Benjamin Caplan, MD

Multiple Health Risk Behaviors in Young Adult Smokers: Stages of Change and Stability over Time

Study finds that most young adult smokers engage in multiple other health risk behaviors. When placed in an intervention, participants were most ready to change their stress management and least ready to change their cannabis use.

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Benjamin Caplan, MDMultiple Health Risk Behaviors in Young Adult Smokers: Stages of Change and Stability over Time
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Video: Cannabis For Symptoms of chronic pain, seizures, and inflammation

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Benjamin Caplan, MDVideo: Cannabis For Symptoms of chronic pain, seizures, and inflammation
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Synthetic Cannabinoids Provide Evidence for Targeting Cannabinoid Receptors in the Treatment of Autoimmune Diseases

Pharmaceutical Cannabis Derivatives Help Discover their Receptors and Functions for Autoimmune Illnesses

A recent study conducted by Michigan State University exposed the potential for cannabinoid receptor 2 (CB2) to target the treatment of inflammatory conditions. Elevated levels of plasmacytoid dendritic cells (pCD, a type of cell in the immune system) contribute to chronic inflammation in autoimmune diseases, such as Rheumatoid Arthritis. Researchers found that synthetic CB2 agonists reported comparable benefits to THC, but minimized the cerebral effects as the psychotropic activity is mediated by cannabinoid receptor 1 (CB1). This evidence demonstrates the potential benefits of CB2-targeted treatment for inflammatory conditions. Unfortunately, there are serious concerns about the misuse of some synthetic cannabinoids, so there is still a missing bridge, in products and public education, between these research products and potential therapeutic pharmaceuticals, down the road.

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Benjamin Caplan, MDSynthetic Cannabinoids Provide Evidence for Targeting Cannabinoid Receptors in the Treatment of Autoimmune Diseases
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Medical Marijuana Confers Benefits Comparable to Prescription Medication, Without the Side Effects

Preferences for Medical Marijuana over Prescription Medications Among Persons Living with Chronic Conditions: Alternative, Complementary, and Tapering Uses

In a survey of 30 patients using medical cannabis for a range of illnesses, including Rheumatoid Arthritis, cancer, Hepatitis C, PTSD, and more, patients reported an array of benefits from their cannabis use. Patients successfully used cannabis as an alternative to prescription medication, as a complementary agent with traditional prescription medicines, and to gradually help halt the use of some prescription medications. Benefits described by participants included the effects of cannabis lasting longer than that of opioids, lower risk of addiction, fewer side-effects. Patients also saw their sleep, anxiety, appetite, and adverse reactions improve with the use of medical cannabis. Larger, more controlled studies may suggest cannabis more affirmatively as an alternative or complementary therapy with prescription medications.

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Benjamin Caplan, MDMedical Marijuana Confers Benefits Comparable to Prescription Medication, Without the Side Effects
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Some, But Not Enough Data on Cannabis for Chronic Pain

Overlaps in pharmacology for the treatment of chronic pain and mental health disorders

Select small trials have demonstrated cannabis to be more effective than other analgesics to treat chronic pain associated with certain conditions. However, the existing research lacks large-scale, controlled experiments relating medical cannabis use to pain management. Additionally, negative effects are documented with respect to cannabis use among adolescents and those suffering from compromised mental health. There is a need for further research on the topic.

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Benjamin Caplan, MDSome, But Not Enough Data on Cannabis for Chronic Pain
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Dronabinol May Provide Relief for Sleep Apnea Patients

Medical Cannabis and the Treatment of Obstructive Sleep Apnea: An American Academy of Sleep Medicine Position Statement

Obstructive sleep apnea is a sleep disorder causing episodic airway obstruction that results in the brief “apneic” (cessation of breathing) episodes for brief periods of time. A recent study investigating Dronabinol, a synthetic cannabis derivative, as a potential therapy for sleep apnea resulted in an improvement of 32% in the apnea-hypopnea index. However, the American Academy of Sleep Medicine does not endorse medical cannabis as a treatment for sleep apnea, due to what they point to as a lack of knowledge surrounding the long-term effects of its use. ” Based on these results, cannabis and its components should be further researched to determine its potential for sleep apnea treatment.

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Benjamin Caplan, MDDronabinol May Provide Relief for Sleep Apnea Patients
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Teens Regularly Consuming Cannabis More Likely to Have Suffered Sexual Abuse

Identifying teenage sexual abuse victims by questions on their daily lives

According to the World Health Association, approximately 13.4% of girls and 5.7% of boys experience child sexual abuse. Victims of child sexual abuse are more prone to, among other negative health and social outcomes, increased consumption of cannabis as teens. Teens who have been a victim to child sexual abuse are significantly more likely to participate in regular cannabis consumption than their non-sexually abused counterparts. Given its status as an international public health problem, further research needs to be completed to determine appropriate therapeutic plans for victims of child sexual abuse in order to reduce their increased odds of negative mental, physical, and emotional outcomes.

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Benjamin Caplan, MDTeens Regularly Consuming Cannabis More Likely to Have Suffered Sexual Abuse
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Guanfacine reducing cannabis withdrawal symptoms?

Guanfacine decreases symptoms of cannabis withdrawal in daily cannabis smokers

A study performed on daily cannabis users with cannabis use disorder (CUD) found evidence for Guanfacine to reduce the irritability and disturbances to sleep, characteristic of cannabis withdrawal. It is potentially a viable, improved alternative to Lofexidine, another treatment for CUD which happens to result in some adverse effects, including drowsiness, dizziness, and altered food intake. However, beyond these effects, while Lofexidine reduced cannabis self-administration following abstinence, Guanfacine did not in this study. Regardless, further research on the therapeutic effects of Guanfacine may be worthwhile and could help reduce cannabis cravings following withdrawal.

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Benjamin Caplan, MDGuanfacine reducing cannabis withdrawal symptoms?
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Edibles: Tasty or Not Tasty?

Edibles are a popular way to consume cannabis because they can be tasty & easy, but maybe this is a problem? Should meds be made unappealing to children or pets? Although many people enjoy treatment via gummy bears, is this a bad path? The Brilliant Dr Peter Grinspoon’s take: http://bit.ly/2KygQov

The following is an interesting perspective from Julie Beck @ https://www.theatlantic.com/health/archive/2017/07/the-tastiest-medicine/533937/

Some interesting related points to consider:

Taste buds likely evolved to detect foods which have a positive (or negative) effect on the body. It seems logical to assume that good taste would prime good effects. Also, cannabis has an effect similar to hypnotizability and suggestibility. If it tastes good, it’s logical to suggest that good tastes would suggest a higher likelihood of improved effect, from a psychological standpoint too.

A counter-argument: “If it tastes good, people (especially kids) would take it all the time. It actually should taste unpleasant so that you only take it when the alternative is worse.”

1 – Better-tasting medications may enhance pediatric adherence to drug therapy, where that is appropriate. 

2 – Sugars, acids, salt, and other substances may reduce perceived unpleasant taste of cannabis With respect to children, in one study, more than 90% of pediatricians suggested that a drug’s taste and palatability were the biggest barriers to completing treatment. 

3 – The potential for taste stimuli to activate nongustatory sensory systems, including those of a visceroceptive nature in the cases where the taste solutions are swallowed, must be considered, particularly as bitter tastes (likely with cannabis) are governed by GPR protein receptors.

4 – Pleasant tasting products activate a conditioned response:  good taste = good effect (when can then generalized to all pleasant-tasting edibles.

5 – “The unpleasant taste of medicine is often a sensory expression of its pharmacological activity; in many cases, the more potent the drug, the more bitter it will be. The more bitter, the more likely the drug will be rejected. Better-tasting medications may go a long way toward enhancing the ability of pediatric patients to adhere to drug therapy, especially when failure to consume may do harm and, in some cases, be life-threatening.” 

6 – On the other hand, frequent use of sucrose-sweetened medicines has been linked to dental caries 

Benjamin Caplan, MDEdibles: Tasty or Not Tasty?
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