Behavior change

Genes in the Endocannabinoid and Opioid Systems may Provide Biomarkers of Obesity

Title: Preclinical and Clinical Evidence for a Distinct Regulation of Mu Opioid and Type 1 Cannabinoid Receptor Genes Expression in Obesity

Researchers have recently found that alterations of the type 1 cannabinoid receptor gene (CNR1) and mu opioid receptor gene (OPRM1)  contribute to the development of obesity. This phenomenon was shown in rat models who were given a high-fat diet and humans currently dealing with obesity. Due to the possibility of the up-regulation of CNR1 and OPRM1 providing a mechanism for developing the obesity phenotype, those two genes could serve as biomarkers for obesity. Fortunately, the up-regulation of CNR1 and OPRM1 is reversible and may also provide a target for combatting obesity and encouraging weight loss in obese individuals. 

Highlighted here are the interactions of the endocannabinoid and opioid systems. Contradictory evidence concerning the interaction of the two systems has come out in recent years making it difficult to come to any conclusions. The endocannabinoid system has been thought to provide a safe and effective method for combatting the opioid crisis. Opioids are highly addictive and dangerous, but they are an efficient way to minimize pain which has kept them in mainstream medicine. Opioids have led to countless overdoses in recent decades causing researchers to search for a more ethical option for pain relief. Cannabis has a much better safety profile, poses no risk of overdose, and offers a welcome change of pace to traditional choices. Conclusive research is still needed to confirm, and reconfirm the details.

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Benjamin Caplan, MDGenes in the Endocannabinoid and Opioid Systems may Provide Biomarkers of Obesity
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The Endocannabinoid System’s Effect on the Cerebellum is a Drawback for Anti-Inflammatory Meds

Title: Monoacylglycerol lipase blockade impairs fine motor coordination and triggers cerebellar neuroinflammation through cyclooxygenase-2

Researchers are constantly considering how cannabis may impact the human brain, for better or worse. A recently published work points out a negative effect on the cerebellum, caused by the inhibition of the main enzyme that is used to break down the endocannabinoid “2- arachidonoylglycerol” (2-AG). By inhibiting the degradation of 2-AG, more of the endocannabinoid is allowed to remain in, and act upon, the human nervous system. This abundance of 2-AG results in reduced synthesis of prostaglandins, which produces an anti-inflammatory effect.

Unfortunately, the abundance of 2-AG also results in motor coordination deficits related to the effect on the cerebellum, but the addition of a cyclooxygenase-2 (COX-2) inhibitor (commonly found in many over-the-counter anti-inflammatory medications) reverses these cerebellar deficits. 

This highlights the far-reaching capabilities of the endocannabinoid system and at least one powerful angle where researchers could develop medications to indirectly impact the endocannabinoid system. Cannabinoids are still a politically hot topic, but synthesizing drugs that alter the level of endogenous cannabinoids available in the body is an ideal way to study the endocannabinoid system and its therapeutic benefits, without engaging with the red tape that surrounds cannabis. The receptors mechanisms for the endocannabinoid system certainly warrants further investigation.

Tweet: Researchers have recently revealed the negative effects on the #cerebellum caused by the inhibition of the main enzyme utilized for the degradation of the #endocannabinoid 2- arachidonoylglycerol (#2-AG). Learn more at

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Benjamin Caplan, MDThe Endocannabinoid System’s Effect on the Cerebellum is a Drawback for Anti-Inflammatory Meds
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Surveys show medical professionals’ opinions clashing around Cannabis

Surveys on medical professionals’ opinions on medical cannabis show that while many are still skeptical and do not think it is completely safe, younger doctors and those on the East coast are more supportive. This clash could be good for solving some common concerns with cannabis. http://bit.ly/2XQVxWz

Benjamin Caplan, MDSurveys show medical professionals’ opinions clashing around Cannabis
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Consuming CBD with THC Decreases Systemic Availability of THC

Title: Model-based analysis on systemic availability of coadministered cannabinoids after controlled vaporized administration 

A new study revealed findings that vaporizing cannabidiol (CBD) with ∆-9-tetrahydrocannabinol (THC) lowers the systemic availability of THC.

Researchers analyzed the blood plasma level of CBD and THC in a randomized, double-blind study, and found that those who inhaled a high dose of CBD were found to have lower levels of THC. Frequent cannabis users were found to have only minorly decreased levels of THC in their plasma when high doses of CBD was coadministered. Future studies should be conducted to examine the validity of these results for other consumption methods. 

This work highlights how those who have consumed too much THC can combat some of the symptoms associated with THC by consuming CBD. Occasionally, cannabis users may overindulge in THC and feel anxiety, panic, or dizziness. One of the best ways to combat such overindulgence (and lower the effects of THC) is to consume a high dose of CBD. Other, non-cannabis related, methods are also commonly recommended, such as relaxation or food with high levels of the terpenes caryophyllene and limonene. When using cannabis it’s important to start low and go slow in order to minimize the possibility of overindulgence. 

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Benjamin Caplan, MDConsuming CBD with THC Decreases Systemic Availability of THC
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The Current Research on Cannabis-Alcohol Interactions and Risk Factors for Using Them Together

Title: Cannabis and Alcohol- From Basic Science to Public Policy

This new analysis summarizes the most recent preclinical trials and epidemiological studies concerning the interactions between cannabis and alcohol, as well as possible risk factors for co-use. Specific risk factors, such as frequency of use or belonging to particular groups, were found to be significant within studies (but not across separate studies.) The compiled data reveals that previous research is inconsistent and emphasizes the need for further research to elucidate at-risk populations.  


This article highlights a few secondary findings which all focus on the gaps in our knowledge concerning cannabis, of which there are many. There may be potential concerns with the integration of cannabis into modern culture, which has essentially normalized alcohol consumption. Future research will undoubtedly evaluate these concerns, and highlight potential advantages that cannabis consumption may offer as an alternative option.

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Benjamin Caplan, MDThe Current Research on Cannabis-Alcohol Interactions and Risk Factors for Using Them Together
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A Call for More Research: Adolescent Cannabis Use and Mental Health Risks

Title: Adolescent Cannabis Use and Risk of Mental Health Problems – The Need for Newer Data

Here, an article presenting a case, justifying the need for new research to determine how cannabis use in adolescents may affect their risk for mental health. Few recent studies have come out discussing mental health and adolescent use. This is problematic because, over the years, cannabis products have been curated to be significantly more potent than in the past. Considering how vulnerable the brain is, during adolescence, because it is still developing, longitudinal studies need to be conducted to fully elucidate the effects of cannabis on development. 


This review highlights how poorly adolescents consuming cannabis seem to be at titrating their dose, or correctly self-regulating consumption of cannabis. There is an overall need for greater education before cannabis is acquired, from a dispensary or otherwise. For adults and teens seeking to self-regulate their use of cannabis, irrespective of the consumption method, it is difficult to succeed, considering the gross lack of knowledge and sophistication around the dosage. The wide variability in choice and make-up of cannabis products, added to the complexity associated with how each patient may process the myriad of cannabinoids within the products consumed leads to a complexity of confounding variables, and here, a call for more studies to be conducted on more than just adolescents. 

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Benjamin Caplan, MDA Call for More Research: Adolescent Cannabis Use and Mental Health Risks
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Incidents of Driving Under the Influence of Drugs Reveals A Need for Stricter Regulations

Title: A review of drug abuse in recently reported cases of driving under the influence of drugs (DUID) in Asia, USA, and Europe

A recent literature review has found that the current driving regulations in Asia, Europe, and the US have not prevented cases of driving under the influence of drugs. The authors observed steady trends of incidences of driving under the influence in all three regions, despite legislature specifically enacted against such actions. In the literature, there is a consistent recommendation that drivers should be regularly tested, especially in the case of an accident, in order to gather more data on the role of drugs in traffic accidents. 


This review highlights the different illicit drugs that contribute to traffic accidents, depending on the region of the world. Cannabis is legal in certain areas of Europe, whereas it is still considered an illicit substance here in the US, and many other locations, worldwide. Looking at the differences in severity or circumstance of the accidents between the type of illicit drug used may provide data to create more beneficial regulations for each country. As the legal status of cannabis continues to evolve, and it becomes more common to find drivers on the road who have consumed a minimal amount of cannabis, new screening techniques will likely be developed to help the culture establish what it considers an “acceptable amount” of blood-borne cannabinoids to be.

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Benjamin Caplan, MDIncidents of Driving Under the Influence of Drugs Reveals A Need for Stricter Regulations
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False Memory Formation Does not Differ between Cannabis Users and Controls

Title: False memory formation in cannabis users- a field study

This new study has revealed that although cannabis use does not increase the rate of false memory acquisition, cannabis use did increase the uncertainty of participants. It was also determined that intoxicated cannabis users were less accurate when recognizing true events, providing evidence that cannabis intoxication hinders memory formation.

This research provides a basis of knowledge for those interviewing people under the influence of cannabis for legal proceedings to determine the validity of their statements. If cannabis intoxication increases the uncertainty and liberal answers provided by users then their statements should be used sparingly or well-corroborated. 


This research highlights the importance of understanding cannabis for legal proceedings. More and more state governments are legalizing medical and recreational cannabis, each year, increasing the amount of those eligible to legally consume cannabis. As cannabis use continues to climb in popularity, witnesses or others interviewed in legal settings may not provide the most accurate information. Acute cannabis use should be a consideration related to legal proceedings so that the users’ statements can be weighed appropriately.  

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Benjamin Caplan, MDFalse Memory Formation Does not Differ between Cannabis Users and Controls
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The Endocannabinoid System May Play a Role in Autism Spectrum Disorders

Title: CB1 receptor antagonism in capuchin monkeys alters social interaction and aversive memory extinction

A recent study has revealed that the dysregulation of the endocannabinoid system may play a role in autism spectrum disorders (ASD). Using non-human primates, researchers were able to mimic some of the social impairment seen in autism models by antagonizing cannabinoid 1 receptors with synthetic cannabinoids. Future research may continue to show links between ASD and the endocannabinoid system, suggesting that cannabinoids may be used to treat the social impairments characteristic in ASD. 


This research highlights how the endocannabinoid system may provide novel targets for developing therapies for what have seemed, previously, to be treatment-resistant disorders. Autism is still not well-understood and has many false beliefs associated with it. By studying the possible role of the endocannabinoid systems in ASD, researchers may be able to shed light on the mechanism(s) underlining the disorders and develop targeted treatments that allow patients a degree of greater control over the symptoms.

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Benjamin Caplan, MDThe Endocannabinoid System May Play a Role in Autism Spectrum Disorders
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In Vivo Availability of Cannabinoid 1 Receptor Levels in Patients With First-Episode Psychosis

A 2019 study found that patients with early-stage psychotic disorders had lower levels of CB1-R (Cannabinoid Receptor – 1) compared to healthy individuals. These findings suggest that targeting CB1R with cannabis-based products could potentially treat psychotic disorders. Interestingly, reductions in CB1R levels were associated with greater symptom severity and poorer cognitive functioning but only in male patients. More research is needed into the intersections of gender and psychotic disorders.

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Benjamin Caplan, MDIn Vivo Availability of Cannabinoid 1 Receptor Levels in Patients With First-Episode Psychosis
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