“New regulations are in place at the federal and provincial levels in Canada regarding the way medical cannabis is to be controlled. We present them together with guidance for the safe use of medical cannabis and recent clinical trials on cannabis and pain.
Tag Archives: cannabis
Cannabidiol, neuroprotection and neuropsychiatric disorders.
“Cannabidiol (CBD) is a non-psychotomimetic phytocannabinoid derived from Cannabis sativa.
It has possible therapeutic effects over a broad range of neuropsychiatric disorders.
CBD attenuates brain damage associated with neurodegenerative and/or ischemic conditions.
It also has positive effects on attenuating psychotic-, anxiety- and depressive-like behaviors.
Moreover, CBD affects synaptic plasticity and facilitates neurogenesis.
The mechanisms of these effects are still not entirely clear but seem to involve multiple pharmacological targets.
In the present review, we summarized the main biochemical and molecular mechanisms that have been associated with the therapeutic effects of CBD, focusing on their relevance to brain function, neuroprotection and neuropsychiatric disorders.”
Medical marijuana programs – Why might they matter for public health and why should we better understand their impacts?
“Although cannabis is an illegal drug, ‘medical marijuana programs’ (MMPs) have proliferated (e.g., in Canada and several US states), allowing for legal cannabis use for therapeutic purposes.
While both health risks and potential therapeutic for cannabis use have been documented, potential public health impacts of MMPs – also vis-à-vis other psychoactive substance use – remain under-explored.
We briefly reviewed the emerging evidence on MMP participants’ health status, and specifically other psychoactive substance use behaviors and outcomes.
MMP participants report improvements in overall health status, and specifically reductions in levels of risky alcohol, prescription drug and – to some extent – tobacco or other illicit drug use…”
Medicinal cannabis.
“A number of therapeutic uses of cannabis and its derivatives have been postulated from preclinical investigations.
Possible clinical indications include spasticity and pain in multiple sclerosis, cancer-associated nausea and vomiting, cancer pain and HIV neuropathy.
Controversies lie in how to produce, supply and administer cannabinoid products.
Introduction of cannabinoids therapeutically should be supported by a regulatory and educational framework that minimises the risk of harm to patients and the community.
The Regulator of Medicinal Cannabis Bill 2014 is under consideration in Australia to address this.
Nabiximols is the only cannabinoid on the Australian Register of Therapeutic Goods at present, although cannabidiol has been recommended for inclusion in Schedule 4.”
“There is some evidence of therapeutic benefit for cannabis products in defined patient populations.” http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4674028/
Cannabinoids for treatment of glaucoma.
“The purpose of this article is to review the current status of cannabis in the treatment of glaucoma, including the greater availability of marijuana in the USA.
The pharmacology of marijuana and its effect on intraocular pressure has not changed since the research in the 1970s and 1980s.
Marijuana is an effective ocular hypotensive agent.
However, cardiovascular and neurological effects are observed at the same dose, and may theoretically reduce the beneficial effect of lowering intraocular pressure by reducing ocular blood flow. The clinician must be cognizant of this potential in diagnosis, prognosis, and therapy.”
Metabolomics of Δ9-tetrahydrocannabinol: implications in toxicity.
“Cannabis sativa is the most commonly used recreational drug, Δ9-tetrahydrocannabinol (Δ9-THC) being the main addictive compound.
Biotransformation of cannabinoids is an important field of xenobiochemistry and toxicology and the study of the metabolism can lead to the discovery of new compounds, unknown metabolites with unique structures and new therapeutic effects.
The pharmacokinetics of Δ9-THC is dependent on multiple factors such as physical/chemical form, route of administration, genetics, and concurrent consumption of alcohol.
This review aims to discuss metabolomics of Δ9-THC, namely by presenting all known metabolites of Δ9-THC described both in vitro and in vivo, and their roles in the Δ9-THC-mediated toxic effects.
Since medicinal use is increasing, metabolomics of Δ9-THC will also be discussed in order to uncover potential active metabolites that can be made available for this purpose.”
Cannabidiol disrupts the reconsolidation of contextual drug-associated memories in Wistar rats.
“In addicts, craving and relapse are frequently induced by the recall of memories related to a drug experience. Several studies have demonstrated that drug-related memories are reactivated after exposure to environmental cues and may undergo reconsolidation, a process that can strengthen memories. Thus, reactivation of mnemonic traces provides an opportunity for disrupting memories that contribute to the pathological cycle of addiction.
Here we used drug-induced conditioned place preference (CPP) to investigate whether cannabidiol (CBD), a phytocannabinoid, given just after reactivation sessions, would affect reconsolidation of drug-reward memory, reinstatement of morphine-CPP, or conditioned place aversion precipitated by naltrexone in Wistar rats.
We found that CBD impaired the reconsolidation of preference for the environment previously paired with both morphine and cocaine. This disruption seems to be persistent, as the preference did not return after further reinstatement induced by priming drug and stress reinstatement.
Moreover, in an established morphine-CPP, an injection of CBD after the exposure to a conditioning session led to a significant reduction of both morphine-CPP and subsequent conditioned place aversion precipitated by naltrexone in the same context.
Thus, established memories induced by a drug of abuse can be blocked after reactivation of the drug experience.
Taken together, these results provide evidence for the disruptive effect of CBD on reconsolidation of contextual drug-related memories and highlight its therapeutic potential to attenuate contextual memories associated with drugs of abuse and consequently to reduce the risk of relapse.”
Cannabinoids for pediatric epilepsy? Up in smoke or real science?
“Public interest in the use of “medical marijuana” for the treatment of childhood epilepsy has burgeoned in the last few years. This has occurred in parallel with a growing interest in “medical marijuana” in general. Physicians and pediatricians must balance their patients’ desire for immediate access to these products with the tenets of evidence-based medicine. This review discusses the biochemistry of cannabis products (the phytocannabinoids) setting this in the context of the endogenous endocannabinoid system. The differing and potentially modulating effects of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are reviewed. The evidence-base supporting or not the use of cannabis products for the treatment of neurological disease and specifically epilepsy is explored. The potential for adverse effects and particularly of neurotoxicity is addressed. Finally, public health and sociocultural implications are touched upon. Specific recommendations for interested physicians are provided including advocacy for patients and for a change in the “scheduling” of cannabis in order to better foster much-needed high-quality scientific research in this important area.”
[Efficacy, tolerability and safety of cannabinoids for chronic neuropathic pain : A systematic review of randomized controlled studies].
“Recently published systematic reviews came to different conclusions with respect to the efficacy, tolerability and safety of cannabinoids for treatment of chronic neuropathic pain.
Cannabinoids were marginally superior to placebo in terms of efficacy and inferior in terms of tolerability.
Cannabinoids and placebo did not differ in terms of safety during the study period.
Short-term and intermediate-term therapy with cannabinoids can be considered in selected patients with chronic neuropathic pain after failure of first-line and second-line therapies.”
http://www.ncbi.nlm.nih.gov/pubmed/26830780
http://www.thctotalhealthcare.com/category/neuropathic-pain/
Regulation of Stem Cells by the Endocannabinoid System
“The endocannabinoids, endogenous lipid mediators of related chemical structure to the prototype exogenous cannabinoid Δ9-THC found in marijuana, have emerged as important mediators that regulate central and peripheral neural functions as well as immune responses.
Endogenous and exogenous cannabinoid ligands bind to cannabinoid receptors: the predominant central cannabinoid receptor type 1 (CB1) and the peripheral cannabinoid receptor type 2 (CB2). CB1 and CB2 are members of the G-protein coupled receptor family.
Cannabinoids were shown to modulate the immune system and to affect the migration of blood cells, such as T-cells, monocytes and myeloid leukemia cells, through CB receptors.
Recent data indicate the potential role of cannabinoid ligands and receptors in the regulation of hematopoiesis and hematopoietic stem cell (HSC) migration and trafficking.
These studies may lead to clinical applications of cannabinoid-based compounds as new HSC-mobilizer agents for therapeutic intervention in bone marrow failure.”
http://link.springer.com/chapter/10.1007/978-94-007-2993-3_30