Author: Sasha Kalcheff-Korn

To date, Realm of Caring (RoC) has published four papers highlighting the benefits of cannabinoid therapy. This data has been gathered by participants who have volunteered their time to report on their cannabis use in our Observational Research Registry (ORR).

 

Relatable motivations for choosing medicinal cannabis included a majority belief that traditional treatments were ineffective and/or had intolerable side effects. Thus far, data from the ORR has shown significantly better self-reported quality of life, health satisfaction, and sleep, and significantly lower pain severity, anxiety, and depression. Here we highlight some of the most notable observations. 

 

Enhanced quality of life

 

Remarkable quality of life improvements were attributed to medicinal cannabis use in RoC’s first published paper in 2020. The two overarching categories of quality of life included enhanced well-being and improved daily functioning. The significant health improvements shown in this data indicate that clinical trials evaluating the efficacy of defined cannabinoid products for specific health conditions are warranted. 

 

Health improvements among people with Epilepsy 

 

Of the 1,783 individuals enrolled in this online, self-reported survey researchers identified a sample size of 418 participants. Of the 418 participants, 93% had listed epilepsy as their primary medical condition with the remaining noting epilepsy as a secondary medical condition. In this sample size, there were 71 adults and 209 adult caregivers of children or dependent adults who were utilizing CBD products for medicinal use. In addition, there was a control group of 29 adults and 109 adult caregivers who were considering CBD use but had not yet begun. 

 

Published in 2021, this paper showed that when compared with controls, CBD Users had a greater health satisfaction, higher ratings of quality of life, and better scores on psychological health. Taking a deeper look, CBD Users reported lower anxiety and depression and improved sleep scores. 

 

Other findings that were of significance relate to pharmaceutical use and healthcare visits. CBD Users had lower instances of reported prescription medication use, lower medication-related adverse effects, less ER visits, and less missing school and/or work days. 

 

Decreased caregiver burden

 

Among significant findings for individuals living with epilepsy, caregiver burden was assessed, evaluating Role Strain (stress due to role conflict or overload) and Personal Strain (personal stress from the experience of caretaking). 

 

Caregivers of patients who were using CBD products reported significantly lower scores on the Role Strain subscale compared to caregivers of Controls in the study. 

 

Antidepressant and anti-anxiety benefits

 

The goal of RoC’s third published paper was to provide insight into the effects of medicinal cannabis use for symptoms of anxiety and depression.

 

​​The participants involved were those who were at least 18 years old and reported having anxiety and/or depression without a specific endorsement, as well as specific endorsements, including: major depressive disorder, postpartum depression, dysthymia, premenstrual dysphoric disorder, seasonal affective disorder, generalized anxiety disorder, panic disorder, social anxiety disorder, and agoraphobia. 

 

Of the 538 participants, 368 reported current use of medicinal cannabis products at the baseline. The other 170 participants, who were considering use but had not yet initiated, served as controls. Of the participants who completed the baseline survey, 211 completed at least one follow-up assessment (145 Cannabis Users and 66 Controls). 

 

Cannabis Users reported lower baseline depression, significantly better past-month sleep quality, a higher overall quality of life, and lower past-month average pain compared to Controls.

 

Cannabis Users did not report lower baseline anxiety, however baseline Controls who had initiated cannabis use reported a significant reduction in both mean anxiety and depression scores from baseline to follow-up surveys [evaluated using the Hospital Anxiety and Depression Scale (HADS)]. This observation was not realized among non-initiators throughout the study. A similar effect was observed among participants who sustained medicinal cannabis use throughout the study, suggesting an improvement in symptoms of anxiety and depression with both the onset of cannabis use and with extended use.

 

A qualitative analysis of findings

 

The most recent published paper from RoC in 2022 presents a qualitative analysis of open-ended survey responses that detail the experiences of 808 medicinal cannabis users compared to a control group of 468 patients with similar health issues and demographics but not using medicinal cannabis. 

 

“The data indicate that patients with a wide array of health conditions report notable physical and mental health benefits associated with medicinal cannabis use that are not evident in patients who do not use medicinal cannabis, and that upon initiation of medicinal cannabis use significant improvements are reported across diverse areas such as sleep, mood, and healthcare utilization” (Garcia-Romeu et al., 2022). The qualitative paper provides an account of those participants’ lived experiences as medicinal cannabis users based on open-ended question data. 

 

Most participants reported cannabis benefits for a variety of conditions where traditional treatments were ineffective. 

 

Looking forward

 

The most recent published paper indicated that among cannabis users and nonusers there were concerns regarding cannabis side effects, legality, lack of information, and cost. These findings speak volumes to the fact that continued research and quality education on the safety and efficacy of cannabinoid therapy is needed. While all four manuscripts present findings that are promising, the work is far from complete. 

 

Research is limited on non-pharmaceutical cannabis products and there is a need for patient-level data on the impacts of increased access to and therapeutic use of cannabis. 

 

Join our research! 

 

Realm of Caring and Johns Hopkins University School of Medicine have developed the Observational Research Registry (ORR) to better understand medicinal cannabis use and its impact on key health outcomes including healthcare utilization, chronic pain, anxiety and depression, caregiver burden, epilepsy, and posttraumatic stress disorder (PTSD). Our registered clients provide critical information that leads to important insights into the therapeutic capabilities of medicinal cannabis. The ORR helps us develop client educational resources and may ultimately serve to legitimize the medicinal use of cannabis.

 

You may find yourself just starting out with cannabinoid therapy or looking into it for yourself or a loved one. And despite legalization in certain states, the years of research, and debunking myths, a certain stigma remains. Because of this it may be difficult to explain to someone in your life why you chose cannabis. Here we aim to help you start these conversations with definitions of the terms often used and research-backed information to support medicinal use. 

 

Terminology and Definitions

 

Cannabis Sativa L. (“cannabis”) refers to the actual plant. “Marijuana” is a legal definition for a cannabis plant containing over 0.3% delta-9-tetrahydrocannabinol (delta-9 THC) and “hemp” is the legal definition for a cannabis plant with 0.3% or less delta-9 THC. “THC” and “CBD” are two of the many cannabinoids found in the cannabis plant. Because THC and CBD are found in such large quantities, they are considered major cannabinoids. Minor cannabinoids, or those found in lesser quantities in the cannabis plant, are becoming more recognized for their benefits as new research emerges. These include CBG, CBN, CBDA, and many more as there are over 100 naturally occurring compounds in the plant. In addition to cannabinoids, the cannabis plant also contains terpenes and flavonoids that all interact with our Endocannabinoid System (ECS). 

 

Legitimizing the Therapeutic Benefits with Research

 

Proof of cannabis use for medicinal reasons dates back thousands of years. Research for specific conditions and diseases grows by the day. Some of the more recent, specific benefits from newly published research include:

 

• CBDA and CBGA prevent entry of coronavirus into human cells
• CBD as a therapeutic tool to ease withdrawal symptoms of nicotine addiction
• CBD for alleviating symptoms of chronic fatigue syndrome
• Cannabinoid therapy as a helpful adjunct to standard palliative care strategies
• Cannabis benefits for menopausal women
• Terpenes found in cannabis to fight insomnia
• Anti-cancer effects of CBD, THC, and CBDA
• CBD as a more efficient and better tolerated alternative to standard PTSD treatments
• Antidepressant and anti-anxiety effects of medicinal cannabis use observed 

 

Legitimate research to understand the medicinal benefits of cannabis allows for an opportunity to truly de-stigmatize the plant. This is why Realm of Caring runs our own observational study to understand the benefits of cannabis for specific conditions and to legitimize this as medicine. Our most recent published paper in July of 2022 concluded that most participants reported benefits from cannabis use for a variety of conditions where traditional treatments were ineffective or unacceptable. 

 

Navigating the Legal Landscape

 

The legal landscape of cannabis is constantly changing. From legalization to age restriction on specific products (yes, even for CBD), it is good to know where your state stands. Norml is a great resource for navigating the legal landscape state to state. 

 

Finding Someone to Talk to

 

When looking to cannabis for medical conditions, we always recommend speaking with a healthcare professional. However, if you are in need of support while on your journey we are here to help. From product selection to dosing guidance to answering questions your family has about your decision to choose cannabis – we are here every step of the way. Send as an email to info@realmofcaring.org, call us at 719-347-5400 or chat with us at realmcaring.org. 

There is no doubt about it, the holidays can be stressful. When turning to cannabis to find relief, we recommend choosing strains high in terpenes that can aid you in your journey to a stress-free holiday season! 

 

Understanding Terpenes

 

One of the most common questions we receive at Realm of Caring is, “What is a Terpene?” Terpenes play an important part in cannabinoid therapy as they may enhance the therapeutic effects of cannabis. To put it simply, terpenes are compounds produced by plants such as fruits, trees, herbs, and a variety of other plant species that are responsible for determining their distinct scents. The therapeutic properties of terpenes combined with the therapeutic properties of cannabinoids may enhance the overall therapeutic effect that the cannabis plant can offer.

 

Best Terpenes for Anxiety and Stress Relief

 

While there are hundreds of terpenes found in nature, they all have different effects on the human body. This means, some are better than others when looking to relieve certain symptoms. Studies have found the following terpenes to be helpful with anxiety and stress:

 

Linalool

 

Linalool is a popular terpene known for its floral scents. Commonly found in lavender, the natural anxiolytic aromas have been known to calm aggressive behaviors and alleviate symptoms of anxiety or stress with its soothing effects. Such sedative effects of Linalool have demonstrated in animal and human studies the ability to help calm an overactive nervous system. Strains that are high in Linalool include Granddaddy Purple, Do Si Dos, Lavender, and Kosher Kush, and are often recommended for individuals experiencing symptoms of stress and anxiety.

 

Limonene

 

Commonly found in citrus fruits, as the name might suggest, Limonene can also be found in cannabis strains, especially those with a strong citrus scent. This is one of the most common terpenes, second to Myrcene. While known for its antioxidant, anti-inflammatory, and antiviral properties, Limonene has also been shown to reduce stress levels, producing a feeling of well-being. Experiments in mice have confirmed Limonene is strongly anxiolytic (anti-anxiety) and boosts serotonin levels— similar to what some antidepressants do. When looking for cannabis strains to bring you a stress-free holiday season, try one of the following Limonene-dominant options: Durban Poison, Jack Herer, Lemon Diesel, Sour Diesel, and Super Lemon Haze.

 

Alpha-pinene 

 

You know the smell you associate with pine trees and other types of coniferous plants? That can be credited to Alpha-pinene! Studies show Alpha-pinene may be helpful in reducing anxiety. While pinene is rarely the primary terpene in a cannabis strain, it is often the second most prominent. Cannabis strains high in Alpha-pinene include Blue Dream, Pineapple Express, Grape Ape, and White Fire OG.

 

Beta-caryophyllene

 

Molecules that target the CB2 receptor of our endocannabinoid system can help to treat symptoms of anxiety and depression. Beta-caryophyllene is one of those terpene molecules! Found in numerous plants in nature including black pepper, rosemary, hops, and cannabis, this terpene also acts as a cannabinoid. Because it only interacts with the CB2 receptor (and not CB1) it does not produce a psychoactive effect. When shopping for strains high in Beta-caryophyllene this holiday season, keep your eye out for OG Kush, White Widow, Sherbert, and Chemdawg.

 

A Very Happy Holiday Season

 

More and more people are turning to cannabis to find relief from common symptoms. Whether you are seeking a stress-free holiday season for yourself, or looking for that perfect gift for a cannabis advocate in your life, terpenes offer a great opportunity for symptom-based decision making. 

 

As always, consulting with a medical professional is recommended. There is a lot to consider when starting cannabinoid therapy and a Realm of Caring care specialist is here to help with your questions. Contact us today by calling (719) 347-5400 or by emailing info@realmofcaring.org.

Research has found the existence of the Endocannabinoid System (ECS) in the skin. Specifically cannabinoid receptors CB1 and CB2 have been located in skin cells. Given that the ECS has a critical role in maintaining skin homeostasis and barrier function, it is possible that topical cannabis products may greatly benefit skin health in general. In fact, cannabinoid therapy has been linked to potential for both skin and cosmetic dermatological disorders.

 

Currently, cannabidiol (CBD) is a widespread ingredient in skin care products formulated as body oils, moisturizers, salves, lotions, and balms. Delta-9-Tetrahydrocannabinol (THC), and potentially cannabinol (CBN), may also be responsible for skin benefits such as reducing cytokine production and oxidative stress. Additionally, cannabigerol (CBG) has powerful anti-inflammatory and antibacterial properties that may add benefit to our skin health. 

 

Bacteria

 

Eczema, dermatitis, psoriasis, and acne are all skin conditions that may become worsened by bacteria. CBD and CBG have shown through research to have remarkably useful antimicrobial properties. For example, formulations of CBD and CBG of varying concentrations and consistencies were evaluated for Staphylococcus aureus (the most dangerous of the staphylococcal bacteria responsible for causing skin infections, pneumonia, heart valve infections, and bone infections). CBG has been noted among the most potent cannabinoids when tested against this strain. CBD was reported to selectively kill a subset of Gram-negative bacteria that includes urgent threat pathogens. 

 

Inflammation

 

What many skin conditions have in common is peripheral inflammation. Preclinical and clinical models have shown that targeting this inflammation by topical therapy is not only effective at reducing visibility but also avoids the central nervous system with oral routes, thereby reducing potential negative side effects and/or tolerance to conventional medications. 

 

A 2019 published study tested the effectiveness of CBD-enriched ointment in inflammatory skin conditions that result in scars. Among those in the study, individuals reported suffering from dermatitis, psoriasis, and acne. After a period of three months, the evaluated skin parameters were significantly improved in all 20 volunteers and none reported any worsening. Specifically, the hydration markers increased by nearly 7%. This study concluded by saying that “topical administration of CBD ointment is a safe and effective non invasive alternative for improving the quality of life in patients with some skin disorders, especially on inflammatory background” (Palmieri, et al.). 

 

Acne and Breakouts

 

The potential reason that individuals experience side effects like dryness, redness, and skin irritation from popular acne treatments, may be because those products contain harsh chemicals. CBD products are often free from irritants. CBD is also beneficial in that it has been shown to reduce sebum production, decrease the spreading of sebocyte cells, and decrease levels of pro-inflammatory cytokines. CBG has also demonstrated abilities to alleviate inflammation within sebaceous glands, thus also lowering the appearance of irritated sebocytes.

 

Itch

 

When it becomes chronic, itch (pruritis) can severely affect one’s quality of life. Though most of the ECS research indicates that the itch response is primarily modulated through CB1 receptors in the central nervous system, some reports argue the involvement of peripheral CB1 receptors could also contribute to itchiness. Trials with rodent models have shown the anti-itch effects when THC was administered topically, however the actions of CBD shows potential as an anti-itch agent as well. Interestingly, it was also found that the therapeutic effects may be more relevant for the lower body versus itch arising from the face or scalp areas. 

 

Observational studies have shown that CBD may contribute to inhibiting itch signals, due to the CB2 receptors being located on peripheral sensory nerve fibers. Therefore inhibiting the signals may alleviate the need to scratch. 

 

Pigmentation

 

Hyperpigmentation can take place as a result of melasma, sun exposure, imbalanced hormone levels, or skin conditions such as acne, dermatitis, or psoriasis. CBD has been quoted through research as a powerful antioxidant. Studies have also shown that CBD may help to hydrate dry and irritated skin. The combination of the ability to defend against free radicals and oxidative stress as well as increase moisture, may help to improve discoloration of the skin.

 

Future Research

 

The ECS has shown to be significant in maintaining skin homeostasis, where dermatological conditions arise from an imbalance. Research is promising for the therapeutic potential of cannabinoids for several skin disorders, but the evidence is still emerging. If you would like to be a part of the movement to understand cannabinoid benefits for skin health, join our observational research registry today. 

 

Looking for a product?

Realm of Caring can help. Our care team offers support on finding quality products, administration for your specific condition, and educational resources based in research. Email info@realmofcaring.org or call our free hotline at 719-347-5400 for all of your cannabinoid therapy questions.

How to Shop for Cannabis this Holiday Season

 

Looking for the perfect gift for the holidays? A recent poll shows that 9 out of 10 cannabis consumers in states with legal recreational cannabis, plan to include cannabis as part of their holiday celebrations. To go even further, an overwhelming majority (76%) of respondents said they plan to give cannabis or related products as gifts this holiday season. If this just sparked your interest, keep reading for our guide on how to shop for yourself & others this holiday season!

 

Outcome Oriented Shopping

 

When shopping for cannabis, we like to recommend starting with the desired outcome to help guide your purchasing decisions. Because every product is unique, when you know your end goal, it can help bring clarity to which product might be right for you or someone you love.

 

One of our favorite ways to do this is by understanding the terpene profiles of a specific cannabis product. Many consumers are looking to terpenes as a way to help predict a strain’s effects, similar to considering whether it is Sativa or Indica. Because terpene profiles work hand-in-hand with cannabinoids, they can produce different experiences even if the strain has the same THC content. 

 

For example, some terpenes are better proven to help fight insomnia. If you’re looking for terpenes to be used as a sleep aid, try strains high in one of the following, known for their sedative effects:

 

• Terpinolene
• Linalool
• Myrcene

 

But let’s say you or a loved one may like to avoid products that give you the munchies. In this case, you would want to shop for products with strains that are high in CBD or THCV content. These can include:

 

• Remedy
• ACDC
• Cherry Wine
• Durban Poison
• Pineapple Purps
• Doug’s Varin

 

What about those loved ones who suffer from allergies? A study published in 2014 found that the terpene A-Pinene was found to be a promising anti-allergic agent. A-Pinene is characterized by a powerful pine and sage aroma that demonstrated a decrease in some symptoms of allergic rhinitis in mice. This research suggests it may be useful in the clinical management of allergic rhinitis, therefore the ability to moderate the unbearable allergy season. Pinene may also help additional symptoms of allergies since it serves as an anti-inflammatory and bronchodilator. So any product high in Pinene could be used along with or instead of traditional allergy therapies.

 

If you don’t feel comfortable making outcome oriented cannabis choices, but have a canna-curious or cannabis lover in your life, we put together a list of accessories that can elevate your experience. These make the perfect stocking stuffers or last minute gift ideas!

 

Shop from Some of our Supported Brands

 

These products have passed our strict quality control guidelines and it is with confidence that we recommend them to you. When you gift one of these brands to a loved one in your life, you can do so knowing that you are providing them with some of the best cannabis on the market.

 

Charlotte’s Web: CBD Sleep Gummies
For those who have trouble sleeping

 

The renowned natural sleeping aid, melatonin, the power of Charlotte’s Web CBD and hemp’s naturally occurring phytocannabinoids come together to support sound, quality sleep, and regular sleeping cycles in these CBD for Sleep Gummies. With a delicious flavor derived from naturally derived ingredients, these Sleep CBD Gummies can become an essential part of your wellness routine and sleep ritual.

 

NUUME Organics: Cooling Sports Cream Roll-On

For the athletes

 

The cooling effect in this Sports Cream Roll-On is obtained through the addition of a generous amount of organic menthol crystals. Combined with 500mg of CBD + 50mg of other beneficial cannabinoids (CBG, CBN, etc.), terpenes and flavonoids, you can expect exceptional results.

 

CANNACEA: ACTIVATED 40 – Full Spectrum Hemp Oil
For those new to CBD

 

ACTIVATED 40 provides a complete blend of pure extractions from two proprietary organic Hemp varieties. This ensures a genuine Full Spectrum of primary and secondary Phytocannabinoids with key monoterpenes, sesquiterpenes, and flavonoids native to Hemp (all lab-certified). The complexity of ACTIVATED 40 is immediately sensed in the spicy and earthy notes that accompany its nutty aroma and flavor.

 

Aspen Green CBD: Full Spectrum CBD Oil for Pets

For the pet lovers

 

Aspen Green’s Certified Organic Full Spectrum CBD Oil and all its naturally occurring terpenes and flavonoids help ease the occasional anxiousness, promotes a sense of calmness, and supports mobility in your pets. Available in a variety of sizes so every pet receives the proper dosage. Pets that are mobility impaired, struggling with joint pain, arthritis, or inflammation, can benefit from cannabinoid therapy just like humans!

 

How To Talk To Your Family About Cannabis

 

We understand that cannabis tends to be one of those hot topics where our own beliefs and opinions might begin to differ from some of the people we hold most dear. Whether you are gifting, receiving, or using cannabis for the holidays, we have compiled some talking points on how to broach the subject with people in your life who may not have the same opinions about the plant-based therapy. 

 

As always, consulting with a medical professional is recommended. There is a lot to consider when starting cannabinoid therapy and a Realm of Caring care specialist is here to help with your questions. Contact us today by calling (719) 347-5400 or by emailing info@realmofcaring.org.

Post-Traumatic Stress Disorder (PTSD) is defined by the PTSD Foundation of America as a psychiatric disorder that can occur following the experience or witnessing of life-threatening event such as military combat, natural disasters, terrorist incidents, serious accidents, or physical or sexual assault in adult or childhood. 

 

Military veterans who suffer from PTSD vary by service area. PTSD diagnoses among veterans, as well as those currently in-service, may stem from war zone deployment, training accidents, and military sexual trauma (MST). 

 

Why cannabinoid therapy for PTSD? 

 

Medications recommended for the treatment of PTSD are currently either selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), which do not specifically target the memory process. This could be why the pharmacological treatment of PTSD has shown to be difficult, with the potential for considerable side effects. However, interventions that directly affect our endocannabinoid system (ECS) have shown promise as they can affect both emotional and cognitive aspects. Recent studies have pointed towards the ways in which cannabinoid therapy may help alleviate associated symptoms of PTSD such as anxiety, nightmares, increased alertness, panic attacks, depression, and overwhelming emotions. 

 

There have been two observations of importance that have led researchers to further explore cannabinoid therapy as a PTSD treatment option. First, patients with PTSD were found to be more likely to consume cannabis as a form of self-medication in an attempt to reduce their symptoms of anxiety and disrupted sleep. Secondly, patients with PTSD were shown through research to have increased levels of cannabinoid receptors while decreased peripheral levels of the endogenous cannabinoid, Anandamide (AEA). This means that those suffering with PTSD may be experiencing an AEA deficiency. 

 

Due to the modulating effect of cannabidiol (CBD) on the ECS, and considering the many body processes that the ECS regulates, CBD has seen increased research for potential value in several conditions. Research has stated that the “ECS can provide more efficient and better tolerated alternatives to the standard treatments for PTSD”. The potential of cannabinoid therapy has been repeatedly demonstrated in animal models of traumatic event exposure as well as anecdotally in humans. CBD, in particular, is promising as it has been researched for its effectiveness among generalized anxiety disorders, depression, and traumatic memories while proving to be well tolerated by humans, both in overall safety and possible side effects.

 

Decreasing anxiety and aversive memories

 

Animal studies have shown that CBD is effective in reducing cardiovascular and anxiety responses caused by stress. For example, administered CBD lowered responses related to trauma when administered both before an event and when retrieving the aversive memory in these studies. These effects have been suggested to possibly promote the extinction of fear memories through CBD use. 

 

How this happens relates back to the role of the ECS in this process. To be free from an unpleasant memory requires the involvement of CB1 receptors. By blocking the action of CB1 receptors in previously conditioned mice, either through pharmacological blocking of the receptors in the nervous system or deleting genetically, results showed strongly impaired anxiety and memory extinction. 

 

Confirming benefits seen in animal studies in humans is essential to efficacy and provides validation. Current evidence of oral CBD use for PTSD in humans is minimal, however anecdotal data is being gathered. 

 

Some studies do suggest that the reduced memory of fear due to CBD or a CBD to delta-9-tetrahydrocannabinol (THC) ratio may be a result of blocked reconsolidating of the memory versus increased extinction of it, but either way we have seen that cannabinoids are capable of interfering with memory processing in such a way that it potentially diminishes the aversive memory. 

 

Studies with human participants

 

The first evidence of CBD in the extinction of fear-based learning in humans was studied in 2013 where forty-eight participants were subjected to electric shocks. It was found that CBD was successful in helping to extinguish the memory as well as avoid recall of the electric shock. 

 

In 2016, one case report showed that a daily dose of CBD for a 10-year old patient with PTSD from sexual trauma was associated with a reduction in their anxiety symptoms and sleep disruption without significant side effects. Prior to receiving CBD therapy, the child did undergo standard pharmacological treatment for the conditions, which only produced short-lasting and partial relief but also included disruptive side effects. 

 

Another study, which included 21 adults with PTSD to understand the clinical benefit of CBD for symptom relief was completed between 2016 and 2018, published in 2019. CBD was administered alongside medical treatment, psychiatric medications, and psychotherapy for eight weeks. Of the participants in the study, those who were taking a CBD capsule were instructed to do so once or twice per day based on severity of symptoms. After 4 weeks into the study 91% of individuals saw a decrease in symptom severity. After the 8 weeks, 73% of patients reported a further decrease in PTSD symptoms. Those who continued to receive CBD for 36 weeks or more, reported an improvement in their nightmares as well as improvement in quality of sleep over time. 

 

Sleep

 

In addition to the processing of traumatic events that lead to aversive memories, animal studies have also shown favorable effects of CBD in sleep disorders, another common manifestation of PTSD symptoms. CBD has been researched for its therapeutic potential for sleep disorders through limiting symptoms that may keep us awake at night (pain, anxiety, inflammation) but also may contribute to an increase in sleep duration and depth, as well as decrease in the anxiety responses induced by sleep disturbance. 

 

Nabilone, a synthetic cannabinoid, was approved for treatment of chemotherapy-induced nausea in 1982 by Health Canada and has been since studied for potential benefits. Researchers have found similar effects between nabilone and THC and benefits among those experiencing PTSD. Results from two studies, one among prison inmates and the other among varied traumatic circumstances showed statistically significant improvements in nightmare occurrences and/or severity, therefore an improvement in quality of sleep. Studies, such as these, show support for further research as well as potentially utilizing acute administrations of THC, or medical cannabis, to alleviate sleep disturbances among individuals living with PTSD. 

 

How to find support

 

Finding support and recommendations for cannabinoid therapy and PTSD can be difficult. But that is where Realm of Caring may step in to help. Our care specialists are trained to help with product and practical administration suggestions. In general, cannabis is safe but responsible use and guidance, as well as oversight by a healthcare professional whenever possible, are always recommended. We are here to help start and facilitate those conversations along the way. 

 

If you want to reach out to our care team to discuss anything cannabinoid therapy related one on one, or how to get enrolled in research to further legitimacy for this form of therapy, we are here for you! You can call us at 719-347-5400, email us at info@realmofcaring.org, or schedule an appointment. 

 

Cannabis is considered to be one of the earliest plants used for medicinal purposes by humans. It is also widely known for non-medical uses as well. Given increased access as of recent years, investment in further research and education for the general public to address health or safety concerns is necessary. 

 

There is extensive research on the safety and toxicology of cannabinoids and there are several studies that suggest that cannabinoids are well-tolerated and safe for humans at high doses. However, there can be potential drug interactions. In addition, there is not enough evidence to determine the absolute safety of using cannabis for special populations (for example those pregnant or nursing and some psychiatric conditions).

 

While anecdotal evidence and published data may help us to determine reasonable doses for any one individual on their cannabinoid therapy journey, accidents can happen so it is best we educate ourselves to prevent harm. Common questions this article seeks to address are:

 

What do I do if I feel I’ve taken too much cannabis?

How do we prevent product abuse and misuse? 

Who do I contact if my child gets into my medicine? 

 

What do I do if I feel I’ve taken too much cannabis?

 

If you feel you have taken too much, first of all – do not panic. Just as with consuming too much caffeine, it may be unpleasant and uncomfortable, but with time it will pass. You may experience symptoms such as lethargy, anxiety, paranoia, and/or low blood pressure that may lead to nausea. 

 

To help, you may want to try an isolate CBD, as CBD may reduce the unwanted, euphoric side effects of THC. Drinking water with lemon or eating black peppercorns may also help to offset those effects. This may help because of the potential terpene entourage of limonene from the lemons and beta-caryophyllene from the pepper. Both limonene and beta-caryophyllene possess potent anti-inflammatory activities, while limonene also has anti-nausea and uplifting properties. Deep breaths, getting fresh air, and focusing on something you enjoy or talking to a close friend may also help to deter any feelings of anxiety. 

 

It is good to know that cannabis itself has no realistic lethal dose following consumption for humans. The low density of CB1 receptors in the brainstem region means that no damaging effect is reported on cardiovascular or respiratory functions.

 

How do we prevent product abuse or misuse? 

 

When it comes to product abuse, some may first question “did I abuse the product or was the product not of quality?”. In your cannabis journey it is always important to remember that the quality of your product absolutely matters. A certificate of analysis (COA) for your product should show that your product has been tested and clear of any residual solvents and is free of pesticides and heavy metals. 

 

However, even safe and quality products may be misused or abused with limitless consequences. From over the counter (OTC) medications to household cleaning products, improper use does happen so it is best to bring awareness to it so we may all be a part of the solution. It is reported that 90% of accidental poisonings of any product occur at home. Poison control statistics from 2020 in the United States show that cosmetics and personal care products lead the list of the most common substances implicated in pediatric exposure (under 6 years of age). Pain medications lead the list of the most common substances implicated in adult poison exposures (20 years of age and older). 

 

To keep children safe, products are best kept out of reach and out of sight. Older children may benefit from conversations about what is safe to taste and what is not safe to taste. For adult cannabis consumers with children at home, a dad with similar concerns did not want to have to question whether or not his kiddos would find his medicine. So he created lockable cases and bags with smell proof technology. 

 

Self-medication practices are essential to any health care system. OTC medications are a part of this practice and improper dosing or self-diagnoses may lead to product misuse or abuse. It is suggested that underutilized pharmacists could help to mitigate potential harms through direct education and customer awareness. With medical and recreational use laws passing state to state, cannabis has become a growing part of the self-medication practice. Understanding what product to take and how much of it based on specific ailments should be a part of everyone’s cannabis journey. It is always recommended to seek advice from a medical professional. However, if free support and guidance is needed, Realm of Caring is here to help too. 

 

Who do I contact if my child gets into my medicine? 

 

If the truly unfortunate happens and you suspect your child has gotten into your medicine, or any product that is not safe to ingest, call poison control. Poison control’s 24/7 hotline is (800) 222-1222. Common clinical effects associated with children after accidental overconsumption of cannabis products may include vomiting, dizziness, difficulty walking, a rapid heart rate, drowsiness, confusion, and breathing difficulties. 

 

For additional adverse reporting and toxicology consultation, SafetyCall offers 24/7 support for humans and pets. They also respond to inquiries regarding the safety of certain products. Their consumer care center can be reached at (866) 327 – 7282. 

 

Get help in advance of product buying

 

Realm of Caring takes part in research and education for safe and responsible use of cannabis products. We are here to help with quality product selection, administration guidance, and free one on one support. Understand what to look for and how much to take of any cannabis product before you head to the dispensary or order online. You can reach our care team by calling 719-347-5400, emailing info@realmofcaring.org or scheduling an appointment.  

 

Cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC) are the two major cannabinoids found in the Cannabis Sativa plant. In recent years, CBD has been more widely discussed as preclinical and clinical studies suggest its therapeutic use across multiple conditions. 

 

A published 2018 study sought to understand why consumers were flocking toward CBD products. It found that nearly 62% of CBD users reported using it to treat a medical condition. The odds of using CBD for these reasons was greater among non-regular users of cannabis than among regular users. 

 

The regular cannabis user, who leans towards THC products of various strains may question: why add CBD to my current regimen? While it may not be for everyone, here are some reasons why you might want to consider it. 

 

CBD + THC: Synergistic benefits 

 

CBD and THC have researched benefits of their own. They also have benefits that may be amplified when administered in combination or that are complementary to one another. There is evidence to suggest that the observed therapeutic properties of THC are not solely dependent on the presence of THC, rather the interplay of phytocannabinoids. These cannabinoid combinations may mitigate side effects or improve the therapeutic activity of THC. 

 

A recent study examined effects of THC-dominant cannabis, CBD-dominant cannabis, and THC/CBD-equivalent cannabis on self-reported anxiety among 26 healthy recreational cannabis users. It was found that, when baseline anxiety was low, CBD completely counteracted THC-induced anxiety. In conclusion, the study showed that THC/CBD-equivalent cannabis induces less state anxiety than THC-dominant cannabis.  

 

THC and CBD are both known for their anti-inflammatory, antioxidant, and sleep benefits. It has also been proposed in research that targeting both cannabinoid anti-tumor pathways simultaneously, by combining THC and CBD, may lead to enhanced anti-tumor activity. Therefore, when taken in tandem, benefits may be realized more noticeably and/or at lower administration levels. Researchers believe that while they have impressive benefits on their own, they are best when they are taken in such a way that more closely resembles the plant’s natural state (taken together along with other minor cannabinoids, terpenes, and flavonoids). This synergy between the compounds in cannabis is commonly referred to as the entourage effect. 

 

CBD is a negative-allosteric modulator (NAM)

 

Within our endocannabinoid systems (ECS) are cannabinoid receptors CB1 and CB2. CB1 receptors are expressed in high levels throughout the central nervous system. THC binds to and activates CB1 and CB2 receptors. This action may have several therapeutic benefits for regulation of homeostasis. For example, activation of CB1 receptors may lead to an induction of sleep and activation of CB2 receptors can produce anti-inflammatory effects. 

 

CBD is known to modulate the activity of receptors throughout the brain and body. It has long been proposed to reduce or block THC-associated euphoria. The ability of CBD to inhibit CB1 signaling, observed in one study, offers a potential mechanism for the reduction of select, unwanted THC side effects. 

 

It is the same action of CBD that might contribute to its medicinal value. The negative allosteric modulation of CB2 activity by CBD might explain its action as an anti-seizure as well as benefits for other neural disorders. 

 

CBD’s role in the brain’s hippocampus

 

A study published in 2019 looked at the counteractive effects CBD could have on the intoxicating side-effects of THC. They looked to the hippocampus, as the ventral hippocampus is responsible for emotional arousal through dopamine neuronal activity states. 

 

Despite the complexity of cannabis, there is increasing evidence to suggest differing effects of THC and CBD, as they relate to euphoric effects. THC may induce dysregulation of subcortical dopamine transmission; therefore, when used at increased concentrations, may lead to short-term side effects to include anxiety, perceptual changes, disorientation, nausea, and/or headache. CBD normalizes dopamine signaling and regulates affective stimulus processing, therefore possesses antipsychotic and antianxiety properties. 

 

Researchers in this study demonstrated that THC induced cognitive abnormalities resembling neuropsychiatric symptoms in the hippocampus, while dysregulating dopamine activity states by modulation of the extracellular signal-regulated kinase (ERK) signaling pathway. Comparatively, when coadministered with THC, CBD blocked the THC-induced ERK activity and prevented the THC-induced behavioral and neural abnormalities. The findings illustrate how the CBD molecule’s mechanism of action can mitigate side effects of THC. 

 

How do I incorporate CBD into my cannabis regimen?

 

If you are looking for ways to enhance your current regimen by incorporating CBD, the first thing you can do is find a product to complement what you are already doing. The Realm of Caring is here for free guidance on understanding the additional, potential benefits as well as souring a quality product. You can reach our care team by calling 719-347-5400, emailing info@realmofcaring.org or scheduling an appointment. 

 

When you are visiting your local dispensary, you can also keep an eye out for ratios. A cannabis product with a ratio on it is indicating the concentration of one cannabinoid to the other. Most often this will be a CBD to THC ratio, but more recently we have seen additional, minor cannabinoids represented in this way. Having more weight on the CBD or THC side depends on the outcome you desire. Again, our care team is here to help you navigate so you can step up to your dispensary counter feeling more confident in the decisions you are about to make for your health. Connect with us today! 

 

Breast cancer is the most common cancer in women worldwide. Despite advances in early detection, it remains the second leading cause of cancer death in American women, mostly attributed to drug-resistant refractory tumors. 

 

A study published this year showed that out of 612 participants, 42% reported use of cannabis for relief of symptoms and 49% believed cannabis could be used to treat cancer itself. In recent years, as the legalization of cannabis expands, cannabis and the endocannabinoid system have increasingly become topics of interest for the treatment of various conditions. 

 

The dysregulation of our endocannabinoid system has been associated with several diseases, including cancers. Evidence reveals that the endocannabinoid system is altered in breast cancer. An increasing number of studies also highlight the role that cannabinoids have in cancer spreading. Specifically these report on invasion, angiogenesis, migration, and metastasis. 

 

Despite the need for more studies focused on breast cancer, cannabinoids thus far have shown to be promising therapeutic agents for the various breast cancer subtypes, with the ability to exert important actions on cell survival and metastasis.

 

The Endocannabinoid System (ECS)

 

Our ECS is the largest neurotransmitter system in the body composed of endocannabinoids, cannabinoid receptors, and metabolizing enzymes. Endocannabinoids are arguably one of the most widespread and versatile signaling molecules known to man; two key endocannabinoids that have been identified are Anandamide (AEA) and 2-Arachidonoylglycerol (2-AG). The endocannabinoids activate different receptors throughout the body and brain called CB1 and CB2 receptors. CB1 receptors are found in high levels in the brain and central nervous system; whereas CB2 receptors are found in numerous immune cells and the peripheral nervous system. 

 

Modulation and activation of the cannabinoid receptors by these endocannabinoids can have various effects within the body. It is likely that endocannabinoids impact several cancer-related signaling pathways. For example, AEA has been shown to inhibit breast cancer cell growth and migration in multiple mouse model studies. It is known that in breast cancer, CB2 receptors are over-expressed and CB1 is present in lower quantities

 

Findings of the endocannabinoid system have inspired further studies to take place with exogenous or phytocannabinoids, that mimic the actions of endogenous cannabinoids and their interactions with cannabinoid receptors. 

 

Anti-tumoral Effects

 

Most existing cancer therapies are not developed to specifically target metastatic progression, despite tumor metastasis accounting for 90% of cancer-related deaths. Breast cancer, in particular, has been noted as typically incurable once clinically apparent metastases develop, therefore there is a need for non-toxic therapeutic interventions to target this progression. 

 

There has been compelling evidence of the anti-tumoral activity of cannabinoids in preclinical models of breast cancer, both witnessed in cell culture systems and clinically relevant animal models. In recent years, the two most abundant cannabinoids found in Cannabis sativa, cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC), have been more closely studied for their anti-tumor activity against a variety of aggressive cancers, with each compound having its own unique mechanism of action. It has been proposed in research that targeting both cannabinoid anti-tumor pathways simultaneously, by combining THC and CBD, may lead to enhanced anti-tumor activity.

 

A study published in the British Journal of Pharmacology in 2014, demonstrated that moderate doses of CBD were effective at inhibiting metastatic progression in female mice, leading to prolonged survival in multiple preclinical models of breast cancer. This study also discovered that while moderate doses of CBD could have this inhibiting effect, higher doses were required to inhibit tumor growth. 

 

Although the strength of experimental data is different for each case, evidence obtained so far suggests that cannabinoid therapies may be useful for these breast cancer subtypes:

 

Hormone-sensitive (ER+ / PR+)

HER2-positive 

Triple-negative 

 

Cell Death and Cell Growth

 

Apoptosis is a form of programmed cell death. Apoptosis in cancer aids specifically in cancer cell death. This activity is well documented across several cancer models while undergoing cannabinoid therapy. Published research from 2011 shows that CBD induced not only apoptosis but also autophagy-induced death in breast cancer cells. CBD was shown to preferentially target breast cancer cells by inducing estrogen receptor (ER) stress and enhancing reactive oxygen species (ROS). 

 

Another study published in 2006 explains that CBD exerts its effects on these cells through a combination of mechanisms that include either direct or indirect activation of CB2 and TRPV1 receptors and induction of oxidative stress, which may all contribute to induce apoptosis.

 

Antiproliferation is the suppression of cell growth. Data gathered in 2015 for the American Association for Cancer Research studied the effects of CBD, THC, CBN, and CBG on proliferation of breast cancer cells. Among the tested, CBD was the most potent inhibitor of human breast cancer cell aggressiveness.

 

In ER+ breast cancer, cannabinoids have shown the potential to inhibit cell growth and avoid metastatic development.

 

Considering other cannabinoids

 

When it comes to cancer models, the anticancer activity of CBDA was investigated on acute lymphocytic leukemia, promyelocytic leukemia cells, and human prostate carcinoma androgen receptor positive cells. CBDA was found to be less active than CBD for all of these, until tested towards MDA-MB-231 cells, a highly aggressive triple negative breast cancer. CBDA was found to inhibit breast cancer cell migration. The data in the report showed that CBDA offers “potential therapeutic modality in the abrogation of cancer cell migration, including aggressive breast cancers”.

 

Initial findings in literature and research show CBG potential as a therapeutic agent in helping slow the proliferation of breast cancer cells, therefore possibly lessening tumor severity. CBG may also be useful as an anti-emetic or anti-inflammatory to complement traditional cancer treatments. 

 

Terpenes and Flavonoids

 

Terpenes are compounds found in all known life forms, including fruits, trees, herbs, and a range of other plant species that are responsible for determining their distinct scents. There is a complex diversity and varying concentration of terpenes in cannabis plants. Yet, quality research is available in regard to terpene-specific benefits, although not all research is available in living models as of yet. B-Caryophyllene, limonene, pinene, linalool, bisabolol, humulene, terpineol, and nerolidol are among those studied for apoptosis effects. As well, limonene, pinene, linalool, eucalyptol, terpineol, and camphene are associated with reduced tumor growth. 

 

Flavonoids account for nearly 10 percent of compounds known in cannabis and may represent up to 2.5 percent of cannabis’ leaf and flower dry weight. They are the largest class of polyphenols. Kaempferol, apigenin, cannflavin B, silymarin, and luteolin are among those researched for tumor-reduction abilities. Kaempferol is also associated with reduced metastasis. Orientin, vitexin, and isovitexin have been studied to induce apoptosis.  

 

Additional benefits of cannabinoids in breast cancer

 

A feature of cannabinoid anti-tumor action in breast cancer, as well as other cancer types, is that there is no toxicity observed in non-tumor cells. With this, and other observations, cannabinoids have adopted the reputation as having safe profiles. In fact, they have proven safe in thousands of individuals among many clinical trials in cancer patients.

 

Preclinical and clinical evidence suggests the efficacy of CBD and THC in targeting cancer-associated pain, anxiety and depression, sleep issues, nausea and vomiting, and oral mucositis that are associated with cancer and traditional treatments. These same studies also suggest that cannabinoids may enhance the efficacy of traditional treatments such as chemotherapy and radiation therapy, as well as protect against neural and organ damage. 

 

The most realistic approach in clinical trials has been introducing this therapy in combination with standard treatment. The evidence has shown the combination does not have negative effects and that anti-tumor effects were actually improved. 

 

Hormone-receptor positive breast cancer

 

Around 70-80% of breast cancers are hormone receptor-positive (HR+) 

 

There is preclinical evidence that the molecular pathways between the cannabinoid receptors within our body and estrogens overlap, which may impact the pathogenesis of common diseases including HR+ breast cancer. In one study, researchers concluded that the endocannabinoid, AEA, blocks human breast cancer cell proliferation, however evidence for anti-tumor cannabinoid action in HR+ breast cancer is less clear. There are many possible interactions between HR+ breast cancer and exogenous and endogenous cannabinoids but currently there are no clinical trials evaluating the effect of cannabinoids on treatment outcomes and/or prognosis. 

 

The interactions between HR+ breast cancer and exogenous and endogenous cannabinoids, specifically, are reported as nearly impossible to predict. The use of cannabinoid therapy in palliative medicine is well established, but researchers indicated that clinical trials are needed to determine the safety of cannabinoid therapy in various other breast cancer settings. Until we have this further evidence there should be an emphasis on close monitoring when using cannabinoid therapy in an HR+ breast cancer setting. 

 

Pro-tumor controversy 

 

Although the majority of reports published to date show that cannabinoids induce anti-tumor responses, not only for breast cancers but many other types, there are a reduced number of articles that have reported pro-tumor actions in response to cannabinoid therapy. In two published cases, both observed pro-tumor effects of cannabinoids were either undetectable or very low levels of cannabinoid receptors were present; therefore the interaction between cannabinoids and cannabinoid receptors was not fully observed or understood. As well, it has been hypothesized that pro-tumoral versus anti-tumoral effects may be explained by the biphasic effects of cannabinoids, where too little or too much may result in opposite effects. 

 

Therefore, it is important when starting out with cannabinoid therapy to be transparent with your doctor so you may be closely monitored and to ease into your therapy so you may understand how the cannabinoids interact with your body and specific diagnosis. 

 

A call for more research 

 

Among the published articles that are available, there is a common call to additional research to further provide evidence for the use of cannabinoid therapy for specific conditions. Results obtained are optimistic thus far, however breast cancer is diverse and we have a long way to go before we fully understand the role of cannabinoids in each breast cancer subtype. 

 

This is one of the many reasons why Realm of Caring has partnered with Johns Hopkins University School of Medicine for our Observational Research Registry. This allows individuals to self-report their condition, products being used (or not being used), how much they are taking, and when they are taking it in their natural environment. This observational data helps to further pave the way for clinical research, legitimize plant-based therapies, and destigmatize the cannabis plant. 

 

Free one on one support

 

If you want to reach out to us to discuss anything cannabinoid therapy related one on one – we are here for you! From quality product selection in your area to dosing guidance along the way, our care team is available. ​​You can call our free hotline at 719-347-5400, email info@realmofcaring.org, or schedule an appointment.