based on demographic, experiential, or attitudinal variables. We found that 50.8% were able to stop all opioid usage, which took a median of 6.4 years (IQR=1.75-11 years) after excluding two patients who transitioned off opioids by utilizing opioid agonists. For those 29 patients (47.5%) who did not stop opioids, 9 (31%) were able to reduce opioid use, 3 (10%) held the same baseline, and 17 (59%) increased their usage. Forty-eight percent of patients subjectively felt like cannabis helped them mitigate their opioid intake but this sentiment did not predict who actually stopped opioid usage. There were no variables that predicted who stopped opioids, except that those who used higher doses of cannabis were more likely to stop, which suggests that some patients might be able to stop opioids by using cannabis, particularly those who are dosed at higher levels.

Conclusions: In this long-term observational study, cannabis use worked as an alternative to prescription opioids in just over half of patients with low back pain and as an adjunct to diminish use in some chronic opioid users.”

https://pubmed.ncbi.nlm.nih.gov/32923663/

“Cannabis has been used for centuries as an analgesic and has been shown to reduce chronic pain. In this long-term observational study of a single-center cannabis medical practice site, the addition of cannabis use worked as an alternative to prescription opioids in 50% of patients with chronic back pain. It worked as an adjunct to diminish use in some chronic opioid users. There was only one variable that predicted those who were able to stop opioids suggesting that some patients might be able to stop opioids by using cannabis and that those who do not stop opioids may not be titrated at doses of cannabis high enough to achieve the desired effect necessary to diminish or stop their opioid usage.”

https://www.liebertpub.com/doi/10.1089/can.2019.0039