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Could Implementing Medicinal Cannabis programs mean lower health insurance costs?

Studies on the long-term impacts of medicinal cannabis policies on healthcare costs and potential, individual healthcare savings have recently emerged. Where initially there were concerns about cannabis legalization leading to an increase in medical expenses, we are actually witnessing a decrease in medical expenses – ranging from decreased prescription use to lessened need for treatment facilities. 

 

Here we explore some of the researched ways medical savings are taking place when cannabis is legalized for medicinal use. 

 

Less ER visits and hospital admissions

 

The key finding of a 2020 published study, including 1,276 participants, was that medicinal cannabis use was associated with more positive ratings of health and quality of life, assessed across multiple domains. The group of individuals from this study who initiated cannabis use after their first study showed improvement in their health. The group of individuals using cannabis who stopped using cannabis showed diminished health. 

 

From this study, in addition to 14% of cannabis users reporting less use of current prescription medication, 39% reported less past-month Emergency Room (ER) visits, and 46% reported less hospital admissions. 

 

Reducing occurrences of substance use disorders

 

There is a longstanding debate that cannabis use complements use of hard drugs. However, one 2015 study showed no evidence that cocaine and heroin use increases with cannabis use. Instead, in states with medicinal cannabis laws, there was a 20% decrease in treatment for heroin use disorders and no change in treatment for cocaine use disorders following implementation.

 

A 2022 published study used a longitudinal, co-twin control design in 4043 twins. The tested the effect of cannabis legalization on outcomes of interest and whether legalization interacts with established vulnerability factors (age, sex, or externalizing psychopathology). They found that while legalization was associated with increased cannabis use that it was not associated with cannabis use disorder. Additionally and most notably, the authors found a decrease in alcohol use disorder symptoms and no changes in alcohol or illicit substance consumption.  

 

Decreased need for mental health treatments

 

Literature on the effects of expanding cannabis legislation on mental health treatment is scarce. There is evidence to point to decreased prescriptions for antidepressants and sedatives among the elderly and, more recently, research to show a decrease in the number of mental health treatment admissions. Data collected from the Substance Abuse and Mental Health Services Administration (SAMHSA) illustrate the correlation between states who have passed recreational cannabis laws and a clear, immediate, statistically significant decrease in total admissions. Due to limitations, it is difficult to identify the exact mechanisms leading to a decline in seeking mental health treatment; therefore it is recommended that future studies examine outcomes of improved mental health, self-medication, or other factors. 

 

Type 2 Diabetes Intervention

 

Diabetes is among the most expensive chronic conditions in the United States, where $1 out of every $4 of healthcare costs is spent on caring for individuals with diabetes. That total annual cost comes to about $327 billion per year, with an estimated cost among medicare beneficiaries who are 65 and older at $5,876 per person, per year. 

 

Researchers examined the effects of cannabis on glucose regulation and insulin secretion, publishing findings in August of 2023. From this publication, a meta-analysis of 7 studies containing 11 surveys and 4 cohorts revealed that the odds of developing type 2 diabetes in individuals exposed to cannabis was 0.48 times lower than those without cannabis exposure. 

 

While interventions for chronic conditions are important to reduce the number of individuals affected, and cannabis is being realized as a beneficial intervention, it is recommended that more studies be conducted to increase levels of evidence.

 

Lower health insurer premiums in the individual market

 

Implementing medicinal cannabis laws may have a direct effect on individual market health insurance premiums – for both cannabis users and non-users given the nature of insurance pooling. A 2023 published study looked at state-level private health insurer data from the National Association of Insurance Commissioners from 2010-2021. Specifically, researchers were looking at the changes to health insurance premiums after a state adopted a medicinal cannabis policy. 

 

The authors “provide evidence that although the effect does not begin until seven years post-medical cannabis law implementation, there is a significant and sizable reduction in health insurance premiums” (Cook et al., 2023). A conservative statistical analysis predicts a reduction in annual premiums of $1,663 per individual. When considering the number of individuals enrolled in an individual health insurance market across legalized states – the resulting estimate in annual savings is approximately $9.6 billion. 

 

Finding Support

 

Evidence is spreading across the healthcare sector that cannabis has many health benefits. However, one thing that may be challenging is finding a product or dose that is right for you and your specific circumstance. This is where Realm of Caring steps in to support with free one-on-one guidance. Reach our dedicated and knowledgeable care team by calling (719)347-5400 or emailing info@realmofcaring.org. Quality of life matters, we are here to help. 

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Cannabis & Exercise: What the Research Says

In recent years, the intersection of cannabis and exercise has sparked significant interest among researchers and health enthusiasts alike. With the growing legalization and decriminalization of cannabis, more people are exploring its potential benefits, especially in conjunction with physical activity. Contrary to outdated stereotypes, emerging research suggests that cannabis consumption may be associated with increased physical activity, reduced pain levels, and enhanced positive emotions during exercise. 

 

Cannabis and Physical Activity: A Surprising Connection

 

Traditionally, stigma has created a stereotypical image of a cannabis user, i.e. couch-lock and sedentary behavior. However, recent studies have challenged this perception, revealing that cannabis consumers are more inclined to engage in physical activity than previously thought.

 

A study published in the Frontiers in Public Health journal (2019) examined the exercise habits of over 600 cannabis users. Surprisingly, the study found that cannabis users reported higher levels of weekly exercise compared to non-users. This unexpected correlation suggests that cannabis might play a role in motivating individuals to stay active.

 

Pain Management and Exercise: A Dual Approach

 

One of the most promising aspects of cannabis use in conjunction with exercise is its potential to alleviate pain. Both cannabis and exercise have been independently shown to reduce pain levels, making them a potentially powerful combination for those dealing with chronic pain conditions.

 

Research published in the National Library of Medicine (2019) and the Cannabis and Cannabinoid Research Journal (2023) explored the impact of cannabis use on pain perception before and after exercise. The studies observed that cannabis users reported lower pain levels after engaging in physical activity compared to non-users. This suggests that cannabis could act synergistically with exercise, offering enhanced pain relief and potentially allowing individuals to push through discomfort during workouts.

 

Elevated Positive Affect and Enjoyment

 

The role of positive affect, tranquility, and enjoyment during exercise cannot be underestimated. These emotional states can significantly impact our motivation to work out and our overall satisfaction with the activity.

 

Diving further into the 2019 study results mentioned above, there is indication that cannabis users experienced greater feelings of positive affect, tranquility, and enjoyment during exercise compared to non-users. This suggests that cannabis may enhance the overall exercise experience, making workouts more enjoyable and potentially leading to increased adherence.

 

Next Steps

 

While the emerging studies are promising, it’s important to approach the combination of cannabis and exercise by keeping in mind that further research is still needed. Individual responses to cannabis vary widely, and factors such as dosage, strain, and method of consumption can influence outcomes. 

 

Before incorporating cannabis into your exercise routine, we always recommend speaking with a healthcare professional, especially if you have any underlying health conditions or are taking medications that may interact with cannabis. However, if you are in need of support while on your journey we are here to help. From product selection to dosing guidance – 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.

 

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CBD Benefits for Liver Function

Cannabidiol (CBD), extracted from Cannabis Sativa, has been well-researched for its many benefits and is quickly becoming a favorable therapeutic option as adverse effects are limited, it does not cause psychoactive effects, and it lacks abuse potential. Included in the growing list of well-studied benefits, are the pharmacological properties of CBD that may protect the liver. This is due, in part, to the antioxidant and anti-inflammatory capabilities. 

 

Here we will discuss CBD’s potential role in restoring liver function, in alleviating liver injuries in alcoholics, and as an anti-cancer therapy. 

 

Restoring liver function

 

CBD is being more closely looked at for benefits in individuals suffering from hepatic encephalopathy (HE), a syndrome observed in those with end-stage liver disease and exacerbated by inflammatory responses. Given the novel anti-inflammatory and non-intoxicating properties of CBD, it makes it a promising treatment for HE. 

 

For one study in particular, researchers injected mice with acute liver injury, which raised their levels of ammonia, bilirubin, and liver enzymes after administration. CBD partially restored all of the indices induced by the injection to normal levels, therefore restoring liver function. For the control animals who did not receive injections, CBD had no effect on any of the liver-associated levels. 

 

Alleviating liver injuries in alcoholics

 

Alcohol abuse and high-fat diet-induced liver diseases are among the most prevalent chronic liver diseases as well as the leading reason for liver transplantation around the world. Inflammation has an important role in the formation and progression of liver damage that may be induced by either alcohol or a high-fat diet. 

 

Published research in 2021 looked to CBD to further study its ability to alleviate liver injuries induced by ethanol plus high-fat cholesterol diets, a model simulating heavy alcohol drinkers in a Western diet. This study took place over a span of 8 weeks with mice liver injury models. 

 

Results found that CBD ameliorated steatohepatitis (liver inflammation and damage caused by a buildup of fat in the liver), alleviated oxidative stress, decreased hepatic inflammation, prevented key activations responsible for the development of liver diseases, and attenuated liver inflammatory responses. 

 

Anti-hepatocellular carcinoma potentials

 

Hepatocellular carcinoma (HCC) represents over 85% of primary liver cancers. Liver cancer is the 5th most common cancer in men and 9th most common for women worldwide. It is estimated that 70% of liver cancers may be prevented. 

 

Researchers sought to understand the efficacy of Cannabis sativa, specifically an extract with major components delta-9-tetrahydrocannabinol (THC), CBD, and cannabinol (CBN) with percentages at 16.26%, 14.98%, and 13.486% respectively. Clinical trials and observational studies have, for many years, shown the safety of cannabis administration in the treatment of therapies. Therefore researchers in this study wanted to build upon that anti-cancer knowledge. 

 

The cannabis sativa extract increased the activity of antioxidant enzymes, ameliorated lipid peroxidation, displayed anti-angiogenic potential, lead to apoptosis, and demonstrated anti-inflammatory benefits. 

 

Conclusion

 

While benefits are being realized in regards to understanding CBD as a protectant of liver function, more research is needed, especially in the arena of CBD use in combination with pharmaceuticals. As with any therapy, effective dosing varies widely by individual and condition. 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, the care team at Realm of Caring is here to help! Send an email to info@realmofcaring.org, call at 719-347-5400 or schedule an appointment.

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Cannabis: Less Addictive Than Technology?

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Enhancing Your Skincare Routine with CBD

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The Importance of the Hemp Plant

“Hemp is of first necessity to the wealth and protection of the country.”

Thomas Jefferson

 

The Agriculture Improvement Act of 2018, also known as the Farm Bill, excluded hemp from the Controlled Substances Act. By removing hemp from the statutory definition of marijuana, hemp products are now allowed to be transferred across state lines when purchased in a state where it was lawfully produced. The majority of cannabidiol (CBD) products that are available to purchase, are hemp-derived. This means that the CBD oil is produced from a hemp plant rather than a marijuana plant. The difference between the two will be discussed here, but first, what is hemp?

 

Hemp is of the Cannabis genus, specifically the Cannabis Sativa species. Its uses date back for over 10,000 years across many different cultures for purposes ranging from pottery making to medicinal and food sources. The reason why this Farm Bill was needed in the United States was because industrial hemp became looped in as a part of the Marihuana Tax Act of 1937, strictly regulating the cultivation, production, and sales of all forms of cannabis. Although hemp has low quantities of the intoxicating cannabinoid, delta-9-tetrahydrocannabinol (THC), the industrial crop became criminalized. There are theories that hemp was included in this ban so those in positions of power could protect their own interests in the synthetic fiber and tree-made paper industry. The 1937 Act eventually led to the hemp farm ban in 1970 along with the passing of the Controlled Substances Act to label hemp as a Schedule 1 drug. To date, while hemp has been removed by the 2018 Farm Bill, cannabis is still classified as a Schedule 1 drug meaning it has “no currently accepted medical use and a high potential for abuse”. 

 

For decades, advocates and activists have been championing the benefits of hemp for its multitude of uses. From Jack Herer’s The Emperor Wears No Clothes published in 1985 to Charlotte Figi’s remarkable story presented in Sanjay Gupta’s CNN documentary, Weed, in 2013; the capabilities of the plant are becoming more widely known. 

 

From the long history of uses across several cultures, here are just eight of the facts we would like to share with you about hemp: 

 

  1. Hemp played a prominent role in United States history

 

Hemp arrived in Colonial America along with the Puritans. The seeds were stored with the intention of planting, and the ropes and sails of the Mayflower were made with hemp fiber. Once they arrived in America, the colonies were required by British law to grow hemp and it soon became a staple in the expanding economy. The first drafts of the Declaration of Independence were written on hemp paper. Presidents George Washington and Thomas Jefferson both grew hemp on their farms. Hemp played an important role up until the Marihuana Tax Act of 1937, where heavy taxes were imposed on farmers, physicians, and pharmacists for growing, prescribing, and selling cannabis products.  

 

During World War II there was a “Hemp for Victory” campaign due to a shortage of fibers necessary to make ropes, shoelaces, and parachute webbing. Although hemp was illegal in America at this time, a propaganda film was made to persuade farmers to grow hemp instead of maize for the war efforts. Hemp was once again prohibited with the end of the war.

 

  1. Hemp seeds are a superfood

 

One might say that hemp seeds have the ability to offer total nutrition for the body. They contain high levels of omega-3 and omega-6 fatty acids and are a great source of protein in that they provide all nine essential amino acids. Hemp seeds also have an assortment of minerals and vitamins such as magnesium, potassium, iron, zinc, vitamin B, and the well-researched antioxidant – vitamin E.  It also has something else that sets it apart from most superfoods we know of today. One of those omega-6 fatty acids hemp seeds contain is known as gamma linolenic acid (GLA), which is also found in breast milk. This vast nutritional profile may benefit as a neuroprotectant, anti-inflammatory, and immune and heart health regulator.

 

Hemp seeds can also be made into flour, oil, or milk. The many capabilities of the seed arguably gives it potential to address malnutrition and food shortages in the world. 

 

  1. Hemp may improve the environment it is grown in

 

The hemp plant is able to consume four times as much CO2 as trees do from the environment, in the process known as carbon sequestration. The root has a lot to offer as well. The deep root allows the plant to reach nutrients left behind by previous plants as well as find deep water sources. This ability of the roots not only benefits the plant but the surrounding soil. It loosens the soil, therefore encouraging plant growth afterward, as well as holds the soil together to reduce erosion. 

 

The potential of hemp plants to remove toxins from the soil where it is being grown is being studied as well. In fact, hemp is being grown in the surrounding areas of Chernobyl to assist in removing caesium (a radio-nuclide left over from the devastating 1986 explosion) from the soil. This process is called phytoremediation, where plants may be used to decontaminate soil of high concentrations of contaminants, such as heavy metals, by the plants’ ability to accumulate them in their plant tissue. Although there are many plant species with this ability, hemp has an advantage due to its superior tolerance, root system, and biomass. 

 

  1. Hemp could easily replace what trees produce

 

On average, the amount of paper produced by 2-4 acres of trees in a year can be accomplished in one acre of hemp. The paper manufactured from hemp pulp is able to be recycled several more times than paper manufactured from wood pulp, and the fiberboard that can be produced from hemp is reportedly stronger and lighter than wood. 

As documented in 2012, about 521 million acres are reserved in the United States for timber harvesting, which will primarily produce wood for lumber and construction materials. Harvesting takes place when the tree reaches a large enough diameter. This process can take, on average, 10-20 years depending on the tree species. In contrast, hemp plants for pulp and fiber are ready for harvest in 60-120 days. 

 

  1. Growing hemp requires a lot less resources than growing cotton

 

The water footprint to produce one pound of cotton is approximately 1,320 gallons whereas the water footprint required to produce one pound of usable hemp fiber is about 255 gallons. Considering that it only takes low to moderate amounts of water to effectively grow hemp plants, it is able to be successfully grown in all 50 states and across many climates. 

 

Just as with trees, utilizing hemp plants may save on acreage as well. Case studies show that while about 1,190 pounds of cotton fiber can be produced per acre; 2,645 pounds of hemp fiber can be produced per acre. While cotton fabric may be softer (due to the fibers quickly and easily breaking down), hemp fabric tends to be stronger, longer lasting (due to the fibers taking longer to break down), and more insulating. 

 

  1. Protein from hemp seeds is more nutritious than most protein sources

 

In our second point, we discussed hemp seeds as a great source of protein, however there is more to add to this point! Hemp seed protein can be used to produce milk, butter, cheese, salad dressings, tofu, veggie burgers, ice cream, and more. Hemp flour can make pasta, bread, and other baked goods. 

 

While in comparison to other foods that are high in protein, it may seem that hemp seeds are not that superior at about 10 grams of protein per 3 tablespoons. However, what sets them apart is the lack of trypsin inhibitors. Trypsin is a digestive enzyme, which breaks down proteins we ingest within the small intestine, making the amino acids and other nutrients available to the body. Trypsin inhibitors block this function. Meaning, if you are eating a high protein food that contains them, not all of that protein is being broken down and digested. The fact that hemp seeds do not contain these inhibitors, means that all of the protein taken in becomes available to the body. Soybeans and legumes are among the several protein-rich foods that contain trypsin inhibitors, although the amount is able to be reduced by means of heating. 

 

  1. Hemp and marijuana are not the same

 

Hemp belongs to the Cannabis Sativa species only. Marijuana, on the other hand, can be of either the Cannabis Sativa or Cannabis Indica species. The most basic of differences between the two is that hemp will contain less than 0.3% THC. Marijuana is typically grown to encourage the development of trichomes, which are glands on the flowers of the plant where THC is concentrated. These female plants are kept separate from the male plants to avoid fertilization, as fertilized cannabis flowers may produce lower THC. 

 

CBD can come from hemp or marijuana plants – regardless of the plant, the compound that is CBD remains the same in molecular structure. All hemp-derived CBD products are what will be available to purchase over the counter or be shipped state to state and to most countries. Marijuana-derived CBD will only be available to purchase in a state that supports recreational use or a medical marijuana program, as it will contain more than 0.3% THC.  

 

If what you are looking for is a federally legal product that contains low THC, high CBD, and is full-spectrum, in that it contains all of the natural cannabinoids of the plant, a hemp-derived CBD product would be the way to go. 

 

  1. Hemp is a versatile natural resource, with more to offer than almost any other

 

In addition to the capability of being a source of fiber for ropes, nutrition, paper, and a cotton replacement, hemp seed oil could be used to produce fuel, laundry detergent, natural wood finish, and much more. For example, hemp cellulose may be used to produce hemp durable and biodegradable plastic. In 1941 Henry Ford famously showcased a car made from soybean and hemp plastics, gloating that it was lighter than steel and could withstand ten times the impact. 

 

How is that possible; that hemp fibers are stronger than steel? It comes down to tensile strength and compression strength. Hemp fibers have greater tensile strength, meaning it may handle more tension before it is permanently deformed. For example: the weight endurance a rope can hold before it tears. The weakest hemp fiber needs more pressure to break than the weakest variation of steel. Hemp has the capacity to hold double the weight. Compression strength is how much damage an object can endure before it loses the capacity to mend itself. Hemp has six times the ability of steel to not bend with pressure.

 

For these very good reasons, we celebrate the wrongly criminalized hemp plant. It has the potential to play many important roles, thus education and awareness of its capabilities is paramount. If you have any questions about what was discussed here, or wish to find out more, refer to the Hemp Week educational campaign or contact a Realm of Caring Care Specialist at info@realmofcaring.org

 

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Taking a Break from Cannabis: THC Tolerance Break 101

There may come a time when you find yourself in need of a THC detox. Whether it’s due to a forthcoming drug test for a job opportunity or a personal decision to embark on a tolerance break (T-break), effectively resetting your system is crucial. With the growing acceptance and legalization of cannabis in many regions, it is important to understand how to consume it responsibly and maintain a healthy relationship with the plant. One effective strategy for achieving this is by incorporating THC tolerance breaks into your cannabis routine. 

 

In this blog, we will explore what T-breaks are, why they are beneficial, and how to efficiently flush THC (tetrahydrocannabinol) out of your body and prepare for a fresh start.

 

What is a Tolerance Break?

 

A tolerance break, also known as a “T-break,” refers to a deliberate period of abstinence from cannabis consumption. The purpose of a tolerance break is to reset the body’s response to THC (tetrahydrocannabinol), the primary psychoactive compound in cannabis. Extended and frequent cannabis use can lead to the development of tolerance, where the body becomes less responsive to the effects of THC. Taking a break allows the body to restore its sensitivity to THC, resulting in a more enjoyable and efficient experience upon resuming cannabis use.

 

3 Benefits of Tolerance Breaks

 

  1. Enhanced Sensitivity: Regular cannabis consumption can lead to a diminished response to THC, requiring higher doses to achieve the desired effects. By taking a tolerance break, you give your body a chance to reset its cannabinoid receptors, leading to increased sensitivity. This means you’ll be able to experience the effects of cannabis more profoundly with smaller amounts, potentially saving money in the long run.

 

  1. Avoiding Plateaus: Over time, frequent cannabis use can reach a point where the effects plateau, resulting in a diminished experience. By incorporating tolerance breaks into your routine, you can prevent or break through these plateaus, ensuring that each cannabis session remains enjoyable and effective.

 

  1. Cognitive Clarity: While cannabis can provide many benefits, it may also affect cognitive function, particularly short-term memory and concentration. Taking a break allows you to regain mental clarity and focus, which can be particularly beneficial for those who require enhanced cognitive abilities for work, studies, or other activities.

 

How to Successfully Implement a Tolerance Break

 

  • Abstain from Cannabis: The first step in a successful THC detox is to abstain from cannabis consumption entirely. This includes avoiding smoking, vaping, edibles, tinctures, or any other form of cannabis ingestion. The duration of your detox will depend on various factors, such as your usage patterns and metabolism, but typically ranges from a few days to several weeks. Choose a realistic timeframe that suits your needs and lifestyle.

 

  • Hydrate and Exercise: Staying well-hydrated is essential during a THC detox. Drinking plenty of water helps flush out toxins from your body and supports overall detoxification. Additionally, engaging in regular physical exercise, such as cardiovascular activities or sweating through saunas, can assist in the elimination of THC stored in fat cells.

 

  • Communicate with Others: Inform your friends, cannabis-using buddies, or anyone you typically consume cannabis with about your decision to take a tolerance break. This will help prevent any social pressure and ensure their support during this period.

 

  • Seek Alternatives: Find alternative activities or hobbies to engage in during your break. This can help distract you from cannabis-related thoughts and cravings. Consider pursuing physical exercise, creative endeavors, spending time in nature, or engaging in social activities that do not revolve around cannabis.

 

  • Follow a Nutritious Diet: Opting for a nutrient-rich diet is beneficial during a THC detox. Focus on consuming foods that support liver function, as the liver plays a vital role in metabolizing and eliminating toxins from your body. Incorporate fruits, vegetables, whole grains, lean proteins, and foods high in antioxidants into your meals.

 

  • Manage “Withdrawal” Symptoms: Some individuals may experience mild “withdrawal” symptoms during a tolerance break, including irritability, sleep disturbances, decreased appetite, and mood swings. These symptoms are temporary and typically subside within a few days. Engage in stress-reducing activities like meditation, deep breathing exercises, or yoga to support your overall well-being and optimize the detoxification process.

 

  • Reflect and Reintroduce: Use this break as an opportunity for self-reflection. Evaluate your relationship with cannabis and how it fits into your life. Once your tolerance break is over, gradually reintroduce cannabis back into your routine. Start with lower doses to gauge your sensitivity and adjust consumption accordingly.

 

Conclusion

 

Embarking on a T-break or THC detox is a proactive step towards achieving your desired goals, whether it’s passing a drug test or resetting your tolerance to cannabis. By abstaining from cannabis, staying hydrated, exercising regularly, following a nutritious diet, and managing stress, you can effectively flush THC out of your system. Remember, responsible cannabis consumption involves finding the balance that works best for you and respecting your body’s needs.

If you are in need of support while on your journey, the Care Team at Realm of Caring is here to help! Send an email to info@realmofcaring.org, call at 719-347-5400 or chat at realmofcaring.org.

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Cannabis for Migraines and Headaches

Migraines impact more than 39 million men, women, and children in the United States; and are especially common in women. Symptoms include dull and throbbing head pain, piercing cluster pain, neck pain and tension, nausea, and hypersensitivity to light, sound and smells. When left untreated, headaches and migraine may lead to depression and anxiety. 

 

The causes of migraines are not definitive, but genetics and environment may play a role. Most people with migraine will have a spontaneous attack with no identifiable cause, however common triggers may include stress, diet, alcohol, sleep patterns, changes in weather, hormonal changes, concussions, and traumatic brain injuries.

 

Current treatments for Migraine and Headache

 

There are two primary types of treatments for migraine: acute and preventative. Acute treatments include over the counter pain relievers, prescription medications, or devices to stop the pain. Preventative treatments are designed to reduce frequency, severity, and duration of attacks before they occur. 

 

Research shows that behavioral treatment, such as stress management and biofeedback can help reduce attack frequency and severity. 

 

Although the pathophysiology of migraine is still fairly elusive in the medical community, there is still an understanding of the main mechanisms underlying migraine attacks, such as neurogenic inflammation. Inflammatory chemicals irritate and dilate blood vessels, which leads to a release of more sensory neurons and increase of pain impulses. 

 

The Role of the Endocannabinoid System

 

The endocannabinoid system (ECS) is our physiological system composed of endocannabinoids, their metabolic enzymes, and their receptors. Endocannabinoids within our central nervous system are involved in the modulation of specific brain functions. Through activation of CB1 receptors, endocannabinoids are able to control movement, memory, wake/sleep cycles, thermogenesis, appetite and pain. 

 

Research published in 2014 suggests that CB2 receptors, especially those located outside the central nervous system, may also play a role in the perception of pain. When studied in animal models, exogenous cannabinoids induced antinociception (the action or process of blocking the detection of a painful or injurious stimulus by sensory neurons). It has been clearly demonstrated that CB1 receptors are involved in modulating pain signals, but this showed that CB2 receptors also contributed to the analgesic effect. 

 

Endocannabinoid deficiency in head pain studies

 

Endocannabinoid deficiency has been hypothesized to be a reason why individuals suffer from migraines, with recent clinical studies supporting this idea. However, scientific evidence for the potential efficacy of cannabinoids in migraine is limited. 

 

Clinical endocannabinoid deficiency was first presented in 2001 by Dr. Ethan Russo and has been further explored since then. Because endocannabinoids are involved in different physiological and pathological processes such as regulating food intake, immunomodulation, inflammation, pain, cancer, addictive behavior, seizure disorders and more; it would seem that if  levels of endocannabinoids (or endocannabinoid function) were decreased in the body, then we would witness a disturbance in digestion, pain threshold, mood, sleep, and more. The greatest evidence for clinical endocannabinoid deficiency is present with PTSD, IBS, fibromyalgia, and migraines as they have common pathophysiological trends, one being that they all display elevated incidences of anxiety and depression. 

 

Another piece of evidence seen is that, for the most part, these conditions are treatment-resistant. There may be pharmaceutical drugs available to alleviate certain associated symptoms, resulting in one taking several different medications to target the various symptoms, but not one conclusive treatment. 

 

A study published in 2007 reported reduced levels of the endocannabinoid anandamide (AEA) in the cerebrospinal fluid of patients with chronic migraine. This showed the possibility that reduced levels of AEA (or an endocannabinoid deficiency) may be associated with increased activation of the TVS (trigeminovascular system), a common occurrence before and during migraine attacks. Theoretically, the reduction of AEA levels, and hence the reduced inhibitory effect of ECS, may contribute to facilitating and/or maintaining central sensitization in chronic head pain. 

 

An important role for AEA in head pain is also observed in that AEA possesses a vasodilator activity and it has been identified also in endothelial cells, confirming its potential role in the modulation of the vascular system. AEA is actually classified as a true “endovanilloid” as it activates the transient receptor potential vanilloid receptor (TRPV1), an ion channel receptor primarily located on sensory nerves and activated by specific stimuli capable of initiating and amplifying pain and inflammation.

 

Early Cannabinoid Therapy for Migraines and Headaches

 

The use of cannabis in the symptomatic and prophylactic treatment dates back in research to the early 19th century. Dr. S. Mackenzie advocated the use of cannabis twice daily in 1887 for chronic daily headache. Dr. J.W. Farlow recommended cannabis suppositories in 1889 for nervous headaches. In 1915, Sir William Osler, the acknowledged father of modern medicine, proposed the treatment of migraine with Cannabis indica. The following year, Dr. Dixon, Professor of Pharmacology at the Kings’ College and the University of Cambridge, reported the therapeutic effects of smoked cannabis for headache treatment. Subsequently, the medicinal use of Cannabis indica for both acute and preventative headache treatment was advocated by many more prominent physicians through the 19th and early decades of the 20th centuries. 

 

In the late 1990s Dr. Ethan Russo had received FDA support in conducting a study looking at the effects of smoked cannabis in the treatment of migraines. However, his study was halted by the National Institute on Drug Abuse (NIDA). He stated the following

 

“My FDA-approved study on cannabis’ ability to reduce

migraine was stone-walled because NIDA holds a monopoly on

the legal supply of cannabis for research, and they refused to

provide it for my study. As a doctor and a citizen, knowing that

researchers in other countries are researching and confirming

new medical uses for cannabis all the time, such as its ability to

protect the brain after head trauma or stroke, I am dismayed by

policies that prevent us from fully utilizing the healing potential

of this plant and preventing people from using the best medicine

for their condition.”

 

Medicinal Cannabis and Pain

 

One of the most documented uses of medicinal cannabis is in the treatment of pain, particularly chronic pain, and suppression of hyperalgesia. Most published studies involve endocannabinoids, delta-9 THC, or synthetic cannabinoids. The cannabinoid-opioid interactions and “opioid-sparing effect” of cannabinoids has attracted interest in medicinal cannabis for a possible alternative to narcotics with less potential for dependence, addiction, and abuse. 

 

Recent Studies

 

Both delta-9 THC and CBD have analgesic properties, although they act through different mechanisms, and the potential euphoric side effects of delta-9 THC may be a limiting factor in its use. However, given the pharmacology and reported therapeutic benefits of cannabis in pain medicine, it is logical that this benefit may extend to the arena of headache medicine, including migraines.

 

A case study reported a woman with medically refractory pseudotumor cerebri would smoke a cannabis cigarette about once per week when her headache disorder became severe. She would have complete resolution of her headache within 5 minutes and it would not recur that day. 

 

Other studies suggest that cannabinoids may reduce intracranial pressure in traumatic brain injuries (TBI’s) as well as intraocular eye pressure in glaucoma. 

 

A case study involving one male  reported that smoking cannabis at the onset of cluster headache attack would consistently give complete headache relief. He eventually replaced smoked cannabis with ingestibles, finding the onset time was a few minutes delayed but provided the same relief. Oral administration is associated with slower onset of action and longer duration of action and effects. 

 

A prospective clinical trial published in 2020 focused on 68 patients who smoked or vaped medical cannabis. The study focused on the associations between phytocannabinoid treatment and migraine frequency reporting better migraine symptom reduction, less negative headache impact, better sleep quality, and decreased medication consumption. Studies have also shown improvements in nausea and vomiting associated with migraines; but also shown to have unpredictable effects due to psychotropic nature. 

 

A 2021 published study looked at a survey provided to 50 medical cannabis users. It showed that hybrid strains of cannabis of high THC/THCA, low CBD/CBDA strains and those with predominant terpenes b-caryophyllene, and myrcene, were most preferred in headache and migraine groups. It also showed that THC:CBD ratios had a 40% improvement and was potentially best used for acute attacks. 

 

Research Limitations

 

While studies have shown improvements in pain as well as nausea and vomiting associated with migraines, limitations exist that prevent a quality analysis. This is why participation in research for the benefit of cannabinoid therapy in specific ailments, such as headaches and migraines, is critical to move science and access forward. If you or someone you know would be interested in joining Realm of Caring’s Observational Research Registry in collaboration with Johns Hopkins University School of Medicine, join today

 

With all of the information and misinformation available, it is easy to become overwhelmed when beginning cannabinoid therapy. Our trained care specialists are here to help with free support. Set up an appointment, email, or chat  with us today for help in getting started, calculating a dose, or finding a quality product. We are always happy to help answer your questions. 

 

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Managing Stress with Cannabis: Men’s Health Awareness

June is Men’s Health Month. A time for acknowledging that men’s health issues are often overlooked and encouraging society to destigmatize men seeking help for mental health conditions.

 

Although no individual is free from exposure to stress, a published study showed that hormonal differences may alter how individuals manage stress. When stressed, hormones cortisol and epinephrine are released into the bloodstream. These are responsible for elevating blood pressure, blood sugar levels, and decreasing the effectiveness of the immune system. Oxytocin is another released hormone, which promotes nurturing and relaxing emotions. The study showed that women may release higher levels of oxytocin, therefore they are more likely to nurture themselves when under stress. Men, however, produced lower levels of oxytocin, which may result in suppressing stress or seeking avenues to escape the problem altogether. 

 

Hormonal results of stress may lead to chronic health problems, especially when early symptoms are ignored and not enough emphasis is placed on managing the contributing factors to stress. While acute stress may improve functioning and immune health, chronic or repeated stress can lead to exacerbating mental illnesses and/or suppressing the immune response to bacterial and viral infections, vaccinations, and cancer. 

 

Finding stress-relieving activities may be beneficial. However, lifestyle changes that promote uninterrupted sleep, healthy eating and digestion as well as reduce pain, anxiety, and depression may be keys to preventing chronic stress and the ailments that follow. 

 

The endocannabinoid system (ECS) is a key regulator of stress response, critical to assist our bodies in returning to a non-stressed state. The ECS limits the magnitude of the stress response, helps to return the HPA axis to non-stressed levels, and facilitates habituation of the stress response where repeated or ongoing.The interaction of plant-based cannabinoids and our ECS makes cannabis a likely candidate for alleviating the symptoms of many health conditions, to include stress. In fact, cannabis has been used medicinally for thousands of years in various societies around the world to reduce the physiological and psychological consequences of stress and fear. 

 

Cannabidiol (CBD) and Stress

 

The first clinical evidence that CBD reduces the stress response was from the studies of CBD’s ability to reduce the adverse effects of THC in healthy volunteers. 

 

In 2021, a study reviewed eight clinical trials (seven controlled and one partially controlled) of CBD for stress. The eight trials had a combined total of 352 participants. All showed that CBD was highly effective in significantly reducing the stress response and was non-inferior to pharmaceuticals, when used for comparison. 

 

CBD works with cannabinoid and non-cannabinoid receptors. For example, even at low doses, CBD has been shown to block stress-induced changes in the 5-HT1A receptor gene expression that reduced anxiety associated with the stress-response. 

 

CBD, as well as additional cannabinoids, may be a large influence to major hormones that may affect our stress levels, including epinephrine and cortisol. 

 

Epinephrine

 

Epinephrine, also known as adrenaline, is released during periods of sudden or chronic stress that leads to “fight or flight” actions. While epinephrine is important for sending more blood to our brain and muscles, making us more alert and providing energy, too much can put us at risk for anxiety, depression, and heart complications. Therefore, finding ways to naturally control the overproduction of epinephrine is essential. 

 

In 2001, researchers sought to understand the effects of cannabinoids on adrenaline secretion. It is well known that cannabinoids may promote cardiovascular homeostasis, so they carried out a study with rabbits to look more closely at how and why. It was found that due to the interaction of cannabinoids with the CB1 receptor, the cannabinoids used were able to lower the electrically evoked adrenaline release in the adrenal glands of the rabbits. 

 

While this study did not look at commercially available products for adrenaline control, findings were important to support involvement of specific cannabinoid receptors in the decrease in plasma adrenaline concentration.

 

Cortisol

 

Along with releasing epinephrine during times of stress, cortisol also releases from the adrenal glands to keep us on high alert, further contributing to “fight or flight”. Cortisol also triggers the release of glucose from the liver for increased energy. While research on CBD and cortisol is its infancy, there have been several clinical trials and one partially controlled trial looking at CBD for stress. All showed that CBD was effective in significantly reducing the stress response and comparable to pharmaceuticals where included. 

 

Not only may CBD be helpful in reducing stress-associated anxiety, but it may normalize abnormal stress responses. One study, looking to understand the effects of CBD on participants at high risk of developing psychosis who are found to have decreased levels of cortisol as a stress-response. The CBD treatment adjusted the abnormal cortisol response as well as reduced stress-associated increase in anxiety. 

 

Frontline healthcare workers were looked to in the height of the COVID-19 pandemic to investigate the safety and efficacy of CBD therapy in reducing emotional exhaustion and burnout. By day 14 of treatment, emotional exhaustion and symptoms of burnout were significantly reduced among the majority.

 

Studies confirm that a misalignment of the sleep-wake cycle has a negative impact on the stress system. There are a few discrepancies in studies when it comes to the relationship of sleep and cortisol, however unbalanced cortisol levels have been observed in individuals with obstructive sleep apnea (OSA) and many studies have shown increase in cortisol levels throughout a night of sleep deprivation and in the prolonged wakefulness of the following day.

 

Cannabis and Sleep

 

Needless to say, along with stress comes disrupted sleep. Cannabis Sativa is often used for improved sleep and relaxation, attributed to Indian hemp in the nineteenth century. 

 

For starters, hemp seeds contain a vitamin B6 content that can trigger the conversion of our body’s tryptophan into serotonin, which can then be converted to melatonin. 

 

CBD has been researched for its therapeutic potential for sleep disorders through limiting symptoms that may keep us awake at night but also may contribute to an increase in sleep duration and depth, as well as decrease in the anxiety responses induced by sleep disturbance. 

 

In comparison to CBD, delta-9-tetrahydrocannabinol (THC) has shown in studies as having an effect on mental and physical sedation, even in low amounts. THC also has positive therapeutic benefits that may lead to better sleep.

 

Cannabinoids CBD, THC, and cannabinol (CBN) have been lightly studied for their effects in balancing melatonin production. Cannabinoids are also being studied to better understand the complementary relationship they have with melatonin. Data published in 2022 suggest that a CBD-melatonin formula could be competitive with synthetic-hypnotic drugs (i.e. Ambien, Unisom). The antioxidant activity of melatonin that benefits the brain network coupled with the pain reduction and anti-anxiety effects of CBD promoted a balanced sensation of wellbeing during sleep. 

 

Overall, Assessed data from a 2020 published observational study looking at various quality of life measures showed that adult cannabis users had greater sleep quality, shorter sleep latency, longer sleep duration, fewer sleep disturbances, and a significantly better sleep score compared with the control group.

 

Finding Support for Cannabinoid Therapy

 

As with any therapy, effective dosing varies widely by individual and condition. 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, the care team at Realm of Caring is here to help! Send an email to info@realmofcaring.org, call at 719-347-5400 or chat at realmcaring.org.

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