A new literature review summarizing the recent findings relating to cannabis and anxiety.
Researchers conclude that CBD and low-dose THC can cause relaxation and decrease anxiety and self-spun thoughts. Some studies show that high-dose THC can cause psychotic symptoms; however, studies also show that CBD can protect against those THC-induced symptoms. Therefore, using cannabis extracts with THC and CBD could be a safe way to reduce anxiety.
Something still not entirely understood is why cannabis affects people differently. A study looking at THC interactions in the brain show that rewarding and adverse effects are produced by anatomically different areas. Individual experiences likely differ due to genetic variation.
Self-reported Medical and Nonmedical Cannabis Use Among Pregnant Women in the United States
An observational study has revealed that the prevalence and frequency of cannabis use in pregnant women have increased over the past two decades.
No trends were seen although except a slight decrease in fetal growth in women who frequently used during the first two trimesters. The data concerning fetal growth, such as length and weight, were not statistically significant and would require further studies to appropriately indicate a correlation between cannabis use and decreased fetal growth.
The authors acknowledge that cannabis use may suffer from recall bias as women may underestimate the amount of cannabis they consumed or purposely withheld some information due to stigma, although some of the surveyed women were using recommended medical cannabis.
This article highlights the large issue surrounding women consuming cannabis while expecting. Cannabinoids are able to cross the placenta and therefore affect the fetus during development. The American College of Obstetrics and Gynecologists recommend the cessation of any cannabis consumption while pregnant although there has been limited data discussing the actual effects on fetal development. A previously featured article on this blog stated that cannabis use had no effect on birth outcomes but also noted uncertainty in the possible effect on fetal growth. Considering this uncertainty, physicians should push for more research so that women who take medical cannabis can accurately discern whether or not to cease consumption while pregnant.
Safety and Efficacy of Medical Cannabis in Fibromyalgia
A recent study has concluded that cannabis is a safe and effective treatment for patients suffering from fibromyalgia symptoms.
Fibromyalgia is a disorder characterized by widespread pain, fatigue, and issues sleeping. Cannabis is well known for its ability to treat pain, especially in lieu of opioids as the side effects are minimal and the risk of addiction minimal. This study found that over 200 patients were greatly benefited by cannabis as it moderated their pain and improved their mood. Future studies should aim to directly compare cannabis-based treatment with the currently accepted methods of fibromyalgia treatment to validate efficacy.
This study highlights how beneficial cannabis can be for those patients who are treatment-resistant for the general treatment of most disorders, especially when pain is involved. Cannabis has been proven to be much safer than opioids, and yet our lack of complete information, concerning the exact mechanisms of the endocannabinoid system and how different cannabinoids act on those mechanisms severely limits our ability to offer practical, novel therapies. Cannabis has previously been shown to be beneficial for treatment-resistant forms of epilepsy and depression, which holds promise when continuing to look for novel treatments for other disorders that have proven difficult to treat.
A report published by the British Journal of Psychiatry in 2001 demonstrates the progress the medical community has made but also what gaps still need to be filled in when utilizing cannabis. This report found that excess consumption of cannabis leads to feelings of panic and anxiety and that 15% of those willing to respond to a survey experienced acute psychotic symptoms. It was also found that cannabis dependence can occur, as well as withdrawal, which can last for close to a week. This article was a review that synthesized relevant studies but also claimed that the casual conclusions of these papers were difficult to find or replicate.
This paper is interesting given its age considering it put out what was current data but then ended by stating the casual conclusions of each paper may not stand. 18 years later, some of the data has stood, and some have not. Users can gain a tolerance to cannabis but many are looking to mitigate it. The author uses the word dependence when discussing cannabis which is a word that holds weight and is up for debate. Intoxicating cannabinoids, like THC, affect the reward center, but non-altering cannabinoids, such as CBD, tend to work more noticeably outside of the brain, although all have mixed effects in both regions. Cannabinoids are not all the same, apply quite differently to various ailments, and have divergent effects. Blanketing an entire crop with a misinformed warning label seems irresponsible and unduly harsh. Users or those looking into cannabis-based medicine are encouraged to do their research.
Orbitofrontal cortex volume prospectively predicts cannabis and other substance use onset in adolescents
Researchers have recently unveiled that the volume of the lateral orbitofrontal cortex (OFC) is able to predict future substance use in adolescents. Individuals were followed for 13 years after undergoing magnetic functional resonance imaging and surveyed for cannabis and alcohol use. Interestingly, the authors chose to utilize those who had used cannabis, but in limited quantities, as a control group instead of including them in their cannabis users group. Similarly, the alcohol only group of participants also included those who used cannabis multiple times within the past year. Nevertheless, the authors conclude that the size of the lateral OFC is able to predict drug use in adolescents although not without admitting the need for replication and validity.
This paper represents an important example of biased information within the medical community. Bias is inherent, there is no way around it. But, it is the duty of researchers to publish their findings while remaining as objective as possible, and to do so, transparently. The grouping decisions for the study groups here, and the choices the authors made regarding statistical analysis of this data are odd, considering their definitions and broad claims. This may be due to the views of the organization funding the research, or the bias of the research team members themselves, but the limitations of the study should be considered strongly. Even beyond the groupings, the fact that this research took place in a state where cannabis use is legal for recreational and medical use is a reason to consider other confounding variables. Scientists have an obligation to pursue the truth and not extrapolate their findings to fit a personal or professional agenda. Many articles cherry-pick statistics and extrapolate small findings of data, leaving readers and media outlets to polularize findings that do not represent a full picture. It falls on discerning readers to read mindfully and consider a study’s methodolgy and demographics, as carefully as possible.
Cannabinoid-deficient Benin republic hemp (Cannabis sativa L.) improves semen parameters by reducing prolactin and enhancing antioxidant status
Cannabis sativa, specifically Nigerian hemp, has been found to have adverse effects on male fertility. It’s use has been linked to a decrease in semen parameters, germ cell proliferation, and reproductive organ weight. It can induce hyperprolactinemia, a condition causing infertility in 11% of men with low sperm count.
Data from the National Drug Law Enforcement Agency in Nigeria has suggested users preferentially obtaining hemp from the Benin Republic. In a recent study investigating the composition of Benin republic hemp, a lack of THC and lower levels of cannabinol were observed. Additionally, an ethanol extract of Benin republic hemp increased sperm count, morphology, and viability.
Additional Point: Certain phytocannabinoids found in cannabis have demonstrated a detrimental effect on male fertility. However, analysis of hemp from the Benin republic shows a low to no levels of these toxic cannabinoids and evidence points to this particular hemp enhancing male fertility.
Characteristics of Daily E-Cigarette Use and Acquisition Means Among a National Sample of Adolescents
From 2017 to 2018 the amount of middle school and high school electronic cigarette (e-cigarette) users increased by 48% and 78% respectively. One of the first studies examining the association between e-cigarette characteristics and daily use among US adolescents is calling for comprehensive tobacco control efforts to reduce e-cigarette and nicotine addiction among adolescents. 38% of adolescent users report using their e-cigarette devices for cannabis which can be hazardous due to the lack of regulation. The potential risks associated with nicotine use and the dangerous misuse of these devices for other substances is putting youth’s health at risk.
A 2018 literature review summarizes the various ways patients can consume cannabis (orally, topically, etc.) and the pain reductions associated with each method. The review focuses on the treatment of multiple sclerosis, cancer, anorexia, arthritis, and other painful disorders.
