SweetSue's Class Notes

[SweetSue]

Compliments of Tiffany, the Wake + Bake intern:

WHAT IS CBD?
I imagine CBD to be THC’s rad side kick and they are working together to make us feel better. That’s not to downplay the many other superhero cannabinoids in cannabis… but, CBD and THC are the primary ones.

Common ways of ingesting CBD are with tinctures, CBD oil, capsules, vaporizing or smoking, CBD topicals (lip balm, lotions, etc.), and even suppositories.

The Benefits of CBD
We’ve only begun to uncover the medicinal benefits of CBD. Here are some of the proven effects of CBD.

Anti-inflammatory

Combats inflammatory diseases such as, Irritable bowel syndrome (IBS), arthritis, fibromyalgia

Anti-tumoral/anti-cancer

Proven to shrink breast cancer cells and prevent them from growing

Combats tumor and cancer cells

Anti-psychotic

Combats psychotic disorders; such as, schizophrenia, delusional disorder, psychotic disorder

Anti-depressant

Combats mood disorders; such as, bipolar/manic depression, PTSD, panic disorder, addiction

Analgesic

Reduces chronic pain or pain that can be caused by many kinds of illnesses; such as, diabetes, fibromyalgia, IBS, etc.

Antiemetic

Reduces nausea caused by cancer, mood disorders, IBS, other digestion issues, etc.

Anxiolytic

Combats anxiety disorders; such as, Post Traumatic Stress Disorder (PTSD), panic disorder, Obsessive Compulsive Disorder (OCD), etc.

Antioxidant

“Protects body from damage caused by harmful molecules that can cause cancer.” – WebMD

Combats neurodegenerative disorders such as; Parkinson’s, Alzheimer’s, Huntington’s

Protects memory

Helps with Diabetes

Improves insulin levels, reduces blood glucose levels, reduces blood pressure and reduces inflammation

Anticonvulsant

Suppresses seizure activity caused by: seizure disorder, epilepsy


In 2007, there was a study at the California Pacific Medical Center in San Francisco done by Dr. Sean McAllister and some of his colleagues. They reported on how effective CBD can be when being used to kill breast cancer cells. According to ProjectCBD, “CBD destroys breast cancer cells by down-regulating a gene called ID-1, which is implicated in several types of aggressive cancer. Silencing the ID-1 gene is, thus, is a potential strategy for cancer treatment.”

CBD is Commonly Used for the Following Conditions

* Cancer
* IBS
* Diabetes/Metabolic Syndrome
* Fibromyalgia
* Chronic Pain
* Nausea
* Arthritis
* Anxiety/Mood Disorders
* Epileptic Disorders
* Parkinson’s Disease
* Chronic/Neuropathic pain
* Overcoming addiction (to things like: cigarettes/nicotine, opioids, alcohol, etc.)

 

[Lady G2HM]

Those brain diagrams say it all. Thank you for paving the way. .

 

[SweetSue]

Those brain diagrams say it all. Thank you for paving the way. .

I'm so glad you found this thread. I always think of you when I post here. I couldn't be happier to help you gain more understanding of how marvelously your body works and how powerful the healing force within you is.

When they diagnosed you they gave you a story with a sad and unsatisfying ending, and for a time you both bought that story. It thrills me that you figured out that the story that makes the difference isn't the one they write, but the one you write for your own internal dialogue, and the one you share with others. Your story is written with gratitude that your body has a way to heal itself and bring your beautiful brain back to its balance point.

You're an inspiration, and someday you'll be traveling around sharing this story with so much joy that it'll stun people.

I'm honored to be a small part in the beautiful story of your magnificent life.

 

[Lady G2HM]

Oh wow, that was powerful to read, thank you for investing in my future. I'm soaking it all up like a good brainy student ..

 

[SweetSue]

Burning Mouth Syndrome

Science/Human: Altered cannabinoid receptors in burning mouth syndrome
Burning mouth syndrome (BMS) is an intra-oral burning sensation, for which presently no medical or dental causes have been found, and in which the oral mucosa appears normal. Reseachers found that “in BMS patients there was increased TRPV1, decreased CB1 and increased CB2 expression in tongue epithelial cells also associated with a change in their distribution. It would appear that these receptors are related to BMS.”
Division of Anatomy and Physiopathology, University of Brescia, Italy.
Borsani E, et al. Histol Histopathol. 2013 Nov 5. [in press]

So....... How would one treat it with cannabis? I'd figure oil. Motoco successfully recommended a 2:1 ratio of THC:CBD using a sativa-dom. Given this bit of research showing the increase in CB2 receptors I'd think a balanced ratio might be a better choice. Suppositories would be recommended, since the syndrome is painful for any oral applications like tacking. One of the patients Motoco worked with complained of severe pain when tacking.

If I were making a recommendation, it'd be a balanced ratio, something high in beta-Caryophyllen for the additional pain relief and to activate more of the CB2 receptors.

 

[SweetSue]

Primary insomnia, under its current definition, is sleeplessness that cannot be attributed to a medical, psychiatric, or environmental cause. What I've discovered in researching insomnia is there's tremendous frustration on the part of insomniacs, believing that they're grossly misunderstood. It might be interesting to ask members to describe what insomnia means to them.

Let me start with Dr. Frankel's guidelines.

Anxiety and Insomnia: Using Cannabis For Treatment

Having trouble falling asleep and then staying asleep is very different from falling asleep but then having early morning waking.

For someone having difficulty falling asleep, but who stays asleep once they get there, a little CBD with THC will do.

A patient dealing with early morning waking is doing so because of cortisol spikes from the adrenal glands.
* If anxiety metabolites are already circulating due to either recycled anxiety or hard-wired anxiety the patient will wake with a start
* Treating with low doses of CBD during the day will generally result in easier early morning waking S.

Patients who don't seem to have anxiety issues and can drift off a balanced ratio of as little as 5 mg of THC:CBD will do the trick. Others may respond well to THC with little CBD present.

 

[SweetSue]

I believe the cannabinoid I'm looking for for diabetes is THCV.

From the Herb Company's list of good chemovars for diabetic treatment:


Doug’s Varin

This sativa may be a tricky flower to find. While it is sometimes available in California, Doug’s Varin is a strain bred to contain high levels of THCV.

THCV is a mildly psychoactive cannabis strain with a host of promising health benefits. In a Efficacy and Safety of Cannabidiol and Tetrahydrocannabivarin on Glycemic and Lipid Parameters in Patients With Type 2 Diabetes: A Randomized, Double-Blind, Placebo-Controlled, Parallel Group Pilot Study | Diabetes Care of 62 diabetic patients, scientists found that THCV treatment successfully improved fasting insulin levels and reduced blood glucose.

Doug’s Varin contains both THC and THCV. In fact, a test performed by Steep Hill Labs back in 2014 found that this bud contained about 19 percent THC and 15 percent THCV. That means this is one potent bud. Doug’s Varin is thought to have a zippy, energetic high that’s perfect for daytime consumption.


Black Beauty

Black Beauty is another rarity. However, based on the small amount of research available, this strain is a great match for patients with diabetes. At this time, this flower produces a 2:1 THC to THCV ratio. However, breeders hope to play up this strain’s ability to also produce decent amounts of CBD.

.............

With strong anti-inflammatory properties and the possible ability to improve insulin sensitivity, THCV and CBD are the two cannabinoids that have shown the most promise in diabetes.

 

[SweetSue]

Medical Cannabis Treatment for Adults and Children - Dr. Bonnie Goldstein

United in Compassion Medical Cannabis Symposium, Sydney, Australia, June 14-15, 2016

We need to stop identifying cannabis as a drug of abuse. It's a medicine.
- In all her years working in pediatric ERs with over 60,000 patients she never saw a cannabis patient problem.
- No one has ever died from ingesting cannabis.
- Education is the only way to move the message forward. Educate ourselves and share that knowledge.

In her practice she sees both adult and pediatric patients.
- Pediatric patients are mostly confined to treatment-resistant epilepsy, autism, and advanced cancer, though she does have some psychiatric disorder patients.
- Beginning to see an increase in a newly-diagnosed and little understood PAD or PANDA, a type of Pediatric Autoimmune Disease.
- The most common thing they see adults for is chronic pain, followed by a long list of everything, including sleep disorders, psychiatric concerns, and so on.
- Because of where the receptors are located the ECS effects almost every physiological system in the body.

There are over 400 compunds in the typical cannabis plant, over 100 of which are cannabinoids, the most studied among them THC and CBD.
- It's going to work differently in the body than a single isolate med will.
- Breeders are beginning to develop designer strains with increased amounts of particular cannabinoids.
- The entourage effect: the sum is greater than its parts. Choose whole-plant medicines and full-plant extractions over isolates.
- Terpinoids are basically essential oils that have medicinal properties.

The choice of what strain to choose to treat a particular disease is entirely individual.
- Determine the patient's goals from the treatment and assess the general condition of the patient.
- How is the patient expressing the disease? What's the underlying cause and how is this disease expressing itself in this patient.
- You want to pursue an individualized approach. Cannabis will offer an individual response.
- Patients with identical diagnoses, using identical strains with th same cannabinoid and terpene profiles and at the same dose, and have completely different response and experiences.

Start low, go slow
- Begin sub-therapeutically and titrate up slowly and thoughtfully.
- Dr. Abrams of UCSF stated it as "Patient will determine self-titrating dose."
- Its a little different for epileptic and cancer patients, but generally the patient gets to choose the dose.
- You'll find the sweet spot by trial and error, titrating up until you feel "too much!!" and then backing off one increment. This is the optimal therapeutic dose.

I like the way Martin Lee expresses it: you want a CBD-rich medication with as much THC as the patient can tolerate.

Cannabis is not one size fits all.

Your endocannabinoid tone is of great importance. Fall below or above that baseline and disease comes calling.
- She explains it to her patients as you have a point of balance where your ECS is working well. Disease sets in if your tone becomes deficient. Over-excitability of the system leads to receptors being taken off line, which can complicate things too.
- She likens it to a thyroid condition. If the thyroid was deficient your doctor would prescribe thyroid medication. If the ECS is deficient you bring in more cannabinoids, terpenes, and flavonoids.
- If you or someone you love has disease you haven't found a pharmacological solution to its worth supporting the ECS.
- If you're not supporting the ECS you're shooting around the target when the ECS is the bullseye.

New patient intakes include
- history, what they've tried as treatment, whether or not they've used cannabis before
- A cannabis naïve patient or one who used slightly years ago need to be handled differently from experienced patients.
- If someone used years ago you want to know what they're experience was like to help you decide which strain to choose and what treatment path to take.
- For someone who remembers being stressed by the experience, this may suggest they have a sensitivity to high THC or sativas.


Delivery method needs to be properly matched to the patient.
- Ask the patient "What sounds good to you?" (Speaking of experience)
- A patient going through chemotherapy may not be able to process edibles in the way you need. Chemo destroys the gut flora, so things don't get absorbed. How frustrating would that be?
- There must be options for delivery methods so patients have a wide range to search through to find what works for them.
- A majority of patients us inhalation (smoking or vaping), sublingual tinctures, and a small percentage of patients find edibles help.
- Dosing through the liver can be trickier with metabolism.

Effects of THC and CBD
- With most patients a combination formulation works best.

Bonnie's 3-Tier approach, developed so that patients would be able to read labels and determine the anticipated effects of the different ratios.
1) THC-rich medications are strong in the THC effect.
- The thought that THC is only recreational is erroneous. THC is powerful medicine. Control it with dosing and delivery.
- Don't drive when you're intoxicated
- Patients use THC-rich meds to treat sleep, pain, nausea, mood and appetite.

2) High ratio CBD:THC will be mostly influenced by CBD.
- This offers meds for daytime that avoids euphoric effects that come with THC.
- It's not sedating
- choose this type if treating pain inflammation, mood, and seizure disorders.
- Patients usually see euphoria fall away at 10:1.


3) Low ratio CBD:THC will have some intoxication, depending on the CBD content and the terpene profile.
- May or may not be psychoactive, it's that individual response, determined by patient's condition, how experienced a cannabis consumer they are and how their brain responds to the cannabinoids.
- CBD will buffer some of the euphoria, depending on your system's response to the compounds.
- Patients find relief for pain, inflammation, mood, sleep, neuropathic pain, and nausea.

Case report: 54-yr old woman with diabetic neuropathy.
- Middle school counselor, so very private about her cannabis use.
- History of adult-onset Diabetes 2 with 6 years of nerve pain interfering with sleep.
- Used to be morbidly obese, and underwent gastric bypass. Glucose was controlled by the procedure, but neuropathic pain persisted.
- Tried numerous drugs, including Gabapentin and opiods, to no avail.
- A friend gave her a cannabis edible prior to her visit, probably a high THC product, and she had complete relief from pain and was able to sleep again. She visited Dr. G to become legal.
- Started her on high-CBD tincture (25:1) for pain and uses topicals for feet if bothering her.
- She only treats on days when she has pain. This seems counterproductive to me. Obviously a baseline of available cannabinoids would go a long way to promoting more healing.
- At bedtime she uses a 1:1 ratio edible. She takes it at about 8-9 PM and gets between 618 hours of uninterrupted sleep, and her feet don't hurt when she wakes up in the morning.
- Again, if no pain she passes on the dose. She says some weeks are good, some not so good.
- She's now off all pain and sleep medications. She is now controlling with diet and is pharmaceutical-free.

Case report: 26-yr old woman with juvenile rheumatoid arthritis, diagnosed at the age of 15.
- Dr. G saw her first at the age of 24.
- Patient had significant side effects with conventional medication. She'd had a life-threatening reaction to one medication that sent her to the ICU, and she sought out Dr. G following that event.
- She was wheelchair bound, severely depressed, with severe pain and swelling, unable to go to school and care for herself.
- She was the oldest of four sisters, and the other two were living normal lives. She was feeling left behind, which caused anxiety and depression.
- She started out anti-cannabis, but enough friends and family had suggested it that she wanted to at least try.
- Started on a high-dose CBD oil, at a ratio of 27:1, upwards to 200 MG of CBD per day in three doses, spaced 8 hours apart. Also uses high THC sublingual meds for breakthrough pain.
- She knew she was getting better can now clip her own fingernails. She started cooking and can now shower on her own.
- She isn't taking any other medications

Case report: 47-yr old man, a construction worker, father of two, who had a severe work injury to his spine that herniated lumbar disc.
- Went the typical pharma route of opioids, muscle relaxers, nonsteroidals, physical therapy and epidural injections, with no real relief from any of that.
- He was reluctant to have surgery. From a family of police officers, he was reluctant to enquirer about cannabis, but someone had started him on cannabis, it worked, and he wanted to be legal.
- CBD was ineffective for his pain. He uses THC-rich meds at night.
- He says if he's overexerted himself at work and feels inflammation flaring up he now uses CBD as well at night, and he found he doesn't get the full-blown episodes where he can't get out of bed.
- He uses acupuncture and exercise to assist healing and is now pharmaceutical-free.

Pediatric use

- Science is pointing to ECS deficiency with seizure disorders and autism. If it's the ECS that's failing, it's the ECS we need to treat.
- Cannabis has an excellent safety profile. She sees no negative side effects with any of her pediatric patients.
- Quality of life is everything for these families. It may not be the perfect solution, but there usually will be some improvement and no negative side effects.
- Compassionate care and end-of-life patients.
- It took California nearly 22 years after passing the first MMJ law to finally get regulations up and running.

CBD use with epilepsy

There were 3 small trials with CBD and pediatric patients in the 70s and 80s. The last of the early trials with CBD and epilepsy was in 1985, and nothing else was done until 2005.

Findings showed
- CBD was well-tolerated
- there were little to no side effects
- it was a promising therapy

A 2005 presentation to the 2005 Congress on Cannabis and Cannabinoids in The Netherlands, summarizing an open study of 18 patients with refractory seizure disorder
- no side effects requiring CBD discontinuation
- the majority of patients saw at least a 25% improvement in seizures with low CBD doses
- all patients recieving CBD had improvement in consciousness and reduction in spasticity, if that was a symptom

Report in Epilepsy and Behavior in 2013
- 2 Stanford doctors interviewed 19 patients with severe epilepsy using CBD-rich cannabis (using Charlotte's Web)
- The average number of anti-seizure medications used was 12.
* Only 50% of children respond to the first medication used.
* Percentages drop with each new drug introduced- 13% respond to the second medication, 1-4% respond to the third medication.
* If you're trying 12 medications you can be sure you have a treatment-resistant condition, at least which conventional treatment.

THIS IS PURE BULLSHIT!!! To put children through this is reprehensible. I don't believe in hell, but there are moments I wish I did.

In their survey they found that 16 out of the 19 families reported a reduction in child seizure frequency while using Charlotte's Web.
- Two of the children became seizure-free. These were children who'd been told they were intractable.
- 8 out of the 19 reported a greater than 80% reduction.
- 6 out of 19 reported a 25% - 60% reduction

Beneficial side effects
* Increased alertness
* Better mood.
* Better sleep.

Adverse side-effects
* drowsiness
* fatigue

A small study out of Colorado showed that 73% of patients that took CBD oil showed a 98 - 100% reduction in seizures.
- At 3 months 45% were seizure-free

At 34:00 she begins to explain a chart we can't see in the video that would be really nice to find. It shows drug interactions with CBD.
- CBD can be metabolized in the liver, where many of these other drugs are also metabolized.
- Clobazam (brand name - Onfi) levels skyrocket upon administration of CBD. In one patient it rose to over 400%, where for others it was as low as 70 - 80%.
- The medication cocktail that the patient is on can confuse all the variables.

When adding CBD to the regimen of a child on Omfi you know to watch out for side effects, because Omfi levels aren't something anyone's thinking to check.

When adding CBD to a regimen that includes Lamotrigine (brand name Lamictal) alert the parents that an increase in seizures isn't the CBD, it's because the CBD is causing the Lamictal levels to drop, and because the practice is to start low and increase slowly there may not be enough CBD in the system to pick up the slack.

In a survey in UCCA of 117 families using whole plant oils to treat their children's seizure disorders:
* 85% reported seizure reduction
* 14% reported complete seizure reduction
* average number of anti-seizure meds was 8

Reported benefits
53% - improved sleep
71% - improved alertness
63% - improved mood

The study listed increased appetite as a bad side effect, but this is a disconnect from the reality the families share. Most families are pleased to have their children take an interest in food.

One study found that using CBD with Clobazam increased the chances of having seizure reduction
Clobazam co-therapy was associated with a higher rate of treatment - 57% vs 39%
*** You can use them together to get the dose of Clobazam down to a level where the negative side effects fall away.

She has two patients that they weaned entirely off pharmaceuticals that had seizure reduction, but not cessation. Once pharma drugs were gone there was a slight rise in seizures, so they put them each on very low dose Omfi and the children stabilized with reduced seizures.

Combination therapies are possible with patients with therapy-resistant conditions.

How CBD Works As An Anticonvulsant

THC is monogamous to the CB1 receptor

CBD has multiple sites of action.
- receptor-independant channels
- binds or blocks to 9 eCBRs
- modulates the flow of neurotransmitter
- modulates calcium channels
- CBD will block the uptake of your own endocannabinoids. If the child is having seizures due to an Endocannabinoid deficiency, CBD can theoretically enhance the child's ECS by freeing up anandamide.
- anti-inflammatory
- neuroprotective
- anti-oxidant

CBD is a multi-tasker, working on many levels and from many pathways. This may explain the widespread success with epileptic patients.

The challenge of tolerance

Patients with severe seizure disorders can develop tolerance, and you really can't keep ramping up the dose without introducing unwanted side-effects.

There's some concern about the effects of euphoria on the developing brain. I don't know if this is justified. There's anandamide in breast milk. It's my understanding that young children don't have the same concentration of eCB receptors as adults.
- We don't know the long-term effects of the multiple anti-convulsants on my the developing brain either. Cannabis looks like the better choice here.

Clinically she's found low doses of THC, either sub-lingually or through the gut, can be very helpful when weaning off anti-convulsants.
- If you're getting good results with co-therapy and decide to wean off the pharma drugs you may see an increase in seizures, called "withdrawal seizures". Families report that if they use low-dose THC for a couple weeks following a step-down reduction it can help them get through a very difficult period.

If you can get oil to 10 mg of THC per 1 ml, you can load a 1 ml syringe and administer down to .1 ml. Some children are very sensitive to low THC doses. You don't need a lot.

.1 ml is equal to about four drops, or 1 mg of THC in this particular formulation.

Doctors are enamoured with controlled dose. I see their point and counter that with cannabis "Close enough for government work" will also get the job done without dangerous side effects.

- You can titrate slowly and find the sweet spot, and then repeat it when you use oils you know the cannabinoid count in. [COLOR="#80008

She starts with a 25:1 or 27:1 CBD:THC ratio.
Most of her patients are using either Charlotte's Web or AC/DC. There are now 8 different chemovars that meet the requirements for effective medication for seizures. Find out what they are.
- If one doesn't work, try another.

She recounts the story of a young patient who developed rage following brain surgery. They have him on a 10:1 ratio, using a high THC medication. His seizures are under control (from 50 grand mal a month to 6) and he's back in school.

Having more than one chemovar means you can custom-mix a formulation that works for this particular patient.
- If you're trying strain after strain and not finding relief, consider mixing high CBD with high THC.

Other cannabinoids and hat may be useful for seizure control:

CBDV has been investigated as an anti-convulsant
- appears to have an additive effect when added to CBD

THCa, the non-psychoactive precursor to THC, is now available in CA in a measured oil.
- potent anti-inflammatory
- anecdotally it's an anti-convulsant

She has patients who can't get seizure control with CBD, so they added in THCa and have seizure control. She has patients that didn't respond to CBD but did to THCa.

CBN - conflicting reports

Delta-8 THC there's some tolerance that develops

THCV appears to be effective, but isn't readily available.

51:00 She shared a study she did with 200 of her patients that'd been on one cannabis oil for three months min.
- average # of drugs coming in was 12, ranging from 2 to 22
- After adding CBD the meds fell to an average of 3, with a range of 0 to 7.
- Patients present a wide range of other conditions. It's not just epilepsy they treat.

About 4% of patients had worsening seizures. It's hard to know if that was from drug interaction. Two of the 8 affected weren't on any medication.

About 6 patients had no response at all.

28 patients (14%) had no decrease in seizure events, but parents reported less intensity and shorter duration. When you're having a 2-minute seizure it feels like 20 minutes, so being able to get them down to something like 14 seconds is a change the families were happy with.
- They also reported cognitive improvement. The children were more alert and interactive.

Breaking down the seizures:
Overall they saw a 25 - 49% reduction in seizures.
18% had 50 -74% reduction
37% had 75 - 99% reduction
13% had seizure freedom

Over 68% of her patients surveyed had greater than 50% reduction in seizures.

Of the 27 seizure-free patients, 8 are off other medications.
- 40% were able to wean off one or more medications

The only side effects noted were drowsiness and diarrhea. Diarrhea is a potential complication of too high a dose of CBD.

Positive side effects:
- more alert
- better mood
- better sleep
- more energy
- better responsiveness to therapy
- improved appetite
- improved focus
- less hospital stays
- less need for rescue medications

Two patients with diabetes reported a more stable glucose level when they added CBD to the regimen.

They start patients at 1 mg/kg per day. She doesn't like to start high because this is a huge expense out-of-pocket for the parents and some children respond to the low dose. If you start too high you miss the optimal therapeutic dose.

She increases every couple weeks, as long as the child is tolerating the dose. Doses are administered sub-lingual lay, orally, or through the g-tube.

Average dose if 5-10 mg/kg per day, but that's deceptive, because every patient is individual, and the doses were all over the place.

For non-responsive you can
- change the chemovar
- change the CBD:THC ratio

There appears to be no tolerance to CBD. Once you find the dose, it seems to stay consistent. Influences to a dose increase would be growing, gaining weight, or some other variable.
- When weaning off other drugs she may increase CBD, to drop the dose back down after the drug has been cleared from the system.

You want to stay consistent with the chemovar. With pediatric patients there's a real concern that switching chemovars can trigger an increase in seizure occurance and severity.

CBD Saturation: There's no research data to back this up, but it's being reported by clinicians. If a patient has been on a very high dose of CBD long-term (6 months to a year) there may be an uptick in seizures when there's nothing else to point the finger at.
- The solution: skip a half-dozen doses, anywhere from 1-3 days worth of doses, and then reset at a lower dose. The child typically does great.

Of 25-30 patients she's tried this with, only 1 didn't respond positively.

She sees a fair number of children with autism. Their concerns include
- communication
-repetitive behavior
- social challenges: anxiety, tantrums
- self-injurious behavior or harm to others

The ECS regulates emotional responses. Anxiety, behavioral, social interactions, immune system concerns are all aspects of autism.

It's been suggested that it's tied to genetic malfunction of the ECS. Children with autism had an abnormality in the number of eCB receptors expressed on their white blood cells.

There are many anecdotal reports of children with autism responding to CBD and THC, sometimes in combination.

She surveyed 27 patients. All started on high CBD:THC.
- About 15% got more agitated. CBD can be too stimulating for some patients. In low doses, CBD can be alerting. Higher doses can be sedating.
- 63% reported calmer behavior, reduction in self injury, improved communication, improved focus, improved reports from therapists and teachers.

Many of her parents don't tell teachers or therapists that the child is on a cannabinoid therapy, in the hopes of getting unbiased positive feedback from professional support teams.

Dosing is lower than for epileptic patients.

1 - 3 times a day

Popular strains to treat autism:
Harlequin, Cannatonic, AC/DC, Charlotte's Web,

High CBD to THC can be too stimulating. By lowering the ratio you can sometimes balance it out

Case study of a patient, a 10-yr old girl, that stopped wandering the house at night when they introduced a low dose of THC at night. She also had less anxiety and more focus and her sleep improved.
- on the weekends they began toggling the THC into the mix until they found the sweet spot.

5 mg of CBD + 3 mg THC resulted in

Low behaviors
Low anxiety
Less fixating
Teachers reported good days and good behavior
No signs of psychoactivity.

Pediatric cancer

Cannabis can be used to treat symptoms, but it will also
- inhibit tumor growth
- cause apoptosis
- inhibit metastasis
- inhibit angiogenesis
- recent evidence shows synergism with some chemo drugs

She uses combination high CBD and THC doses for cancer patients. It's all new territory with no real research to back it up yet.

She shared a story of a patient who came to her at 17 after years of chemo and numerous surgeries. They'd sent him home, telling him he had 90 days. The parents decided to go with cannabis and without her knowledge got him up to a gram a day, 1:1 CBD:THC. When the scans were done months later he was cancer-free.

Why do we persist in this madness? His oncologist sent him to Bonnie for end-of-life, after they'd put him through hell for years, right there in a state that was legal. Why do we allow this to persist?

 

[SweetSue]

Next up: The ECS

Let's see if I can have some study fun this next year and make Cajun smile at the same time.

 

[SweetSue]

Jeffrey Chen, MD, Director, UCLA Cannabis Research Institute

Players:
* endogenous cannabinoid receptors
* eCBs anandamide and 2AG
* enzymes that degrade eCBs
On-demand synthesis of endocannabinoids

CB1 receptor resides on pre-synaptic cell

eCBs are created from lipids in post-synaptic cell membrane

Activation of eCBR attenuates influx of calcium. In physics, attenuation is the gradual loss of flux intensity through a medium.

This is a way for the post-synaptic cell to have some protection against disruptions to homeostasis.

At 11 "So having this auto-protective, negative feedback mechanism...so this is very different to how typical neurotransmitters work.

And the other thing that's interesting to note is that classic neurotransmitters are water soluble, and so they're made beforehand and stored in vesicles. Like in this diagram, we see glutamate is stored in vesicles and released on demand.

Endocannabinoids, being lipid soluble, you can't really store them in vesicles as well, they'll just kind of float out. So they're synthesized on demand, released on demand, travel in a retrograde fashion, and afterwards they're degraded by these enzymes like FAAH, which degrades anandamide, or MAGL, which degrades 2AG. "

The obvious follow up question: how do phytocannabinoids interact with our ECS?

THC is a partial agonist at both CB1 and CB2 receptors.

CBD doesn't appear to activate either eCB receptors directly.

It's believed CBD inhibits FAAH, thereby boosting certain endocannabinoid levels, like anandamide.

CBD also targets non-cannabinoid receptors, like serotonin and vanilloid.

CBD is an allosteric modulator at the eCBR
- not an agonist, an allosteric modulator
- CBD is a negative allosteric modulator at the CB1R, which might explain the ability to attenuate the psychoactive effects of THC when taken in combination with THC.

Pick up at 13:50 OR start at the beginning. This was incomplete.

*sigh* I'll need to relight the spark in the morning.

 

[SweetSue]

 

[SweetSue]

 

[SweetSue]

A TED talk by one of the creators of the following film on the inner life of a cell.

 

[SweetSue]

Interview with Jeffrey Chen, MD, Director, UCLA Cannabis Research Institute

Cannabis contains hundreds of compounds, the most studied of which are THC (Tetrahydrocannabinol) and CBD (Cannabidiol)
- there are actually over 100 different cannabinoids, most unidentified
- cannabinoids are pret much unique to the cannabis plant (they show up in limited variety and supply in a few other plants)
- also find terpenes, fatty acids, and flavonoids

Even today the government has approved medications based on cannabinoids, although they refuse to admit that there's any medicinal value to the plant. This divergence from scientific evidence is the basis for their keeping the plant on the schedule.
- Marinol, synthetic THC, has been available since the 1980s, approved for nausea induced by chemo, for patients with anorexia, and AIDS
- In Europe Sativax, a balanced med of THC and CBD is available for MS
- In the US we're in late-stage trials for Epidialex, purified CBD, for pediatric epilepsy.

These are FDA approved medications for synthetic compounds of the natural source, cannabis.
- Remaining a Schedule 1 drug means it can't be studied without jumping through hoops put in place to stall or frustrate research to a standstill.
- This stance also severely restricts funding that can be directed to medical cannabis.

In the early 1990s the first successful cloning of the CB1R occured.
- This led to the realization that there were multiple sub-types of these receptors.
* eCB1 is predominantly found in the CNS, eCB2 is found mostly on the immune cells
* This is not a hard-fast rule. CB2 receptors can be found in the brain, particularly during the healing of brain trauma, and CB1 receptors can be found throughout the body, for instance on the cells of the liver, fat cells, on the surface of muscle cells, and bone tissue.

The predominant receptors are to influence neurotransmitters, but that's not the only function of eCBRs.
* The concentration of eCBRs being in the CNS is simply because of the sheer number of brain cells that are in the human body.
Functions of the ECS
- A very primitive system, thought to only have evolved over 500 million years ago.
- As old as our endogenous opiate system.
- Functions are broad, stretching from mood to memory, sleep, pain response, stress response, immune function, reproductive function, energy metabolism, embryology and fetal development.
- Within a few days of life embryonic cells begin expressing eCB1Rs and there're cannabinoids in breast milk.
- eCBs are arguably the most diversified and widely-expressed signalling molecules in the human body.
* This expression is true across all vertebrate families.
- This important physiologic body system is charged with maintaining homeostasis.

Homeostasis = The maintenance of a stable environment, despite external forces, stressors, or changes in the external environment.

Players of the ECS
* endogenous cannabinoid receptors
* eCBs anandamide and 2AG
* enzymes that degrade eCBs, FAAH and MAGL (break down eCBs in the synaptic cleft)

eCB1 receptors are the most abundant G-coupled receptors in the mammalian brain
- most concentrated in the hippocampus, basal ganglia, and cerebellum, but also found on cells throughout the body

eCB2 receptors are found predominantly in the immune system (leucocytes in the blood and micro glia in the brain)
- also in tissues of the heart, lungs, bone, liver, and reproductive organs

Cannabinoids are primarily neurotransmitters, but are also found circulating in the blood and body.
- Precursors are omega fatty-acids.
- When you supplement omega fatty-acids into your diet (omega-3s) you'll see a boost in eCB levels in the brain.

How eCB signalling works

Picture A shows a pre-synaptic neuron, and the receptors on the post-synaptic neuron. This is a classical example of how energy flows through the neurons.
- As action potential travels down neuron, it triggers voltage-gated calcium channels.
- An influx of calcium causes the release of a neurotransmitter (in this example the excitaory transmitter glutamate).
- Glutamate binds to the downstream receptor, opening calcium channels on the post-synaptic neuron, allowing the action potential to propagate.

Picture B shows the inclusion of eCB into the picture.
- The action potential travels down the pre-synaptic cell, releasing glutamate as per the example above.
- In addition to triggering calcium channels in the post-synaptic cell you also have on-demandsynthesis of endocannabinoids.
- eCB ps are created from fatty acids stored in the cellular membrane.
- eCBs travel in a retrograde fashion, across the synaptic cleft, back to CB1 receptors on the pre-synaptic neuron.
- The activation of the eCB1 receptor slows the flow of calcium, thus slowing or stopping the release of the neurotransmitter.

This is a protective measure for the post-synaptic cell, in this case against too much excitation.

CB1 receptor resides on pre-synaptic cell

eCBs are created from lipids in post-synaptic cell membrane

Activation of eCBR attenuates influx of calcium. In physics, attenuation is the gradual loss of flux intensity through a medium.

This is a way for the post-synaptic cell to have some protection against disruptions to homeostasis.

At 11 "So having this auto-protective, negative feedback mechanism...so this is very different to how typical neurotransmitters work.

And the other thing that's interesting to note is that classic neurotransmitters are water soluble, and so they're made beforehand and stored in vesicles. Like in this diagram, we see glutamate is stored in vesicles and released on demand.

Endocannabinoids, being lipid soluble, you can't really store them in vesicles as well, they'll just kind of float out. So they're synthesized on demand, released on demand, travel in a retrograde fashion, and afterwards they're degraded by these enzymes like FAAH, which degrades anandamide, or MAGL, which degrades 2AG. "

The obvious follow up question: how do phytocannabinoids interact with our ECS?

THC is a partial agonist at both CB1 and CB2 receptors.

CBD doesn't appear to havecmuch activity at either eCB receptors directly.

It's believed CBD inhibits FAAH, thereby boosting certain endocannabinoid levels, like anandamide.

CBD also targets non-cannabinoid receptors, like serotonin and vanilloid.

CBD is an allosteric modulator at the eCBR
- not an agonist, an allosteric modulator
- CBD is a negative allosteric modulator at the CB1R, which might explain the ability to attenuate the psychoactive effects of THC when taken in combination with THC.

Therapeutic potential of cannabis

A disfunction of the ECS is implicated in an incredibly wide variety of pathalogic states.
- Certain diseases of the CNS or degenerative diseases are looking like therapeutic targets for cannabinoid therapies.
- Degenerative neural diseases and mood disorders are both affected.
- Low levels of anandamide are found in the systems of schizophrenics.
* In a recent study that treated schizophrenics with CBD it reduced the psychosis of the disease, and it's believed that was due to CBD's ability to boost anandamide levels in the system.
- The ECS can be a target for cardiovascular disorder, liver diseases, IBS.
- The ECS disfunction is implicated in obesity and diabetes, in certain bone disorders like osteoporosis, as well as in cancer and auto-immune disorders.

This is a brand new area for drug development.
- At the moment there aren't many drugs that target the ECS. At the moment we're limited to Marinol and Sativax.
- A weight loss drug, Romanoban (?) that targeted the CB1 receptors was pulled from the market despite its success in reducing appetite. It also had a high incidence of depression and suicide. This is not an easy-fix drug market.

Traditionally there's been very little funding for the therapeutic values of cannabis.
- In the US cannabis is a Schedule 1 drug, locking up access and funds.
- The federal government will fund studies into the dangers of cannabis, but not into the therapeutic potential.
- Despite the majority of states approving of medicinal cannabis the federal govt has been adamantly unresponsive to the will of the people.
- In a legal state you can't access legitimately-available cannabis for research. You have to accept the trash the federal govt grows.

Modulating Endocannabinoid function
- Exogenous cannabinoids, like phytocannabinoids, modulate the ECS activity.
- Non-cannabinoid components like terpenes and flavonoids also modulate the ECS.
- Beta-Caryophyllen, present in cannabis and in black pepper, is a CB2 agonist.
- Lifestyle modifications can change ECS activity. After exercise ECS levels are boosted. Runner's high is a real high.
- Ibuprophen boosts endocannabinoid levels.
- Dietary changes like increasing the intake of omega fatty acids will boost endocannabinoid levels.

Focus of the UCLA center will be the use of cannabis or its cannabinoids for their opiod-sparing properties.
- We have a national epidemic of opioid abuse. There's an opioid overdose every 15 minutes, with no signs of slowing down.
- The epidemic is so profound that it's bending the life-expectancy curve for our country, reversing a trend that's been ongoing for the past 25 years. In the last year it fell.
- There's conclusive evidence that cannabinoids can be used for chronic pain.
- States that enact medical cannabis laws see a dramatic decrease in opioid prescriptions and overdose
- Controlled lab experiments demonstrate that cannabinoids have opioid-sparing properties. Add cannabinoid therapy and you can reduce opioid need.

So far there hasn't been a longitudinal study of the use of cannabis or cannabinoids in the care of pain patients on opioids.

In states with medical cannabis laws doctors aren't permitted to prescribe cannabis, they can recommend
- Prescribing means there's a standardized, replicatable, high-quality source of cannabis that can be prescribed in a metered dose.
- A court case in 2000 secured the right of a doctor to recommend cannabis to the patients in states that allow it, protecting the physicians from federal prosecution.
- In legal states the state medical boards officially recognize. That there's medical benefit to cannabis.
- Typically physicians aren't allowed to recommend a particular brand or product, nor are they necessarily allowed to direct patients to a particular store or dispensary.


Interview with Dr. Raphael Mechoulam

Certain disease states respond best to particular cannabinoids.
- Auto-immune diseases, where the body attacks itself for various reasons, responds best to CBD-rich medications.
- Diabetes Type-1 is a disease where the body attacks the cells that produce insulin. CBD is much more important than THC.
- In trauma it's apparently THC that's more important.

What role does cannabis play in up-regulating the ECS?
- The NIH recently stated that the ECS is involved in all disease states.
- CBD can relieve anxiety and mild depression so it's implicated for daily use in a society that has a proclivity for stress.
- Dr. Mechoulam believes that non-clinical depression can be effectively treated with CBD.

In mouse studies CBD has been a good treatment for head trauma. There have been no clinical trials.

In the 1980s he was part of small clinical trial (15 patients) of epilepsy treated with CBD.
- Of the 8 patients recieving CBD 4 had no seizures, 3 had reduced incidence, and only 1 was unresponsive to CBD.

For 35 years our federal government held up the research, extending and expanding the suffering.

Clinical trials are now underway in the US, and as that data begins to flow you won't be able to stop the interest.

Pick up at 29:58

 

[SweetSue]

Continuing on...

Interview with Jeffrey Chen, MD, Director, UCLA Cannabis Research Institute

Cannabis contains hundreds of compounds, the most studied of which are THC (Tetrahydrocannabinol) and CBD (Cannabidiol)
- there are actually over 100 different cannabinoids, most unidentified
- cannabinoids are pret much unique to the cannabis plant (they show up in limited variety and supply in a few other plants)
- also find terpenes, fatty acids, and flavonoids

Even today the government has approved medications based on cannabinoids, although they refuse to admit that there's any medicinal value to the plant. This divergence from scientific evidence is the basis for their keeping the plant on the schedule.
- Marinol, synthetic THC, has been available since the 1980s, approved for nausea induced by chemo, for patients with anorexia, and AIDS
- In Europe Sativax, a balanced med of THC and CBD is available for MS
- In the US we're in late-stage trials for Epidialex, purified CBD, for pediatric epilepsy.

These are FDA approved medications for synthetic compounds of the natural source, cannabis.
- Remaining a Schedule 1 drug means it can't be studied without jumping through hoops put in place to stall or frustrate research to a standstill.
- This stance also severely restricts funding that can be directed to medical cannabis.

In the early 1990s the first successful cloning of the CB1R occured.
- This led to the realization that there were multiple sub-types of these receptors.
* eCB1 is predominantly found in the CNS, eCB2 is found mostly on the immune cells
* This is not a hard-fast rule. CB2 receptors can be found in the brain, particularly during the healing of brain trauma, and CB1 receptors can be found throughout the body, for instance on the cells of the liver, fat cells, on the surface of muscle cells, and bone tissue.

The predominant receptors are to influence neurotransmitters, but that's not the only function of eCBRs.
* The concentration of eCBRs being in the CNS is simply because of the sheer number of brain cells that are in the human body.
Functions of the ECS
- A very primitive system, thought to only have evolved over 500 million years ago.
- As old as our endogenous opiate system.
- Functions are broad, stretching from mood to memory, sleep, pain response, stress response, immune function, reproductive function, energy metabolism, embryology and fetal development.
- Within a few days of life embryonic cells begin expressing eCB1Rs and there're cannabinoids in breast milk.
- eCBs are arguably the most diversified and widely-expressed signalling molecules in the human body.
* This expression is true across all vertebrate families.
- This important physiologic body system is charged with maintaining homeostasis.

Homeostasis = The maintenance of a stable environment, despite external forces, stressors, or changes in the external environment.

Players of the ECS
* endogenous cannabinoid receptors
* eCBs anandamide and 2AG
* enzymes that degrade eCBs, FAAH and MAGL (break down eCBs in the synaptic cleft)

eCB1 receptors are the most abundant G-coupled receptors in the mammalian brain
- most concentrated in the hippocampus, basal ganglia, and cerebellum, but also found on cells throughout the body

eCB2 receptors are found predominantly in the immune system (leucocytes in the blood and micro glia in the brain)
- also in tissues of the heart, lungs, bone, liver, and reproductive organs

Cannabinoids are primarily neurotransmitters, but are also found circulating in the blood and body.
- Precursors are omega fatty-acids.
- When you supplement omega fatty-acids into your diet (omega-3s) you'll see a boost in eCB levels in the brain.

How eCB signalling works

Picture A shows a pre-synaptic neuron, and the receptors on the post-synaptic neuron. This is a classical example of how energy flows through the neurons.
- As action potential travels down neuron, it triggers voltage-gated calcium channels.
- An influx of calcium causes the release of a neurotransmitter (in this example the excitaory transmitter glutamate).
- Glutamate binds to the downstream receptor, opening calcium channels on the post-synaptic neuron, allowing the action potential to propagate.

Picture B shows the inclusion of eCB into the picture.
- The action potential travels down the pre-synaptic cell, releasing glutamate as per the example above.
- In addition to triggering calcium channels in the post-synaptic cell you also have on-demandsynthesis of endocannabinoids.
- eCB ps are created from fatty acids stored in the cellular membrane.
- eCBs travel in a retrograde fashion, across the synaptic cleft, back to CB1 receptors on the pre-synaptic neuron.
- The activation of the eCB1 receptor slows the flow of calcium, thus slowing or stopping the release of the neurotransmitter.

This is a protective measure for the post-synaptic cell, in this case against too much excitation.

CB1 receptor resides on pre-synaptic cell

eCBs are created from lipids in post-synaptic cell membrane

Activation of eCBR attenuates influx of calcium. In physics, attenuation is the gradual loss of flux intensity through a medium.

This is a way for the post-synaptic cell to have some protection against disruptions to homeostasis.

At 11 "So having this auto-protective, negative feedback mechanism...so this is very different to how typical neurotransmitters work.

And the other thing that's interesting to note is that classic neurotransmitters are water soluble, and so they're made beforehand and stored in vesicles. Like in this diagram, we see glutamate is stored in vesicles and released on demand.

Endocannabinoids, being lipid soluble, you can't really store them in vesicles as well, they'll just kind of float out. So they're synthesized on demand, released on demand, travel in a retrograde fashion, and afterwards they're degraded by these enzymes like FAAH, which degrades anandamide, or MAGL, which degrades 2AG. "

The obvious follow up question: how do phytocannabinoids interact with our ECS?

THC is a partial agonist at both CB1 and CB2 receptors.

CBD doesn't appear to havecmuch activity at either eCB receptors directly.

It's believed CBD inhibits FAAH, thereby boosting certain endocannabinoid levels, like anandamide.

CBD also targets non-cannabinoid receptors, like serotonin and vanilloid.

CBD is an allosteric modulator at the eCBR
- not an agonist, an allosteric modulator
- CBD is a negative allosteric modulator at the CB1R, which might explain the ability to attenuate the psychoactive effects of THC when taken in combination with THC.

Therapeutic potential of cannabis

A disfunction of the ECS is implicated in an incredibly wide variety of pathalogic states.
- Certain diseases of the CNS or degenerative diseases are looking like therapeutic targets for cannabinoid therapies.
- Degenerative neural diseases and mood disorders are both affected.
- Low levels of anandamide are found in the systems of schizophrenics.
* In a recent study that treated schizophrenics with CBD it reduced the psychosis of the disease, and it's believed that was due to CBD's ability to boost anandamide levels in the system.
- The ECS can be a target for cardiovascular disorder, liver diseases, IBS.
- The ECS disfunction is implicated in obesity and diabetes, in certain bone disorders like osteoporosis, as well as in cancer and auto-immune disorders.

This is a brand new area for drug development.
- At the moment there aren't many drugs that target the ECS. At the moment we're limited to Marinol and Sativax.
- A weight loss drug, Romanoban (?) that targeted the CB1 receptors was pulled from the market despite its success in reducing appetite. It also had a high incidence of depression and suicide. This is not an easy-fix drug market.

Traditionally there's been very little funding for the therapeutic values of cannabis.
- In the US cannabis is a Schedule 1 drug, locking up access and funds.
- The federal government will fund studies into the dangers of cannabis, but not into the therapeutic potential.
- Despite the majority of states approving of medicinal cannabis the federal govt has been adamantly unresponsive to the will of the people.
- In a legal state you can't access legitimately-available cannabis for research. You have to accept the trash the federal govt grows.

Modulating Endocannabinoid function
- Exogenous cannabinoids, like phytocannabinoids, modulate the ECS activity.
- Non-cannabinoid components like terpenes and flavonoids also modulate the ECS.
- Beta-Caryophyllen, present in cannabis and in black pepper, is a CB2 agonist.
- Lifestyle modifications can change ECS activity. After exercise ECS levels are boosted. Runner's high is a real high.
- Ibuprophen boosts endocannabinoid levels.
- Dietary changes like increasing the intake of omega fatty acids will boost endocannabinoid levels.

Focus of the UCLA center will be the use of cannabis or its cannabinoids for their opiod-sparing properties.
- We have a national epidemic of opioid abuse. There's an opioid overdose every 15 minutes, with no signs of slowing down.
- The epidemic is so profound that it's bending the life-expectancy curve for our country, reversing a trend that's been ongoing for the past 25 years. In the last year it fell.
- There's conclusive evidence that cannabinoids can be used for chronic pain.
- States that enact medical cannabis laws see a dramatic decrease in opioid prescriptions and overdose
- Controlled lab experiments demonstrate that cannabinoids have opioid-sparing properties. Add cannabinoid therapy and you can reduce opioid need.

So far there hasn't been a longitudinal study of the use of cannabis or cannabinoids in the care of pain patients on opioids.

In states with medical cannabis laws doctors aren't permitted to prescribe cannabis, they can recommend
- Prescribing means there's a standardized, replicatable, high-quality source of cannabis that can be prescribed in a metered dose.
- A court case in 2000 secured the right of a doctor to recommend cannabis to the patients in states that allow it, protecting the physicians from federal prosecution.
- In legal states the state medical boards officially recognize. That there's medical benefit to cannabis.
- Typically physicians aren't allowed to recommend a particular brand or product, nor are they necessarily allowed to direct patients to a particular store or dispensary.


Interview with Dr. Raphael Mechoulam

Certain disease states respond best to particular cannabinoids.
- Auto-immune diseases, where the body attacks itself for various reasons, responds best to CBD-rich medications.
- Diabetes Type-1 is a disease where the body attacks the cells that produce insulin. CBD is much more important than THC.
- In trauma it's apparently THC that's more important.

What role does cannabis play in up-regulating the ECS?
- The NIH recently stated that the ECS is involved in all disease states.
- CBD can relieve anxiety and mild depression so it's implicated for daily use in a society that has a proclivity for stress.
- Dr. Mechoulam believes that non-clinical depression can be effectively treated with CBD.

In mouse studies CBD has been a good treatment for head trauma. There have been no clinical trials.

In the 1980s he was part of small clinical trial (15 patients) of epilepsy treated with CBD.
- Of the 8 patients recieving CBD 4 had no seizures, 3 had reduced incidence, and only 1 was unresponsive to CBD.

For 35 years our federal government held up the research, extending and expanding the suffering.

Clinical trials are now underway in the US, and as that data begins to flow you won't be able to stop the interest.
- most are with CBD due to the side effects of THC

Recounts a clinical trial done in Israel using high doses of pure CBD (300-400mg doses) with bone marrow transplant patients
- reduced many of the discomfort suffered by these patients
- a company is now developing a medication as a result of these trials

With schizophrenia, a German clinical trial demonstrated that high doses of CBD (800 mg per day or more) helped patients find relief.
- Schizophrenia is widespread, effecting 1% of the world's population, and the common meds prescribed come with unwanted side effects.

How does Dr. Mechoulam see cannabis being used therapeutically to greatest effect, at this stage?
- Israel has 26,000 patients using medicinal cannabis, most for pain.
-

He stated that it's not for acute pain "If you're going to have your tooth pulled, it's not for that."

He's wrong. I had five teeth pulled, and the only pain relief I needed to get through it with no unreasonable discomfort was cannabis, and not all that much either. I don't know that Dr. Mechoulam has ever used cannabis.

- He can see that it's used to good effect for pain, anxiety, depression, but he wants more clinical data.

Although I see the need for more data flowing, I don't see the lack of data as a deterrent to clinical use. Most of why we do the trials is to determine safe doses. Not effective doses, but safe doses. Cannabis is as safe as they come. You can't be hurt the way pharmaceuticals will hurt you. With cannabis you can sleep it off.

He believes that the medical use and recreational use should be seperate entities.

I think they should just be free, and get out of our way, thank you very much.

He believes the medical side should be advanced the way we do for pharma drugs, lab tests to animal trials to clinical trials.

Recreational use is a social concern. Work that out socially. It needs to be regulated in a completely different way from medical cannabis.

Interview with Dr. Stuart Silverman, M.D., Rheumatologist and cannabis expert

Dr. Silverman works with UCLA and in private practice

Most of his patients have chronic pain. He discovered that cannabis not only helped with pain, but also positively impacted many other systems like sleep, appetite, mood regulation and more, all concerns made more complicated by Pharma drugs.

After being asked to do a talk on cannabis he did research at dispensaries and in the field and became a strong advocate.

He's interested in the potential of relief from bone damage, inspired to dream by the work coming out of Dr. Mechoulam's lab.

He uses cannabis to help them taper down on opioids. It allows them to reduce opioid doses and get greater relief, translating into better social functionality.

He deals mostly with pain, sleep disruption, and nausea, but also sees relief from muscle spasms, and glaucoma. He knows it's used for AIDS, cancer and IBS with great effect.

He's excited about the new work being done with pediatric seizure patients.

He's seeing good signals coming from pediatric bone marrow cases. The plans for clinical trials for using cannabis to treat Graft vs Host are underway.

The entourage effect speaks to whole-plant medicine. The whole is more than the parts.

He uses cannabis in his practice to:
- gain better pain and body management
- reduce opioid dependency

His peers don't know much at all about medicinal cannabis. He says they hear from their patients that it's effective, and they'd like to know more.
- He believes some are reluctant to discuss cannabis as a therapeutic modality because they don't know what to say to their patients.
- They're uninformed and I'm getting really tired of hearing this. It's coming on 2018. California will go fully legal next month, and we still have doctors uneducated about the therapeutic effects of cannabis? This is on them for choosing to keep their heads in the sand.

Patients risk losing good care by asking about cannabis. "What if he's not receptive? What if he refuses to treat me because I use cannabis?"

Health risks and concerns
- He doesn't prescribe for recreational, he has patients seeking relief. Many have psychological pain associated with RH - anxiety, depression, panic disorder, etc, etc.
- High THC and the wrong terpene mix can aggravate anxiety and depression.
- They've seen cases in the ER of hyperemesis (One wonders how many cases have been seen and how that translates to the population?)
- He makes a statement at around 47:50 about it potentially being a problem for lung conditions when it's been proven already that cannabinoids benefit the lungs, period. It's not helpful when the experts are ill-informed, is it?

If the patient and physican are going to have a dialogue that will benefit the patient it helps if the doctor is speaking from what's known and not from the stereotypical propaganda talking points.

He deals with many patients with fibromyalgia. One of the chief concerns is chemical sensitivity. They're also sensitive to light, sound, and smell. He always recommends that lab results he consulted to avoid mold or mildew in the harvest.

Methods of administration
- Smoking is most familiar.
- Edibles are too difficult to control the timing of onset, as well as equal distribution of cannabinoid content.
- He prefers sublingual. Sprays are becoming preferred sublingual administration.

Once pain is controlled he pushes exercise and nutritional control.

His first focus on cannabinoid therapies is on THC content, because of its euphoric effect.
- He typically begins with pure CBD or a low THC, 20:1 or 25:1 CBD:THC, or no more than 5% THC.
- studies with AIDS patients with neuropathy showed best effect with 1:1 ratio, but he has a fear of the euphoria.

WHY ARE WE SO AFRAID OF FEELING GOOD?

Labeling needs to improve.

Doctors do no one a service by sitting on the fence and waiting to be hand fed.
- Many patients know more about medical cannabis than their doctors do. I'd call that most patients.
- Patients appreciate being able to have medical support and oversight for their cannabinoid therapies. AMEN!

 

[SweetSue]

The ECS balances the CNS with the Immune system. I went looking for decent info on how that works.

A "complete" book that somehow overlooked the master system.

Haven't yet found a name for the pad.

 

[ginganinja30]

The ECS balances the CNS with the Immune system. I went looking for decent info on how that works.

A "complete" book that somehow overlooked the master system.

Haven't yet found a name for the pad.

Hi Sue. Would you be able to reply with the ISBN number or the link for this book please.

Looks like a good addition to my study material ...

 

[SweetSue]

Neuron input C is an endocannabinoid.

How is it possible that I know that and the physiology specialist that complied this pretty book didn't?

I can't wrap my head around the disconnect in the medical community. It's not my place to make it right. I'll make it my place to have our membership better informed than their doctors. Is anyone else seeing the potential in this information as applies to cannabinoid therapies?

 

[SweetSue]

Neuron input C is an endocannabinoid.

How is it possible that I know that and the physiology specialist that complied this pretty book didn't?

I can't wrap my head around the disconnect in the medical community. It's not my place to make it right. I'll make it my place to have our membership better informed than their doctors. Is anyone else seeing the potential in this information as applies to cannabinoid therapies?

Edit: not a cannabinoid itself, but modulated by an eCB. I'd bet my life the inhibitory neuronal impulse C is modulated by the release of an eCB.

 

[Lady G2HM]

Neuron input C is an endocannabinoid.

How is it possible that I know that and the physiology specialist that complied this pretty book didn't?

I can't wrap my head around the disconnect in the medical community. It's not my place to make it right. I'll make it my place to have our membership better informed than their doctors. Is anyone else seeing the potential in this information as applies to cannabinoid therapies?

Are you kidding me SweetSue, THIS IS HUGE!!! I mean, you/we are essentially unveiling a system that heals with Cannabinoids. That would be called Adult Neuro Genesis for the brain - the act of creating new neurons. A whole new way to heal that the medical system doesn't even recognize, but it's not NEW to you/us. WOW, SweetSue, you are opening the doors for us to learn. From a patients pov, I am a walking chronicle that promotes the living truth and high functioning of the ECS system and how it can promote healing for the brain.

I need to research this more soon. Those pages are exactly what I must look at and read about their particular role. That's why video's are sooo good, thank you for that.

I just didn't realize what a big deal that was until you took us on this search. Wow, goosebumps moment I have. You are the connection...you bring us all together. You will be the one to unveil the truth... Lead on dear Teacher, we are listening... Such a profound moment to learn this is happening. Mark this day.