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Cannabinoid Therapy for Pain

Pain and inflammation are the body’s physiological responses to tissue injury, infection and genetic changes. These responses can be divided into two phases: acute and chronic. The acute phase is the early, non-specific phase and is characterized by increased blood flow to the localized area, increased inflammation, and edema, which is swelling caused by excess fluid trapped in your body’s tissues. Pain is produced by pro-inflammatory agents that also lead to an increased sensitivity to feeling pain and an extreme response to pain, or hyperalgesia. 


If the condition that causes the damage is not resolved, the inflammatory process progresses towards subacute/chronic inflammation. Chronic inflammation plays a critical role in the onset of classic inflammatory diseases such as arthritis, but also of various other conditions such as cardiovascular and neurodegenerative diseases, diabetes, cancer, and asthma.


The chronic pain state, including neuropathic pain, is a leading health problem worldwide as it causes one to suffer beyond the resolution of the pain source and can deeply impact quality of life. Unlike physiological pain, in which tissue injury and/or inflammation can induce reversible adaptive changes in the sensory nervous system leading to protective sensitization, changes in sensitivity become persistent or chronic in neuropathic pain


To date, there is no one designated clinical treatment for chronic pain. Adequate pain relief may be achieved using drugs with adverse effects on the central nervous system side. The quality of life of those with chronic pain is often aggravated by comorbidities such as sleep disorders, depression and anxiety.


Endocannabinoid System and Pain Management


Findings on the endocannabinoid system have opened up a new era for cannabinoid research, discovering and evaluating various therapeutic uses. Specific CB2 agonists have shown considerable efficiency in a variety of neuropathic pain preclinical models. Increasing amounts of evidence, derived from both clinical and observational studies, have confirmed the potential of the endocannabinoid system in providing benefits for individuals with chronic pain and chronic inflammatory diseases. Preclinical studies have shown that cannabinoid receptor agonists block pain in various acute and chronic pain models and that inflammation is reduced. 


Data from clinical trials on synthetic and plant-derived cannabis-based medicines have suggested that they are a promising approach for the management of chronic neuropathic pain of various origins. It is also hypothesized that cannabis reduces the negative effects that chronic pain can have on cognitive performance.


Currently, individuals with chronic arthritic and musculoskeletal pain are reported among the most prevalent users of therapeutic cannabis products.


Synthetic Cannabinoid Studies


Dronabinol is a semi-synthetic form of THC, which is available in capsule form and as a solution, that has been approved by the FDA for appetite stimulation and the treatment of chemotherapy-induced nausea in patients with AIDS. A published study that compared the oral solution and capsule forms of dronabinol under fasting and fed conditions, found Dronabinol exerted a modest, but clinically relevant, analgesic effect on central pain in the pain treatment of patients with multiple sclerosis. Although the proportion of patients that showed adverse reactions was higher in dronabinol-treated than in placebo-treated patients, it decreased over the drug’s long-term use.


Using THC for pain


Cannabis use for pain can be traced back thousands of years. In 2900 B.C. ancient Chinese texts show written records of cannabis as a medicine, recommending cannabis for constipation, rheumatic pain, female reproductive tract disorders, and malaria. It was also used in conjunction with wine to anesthetize patients during surgical procedures. The Chinese mostly used cannabis seeds containing very low levels of THC. From there, use spread of varying preparations and potencies across and to India, however it wasn’t until the early 19th century that cannabis started to be explored in Western medicine. 


More recent studies with medical cannabis (THC)


Bringing it to more recent times, here are a few studies looking to THC use for pain and pain-related conditions. 


Patients with cancer enrolled in Minnesota’s Medical Cannabis Program self reported after 4 months of beginning medical cannabis that there was a significant reduction in the severity of symptoms across all eight measures included in the study (anxiety, lack of appetite, depression, disturbed sleep, fatigue, nausea, pain, and vomiting) compared with baseline.


In another study that took place in Israel, a total of 128 individuals over the age of 50 with chronic pain and sleep issues were recruited. Medical cannabis use was associated with less problems waking up at night compared with non-medical cannabis use showing that medical cannabis use may have an overall positive effect on maintaining sleep throughout the night in chronic pain patients. 


Opioids and cannabinoid use


With increased access to cannabis and more conservative opioid prescribing, evidence suggests that patients are substituting cannabis for opioids. For example, opioid analgesic prescriptions filled by Medicare Part D enrollees fell significantly in states with medical cannabis laws, and patients with chronic pain report over 60% reduction in their opioid use in these states. Some pain patients reported that cannabis increased the analgesic effects of their opioids or decreased the opioid dose needed for therapeutic effect. 


The demonstration of analgesic effects of cannabinoids in those taking opioids for chronic pain suggest that cannabis may increase the pain-relieving properties of opioids, therefore decreasing the total dose, or provide enough pain-relieving qualities on its own to serve as a substitute. However, there are no data from placebo-controlled studies directly addressing whether cannabis can decrease the effective analgesic doses of opioids. Additionally, to date, no studies have investigated the impact of opioid-cannabinoid drug combinations on abuse liability, a critical aspect when considering the therapeutic utility of two drugs that may have significant abuse liability when administered alone.


Researchers of these studies suggest that a pharmacotherapeutic strategy that capitalizes on THC’s potential to decrease opioid use while also minimizing its intoxicating effects should be prioritized. For example, oral THC produces analgesic effects that are longer lasting than smoked cannabis while eliciting lower ratings of intoxication and positive subjective effects.


CBD applications


To date, the widespread use of medical cannabis is still controversial, mostly because the plant produces both therapeutic and psychoactive effects. There is strong evidence suggesting that the non-intoxicating cannabinoids, such as CBD, could also alleviate chronic inflammation and pain in animals. Several clinical studies have demonstrated that a THC to CBD combination can be an effective therapeutic option for individuals with neuropathic pain, as well as other types of chronic pain. However, researchers point to the need to improve the efficacy of these cannabinoids in targeting chronic pain. One obstacle is the uncertainty of the molecular targets for cannabinoid-induced analgesic effects. Recent studies have shown that glycine receptors (GlyRs) are an important target for cannabinoids in the central nervous system. One study with rodents showed that glycinergic cannabinoids, such as CBD, are ideal therapeutic agents for inflammation and neuropathic pain as they can suppress both without causing significant intoxicating side effects or analgesic tolerance. 


There has been accumulating evidence through observational trials and animal studies that CBD presents an opportunity for the treatment of intractable chronic pain for which primary treatments are insufficient or not possible. Since the early 2000s, clinical trials involving CBD for chronic pain have shown effects ranging from placebo-equivalent to highly effective among patients suffering from multiple sclerosis, spinal cord injury, brachial plexus injury, limb amputation, fibromyalgia, and kidney transplantation. 


Observational studies have consistently shown improvements among self-reported quality of life and quality of sleep. More recently, cannabis users in one observational study reported lower past-month average pain relative to controls. 




For some who are in the acute phase of chronic pain, or who are not quite ready to take cannabinoid therapy orally, topical products may offer relief. Topical administration is potentially ideal for localized areas, such as those found in dermatological conditions and arthritis but also in peripheral neuropathic pain. Topicals may be best for acute flare ups and administration throughout the day. 



Starting your cannabinoid therapy journey


If you are wondering if cannabinoid is right for you on your wellness journey, our care specialists are here to talk with you one-on-one. Reach out by calling 719-347-5400 or emailing






The Realm of Caring Foundation specifically invokes the first amendment rights of freedom of speech and of the press without prejudice. These statements have not been evaluated by the food and drug administration. the products discussed are not intended to diagnose, cure, prevent or treat any disease. Realm of Caring always recommends when and wherever possible that licensed local healthcare professionals be consulted.


The Realm of Caring Foundation is an independent nonprofit with its own governing board. We do not produce or sell cannabinoid products, nor do we receive funds from the sale of other company’s products.

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Delta-8 THC Legal Update

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How To Support The Legalization of Cannabis

Two in every three Americans believe that cannabis should be legalized at the state and federal levels. If asked, as was done in a recent Pew Research Survey, 68% of Americans are comfortable with the idea of making cannabis mainstream. This demonstrates how the attitudes of Americans towards cannabis have changed over time. 


In the last decade, Americans in different states have campaigned and voted for the legalization of cannabis at the state level. Currently, 38 states and Washington D.C. have enacted medical laws, while 18 states and Washington D.C. have legalized adult-use. Several other states are having positive conversations about cannabis, both for medicinal and recreational purposes. We expect more states to move towards full legalization in the coming years. Even states considered to be traditionally anti-cannabis have begun to warm up to positive conversations around cannabis.


The progress made so far has resulted from concerted efforts by cannabis supporters and activist groups to create awareness, ensuring that their efforts yield tangible results. If we are to witness even greater results, we must move past passive support to actively advocate for the legalization of cannabis at both levels. 


In short, it is not enough to believe that cannabis should be legalized and leave it at that. It is crucial that the “two-thirds” actively participate in making cannabis legal in America, both for medicinal and recreational purposes. 


How can one be actively involved in supporting the legalization of cannabis?



Support Cannabis Education and Research



Cannabis legalization is hinged on cannabis research because the information generated from research helps build the case for legalization. There are different ways of supporting cannabis education and research. Whether you are a cannabis user or not, you can offer to participate in research. If you are a product company, you can have your products involved in studies that illustrate how they may positively impact individuals. Alternatively, you can also give towards organizations focused on cannabis research and education. 


Realm of Caring (ROC)


At Realm of Caring we are a nonprofit organization that advocates for the rights of cannabis use through research and education. We provide educational opportunities to individuals, families, medical professionals, researchers, the cannabis industry and everyone else in need of information on hemp and cannabis. We support mainstream acceptance of plant-powered therapies and are committed to our mission and belief that the quality of life matters. Register with ROC today to learn more.



Find Activists & Grassroots Efforts in Your Area



There is strength in numbers, and cannabis advocacy is no exception. It can be challenging to make an impact as an individual trying to advocate for cannabis to be legalized unless you are as exceptional as the likes of our own, Charlotte Figi. Being part of a grassroots activist group will not only boost your morale but will also provide deeper insights on how to go about pushing for legalization. Activist groups working in the grassroots usually capture different demographics and social-economic classes. Inclusivity is typically a catalyst for positive change. Several cannabis activism groups are making a significant impact in the push for legalization. 


The National Organization for the Reform of Marijuana Laws (NORML)


NORML is probably the oldest and largest cannabis activism group, having been in existence since the 1970s. NORML is committed to pushing for the legalization of recreational cannabis and has spearheaded many legalization efforts. NORML has also played a central role in reducing police hostility targeted at marijuana-related crimes. 


The Coalition for Rescheduling Cannabis (CfRC)


This is a group of non-government organizations that have come together to petition the federal government to remove cannabis from its Schedule I list of substances. CfRC is also involved in legal cannabis research and cannabis education. It is made up of the following organizations:


  • The American Alliance for Medical Cannabis
  • The Drug Policy Forum of Texas
  • Americans for Safe Access
  • The Los Angeles Cannabis Resource Center
  • Medically Minded CBD
  • Jon Gettman
  • High Times
  • California NORML
  • The National Organization for the Reform of Marijuana Laws (NORML)
  • Patients out of Time
  • The Oakland Cannabis Buyers Cooperative


The Last Prisoner Project


This non-profit organization is committed to delivering justice to those who are serving prison sentences for cannabis-related crimes. They employ lawyers to push for the expungement of cannabis-related offenses from the records of those directly disproportionately affected by the war on drugs. They serve a client base of about 40,000 individuals who have been convicted of cannabis-related crimes. 


Other cannabis activism groups to consider include the following:


  • Alliance for Cannabis Therapeutics
  • Buffalo Cannabis Movement
  • Dagga Couple
  • Dank of England
  • Green Panthers
  • Marijuana Policy Project
  • Medical Marijuana Assistance Program of America
  • National Cannabis Industry Association
  • November Coalition
  • Safer Alternative for Enjoyable Recreation
  • Society of Cannabis Clinicians
  • Students for Sensible Drug Policy (SSDP)
  • Veterans for Medical Cannabis Access (VMCA)
  • Women Grow

You can also attend cannabis festivals where you can learn more about cannabis advocacy. Freedom Rally and the Global Marijuana March are good ones, to begin with.  



Other Ways to Support Cannabis Legalization



Stay Informed


Marijuana Moment has “up-to-the-minute” news on the politics, business, and culture of cannabis. They offer reliable, up-to-date sources for developments on cannabis policy. 


Contact your Local Politician


For many cannabis enthusiasts, this is stepping out of the box. However, this is one of the easiest but most effective ways to make your voice heard. You can either make a quick call to your local legislator or send them a short email where you can share your personal cannabis story or policy views. 


Build awareness


You can create awareness about cannabis by sharing positive cannabis-related information with your friends and family by word of mouth and social media. 


Vote for Cannabis Bills


In 2020, Arizona, Montana, New Jersey, Mississippi, and South Dakota approved ballot measures to legalize cannabis. A few other states have also used citizen-initiated ballot measures to pass cannabis bills. Should cannabis bills come to the ballot, make sure that you actively participate.





Activism efforts have gotten us to where we are today. It will take similar, if not greater, efforts to take us to where we want to be. To have cannabis fully legalized in the United States, research and education are critical for informed and direct activism. Realm of Caring offers a wealth of information to get you started on your journey to cannabis activism. 




About Realm of Caring


Realm of Caring Foundation (RoC), is a 501(c)3 nonprofit organization that was established by parents in 2013 to support families who were out of medical options. By creating educational resources, conducting research, and assisting families with data-rich answers to their questions, RoC continues to be a leader in the cannabinoid (cannabis/hemp) field. RoC’s no-cost Care Team has served more than 65,000 clients worldwide and supports a network of over 2,000 medical professionals. To learn more about participating or to donate to this cause, visit or call 1-888-210-3772.


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Cannabinoid Therapy to Support Overall Wellness

With much thanks to research, we are all becoming more aware of the potential benefits of various cannabinoids for debilitating conditions. Understanding these benefits has brought more individuals to Realm of Caring recently to ask: can cannabinoid therapy support my overall health and wellbeing? The short answer is that research is pointing towards cannabinoids, like CBD, as strong candidates for antioxidant, preventative, and recovery benefits.  


Let us first discuss the more well known cannabinoid, cannabidiol (CBD). CBD is one of the many phytocannabinoids, or cannabinoids from plants, found in cannabis and hemp and has been researched for its therapeutic benefits. CBD works as a modulator of cannabinoid receptors CB1 and CB2, for example, as well as non-cannabinoid receptors such as the 5-HT1A serotonin receptor. 


Among others, the researched therapeutic actions of CBD are as an:












Endocannabinoid Deficiency


Clinical endocannabinoid deficiency (CED) was first presented in 2001 by Dr. Ethan Russo and has been further explored since then. This theory helps us to gain some understanding of why various phytocannabinoids have so much therapeutic potential. Endocannabinoids, specifically the endocannabinoids AEA and 2-AG, are generated by our cell membranes and either bind or activate cannabinoid receptors within our endocannabinoid system. These endocannabinoids are involved in different physiological and pathological processes such as regulating food intake, immunomodulation, inflammation, pain, cancer, addictive behavior, seizure disorders and more. Therefore, it would seem that if the levels of the endocannabinoids, or endocannabinoid function, were decreased, then we would witness a disturbance in digestion, pain threshold, mood, sleep, and others.


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. 


Through Dr. Russo’s research and the clinical trials that have taken place and continue to take place, we have seen the ability of cannabinoid therapy to offer potential relief to the researched examples of endocannabinoid deficiency among many others. 


Just as our bodies are naturally designed to produce these endocannabinoids to maintain homeostasis, or regulate processes throughout our bodies and brains; our bodies are also naturally designed to eliminate toxins through detoxification. CBD may help enhance the body’s natural detoxification system. 


Antioxidant Benefits


Oxidative stress takes place when potentially harmful free radicals, which are atoms that may cause damage to cells, proteins, and DNA, overwhelm the body’s natural antioxidants. We consume antioxidants through foods and supplements to assist our body in the prevention of or to decrease oxidative stress. The antioxidants safely interact with the free radicals before molecules become damaged. Endogenous antioxidants you may be familiar with are vitamin e, vitamin c, beta-carotene, and zinc; which many of us find in fruits and vegetables or as supplements.


Research has shown the ability of CBD and THC to be equally successful at blocking or modulating toxic levels of glutamate. Glutamate is an excitatory neurotransmitter that is released by nerve cells in the brain and responsible for sending signals. Glutamate plays an important role in our learning and memory, however, it can also be damaging to nerve cells and the brain as a whole. When there are abnormally high concentrations of glutamate or when the receptors are overly sensitive (meaning less glutamate is needed to excite the cell) then the cells can become over-excited leading to their damage or death, in other words, oxidative stress. 


When studied, the effects of CBD and THC on toxic glutamate levels were comparable to the industrial antioxidant known as BHT, suggesting their role as an effective antioxidant. This also shows promise for the CBD as a neuroprotectant, which leads us to preventative benefits. 


Preventative Benefits


Movement disorders, like Parkinson’s Disease, are debilitating conditions linked to oxidative stress, neurodegeneration, and inflammation. Data reviewed in several studies carried out, mostly with rodents, have pointed to the role of CBD and THC in the prevention of certain movement disorders as they appear effective for primary and secondary dystonic movements. 


The reduction of oxidative stress by CBD has further shown in research that it may prevent nephrotoxicity, or liver toxicity, in mouse models.


Cannabinoids have become a strong candidate for the prevention of several conditions. The anxiolytic effects of CBD and CBDA for example may prevent stress and anxiety, which studies have shown effects more than just that behavioral component as it may prevent abnormal increases in blood pressure and cardiac output.


As an antiemetic CBD and, possibly moreso, CBDA may prevent vomiting or nausea caused by motion sickness, but also anticipatory nausea. 


Cannabinoids have been researched to be anti-inflammatory, in fact researchers use terms such as “novel” and “potent” to describe their anti-inflammatory actions. This can have an effect on the prevention of several inflammatory conditions as well as assist our body processes in decreasing harmful inflammation, one being our immune system as cannabinoids may be able to suppress cytokine production and induce T-cell activity to help fight off infections. 


The cannabis plant not only has anti-inflammatory cannabinoids such as THC, THCA, CBD, CBDA, CBC, and CBG (to name a few) but it also contains anti-inflammatory terpenes such as caryophyllene, borneol, nerolidol, linalool, limonene, and pinene among the most popular. In addition, the other, less studied, compounds of the cannabis plant are the flavonoids that share the same mechanisms of some of these terpenes. Cannflavins A, B, and C are among some of the flavonoids with researched anti-inflammatory actions. When working together in a full-spectrum product, for example, each cannabinoid, terpene, and flavonoid may enhance each other’s actions – a concept known as the entourage effect


Recovery Benefits


Speaking of inflammation, CBD, as well as other anti-inflammatory cannabinoids may be helpful in reducing inflammation of the muscles and tissue as a part of post workout recovery, which may aid in preventing injury. The potential of alleviating the muscle inflammation may be able to enhance recovery time by decreasing muscle tension, soreness, and pain. 


When it comes to recovery, having quality sleep is very important. The first way cannabinoids may assist in improving our sleep is by mitigating the conditions that may be keeping us awake, such as pain, anxiety, and inflammation-related autoimmune disorders including arthritis, diabetes, IBS, and Crohn’s disease. All of these may have an effect on our body clock function, therefore leading to sleep disorders. 


Another way cannabinoids may assist is when we consider the actions of each. For example CBD may directly assist in aligning our circadian rhythms, one of which being the sleep-wake cycle. The actions of our endocannabinoid system appear aligned with our circadian rhythms, therefore may modulate them. CBD, being a modulating molecule, has the potential to improve our sleep wake cycles, leading to an increase in the percentage of total sleep overtime. 


THC on the other hand, has shown in studies as having an effect on mental and physical sedation as well as lessening nightmare presence and intensity in PTSD study participants. In addition, THC shares properties of our endocannabinoid known as Oleamide, which is known to benefit apneic events. 


CBN has become a popular cannabinoid when discussing sleep benefits. And while the CBN molecule itself does not show as providing sedating effects in what research is available, when it is presented in combination with THC, higher levels of drowsiness were observed. In addition, CBN, being aged THC, contains heavier terpenes that are slow to evaporate known as sesquiterpenes. These specific terpenes can be naturally more calming, such as nerolidol and caryophyllene oxide. 


Starting your cannabinoid therapy journey


If you are wondering if cannabinoid is right for you on your wellness journey, our care specialists are here to talk with you one-on-one. Reach out by calling 719-347-5400 or emailing






The Realm of Caring Foundation specifically invokes the first amendment rights of freedom of speech and of the press without prejudice. These statements have not been evaluated by the food and drug administration. the products discussed are not intended to diagnose, cure, prevent or treat any disease. Realm of Caring always recommends when and wherever possible that licensed local healthcare professionals be consulted.


The Realm of Caring Foundation is an independent nonprofit with its own governing board. We do not produce or sell cannabinoid products, nor do we receive funds from the sale of other company’s products.

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Help Us Prove What You Already Know

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Antidepressant and Anxiolytic Effects of Medicinal Cannabis Use in an Observational Trial

Understanding RoC’s latest published research on cannabinoid therapy and anxiety/depression.


Between April 2016 and July 2020, 538 participants were enrolled in an observational research study between Realm of Caring Foundation and Johns Hopkins University School of Medicine. Upon completion of a baseline survey, participants were invited to complete additional follow-up surveys every 3 months. 


The purpose of the study was to extend prior findings with a narrow focus on participants who reported having anxiety and/or depression. The goal was to provide insight into the effects of medicinal cannabis use for symptoms of anxiety and depression. 


About the Participants


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). 


Participants were 79% female and had a mean age of 46 years old at the baseline. The majority, at 51%, reported simultaneous diagnoses of anxiety and depression, followed by 34% reporting anxiety alone, and 15% reporting depression alone. As well, many participants, at 69%, reported a co-occurring chronic pain disorder and 36% reported use of a medication for the treatment of their anxiety and/or depression. 


Product-Type and Dosing Means


Among the 74% of participants who did know the cannabinoid content of their product(s), most reported the use of CBD-dominant products (82%), followed by THC-dominant (23%), a THC:CBD balanced ratio (7%), and minor cannabinoid products such as CBG or CBN at 5%. Most individuals who reported using a THC-dominant product were also using a CBD-dominant product. 


The mean CBD dose taken orally was 61mg daily, with a median of 30mg and range from 0.4mg to 1,050 mg. The mean THC dose taken orally was 2.1mg daily, with a median of 1mg and range from ≤0.01mg to 40.3mg. 




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. The CBD doses that were used in trials that found anti-anxiety effects were greater than the average reported by participants. 


Adverse Events


In response to the survey question “How has therapeutic use of cannabis harmed the participant?,” 61% of Cannabis Users reported no perceived harm or left the answer blank. Harms that were reported on included high cost (7%), social stigma/legal issues (5%), intoxication (2%), unpleasant effects associated with inhalation (2%), impaired cognition (2%), fatigue (2%), and gastrointestinal discomfort or nausea (1%). Ten participants reported worsening symptoms of anxiety with medicinal cannabis use and one participant reported worsening symptoms of depression. 


Concluding Remarks


The study suggests that CBD-dominant cannabis use is associated with reduced depression among a sample of mostly female, caucasian adults. Though antidepressant effects of CBD are consistently reported in preclinical observations, it is recommended that the effects be evaluated further in placebo-controlled clinical trials under observation. Future research is necessary to confirm best dosing practices to achieve antidepressant and antianxiety effects. 




Antidepressant and Anxiolytic Effects of Medicinal Cannabis Use in an Observational Trial is authored by: Erin L. Martin, Justin C. Strickland, Ph.D., Nicolas J. Schlienz, Ph.D., Joel Munson, Heather Jackson, Marcel O. Bonn-Miller, Ph.D., and Ryan Vandrey, Ph.D.. 


For general inquiries, please contact or call (719) 347-5400


For media inquiries, please contact


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.



About Realm of Caring


Realm of Caring Foundation (RoC), is a 501(c)3 nonprofit organization that was established by parents in 2013 to support families who were out of medical options. By creating educational resources, conducting research, and assisting families with data-rich answers to their questions, RoC continues to be a leader in the cannabinoid (cannabis/hemp) field. RoC’s no-cost Care Team has served more than 65,000 clients worldwide and supports a network of over 2,000 medical professionals. To learn more about participating or to donate to this cause, visit or call 1-888-210-3772. 

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Which Strains Are Best to Avoid The Munchies?

If  you have tried a Δ9-Tetrahydrocannabinol (THC) potent cannabis strain, such as Jack Herer, you may  be all too familiar with the munchies. For newbies, the munchies are extreme hunger pangs that cannabis users often experience after indulging.


Contrary to popular belief, it is now emerging that not all cannabis types cause the munchies. If you are a regular user, you can probably recall an episode where you didn’t feel quite as hungry as you usually do. In case you are wondering why this happened, it might have been the strain.


Before we get to the cannabis strains that are best to avoid the munchies, here is what you need to know about the munchies.


What Causes the Munchies?


The munchies are generally associated with high THC strains. This means that most hemp strains (less than 0.3% THC) are less likely to cause the munchies. That’s already a hint right there. In short, the munchies are linked to THC. Synthetic THC products have been approved by the FDA for the treatment of cachexia (severe wasting syndrome) in HIV, for example, and are only available with a prescription form a licensed healthcare provider.


A 2013 study that was published Molecular and Cellular Endocrinology showed that THC interacts with ghrelin,  a hormone that revs up the appetite. A different study showed that THC stimulates the olfactory nerves to heighten the olfactory senses. This makes the smell of food more appealing.


Some studies have also suggested that Cannabidiol (CBD) can offset some of the less desirable symptoms  of THC. Perhaps, hunger is one of them. Research on THC’s appetite stimulating effects are not conclusive and it could be that this cannabinoid works through different mechanisms to cause hunger.


CBD and THC are the two dominant phytocannabinoids in cannabis. While THC causes the munchies, CBD does not. Anecdotal finding and early science suggest that consuming high CBD low THC strains may help users to avoid the munchies altogether.


High CBD Strains to Avoid The Munchies


Many popular cannabis strains will have less than 1% CBD content. Therefore, strains with over 4% CBD are considered to be CBD-rich or high CBD strains. The following high CBD strains may offer a number of therapeutic benefits without causing the munchies.


1. Remedy


Remedy is a lemon-scented cannabis strain with about 14% CBD and 1% THC. This strain is non-psychoactive and known for possibly relieving stress and anxiety.




This is another anti-munchies strain with at least 14% CBD and less than 1% THC. It is a strain users choose for help managing pain and providing relaxation.


3. Lifter


As the name suggests, Lifter is an energizing strain that is packed with CBD. It has about 16% CBD with close to zero THC. A favorite among daytime users, it is non-intoxicating and a  mood enhancing strain.


4. Charlotte’s Web


This is one of the most popular high CBD strains that boasts of at least 13% CBD. Users report it may ease anxiety and may alleviate symptoms associated with childhood epilepsy.


5. Cherry Wine


This wine-scented strain has over 16% CBD and less than 1% THC. It is a choice strain for relaxation after a hard day’s work, and it will not trigger the munchies.

Other high CBD strains that may not cause the munchies include Harle-Tsu, Ringo’s gift, and Sour Tsunami.


THCV on Appetite


A different cannabinoid called Δ9-Tetrahydrocannabivarin (THCV) has apparent appetite suppressing effects. Rodent studies have shown that THCV is able to decrease appetite, increase satiety, and increase energy metabolism. This may make it instrumental in weight loss, for obesity, and the prevention of type 2 diabetes. Cannabis strains that contain high amounts of THCV are likely to suppress appetite and reduce the munchies.


High THCV Strains 


The following strains have high THCV content which means that they may have appetite suppressing effects. THCV may also offer additional benefits such as improving bone health, although more research and human data  is needed to confirm this.


6. Durban Poison


Durban Poison is an award winning cannabis strain with a high THCV content of about 1%. This sativa strain has been reported as beneficial at suppressing appetite.


7. Doug’s Varin


Doug’s Varin is known for having the highest THC: THCV ratio which is about 5:4. Being high in concentration, it is a choice strain for concentrates, tinctures, and vape pens. This strain may offer mental stimulation as well as suppress appetite. 


8.  Pink Boost Goddess


Pink Boost Goddess, is a specialized strain that is an indica-dominant hybrid, compared to most other high THCV strains that are pure sativa. This limited strain is only available in select dispensaries in California. 


9. Pineapple Purps


This strain has about 4% THCV and is popular for its energizing effects. It has a sweet and citrusy aroma.


10. Jack the Ripper


Jack the Ripper is a high THC high THCV strain. It probably has the highest amount of THCV in the market with most types having about 5% THCV and about 22% THC.


Other Ways to Avoid the Munchies


The 10 strains mentioned above, as well as other high CBD or THCV products,  may be  a good way to consume cannabis while avoiding the munchies. Additionally, there are a couple of other things that you can do to prevent feeling hungry after consuming cannabis. For example, you can eat a wholesome meal prior to indulging to ensure that you are not doing so on an empty stomach. Additionally, you can keep all food away before consuming cannabis. Remember that THC may  induce hunger by stimulating the olfactory nerves. If you can avoid the smell of food you might be able to avoid feeling hungry. Lastly, try hydrating frequently as anecdotal reports have shown that this is helpful.






The Realm of Caring Foundation specifically invokes the first amendment rights of freedom of speech and of the press without prejudice. These statements have not been evaluated by the food and drug administration. The products discussed are not intended to diagnose, cure, prevent or treat any disease. Realm of Caring always recommends when and wherever possible that licensed local healthcare professionals be consulted.


The Realm of Caring Foundation is an independent nonprofit with its own governing board. We do not produce or sell cannabinoid products, nor do we receive funds from the sale of other company’s products.

Blog Education Uncategorized

Arthritis and Cannabinoid Therapy

Arthritis is one of the most widespread health conditions in the United States, affecting over 54 million men and women and 300,000 children. Arthritis appears in many forms, with the most common being osteoarthritis (OA), followed by rheumatoid arthritis (RA) and psoriatic arthritis. 


As of today, there is no cure for arthritis (as well as rheumatic conditions), rather recommendations for combination therapies such as increasing physical activity, weight loss, OTC pain relievers, crutches or canes, surgery, and cannabinoid therapy due to recent research. 


What is the Endocannabinoid System?  


Our Endocannabinoid System (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-arachidonoyl glycerol (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 endocannabinoids can have various effects within the body. 


How does ECS play a role in arthritis and rheumatoid conditions? 


In a study with 32 osteoarthritis patients and 13 rheumatoid arthritis patients, it was found that cannabinoid CB1 and CB2 receptor protein and RNA, as well as the endocannabinoids AEA and 2-AG are present in the synovia of patients with end-stage OA and RA. This study helps to predict that the cannabinoid receptor system present in the connective tissue that lines the inside of a joint (synovium) may be an important therapeutic target for the treatment of pain and inflammation associated with both OA and RA. As was seen in this study, the endocannabinoids were present in the OA and RA patients where in healthy volunteers, those endocannabinoids were not present. 


In additional studies, the presence of cannabinoid receptors on cells of the immune system and anecdotal and historical evidence suggests that cannabis use has potent immunomodulatory effects. This has led to research directed at understanding the function and role of these receptors within the context of immunomodulating effects of cannabis in humans, animals and in vitro studies of immune cells, such as t-cells that have also provided important evidence. 


These findings have led researchers to discover the role endocannabinoids and phytocannabinoids may have on inflammation and pain within the body, as well as our immune cells


Researched pain and inflammation relieving benefits of cannabinoids


Cannabinoids are commonly investigated as pain-relieving agents, but in recent years more evidence has accumulated on their potential immunomodulatory effect, supported by results in animal models of certain rheumatic diseases. While results that demonstrate the same effect in humans are lacking, cannabinoids and cannabis remain potential options to alleviate the pain associated with rheumatic diseases, as they were shown as safe and causing little to no adverse effects. 


It has also been suggested that cannabinoids have an inflammatory-modulating benefit that could offer therapeutic effects, as cannabinoids were shown to have overall anti-inflammatory effects on immune cells. These results were reinforced by studies in animal models of RA and systemic sclerosis. 


Animal models also suggest a possible therapeutic quality for cannabinoids in RA, with three studies using a rodent model with collagen-induced arthritis showing a beneficial effect of the cannabinoid CBD and synthetic cannabinoids JWH-133 and HU-308. These substances were found to be associated with clinical improvement. CBD was associated with a decrease in cytokine release and production as well as a decrease in lymphocyte proliferation. 


A study with 31 patients with RA suffering from chronic pain were given Sativex (a THC-CBD mouth spray legally prescribed in UK and mainland Europe) and 27 were given a placebo, the controlled trial showed a significant analgesic effect and disease activity suppression. Pain parameters and sleep both improved. In addition, the study found no serious adverse effects in the active treatment group. 


CBD Benefits


We know through research that CBD has a wide spectrum of biological activity, including anti-inflammatory activity. This is why its activity in the prevention and treatment of diseases whose development is associated with inflammation has been tested. Based on current research results, the potential to utilize CBD for the treatment of diabetes, arthritis, as well as cardiovascular disease, cancer, anxiety, psychosis, epilepsy, neurodegenerative diseases, and skin disease is being considered. Clinical studies have confirmed that CBD reduces the levels of pro-inflammatory cytokines, inhibits t-cell proliferation, induces t cell apoptosis and reduces migration and adhesion of immune cells. 


In addition, CBD creates a physiological response with several inflammatory mediator receptors within us. These are known as the PPARy, GPR, and Adenosine A2A Receptors. 


THC Benefits


The anti-inflammatory contributions of THC are also extensively studied, showing PGE-2 synthesis, decreased platelet aggregation, and stimulation of lipoxygenase, all actions related to reducing inflammation. THC has 20 times the anti-inflammatory potency of aspirin and twice that of hydrocortisone. 


Benefits of minor cannabinoids and terpenes 


Other minor cannabinoids in the cannabis plant may also contribute to anti-inflammatory activity. cannabichromene (CBC) was studied with mice, showing that it helped to increase intestinal motility by lessening intestinal inflammation. 


Animal studies have also shown Cannabigerol (CBG) to reduce the effects of inflammatory-related conditions such as inflammatory bowel disease. CBG has also been shown to have potent pain relieving abilities. 


The terpenes in cannabis additionally show analgesic and anti-inflammatory attributes. Myrcene is analgesic and blocks inflammation. The sesquiterpene, B-caryophyllene, also shows promising anti-inflammatory and analgesic properties. 


If you are seeking data-driven answers to your questions about this cannabinoid therapy and arthritis, Realm of Caring (RoC) can help. RoC has 8 years of collected data and research based on individuals utilizing plant-based therapies. They can guide you through product selection, dosing and administration, how to talk with your doctor, and the results individuals are realizing.


The research that has been completed suggests the benefit of cannabinoid therapy for arthritis and rheumatic conditions. Clinical trials and anecdotal evidence helps to point towards starting amounts and methods of administration, particularly for CBD and THC. However, to fully understand the utility of minor cannabinoids mentioned, human data is still necessary.


The RoC Care Team is here to assist. They care a lot about helping you to find success. Reach them by calling (719) 347-5400, emailing, or by scheduling an appointment.






The Realm of Caring Foundation specifically invokes the first amendment rights of freedom of speech and of the press without prejudice. These statements have not been evaluated by the food and drug administration. the products discussed are not intended to diagnose, cure, prevent or treat any disease. Realm of Caring always recommends when and wherever possible that licensed local healthcare professionals be consulted.


The Realm of Caring Foundation is an independent nonprofit with its own governing board. We do not produce or sell cannabinoid products, nor do we receive funds from the sale of other company’s products.

Blog Education

Understanding CBN

Blog Education

Getting to Know CBDA

Cannabidiolic acid (CBDA) is one of three cannabinoid precursor compounds converted from Cannabigerolic acid (CBGA). CBGA also converts to the precursor compounds Tetrahydrocannabinolic acid (THCA) and Cannabichromenic acid (CBCA) or may convert to it’s non-acidic form, Cannabigerol (CBG). 


The cannabis plant produces cannabinoids as prenylated aromatic carboxylic acids, which are converted to their more neutral forms by way of heat, light, or aging. When decarboxylation occurs, by exposing the cannabis plant to either heat or light, CBDA may convert to CBD. 


Research has shown that CBDA may be more potent than CBD, although not as stable of a molecule. Given that CBDA and THCA simply decompose when exposed to light or heat means that they can very easily change from their state. However, chemists have discovered ways to stabilize CBDA so that we may take advantage of this cannabinoid’s potential benefits as an anti-inflammatory, antiemetic, anticonvulsant, and anticancer. 




CBDA inhibits the COX-2 Enzyme. These enzymes are associated with inflammation after injury or infection. Therefore, by blocking COX-2 Enzymes, CBDA may relieve inflammation and associated pain. In a rodent study, equivalent amounts of CBD and CBDA were administered to test efficiency in reducing hyperalgesia. The low amount of CBD was not efficient in reducing this increased sensitivity to pain when exposed to normal stimuli. The CBDA, on the other hand, did reduce hyperalgesia at that same low amount. In the same study, amounts of THC and CBDA so low that they were deemed “ineffective” were administered. When these ineffective, low amounts were combined it was shown in the animal models to have anti-inflammatory and anti-hyperalgesia effects on acute inflammation. 




CBDA affects 5-HT1A Serotonin receptors by enhancing their activation. This action shows promise for CBDA as an antiemetic (anti-nausea).


In studies carried out with rodents, the ability of CBDA to inhibit vomiting induced by toxins or from movement was examined. CBDA appeared to reduce involuntary vomiting and simultaneously delay the onset of nausea and vomiting in response to movement. The effects were more powerful than what was observed with CBD because of the ability of CBDA to enhance 5-HT1A receptor activation. 


In addition to discovering these potential benefits, there is also promise for the prevention of anticipatory nausea. Anticipatory nausea is conditioned or psychological nausea, often provoked by a reminder of something that leads to vomiting. An individual going through chemotherapy treatments may experience this, showing further promise as an alternative option to those who are sensitive to the euphoric effects of THC. 




CBDA is among other minor cannabinoids in cannabis sativa extracts being researched for its anticonvulsant effects in childhood epilepsies, including Dravet Syndrome. This is because there are various epilepsy-relevant receptors that CBDA may interact with, including 5-HT1A, GPR55, and TRPV1.


CBDA has shown to be anticonvulsant against hyperthermia-induced seizures in rodents. Children with Dravet Syndrome often exhibit seizures that are provoked by fever, suggesting that CBDA may benefit those who suffer from this epilepsy type. These reports are consistent with a report showing CBDA as anticonvulsant against pentylenetetrazole-induced seizures; which can be described as general seizures that are chemically induced. 




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. 


Although there is much promise for the therapeutic potentials of CBDA, it is still considered an understudied compound. Further studies carried out, beyond what preliminary research and anecdotal data is available, is necessary to deepen our knowledge of the possible uses and efficacy. Through a greater understanding we may also be aware of any adverse effects and how to administer so that therapy is most effective. 





The Realm of Caring Foundation specifically invokes the first amendment rights of freedom of speech and of the press without prejudice. These statements have not been evaluated by the food and drug administration. The products discussed are not intended to diagnose, cure, prevent or treat any disease. Realm of Caring always recommends when and wherever possible that licensed local healthcare professionals be consulted.


The Realm of Caring Foundation is an independent nonprofit with its own governing board. We do not produce or sell cannabinoid products, nor do we receive funds from the sale of other company’s products.