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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.. 


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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.

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How Cannabis Affects Dopamine

As more states move to legalize cannabis, increasingly more people are warming up to cannabinoid-based therapies. At the same time, Δ9-tetrahydrocannabinol (THC) is gaining considerable interest in mental health. This is causing mixed reactions, with some questioning the long-term effects of cannabis use.


Dopamine is a neurotransmitter that mediates the feeling of pleasure, motivation, and satisfaction in the brain. The release of dopamine motivates one to pursue a pleasurable activity or occupation. A dopamine surge is what makes you feel good after achieving something significant. The right balance of dopamine is vital for both physical and mental wellbeing.


THC is a major cannabinoid of the cannabis plant with clear intoxicating effects. It binds to the CB1 receptor in the brain to elicit its psychoactive properties.


Anandamide, also known as the bliss molecule, is an endogenous cannabinoid that also binds the CB1 receptor. It is not surprising that both anandamide and THC are associated with a feeling of happiness and satisfaction. However, anandamide, unlike THC, is quickly broken down by enzymes and taken out of circulation. 



What’s the Link Between Cannabis and Dopamine?


The endocannabinoid system modulates the dopaminergic system through CB1 receptors and endocannabinoids. 


Endocannabinoids stimulate the release of dopamine. Certain CB1 antagonists can block this effect, demonstrating that CB1 receptors are involved in the dopaminergic effects of cannabinoids.


The link between cannabis and dopamine has to be the CB1 receptors (part of the endocannabinoid system). 


There is evidence of varying effects of acute vs. chronic THC exposure on the dopaminergic system.



Acute Vs. Long-term Cannabis Use


Animal studies have described the interactions that exist between amphetamine (promote dopamine release) and THC. These preliminary studies have demonstrated that the dose of THC consumed potentiates or antagonizes the effects of amphetamines. The researchers in this study proposed that dopamine is “a prime candidate for…the mode of action of Δ9-tetrahydrocannabinol”. 


Acute versus longer-term use of THC could have complex effects on dopamine synthesis and release.  While early studies with rodents show that low doses of THC increased dopamine synthesis and release, some studies show high doses of THC resulting in decreased dopamine synthesis. 


The results from human studies have not been consistent, however there is evidence that there may be reduced dopaminergic function among cannabis users. 


Indeed, THC has profound effects on the dopamine system, contributing to its recreational and harmful effects. Unfortunately, there are no randomized human trials that have been carried out to investigate this phenomenon. Additionally, inconsistencies between preclinical and clinical findings pose a significant challenge. One major inconsistency between animal and human studies is that THC, even in acute studies, was not administered to humans in the habitual manner in which it was typically consumed. 



The Crux of the Matter


THC’s rewarding properties are triggered by the firing of dopaminergic neurons and the release of dopamine in lower doses. Interactions with the CB1 receptors underpin this process.


Evidence suggests that acute vs. chronic THC exposure to the dopaminergic system will produce different effects; that is the crux of the matter.


Acute exposure to THC may cause increased dopamine release, which is associated with a feeling of pleasure.


On the other hand, chronic or long-term exposure to THC has been linked to blunting of the dopamine system. 


While acute exposure to THC may increase a sense of reward and satisfaction, long-term exposure may produce opposite effects. However, the premise of this argument is based on inconclusive, preliminary evidence. Future studies will shed more light on how cannabis affects dopamine over time.




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How Cannabis Concentrates Are Made

At the turn of the century, cannabis enthusiasts began noticing a steep shift in the market. Regular users started smoking less and dabbing more- heating oily extracts to inhale high concentrations of cannabis. These extracts varied from shatter to wax to batter to dabs and honey. Not only were they more potent, but they were also a cleaner and a more convenient way to consume cannabis. This heralded the beginning of a new era.


At the start, cannabis extracts were made using highly flammable hydrocarbons right in their backyards and garages. This was a precarious affair with consequences of explosive proportions, quite literally.


In recent times, the technology of extracting cannabis has grown in leaps and bounds, and we will take you through each of them in great detail.



What Are The Popular Methods of Cannabis Extraction?


When it comes to cannabis extraction, two main methods exist.


Solvent-based extraction: In this method, solvents are added to the plant material to dissolve the resin, which is the concentrated part of the cannabis plant containing the cannabinoids and terpenes. The solvent is then removed, leaving behind extracts such as shatter, vape oil, or wax.


This method yields what is known as a cannabis extract.


Mechanical or solventless extraction: Mechanical or solventless extraction methods do not use solvents. Instead, the resin is pressed, beaten, or rubbed out of the plant, resulting in kief, rosin, or hash.


This method yields what is known as a cannabis concentrate.  



Solvents Used to Make Cannabis Extracts


As discussed earlier, the solvent-based extraction method has been used for quite a long while now.


Let us look in detail at how these solvents work.


Hydrocarbons (Butane, Propane, Hexane, etc.)


Hydrocarbons are used to make butane hash oils (BHO) which includes budder, sauce, wax, shatter, and crumble among others.


Because hydrocarbons are highly flammable, a closed loop system of extraction should be used.


The process of extracting cannabis can be either open-looped or closed-looped. Open-loop systems have exposure to the external environment. When flammable compounds are present, open loop systems can easily cause a fire accident.


Closed-loop systems, on the other hand, are safer but more expensive to implement. Securing the equipment could cost upwards of $30,000 for an average-sized model.


It is also a requirement for manufactures using hydrocarbons to blast-proof the premises. The cost of blast proofing a room could be around $100,000.


CO2 (Supercritical CO2 Extraction)


Supercritical CO2 extraction uses CO2 to separate the different compounds from the cannabis plant material.


The carbon dioxide is subjected to supercritical conditions that causes it to fluctuate between a gas, liquid, and solid-state. It is then passed through the cannabis plant material in a closed loop system to extract the compounds and then the CO2 is evaporated. Because CO2 is a green gas, the extract produced through this method is relatively safe.




Ethanol is a popular solvent used to make super-concentrated Rick Simpson Oil.  It follows the same principle used in creating BHO. With ethanol, the solvent is dripped over the flowers and buds of the cannabis plant, which dissolves these compounds. The next step is to eliminate the solvent and remain with the cannabis extract.


However, ethanol has a higher polarity than butane. This means that it extracts impurities such as chlorophyll, which may affect the quality of the final extract.



Non-Solvent-Based Methods for Making Cannabis Concentrates


Solventless extraction is often used when creating concentrates for medicinal use. This is because the concentrates produced through this method are relatively safer.


Shaking, Sifting, and Dry Sifting-Used to Make Kief


Kief, a type of cannabis concentrate, can be made using different mechanical techniques. 


One technique that has stood the test of time and is exceptionally safe is the use of a mesh. The cannabis plant material is passed through a mesh and the kief collects at the bottom. The kief is then graded based on the level of purity.


Ice Water Extraction


Bubble hash is a popular cannabis extract that is made using kief that has been Ice Water Extracted. It is the brainchild of Neville Schoenmakers, founder of the first Cannabis Seed Bank.


In this method, the cannabis is placed in a simple jar or bubbleator with water and ice and agitated. The resin is separated by the mechanical force and it is collected. Because it uses water, this method is considered to be one of the safest and cleanest ways of making a pure, high-quality hash that has no impurities. It is also a pretty wholesome method of extraction that leaves you with most of the cannabinoids intact.


Heat and Pressure (Rosin Press)


Rosin is a viscous sap whose appearance can range from clear to very dark, and it can be used in its extracted form or as a base for cannabis edibles. Both a rosin press and a rosin bag use pressure and heat to force the trichomes out of the cannabis leaves and buds.



Types of Cannabis Extracts & Concentrates




A runny consistency characterizes wax or budder. These oils are opaque and gooey rather than being hard. It is also easy to roll them onto “a pin and dab,” but they tend to stick to the sides of the packaging container.


Pie Crust/Honeycomb


This is a form of wax/budder which is generally crumbly and brittle. It is, however, softer than shatter. Pie Crust is easier to get out of a jar but is very prone to crumbling.




Shatter is an impressively pure cannabis concentrate that is very brittle and translucent, much like glass candy.  It is mainly extracted using hydrocarbon solvents such as butane and or propane, making it a particularly potent substance.


Caviar/Jelly Hash


Caviar, also known as moonrocks, are a recent fad in the cannabis scene. Making them involves coating cannabis buds with very high-quality resin, which are then rolled in kief.


Caviar doesn’t always have to be rolled in kief, a resin coat may just suffice.






Cannabis extraction is just in its formative stages. With time, we expect to witness the creation of more efficient and purer methods geared towards the production of medicinal cannabis extracts. We hope that through this article, we have helped you understand how cannabis concentrates are made. Feel free to let us know if we left out anything.




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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CBG: Researched Benefits

Over 120 compounds have been isolated from Cannabis Sativa. Of these, the most studied are cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC); however research is expanding to discover the actions of additional cannabinoids such as cannabigerol (CBG).


CBG was first discovered and synthesized by Raphael Mechoulam and Yehiel Gaoni in 1964. It is derived from cannabigerolic acid (CBGA), which has been coined as the “mother of all cannabinoids” as it is a precursor of major cannabinoids that further decarboxylate to additional cannabinoids. In the cannabis plant, CBGA directly converts to cannabidiolic acid (CBDA), tetrahydrocannabinolic acid (THCA), and cannabichromenic acid (CBCA) through processes known as CBDA synthase, THCA synthase, and CBCA synthase. CBGA will also decarboxylate to CBG once heated, becoming a very stable molecule. 


Evidence from experiments show that CBG is devoid of the non-euphoric abilities of THC and that it has therapeutic potential for specific conditions.


Medical cannabis (THC) or nabilone can be recommended to cancer patients as a means to stimulate their appetite while undergoing conventional treatments. Although effective, there is the potential for undesirable, euphoric side effects. Data has demonstrated in animal tests that CBG significantly increases total food intake in that animals studied began feeding sooner, consumed more meals and consumed more during those meals. 


Animal studies have also shown CBG to reduce the effects of inflammatory bowel disease and the development and growth of colon cancer, hypothesizing that CBG may be a promising therapeutic agent for prevention and as a curative medicine. CBG has shown to increase the rate of tissue recovery in the colon, reduce inflammation, and reduce tumor formation and growth in a model of colorectal cancer. 


Several studies, in vitro and in animal models, have shown CBG to have neuroprotective potential for reducing the severity of neurological illnesses, such as Huntington disease (HD), amyotrophic lateral sclerosis (ALS), Parkinson’s disease, and multiple sclerosis (MS). The anti-inflammatory and antioxidant benefits contribute to reducing glutamate-induced oxidative stress and cell death, as shown in mouse models. 


Metabolic syndrome is considered a cluster of five conditions that may lead to heart disease, diabetes, and stroke. It is diagnosed when someone has three or more of the five conditions, being: high blood glucose, low levels of “good” cholesterol in the blood, high levels of triglycerides in the blood, a large waist circumference, and/or high blood pressure. It contributes to the highest rates of healthcare costs and preventable deaths. CBG has recently been compared to rosiglitazone, a pharmaceutical known to improve adipogenesis, a process essential for maintaining metabolic homeostasis. It was found that CBG and CBG/CBD combinations provided similar results as rosiglitazone, supporting the exploration of CBG as a potential therapeutic for metabolic syndrome and related conditions. 


Many cannabinoids have been confirmed to have antibacterial properties, however, CBG has been noted among the most potent cannabinoids when tested against strains of Staphylococcus aureus (the most dangerous of the staphylococcal bacteria responsible for causing skin infections, pneumonia, heart valve infections, and bone infections). 


Evidence from certain preliminary studies that indicate antidepressant activity show the possibility for CBG to have additional clinical applications for mood disorders, such as depression or anxiety as well as disorders of executive function, such as schizophrenia and ADHD. More studies are necessary to confirm these hypotheses. 


Although there is therapeutic promise for the potentials of CBG, there is much more research to be completed and considered to better understand the complete utility of CBG to include adverse events and how to administer so that therapy is effective. It is noteworthy to mention that there have been no published human studies with CBG to date. Much is left to learn and research recommends that the medical community invest in further CBG research as interest and popularity of the cannabinoid increases. 





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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