Cannabis

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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Maintain a Balanced Diet when Consuming Oral Cannabidiol

Title: Food effect on pharmacokinetics of cannabidiol oral capsules in adult patients with refractory epilepsy

Researchers have recently revealed the importance of maintaining a balanced diet, when consuming cannabidiol (CBD). Consuming oral capsules containing CBD may be a more consistent method of consumption than blending CBD into liquids or solid foods, but unfortunately, capsules do not prevent a high degree of potential fluctuation of dosing. The fat content of a meal may vary widely, and so may change the active concentrations of CBD which become active in the bloodstream. In other words, the effects felt by a consumer may be either stronger or weaker, and differ in duration, related to the method of consumption, and the product make-up taken. Patients considering CBD as a therapeutic intervention, who also want a consistency of effect, would be wise to be mindful to maintain a diet with a balanced amount of fat (oils, butter, etc.) when consuming CBD capsules. 


This article highlights the variation of effects felt when altering consumption methods. For example, edibles and inhaled cannabinoids of the same dosage have extremely different effects, because of how they are processed in the body processes. When inhaled, tetrahydrocannabinol (THC) diffuses across structures in the lungs known as alveoli, and are then transmitted to circulate throughout the bloodstream. Edibles introduce THC into the system by first metabolizing with liver enzymes, resulting in an altered metabolite of THC circulating throughout the body. This subtly-altered metabolite of THC can be more potent than the starting material, although the onset is delayed due to the process of consumption, digestion, and metabolism. All consumers would do well to research their consumption method of choice and proceed carefully when switching between methods. 

Tweet: Researchers have recently revealed the importance of maintaining a balanced #diet when consuming #cannabidiol (#CBD). Learn more at

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Benjamin Caplan, MDMaintain a Balanced Diet when Consuming Oral Cannabidiol
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Standardized Registries may Improve Our Knowledge about Cyclic Vomiting Syndrome

Title: Cyclic vomiting syndrome- Pathophysiology, comorbidities, and future research directions

A recent article has called for the establishment of a multicenter registry in order to learn more about cyclic vomiting syndrome and related disorders. Creating such a registry would provide a database of patients for clinical trial recruitment, research on patient outcomes across different treatment methods, the underlying mechanism for the disorder, and the ability to identify potential biomarkers for the disorder. The registry would expand our understanding of the disorder, on all fronts, and hopefully, reveal the most effective treatment method. 


Could such a registry be created while still safeguarding patient privacy?


Highlighted in this article is the similarity of cyclic vomiting syndrome and cannabinoid hyperemesis syndrome (CHS). CHS is often misdiagnosed or goes undiagnosed for an exorbitant amount of time. By creating this registry for cyclic vomiting syndrome and related disorders, including CHS, the same information about genetics, underlying mechanisms, and effective treatments could also be determined.

Finding a genetic basis for cannabinoid hyperemesis syndrome would support patients looking into cannabis-based medicine to decide if cannabis would even be an effective treatment, by allowing them to discover possible side effects to which they might be more susceptible.

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See the full available literature on Cannabinoid Hyperemesis Syndrome here: http://bit.ly/2XHfdrI


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Benjamin Caplan, MDStandardized Registries may Improve Our Knowledge about Cyclic Vomiting Syndrome
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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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Video: Medical Cannabis Around the Globe & Across Centuries

Throughout the ages, from health & wellness, religious rituals, and textile applications to the entertainment and social elements, cannabis has been a vital part of multiple sectors of human culture.

For millions, the modern cannabis revival is a welcome return home to a core element that has been missing for years.

 

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Benjamin Caplan, MDVideo: Medical Cannabis Around the Globe & Across Centuries
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Between Bitter and Sweet Honey, from Algeria Mediterranean Coast, Different Flavonoid Content Contributes to Distinct Antioxidant Potentials

Characteristics of the bitter and sweet honey from Algeria Mediterranean coast

Previous research on honey and its historical use in traditional medicine has pointed toward its therapeutic application for the immune system, anemia, and heart function, among other conditions.

Two kinds of honey harvested from the Algeria Mediterranean coast, so-called poly-floral sweet honey and uni-floral bitter honey, have demonstrated their many medicinal uses. In a comparative analysis of the two kinds of honey, bitter honey had higher flavonoid content, lower sucrose content, and higher total polyphenols and tannins levels, giving it an increased antioxidant potential over sweet honey.

Additional Point: Factors including a higher flavonoid content in uni-floral bitter content gives it an improved antioxidant potential over poly-floral sweet honey. This makes for a wide variety of clinical benefits, including treatment of anemia, colon cancer, improved immune function, and more.

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Benjamin Caplan, MDBetween Bitter and Sweet Honey, from Algeria Mediterranean Coast, Different Flavonoid Content Contributes to Distinct Antioxidant Potentials
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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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Topical Cannabis to help heal chronic wounds

Another thoughtful piece by Abbie Rosner at Forbes, reviewing the healing of chronic wounds with topical cannabis treatments.

https://www.forbes.com/sites/abbierosner/2019/07/09/cannabis-based-medicine-a-breakthrough-for-healing-intractable-chronic-wounds/#7b1362bf9387

Benjamin Caplan, MDTopical Cannabis to help heal chronic wounds
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More Research Needed to Determine Impacts of Cannabis Use During Pregnancy

Cannabis Use in Pregnancy

With rates of cannabis use during pregnancy more than doubling between 2002 and 2017, a need for more studies, over longer periods of time, which investigate prenatal cannabis use has emerged. Existing data ranges from reporting an increased risk for preterm birth and low birth weight to cannabis reducing the risk of preeclampsia and gestational diabetes during pregnancy. Concerns are historically informed by preliminary alcohol and cocaine studies that falsely suggested no gestational harm, despite the eventual recognition that these substances ultimately carry significant risk. Pregnant women should exercise caution in their cannabis use until more definitive conclusions are found, regarding maternal cannabis use.

The decision of where, if anywhere, cannabis fits in relationship to pregnancy is populated with more questions than answers. There are a handful of good quality, long-term studies, to date, that show a pattern that informs some degree of generalization: by and large, the less frequently consumed, and the later during the pregnancy the consumption, the less potential risk. But, for the sake of any pregnant woman and her baby, this type of decision should always be made in direct consultation with the obstetrician supporting the pregnancy.

Additional Point: A lack of high-quality studies relating to cannabis use and gestational risk has resulted in conflicting evidence surrounding prenatal cannabis use. However, historical context involving prenatal alcohol and cocaine use studies informs the need to exercise caution before definitive conclusions are made

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Benjamin Caplan, MDMore Research Needed to Determine Impacts of Cannabis Use During Pregnancy
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