Loading
  • Facebook
  • Instagram
  • Twitter
  • Reddit
  • LinkedIn
Dispense Magazine
  • Home
  • Articles
    • Featured
    • News
    • Health
    • Law
    • Interviews
  • Podcast
  • Resources
    • Physicians
    • Clinics
    • Dispensaries
    • Glossary
  • About
  • Contact
  • Advertise
  • Menu

Cannabis Science

Featured, Health, News Spring 2019
Dispense Magazine - Cannabis ScienceDispense Magazine
Spring 2019 Print Article

The latest news, research, and reports on the therapeutic uses of cannabis from the scientific community

The Case for the Entourage Effect and Conventional Breeding of Clinical Cannabis: “No Strain,” No Gain

Prolific cannabis researcher Ethan Russo published a report on the entourage effect in Frontiers in Plant Science in January 2019, bringing together a large number of known studies on the subject. He starts by discussing the difficulty of identifying the active ingredients of cannabis. “While labeled “strains” in common parlance, this term is acceptable with respect to bacteria and viruses, but not among Plantae. Given that such factors as plant height and leaflet width do not distinguish one Cannabis plant from another and similar difficulties in defining terms in Cannabis, the only reasonable solution is to characterize them by their biochemical/pharmacological characteristics. Thus, it is best to refer to Cannabis types as chemical varieties, or “chemovars.”…Rather, the case for Cannabis synergy via the “entourage effect” is currently sufficiently strong as to suggest that one molecule is unlikely to match the therapeutic and even industrial potential of Cannabis itself as a phytochemical factory. The astounding plasticity of the Cannabis genome additionally obviates the need for genetic modification techniques.”

In this comprehensive overview of the effect, he states, “In 1998, Professors Raphael Mechoulam and Shimon Ben-Shabat posited that the endocannabinoid system demonstrated an ‘entourage effect’ in which a variety of ‘inactive’ metabolites and closely related molecules markedly increased the activity of the primary endogenous cannabinoids, anandamide, and 2-arachidonoylglycerol. …They also postulated that this helped to explain how botanical drugs were often more efficacious than their isolated components. …Although the single molecule synthesis remains the dominant model for pharmaceutical development…, the concept of botanical synergy has been amply demonstrated contemporaneously, invoking the pharmacological contributions of ‘minor cannabinoids’ and Cannabis terpenoids to the plant’s overall pharmacological effect.” With many examples, he lays out the case for botanical medicine. “These studies and others provide a firm foundation for Cannabis synergy and support for botanical drug development vs. that of single components.” He concludes, “The data supporting the existence of Cannabis synergy and the astounding plasticity of the Cannabis genome suggests a reality that obviates the need for alternative hosts, or even genetic engineering of Cannabis sativa, thus proving that ‘The plant does it better.’”

The Contribution of Cannabis Use to Variation in the Incidence of Psychotic Disorder Across Europe (EU-GEI): A Multicentre Case-Control Study

A 5-year study published in The Lancet in May 2019 concludes, “Cannabis use is associated with increased risk of later psychotic disorder but whether it affects the incidence of the disorder remains unclear.” Among the findings, “Use of high-potency cannabis (THC ≥10%) modestly increased the odds of a psychotic disorder compared with never use; this remained largely unchanged after controlling for daily use. Those who had started using high-potency cannabis by age 15 years showed a doubling of risk, without evidence of an interaction.” Researchers were able to come to their conclusions partly due to the wide geographical reach. “Use of high-potency cannabis was a strong predictor of psychotic disorder in Amsterdam, London, and Paris where high-potency cannabis was widely available, by contrast with sites such as Palermo where this type was not yet available. In the Netherlands, the THC content reaches up to 67% in Nederhasj and 22% in Nederwiet; in London, skunk-like cannabis (average THC of 14%) represents 94% of the street market whereas in countries like Italy, France, and Spain, herbal types of cannabis with THC content of less than 10% were still commonly used. … Thus our findings are consistent with previous epidemiological and experimental evidence suggesting that the use of cannabis with a high concentration of THC has more harmful effects on mental health than does the use of weaker forms.

The report concludes, “We report what, to our knowledge, is the first evidence that differences in the prevalence of daily use and use of high-potency cannabis in the controls correlate with the variation in the adjusted incidence rates for psychotic disorder across the study sites. Our results show that in areas where daily use and use of high-potency cannabis are more prevalent in the general population, there is an excess of cases of psychotic disorder.” The authors do acknowledge some of the limitations of the study. “Our findings need to be appraised in the context of limitations. Data on cannabis use are not validated by biological measures, such as urine, blood, or hair samples. However, such measures do not allow testing for use over previous years. Moreover, studies with laboratory data and self-reported information have shown that cannabis users reliably report the frequency of use and the type of cannabis used.”

Access to Medical Marijuana Reduces Opioid Prescriptions

In May of last year, Peter Grinspoon, MD posted in the Harvard Medical School blog about the debate over using medical cannabis to mitigate opioid abuse. He writes, “The idea of using marijuana to mitigate the opiate crisis may seem counterintuitive to many people in the medical community. Some healthcare providers ask questions like, “Aren’t we just replacing one drug with another?” and “Doesn’t marijuana present its own set of dangers, such as addiction, dependency, and other health concerns?” To answer these questions, he referenced two studies recently published in JAMA Internal Medicine, which show, “the rate of opiate prescriptions is lower in states where medical marijuana laws have been passed.” One study showed that “when medical marijuana laws went into effect in a given state, opioid prescriptions fell by 2.21 million daily doses filled per year. When medical marijuana dispensaries opened, prescriptions for opioids fell by 3.74 million daily doses per year. These reductions in daily opioid doses were particularly notable for hydrocodone (Vicodin) and morphine prescriptions.” “The other study analyzed Medicaid prescription data from 2011 to 2016, and that analysis showed that states that have implemented medical marijuana laws have seen a 5.88% lower rate of opioid prescribing, and when they implemented adult-use (i.e., recreational use) marijuana laws, there was a 6.38% reduction in opiate prescribing.”

Just as important as the data, Dr. Grinspoon said, are the editorial comments. He quoted the authors of one study who wrote, “We do not know whether patients actually avoided or reduced opioid use because of increased access to cannabis (marijuana).” According to Grinspoon, “However, given that millions of prescriptions for opiates were not written, and consequently there were millions of fewer bottles of prescription opiates consumed, sold, diverted, or abused, it does not seem to be too big a leap to infer that opiate use was avoided, or at least reduced.”

He concluded with a call for more conversations on this subject between doctor and patient. “Healthcare providers, whether they are pro-, neutral, or anti-medical marijuana, need to leave their prejudices outside the exam room. Physicians need to create a climate where patients feel they can be open with us so that we can know if and how they are using medical marijuana. Physicians can be in a position to advise them on the risks and benefits of safe usage and meaningfully contribute to the conversation (assuming that we ourselves have a modicum of education on this issue). Once we are all on the same page, guided by evidence in new studies about reduced opiate use and adding medical marijuana to the pain relief arsenal, we can start helping patients to minimize their use of opiates.”

The Association between Cannabis Product Characteristics and Symptom Relief

A study published in February 2019 by Scientific Reports used data from the Releaf App to overturn ingrained dogma on the therapeutic effects of THC as well as set a new standard of data collection on the real-time data from a wide cross-section of patients on 27 different “measured symptom categories.” Over a 21-month period, “3,341 people completed 19,910 self-administrated cannabis sessions using the mobile device software, ReleafApp to record: type of cannabis product (dried whole natural Cannabis flower, concentrate, edible, tincture, topical), combustion method (joint, pipe, vaporization), Cannabis subspecies (C. indica and C. sativa), and major cannabinoid contents (tetrahydrocannabinol, THC; and cannabidiol, CBD), along with real-time ratings of health symptom severity levels, prior to and immediately following administration, and reported side effects.”

The study lays out the challenges to research so far. “Medical cannabis markets are currently being flooded with thousands of cannabis strains with unique cannabinoid profiles, novel, uninvestigated cannabis-derived formulates and products with little to no clinical references or formal guidance on how fundamental characteristics of the products themselves may affect pharmacodynamics. Federal laws have all but prohibited the use of perspective, pragmatic, naturalistic studies with random treatment assignment for measuring the effects of cannabis consumed in vivo. What little clinical research does exist is mostly limited to randomized controlled trials (RCTs) using synthetic cannabinoids or low quality and potency cannabis obtained from the federal government that is unrepresentative of the cannabis products used by millions of people every day.”

This has led to contradictory research, especially around schizophrenia. Releaf mobile technology is a revolutionary way to collect data. The study says, “…few large-scale investigations to date have measured the relative effects of THC and CBD consumption in real-time under naturalistic conditions among people diagnosed with schizophrenia or any other user group. … Our observational study using mobile app technology was designed to measure these effects in real-time among a large sample of patients using cannabis for treating their medical symptoms under naturalistic conditions.”

The results are notable. “Patients showed an average symptom improvement of 3.5 (SD=2.6) on an 11-point scale across the 27 measured symptom categories.” Further, “Across product characteristics, only higher THC levels were independently associated with greater symptom relief and prevalence of positive and negative side effects. In contrast, CBD potency levels were generally not associated with significant symptom changes or experienced side effects.” The study concludes, “…with preliminary evidence that cannabis may treat an even wider range of conditions than those tracked in this study, including cancer, it is imperative that the scientific community develop innovative strategies such as the use of mobile technology for measuring the multidimensional relationships among cannabis product characteristics, patient health conditions, perceived symptom relief, and side effect manifestation.”

0 0 vote
Article Rating
September 1, 2019/0 Comments/by Dispense Magazine
Tags: Cannabis News, CBD, medical cannabis, Medical Cannabis Magazine, Medical Cannabis News, medical marijuana, Medical Marijuana Magazine, Medical Marijuana News, News, opioid addiction, pain management
Share this entry
  • Share on Facebook
  • Share on Twitter
  • Share on WhatsApp
  • Share on Pinterest
  • Share on LinkedIn
  • Share on Reddit
  • Share by Mail
https://dispensemagazine.com/wp-content/uploads/2019/09/Cannabis-Science.jpg 720 1280 Dispense Magazine https://dispensemagazine.com/wp-content/uploads/2019/06/Dispense-Magazine-Logo-1.svg Dispense Magazine2019-09-01 11:31:002020-01-12 02:11:36Cannabis Science
You might also like
Dispense Magazine Podcast - Ron Millward Balanced VeteransDispense Magazine Helping Veterans Find Balance: An Interview with Ron Millward
Cannabis Terpenes, a guide for Medical Marijuana PatientsDispense Magazine Let's Talk Terpenes - Bisabolol
Dispense Magazine - Pennsylvanias Medical Cannabis Program: Setting the Keystone StandardDispense Magazine PA’s Medical Marijuana Program: Setting the Keystone Standard
Dispense Magazine Podcast - Trauma PTSD and CannabisDispense Magazine Sara Makin on Trauma, PTSD and Cannabis
Dispense Magazine - Dispense With The NonsenseDispense Magazine Message from the Publisher
Cannabis Terpenes, a guide for Medical Marijuana PatientsDispense Magazine Let's Talk Terpenes - Menthol
Subscribe
Notify of
0 Comments
Inline Feedbacks
View all comments

Featured

  • Cannabis Terpenes, a guide for Medical Marijuana PatientsDispense MagazineLet’s Talk Terpenes – FarnesolJanuary 20, 2020 - 10:50 pm
  • Cannabis Terpenes, a guide for Medical Marijuana PatientsDispense MagazineLet’s Talk Terpenes – CedreneJanuary 13, 2020 - 7:08 pm
  • Cannabis Terpenes, a guide for Medical Marijuana PatientsDispense MagazineLet’s Talk Terpenes – MentholJanuary 6, 2020 - 11:49 am
  • The PA Flower Shortage - Growing Pains or Structural Problems 3Dispense MagazineFlower Shortage in PA – Growing Pains or Structural Problems?January 5, 2020 - 3:06 pm
  • Dispense Magazine Podcast Now Available on iheartradioDispense MagazineDispense Podcast now available on iHeartRadioJanuary 1, 2020 - 5:21 pm
  • Cannabis Terpenes, a guide for Medical Marijuana PatientsDispense MagazineLet’s Talk Terpenes – FencholDecember 30, 2019 - 10:00 pm

Newsletter Signup

Download the Latest Issue!

Like us on Facebook

Follow us on Instagram

Dispense Magazine

800 Bay Ridge Ave

Apt 1
Pittsburgh, PA 15226

412.915.5340

[email protected]

Categories

  • Featured (68)
  • Health (81)
  • Interviews (26)
  • Law (10)
  • News (55)
  • Podcast (34)
  • Science (17)
  • Sponsored (7)
  • Terpenes (26)

Find Dispense Magazine

0 0 vote
Article Rating
© 2019 - Dispense Magazine | Terms of Service | Privacy Policy | Cookies Policy | Disclaimer | Website by Budding Brand
  • Facebook
  • Instagram
  • Twitter
  • Reddit
  • LinkedIn
Anxiety and what it takes to qualify: An Interview with Sara Makin Dispense Magazine Podcast - Sara Makin Anxiety and what it takes to qualify in Pennsylvania Medical CannabisDispense Magazine Cannabis Terpenes, a guide for Medical Marijuana PatientsDispense Magazine Let’s Talk Terpenes – Beta-Caryophyllene Scroll to top

Dispense Magazine utilizes cookies to give you the best browsing experience possible. By continuing to browse the site, you are agreeing to our use of cookies.

OK


How we use cookies

We may request cookies to be set on your device. We use cookies to let us know when you visit our websites, how you interact with us, to enrich your user experience, and to customize your relationship with our website.

Click on the different category headings to find out more. You can also change some of your preferences. Note that blocking some types of cookies may impact your experience on our websites and the services we are able to offer.

Essential Website Cookies

These cookies are strictly necessary to provide you with services available through our website and to use some of its features.

Because these cookies are strictly necessary to deliver the website, refuseing them will have impact how our site functions. You always can block or delete cookies by changing your browser settings and force blocking all cookies on this website. But this will always prompt you to accept/refuse cookies when revisiting our site.

We fully respect if you want to refuse cookies but to avoid asking you again and again kindly allow us to store a cookie for that. You are free to opt out any time or opt in for other cookies to get a better experience. If you refuse cookies we will remove all set cookies in our domain.

We provide you with a list of stored cookies on your computer in our domain so you can check what we stored. Due to security reasons we are not able to show or modify cookies from other domains. You can check these in your browser security settings.

Google Analytics Cookies

These cookies collect information that is used either in aggregate form to help us understand how our website is being used or how effective our marketing campaigns are, or to help us customize our website and application for you in order to enhance your experience.

If you do not want that we track your visist to our site you can disable tracking in your browser here:

Other external services

We also use different external services like Google Webfonts, Google Maps, and external Video providers. Since these providers may collect personal data like your IP address we allow you to block them here. Please be aware that this might heavily reduce the functionality and appearance of our site. Changes will take effect once you reload the page.

Google Webfont Settings:

Google Map Settings:

Google reCaptcha Settings:

Vimeo and Youtube video embeds:

Privacy Policy

You can read about our cookies and privacy settings in detail on our Privacy Policy Page.

Accept settingsHide notification only
wpDiscuz

Enter your email address for a FREE digital copy of Dispense Magazine!

 

Enter your email address to receive this quarter’s issue, absolutely free!

If you would like a physical copy, please click here

Dispense Medical Marijuana Magazine Volume 1 Issue 3 Cover

Please fill out the form below, and we’ll send you a copy of our latest issue.

 

Dispense Medical Marijuana Magazine Volume 1 Issue 3 Cover

 

Enter your email address to receive this quarter’s issue, absolutely free!

If you would like a physical copy, please click here

This is text

2019 Multimedia Advertising Guide

Please fill out the form to receive a copy of our advertising guidelines. Once submitted, one of our advertising reps will get right back to you.