Stigma

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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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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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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Video: Cannabinoids, Internal States, and Anxiety

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. 

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Benjamin Caplan, MDVideo: Cannabinoids, Internal States, and Anxiety
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Current Numbers for Cannabis Use Among Pregnant Women in the United State

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. 

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Benjamin Caplan, MDCurrent Numbers for Cannabis Use Among Pregnant Women in the United State
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A Report on the Psychiatric Effects of Cannabis Demonstrates the Progress and the Gaps in Cannabis Knowledge

Psychiatric effects of cannabis 

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. 

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Benjamin Caplan, MDA Report on the Psychiatric Effects of Cannabis Demonstrates the Progress and the Gaps in Cannabis Knowledge
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Herbal Treatments may prove valuable to treat Alzheimer’s Disease

Promising Therapeutics with Natural Bioactive Compounds for Improving Learning and Memory — A Review of Randomized Trials  

A recent review has determined that herbal treatments, such as those including flavonoids, are beneficial when attempting to prevent neurocognitive decline, commonly seen in Alzheimer’s Disease. Galantamine, quercetin, examples of two flavonoids, as well as huperzine A, bacoside A, and ginkolide B, three flavonoid-like compounds, all proved to be effective when used as a treatment for poor memory function. The authors mention the need for similar results in clinical trials but find the current data compelling evidence for future drug development. 

Highlighted in this paper is the current perception of herbal products as natural, gentle, and safe in comparison to current synthetic drugs. While herbal products are generally safer and considered to be more gentle, it is important to note that for these herbal compounds to truly be effective when treating patients they likely need modification in order to optimize their benefits. The modification would increase potency, selectivity, and pharmacokinetic abilities, as well as lessen any possible side effects. Synthetic drugs may seem frightening, particularly in light of recent illnesses and mortality associated with their abuse, but technology can also be used to optimize novel drugs and it can be efficient to do so. 



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Benjamin Caplan, MDHerbal Treatments may prove valuable to treat Alzheimer’s Disease
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Benin Republic Hemp Improves Male Fertility

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.

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Benjamin Caplan, MDBenin Republic Hemp Improves Male Fertility
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