Beneficial Cannabinoids

EXOGENOUS CANNABINOIDS

The cannabis plant has hundreds of compounds, with more than eighty classified as cannabinoids. Cannabinoids in the cannabis plant are known as phytocannabinoids. Each phytocannabinoid produces different effects.

TETRAHYDROCANNABINOL (THC)

THC is the most widely known cannabinoid and is found in high concentrations in most cannabis strains. Its psychoactive properties cause a “high” feeling.

  • euphoria
  • relaxation
  • pain relief
  • appetite stimulation
  • anti-inflammatory
  • amplified senses
  • improved sense of well-being
  • increased creativity
  • prevention of nerve damage
  • antispasmodic, minimizing spasms and convulsions
  • minimization of vomiting and nausea
  • antioxidant, fighting free radicals in the body
  • promotes growth of new brain cells
  • protects brain cells from damage

When patients consume too much THC, it is possible to experience negative effects. Potential side effects of THC include:

  • anxiety and paranoia
  • confusion or disorientation
  • dry mouth and eyes
  • short-term memory problems
  • potential long-term alterations to memory (particularly verbal memory)
  • increased heart rate
  • sense of slowed time
  • decreased body temperature
  • tremors
  • tolerance over time, reducing effectiveness of THC

TETRAHYDROCANNABINOLIC ACID (THC-A)

THC-A has numerous benefits as a neuro-protectant and anti-inflammatory agent. THC starts in the cannabis plant as THC-A, an acidic compound that is non-psychoactive. When heated, THC-A converts to THC, producing a high; this occurs through decarboxylation. When applying heat to cannabis (decarboxylation), chemical reactions occur and transform THC-A into THC.

What is THC-A effects and benefits:

There isn’t enough research on THCA to definitively state what it can treat and with what degree of efficacy, but preliminary research and anecdotal evidence suggest that THCA will play a pivotal role in cannabis medicine as the industry propels forward. Here are some of the potential benefits studies have started to unveil:

  • Anti-inflammatory properties for treatment of arthritis and lupus
  • Neuroprotective properties for treatment of neurodegenerative diseases
  • Anti-emetic properties for treatment of nausea and appetite loss
  • Anti-proliferative properties noted in studies of prostate cancer

TETRAHYDROCANNABIVARIN (THCV)

THCV is similar to THC in its molecular structure and psychoactive properties but produces different effects. THCV is an appetite suppressant, can regulate blood sugar levels, reduces anxiety, and stimulates bone growth. THCV also improves tremors, motor control, and brain lesions associated with Alzheimer’s disease. THCV is not common in most strains but is most abundant in African sativas such as Durban Poison, Pineapple Purps, and Willie Nelson.

What is THCV effects and benefits:

Research has shown that THCV is effective in the treatment of a variety of symptoms and conditions. Examples of conditions for which THCV is particularly effective in providing symptom relief are listed below:

  • PTSD
  • Parkinson’s disease
  • Seizures (including epilepsy)
  • Alzheimer’s disease

CANNABIDIOL (CBD)

CBD is a non-psychoactive compound that balances the effects of THC. CBD has many medical benefits. Some medical cannabis users prefer CBD to treat their symptoms because of the minimized feelings of euphoria in strains offering higher CBD content.

Benefits of CBD:

  • balances/reduces THC’s negative effects
  • anti-inflammatory properties
  • neuron protection against injury and degeneration
  • mood improvement
  • pain relief
  • antipsychotic characteristics
  • anti-spasmodic
  • decreased appetite

Potential side effects of CBD:

  • dry mouth
  • low blood pressure
  • lightheadedness
  • drowsiness (may be a benefit depending on goal)

CANNABINOL (CBN)

CBN is created when THC is exposed to air. When cannabis is left out in the air, it will have a higher concentration of CBN; this is why many patients keep their cannabis in tightly sealed containers to maintain THC levels. CBN is psychoactive, but at a much lower level compared to THC. CBN causes little to no psychoactive effects, even though it is a psychoactive cannabinoid. This is because CBN content is usually less than 1% in cannabis products. CBN is known for its ability to fight insomnia or sleep issues. It offers similar effects to pharmaceutical sedatives in smaller doses; 5mg of CBN has the same effect as 10mg of diazepam.

Positive effects of CBN include:

  • appetite stimulant
  • sleep aid
  • pain relief
  • anti-inflammatory
  • effectiveness against antibiotic-resistant strains of MRSA infections
  • immune system regulation
  • anti-spasmodic and anti-convulsant
  • supports bone cell growth
  • antioxidant, fighting free radicals in the body
  • reduces intraocular pressure

Potential side effects of CBN:

  • groggy feeling
  • dizziness
  • confusion

CANNABIGEROL (CBG)

CBG is non-psychoactive and is a foundation for THC and CBD. It is formed early in the growing cycle and is not found in large quantities as the plant matures. Strains with higher CBG content tend to minimize the negative effects of THC for many users.

Benefits of CBG:

  • relief of intraocular pressure
  • antibiotic effects
  • antifungal effects
  • pain relief
  • possible anti-tumor effects
  • antidepressant
  • mood regulation
  • antioxidant, fighting free radicals in the body
  • anti-inflammatory
  • counteracts paranoia sometimes experienced with THC

CANNABICHROMENE (CBC)

CBC is a non-psychoactive cannabinoid that is the second most available cannabinoid in cannabis after THC.

Benefits of CBC:

  • anti-inflammatory in the intestinal tract
  • anti-tumor effects
  • antidepressant
  • mild anti-fungal
  • antibacterial against E. coli, staph infections, etc.
  • encourages the growth of new brain cells
  • pain relief, although not as significant as other cannabinoids

by mdradmin

How to Make Cannabis Tinctures

Old-School Method

This is the slowest method, but it’s also the most famous. You’ve probably heard of “Green Dragon” if you haven’t already had it. The fact that it takes almost no extra materials can’t be hurting its popularity.

The Ed Method

Are you a fan of Ed Rosenthal? If so, He seems to come up with the ways of doing things, but even better, he always has a reason behind his methods. This technique is from his newest book on concentrates/edibles (Beyond Buds: Next Generation) and I suggest you pick up a copy. It has good info and I’m sure you’ll learn something new!

Water Bath Method

The water bath method is a fast way to make tinctures, but it also requires the most care since you have to make sure the water bath doesn’t get too hot.

Magical Butter

The Magical Butter Machine is the way to make tinctures. It stirs it more, it constantly heats the material, and it has infinite patience, unlike a human being. It can stir and heat your tincture for 8 straight hours with no work on your part past the initial setup.

1. Old-School Method

This is the slowest method, but it’s also the most famous. You’ve probably heard of “Green Dragon” if you haven’t already had it. The fact that it takes almost no extra materials can’t be hurting its popularity.

Supplies Needed:
  • Medical Cannabis
  • High-Proof Alcohol
  • Dark Colored Mason Jar with Lid
Steps:
  1. Decarboxylate 1oz of weed.
  2. Add the cannabis to a glass container like a mason jar.
  3. Add about 300ml of alcohol to the jar. Close the jar tight.
  4. Place the jar somewhere cool and dark for about 3 months. Shake up the jar when the mood strikes you.

*Alternate Method: Shake the jar over the course of an hour; many people believe this is just as effective as waiting for 3 months. I don’t know if it’s just as effective, but I tested the 60-minute method and it definitely works. It’s like a less-quick quick-wash.

2. The Ed Method

Are you a fan of Ed Rosenthal? If so, He seems to come up with the ways of doing things, but even better, he always has a reason behind his methods. This technique is from his newest book on concentrates/edibles (Beyond Buds: Next Generation) and I suggest you pick up a copy. It has good info and I’m sure you’ll learn something new!

  • Medical Cannabis
  • High-Proof Alcohol
  • Dark Colored Mason Jar with Lid
  • Blender
  • Large Metal Bowl
  • Extra Large Bowl
  • Coffee Filters
Steps:
  1. Decarboxylate 1oz of medical cannabis
  2. Add the medical cannabis to your strainer, then put the strainer in the large metal bowl
  3. Fill the bowl with water until the medical cannabis floats, and let it sit for 90 minutes.
    1. This should help leech out some of the chlorophyll from your bud.
  4. Pull the strainer from the bowl so the water drains.
  5. Collect your wet medical cannabis into a ball and squeeze the water out with your hands.
  6. Break up the squeezed medical cannabis and add it to your blender.
  7. Add about 300ml of your alcohol to the blender and blend on low for 5 minutes.
  8. Let the mixture sit for an hour, then blend again for 5 minutes.
  9. Pour the mixture through the strainer making sure to collect the used medical cannabis material.
    1. Make sure to squeeze any tincture out of the material.
    2. The mixture you just filtered is a potent cannabis tincture! Put it to the side so you can store it later.
  10. Put the used medical cannabis material in a container with fresh alcohol to soak for another hour.
  11. Pour the mixture through a strainer again, but this time you can discard the used medical cannabis.
  12. Pour your tincture into an amber or cobalt blue jar that can be sealed.
  13. Your tincture is ready!

3. Water Bath Method

The water bath method is a fast way to make tinctures, but it also requires the most care since you have to make sure the water bath doesn’t get too hot.

Oddly enough, this method is the lower-budget version of using a Magical Butter Machine since it does all the same things but needs you to be there to take action and monitor for safety.

Important: Do not perform this method with any open flames anywhere in your house! Evaporating alcohol creates a flammable vapor and having an open flame anywhere near flammable vapor is a recipe for fiery disaster. Please be safe!

  • Medical Cannabis
  • High-Proof Alcohol
  • Dark Colored Mason Jar with Lid
  • Dark Colored Mason Jar with Lid (for storage)
Steps:
  1. Decarboxylate 1oz of medical cannabis.
  2. Grind up your cannabis.
  3. Add the medical cannabis to your mason jar.
  4. Add about 300ml of your alcohol of choice to the jar.
  5. DO NOT CLOSE OR SEAL THE JAR!
  6. Fill the pot with 1” of water and place on an electric stove (no gas stoves!) on medium.
  7. Use your thermometer to make sure the water is no hotter than 165°F.
  8. Place the unsealed mason jar with your medical cannabis and alcohol into the pot.
    1. This is called a water bath. See the picture below to see what it looks like.
  9. Adjust the temperature as needed until the alcohol/cannabis mixture gets to 165°F and let it cook for 30 minutes.
    1. Stay next to the water bath and make sure it doesn’t get too hot (above 165°F).
  10. Remove the jar from the water bath and let it cool for about 30 minutes.
  11. Pour your tincture through a coffee filter over a bowl to filter out the tiny particulates.
    1. This step isn’t necessary, but it looks nicer.
  12. Pour your tincture into an amber or cobalt blue jar that can be sealed.
  13. You’re done!

4. Magical Butter

The Magical Butter Machine is the way to make tinctures. It stirs it more, it constantly heats the material, and it has infinite patience, unlike a human being. It can stir and heat your tincture for 8 straight hours with no work on your part past the initial setup.

  • Medical Cannabis
  • High-Proof Alcohol
  • Magical Butter Machine
  • Dark Colored Mason Jar
  • Mesh Strainer
  • Large Metal Bowl
  • Coffee Filters
Steps:
  1. Decarboxylate 1oz of medical cannabis.
  2. Add the medical cannabis to your Magical Butter Machine without grinding it.
  3. Add 2cups (or more for a less potent product) of your alcohol to the machine.
    1. 2 cups are the bare minimum you can add.
  4. Set the temperature to 130°F.
  5. Set the timer to 4 hours (tincture) or set it to 8 hours for a stronger product.
  6. Let the machine finish, then unplug it and let your mixture cool for 30 minutes.
  7. Pour your tincture through a coffee filter over a bowl to filter out the tiny particulates.
  8. This step isn’t necessary, but it looks nicer.
  9. Pour your tincture into an amber or cobalt blue jar that can be sealed.
  10. Tincture time!

by mdradmin

Medical Cannabis

There are few subjects that can stir up stronger emotions among doctors, scientists, researchers, policy makers, and the public than medical cannabis. Is it safe? Should it be legal? Decriminalized? Has its effectiveness been proven? What conditions is it useful for? Is it addictive? How do we keep it out of the hands of teenagers? Is it really the “wonder drug” that people claim it is? Is medical cannabis just a ploy to legalize cannabis in general?

These are just a few of the excellent questions around this subject, questions that I am going to studiously avoid so we can focus on two specific areas: why do patients find it useful, and how can they discuss it with their doctor?

Cannabis is currently legal, on the state level, in 29 states, and in Washington, DC. It is still illegal from the federal government’s perspective. The Obama administration did not make prosecuting medical cannabis even a minor priority. President Donald Trump promised not to interfere with people who use medical cannabis, though his administration is currently threatening to reverse this policy. About 85% of Americans support legalizing medical cannabis, and it is estimated that at least several million Americans currently use it.

Cannabis without the high

Least controversial is the extract from the hemp plant known as CBD (which stands for cannabidiol) because this component of cannabis has little, if any, intoxicating properties. Cannabis itself has more than 100 active components. THC (which stands for tetrahydrocannabinol) is the chemical that causes the “high” that goes along with cannabis consumption. CBD-dominant strains have little or no THC, so patients report very little if any alteration in consciousness.

Patients do, however, report many benefits of CBD, from relieving insomnia, anxiety, spasticity, and pain to treating potentially life-threatening conditions such as epilepsy. One particular form of childhood epilepsy called Dravet syndrome is almost impossible to control but responds dramatically to a CBD-dominant strain of cannabis called Charlotte’s Web. The videos of this are dramatic.

Uses of medical cannabis

The most common use for medical cannabis in the United States is for pain control. While cannabis isn’t strong enough for severe pain (for example, post-surgical pain or a broken bone), it is quite effective for the chronic pain that plagues millions of Americans, especially as they age. Part of its allure is that it is clearly safer than opiates (it is impossible to overdose on and far less addictive) and it can take the place of NSAIDs such as Advil or Aleve, if people can’t take them due to problems with their kidneys or ulcers or GERD.

In particular, cannabis appears to ease the pain of multiple sclerosis, and nerve pain in general. This is an area where few other options exist, and those that do, such as Neurontin, Lyrica, or opiates are highly sedating. Patients claim that cannabis allows them to resume their previous activities without feeling completely out of it and disengaged.

Along these lines, cannabis is said to be a fantastic muscle relaxant, and people swear by its ability to lessen tremors in Parkinson’s disease. I have also heard of its use quite successfully for fibromyalgia, endometriosis, interstitial cystitis, and most other conditions where the final common pathway is chronic pain.

Cannabis is also used to manage nausea and weight loss and can be used to treat glaucoma. A highly promising area of research is its use for PTSD in veterans who are returning from combat zones. Many veterans and their therapists report drastic improvement and clamor for more studies, and for a loosening of governmental restrictions on its study. Medical cannabis is also reported to help patients suffering from pain and wasting syndrome associated with HIV, as well as irritable bowel syndrome and Crohn’s disease.

This is not intended to be an inclusive list, but rather to give a brief survey of the types of conditions for which medical cannabis can provide relief. As with all remedies, claims of effectiveness should be critically evaluated and treated with caution.

Talking with your doctor

Many patients find themselves in the situation of wanting to learn more about medical cannabis, but feel embarrassed to bring this up with their doctor. This is in part because the medical community has been, as a whole, overly dismissive of this issue. Doctors are now playing catch-up and trying to keep ahead of their patients’ knowledge on this issue. Other patients are already using medical cannabis, but don’t know how to tell their doctors about this for fear of being chided or criticized.
My advice for patients is to be entirely open and honest with your physicians and to have high expectations of them. Tell them that you consider this to be part of your care and that you expect them to be educated about it, and to be able to at least point you in the direction of the information you need.

My advice for doctors is that whether you are pro, neutral, or against medical cannabis, patients are embracing it, and although we don’t have rigorous studies and “gold standard” proof of the benefits and risks of medical cannabis, we need to learn about it, be open-minded, and above all, be non-judgmental. Otherwise, our patients will seek out other, less reliable sources of information; they will continue to use it, they just won’t tell us, and there will be that much less trust and strength in our doctor-patient relationship. I often hear complaints from other doctors that there isn’t adequate evidence to recommend medical cannabis, but there is even less scientific evidence for sticking our heads in the sand.

by mdradmin

What is cannabis?

Cannabis—also called weed, herb, pot, grass, bud, ganja, Mary Jane, and a vast number of other slang terms—is a greenish-gray mixture of the dried flowers of Cannabis sativa. Some people smoke cannabis in hand-rolled cigarettes called joints; in pipes, water pipes (sometimes called bongs), or in blunts (cannabis rolled in cigar wraps).1 Cannabis can also be used to brew tea and, particularly when it is sold or consumed for medicinal purposes, is frequently mixed into foods (edibles) such as brownies, cookies, or candies. Vaporizers are also increasingly used to consume cannabis. Stronger forms of cannabis include sinsemilla (from specially tended female plants) and concentrated resins containing high doses of cannabis’s active ingredients, including honeylike hash oil, waxy budder, and hard amberlike shatter. These resins are increasingly popular among those who use them both recreationally and medically.

The main psychoactive(mind-altering) chemical in cannabis, responsible for most of the intoxicating effects that people seek, is delta-9-tetrahydrocannabinol (THC). The chemical is found in resin produced by the leaves and buds primarily of the female cannabis plant. The plant also contains more than 500 other chemicals, including more than 100 compounds that are chemically related to THC, called cannabinoids.2
NIDA. “What is cannabis? .” National Institute on Drug Abuse, 13 Apr. 2020, https://www.drugabuse.gov/publications/research-reports/marijuana/what-marijuana Accessed 12 Jan. 2021.

by mdradmin

Available Treatments for Cannabis Use Disorders

Cannabis use disorders appear to be very similar to other substance use disorders, although the long-term clinical outcomes may be less severe. On average, adults seeking treatment for cannabis use disorders have used cannabis nearly every day for more than 10 years and have attempted to quit more than six times.111 People with cannabis use disorders, especially adolescents, often also suffer from other psychiatric disorders(comorbidity).112 They may also use or be addicted to other substances, such as cocaine or alcohol. Available studies indicate that effectively treating the mental health disorder with standard treatments involving medications and behavioral therapies may help reduce cannabis use, particularly among those involved with heavy use and those with more chronic mental disorders. The following behavioral treatments have shown promise:

  • Cognitive-behavioral therapy: A form of psychotherapy that teaches people strategies to identify and correct problematic behaviors in order to enhance self-control, stop drug use, and address a range of other problems that often co-occur with them.
  • Contingency management: A therapeutic management approach based on frequent monitoring of the target behavior and the provision (or removal) of tangible, positive rewards when the target behavior occurs (or does not).
  • Motivational enhancement therapy: A systematic form of intervention designed to produce rapid, internally motivated change; the therapy does not attempt to treat the person, but rather mobilize his or her own internal resources for change and engagement in treatment.

Currently, the FDA has not approved any medications for the treatment of cannabis use disorder, but research is active in this area. Because sleep problems feature prominently in cannabis withdrawal, some studies are examining the effectiveness of medications that aid in sleep. Medications that have shown promise in early studies or small clinical trials include the sleep aid zolpidem (Ambien®), an anti-anxiety/anti-stress medication called buspirone (BuSpar®), and an anti-epileptic drug called gabapentin (Horizant®, Neurontin®) that may improve sleep and, possibly, executive function. Other agents being studied include the nutritional supplement N-acetylcysteine and chemicals called FAAH inhibitors, which may reduce withdrawal by inhibiting the breakdown of the body’s own cannabinoids. Future directions include the study of substances called allosteric modulators that interact with cannabinoid receptors to inhibit THC’s rewarding effects.

NIDA. “Available Treatments for Cannabis Use Disorders.” National Institute on Drug Abuse, 8 Apr. 2020, https://www.drugabuse.gov/publications/research-reports/marijuana/available-treatments-marijuana-use-disorders Accessed 12 Jan. 2021.

by mdradmin