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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. 

 

Topicals

 

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 info@realmofcaring.org

 

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Disclaimer

 

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.

 

 

Conclusion

 

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. 

 

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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 www.realmofcaring.org 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:

Anti-inflammatory

Anti-anxiety

Analgesic

Anti-bacterial

Anti-depressant

Antiemetic

Antispasmodic

Anti-ischemic

Antioxidant

Neuroprotectant

 

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 info@realmofcaring.org

 

◼

 

Disclaimer

 

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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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. 

 

Results

 

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 info@realmofcaring.org or call (719) 347-5400

 

For media inquiries, please contact rocteam@mygrasslands.com

 

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 www.realmofcaring.org 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.

 

2. ACDC

 

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.

 

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Disclaimer

 

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.

 

Alcohol

 

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

 

Wax/Budder

 

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

 

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.

 

 

 

Conclusion

 

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.

 

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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 www.realmofcaring.org or call 1-888-210-3772.

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Blog Education Featured Uncategorized

Cannabidiol (CBD) Product Use and Health Among People with Epilepsy

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Blog Education Featured

Cannabis Administration and Opportunity Act (CAOA): A Review