Category: Featured

Mental Health Awareness Month is recognized throughout the month of May. As the National Alliance on Mental Illness (NAMI) states, “It’s an opportunity for all of us to come together and remember the inherent value we each hold — no matter our diagnosis, appearance, socioeconomic status, background or ability.” Millions of individuals across the globe are affected by a mental illness, and each condition has its own set of symptoms.

It is estimated that of mental health conditions, around 29 million Americans will suffer from what is known to be the second most deadliest in their lifetime. More than 10,000 deaths each year in the United States are linked to the direct result of an eating disorder. 

There is a lack of effective treatment for eating disorders, such as Anorexia nervosa (AN), bulimia, and binge-eating disorder (BED) however there is extensive evidence that suggests the endocannabinoid system (ECS) plays an essential role in our emotional response to eating as well as the pathophysiology of mental disorders. 

Both delta-9-tetrahydrocannabinol (THC) and cannabigerol (CBG) have been looked at for their potential to serve as an appetite stimulant. User anecdotes also suggest that cannabis use will promote appetite. Studies have shown that caloric intake increases among cannabis users when compared with non-users. This leads to the popular belief that cannabis use leads to unintentional weight gain, however many human epidemiological studies show the opposite. As far as appetite is concerned, when provided care and guidance in your approach to dosing, cannabinoids may actually help to promote a healthy weight. 

Anorexia nervosa studies

A 2013 study observed 25 women with severe, longstanding AN who received 2.5mg of dronabinol twice daily for 4 weeks. A small, but significant weight gain was realized without any significant psychotropic adverse effects. 

Taking it a step further, a 2017 study looked at the complex underpinnings of AN, including social, genetic, psychological, and biological predispositions. Among a group of participants receiving low dose THC, their depression rank significantly improved, which had a positive effect on body weight. Participants showed a less restricted attitude towards body feeling and self-esteem, leading to an improved mood. 

Recent evidence suggests that exaggerated anxiety and diminished reward or motivation to eat are key roles in triggering AN symptoms. The University of California, San Diego is looking at cannabidiol (CBD) for its potential to reduce anxiety, and to investigate benefits for adults living with AN. Their study to understand CBD’s role in regulating meal time anxiety is currently active. 

Cannabinoids as an alternative or complementary therapy

When targeting eating disorders with treatment options, Selective serotonin reuptake inhibitors (SSRIs) may be prescribed. This is often counterintuitive as side effects may include short term weight loss or long term weight gain. CBD is more recently being considered as a therapy option for depression and mental illnesses that exhibit symptoms of depression. The serotonergic mechanism of CBD is distinct from commonly used antidepressant medications in that it does not appear to produce symptoms of withdrawal. CBD has also been shown to synergize with other serotonergic medications. Data suggests that CBD could facilitate the antidepressant effect induced by these antidepressant drugs, therefore allowing the SSRIs to be administered at lower doses, resulting in fewer side effects.

The importance of a dose-outcome relationship

Cannabis is not a one-size fits all approach, and more cannabis does not typically correlate to increased benefit. One-on-one support, taking it slow, and being consistent with your therapy are all key components to finding success. Eating disorders are incredibly complex and more than one therapy may be necessary to alleviate symptoms. Research on cannabis and eating disorders is limited, however if you seek resources for how to talk to your doctor or data-driven answers to your questions about cannabinoid therapy and symptoms of mental health conditions, the Realm of Caring Care Team is here to assist. 

At Realm of Caring, we are not medical professionals nor clinically trained to advise one through their mental health illness. However, we care. We are here to help you find resources. We are also here to support you if you are utilizing cannabinoid therapy to bring symptomatic relief, whether that relief is needed psychologically or physically. Those of us who suffer are well aware, mental health illnesses go far beyond affecting mood, physical symptoms may also be witnessed. 

Reach the care team by calling (719) 347-5400, emailing info@realmofcaring.org, or by scheduling an appointment.

Additional Resources:

• Help for Mental Illnesses
• Looking after you Mental Health
• Find a Therapist who specializes in anxiety, depression, OCD, PTSD, and related disorders.
• A step-by-step guide to finding a mental health professional who you feel comfortable working with
• Fitness 4Mind4Body: Diet and Nutrition
• The Exercise Effect
• A Comprehensive List of Digital Resources for Mental Health

In 2022 Colorado gathered experts across the state to convene in a task force to study intoxicating hemp products and make legislative and rule recommendations. The task force, of which Realm of Caring was a member of, met over the course of six months, collectively committing to thousands of hours. The final report was submitted to the General Assembly on January 3rd, 2023.

Before the bill was introduced to the Senate Finance Committee on April 18th, 2023, those findings and recommendations were dismissed. Over the course of the last three weeks of session, through the Senate and House, amendments were further added going well beyond the scope and intent of the bill.

The intoxicating products the task force were intended to discuss were synthetically derived and synthetic cannabinoids available in the market. The focus quickly transferred from those products to non-intoxicating, hemp-derived CBD products that have been available for purchase globally for more than a decade. Instead of focusing on the crux of the issue, which are intoxicating products, the amendments sought to further regulate those that are compliant with safety data to prove that they do not produce adverse effects. These products that are being threatened are utilized for an array of healthcare conditions, offering a life-saving therapy for infants, children, adults, and animals. Sacrificing access to these products is to sacrifice a life.

To pass this bill with the amendments would impose age restrictions for a subset of the non-intoxicating products now available. Parents are being put into a situation where in order to give their child their medicine, they must verify their age as 21+ for purchasing. Not at a dispensary in Colorado, but at grocery stores, supplement and vitamin shops, and any other retail location where compliant hemp products were once sold without restriction.

There is scientific data available to show that in a CBD to THC ratio product made from hemp, THC levels are non-intoxicating up to 3.7mg per serving. Amendments set forth bring that serving limit down to 1.25mg per serving. The task force gathered to make legislative and rule recommendations based in science, which they did. This new serving limit of 1.25mg is arbitrary, not based in science, and will quickly cause Colorado to lose status as a leader in the hemp industry.

The rhetoric and reasoning behind these amendments are based in fear from a lengthy war on drugs as well as greed from the marijuana industry. Special interest groups took advantage of the opportunity to regulate intoxicating products with an attempt to instead regulate non-intoxicating products.

We cannot risk access to the most vulnerable across our state and nation who purchase from Colorado manufacturers. We have fought too long and too hard to be right back where we were a decade ago. The only difference between then and where we are today, is that we now have a decade of data from our own constituents to support that these products are safe and non-intoxicating.

At Realm of Caring, we support a veto to SB23-271. There is still a concern regarding intoxicating, synthetic and synthetically derived products and this bill does not solve that. A veto here would allow stakeholders to come back next year with reasonable solutions that do not impact access to quality and compliant hemp products.

For additional viewpoints on the process and outcomes of SB23-271, check out the following resources:

Commentary: Is Full Spectrum Hemp a Thing of the Past in Colorado?

Colorado Intoxicating Cannabinoid Legislation Threatens an Industry, Fails to Protect Patients and Endangers America’s Children

Hemp Rising Podcast

There is considerable evidence to suggest that the endocannabinoid system (ECS) is involved in the pathophysiology of depression. 

Endocannabinoids and CB1 receptors are widely distributed in the brain areas that are often related to mood disorders and their expression is regulated by antidepressants. Enhancement of endocannabinoid activity at various receptor sites appears to exert antidepressant-like effects. The 5-HT1A receptor is a serotonin receptor that is located in presynaptic and postsynaptic regions. Activating these receptors have been involved in the mechanism of action of anti-anxiety, antidepressant, and antipsychotic medications. 

Research has just begun to take place to understand if the ability of cannabis to regulate these receptors, support that cannabinoids, such as cannabidiol (CBD) can have anti-anxiety, antidepressant, and antipsychotic effects.

Notable quality of life improvements with CBD

Data indicate that repeated administration of CBD may produce an effect that is consistent with results from studies testing traditional anti-anxiety and antidepressant medications. These are known to be clinically relevant findings as CBD is known to benefit while exhibiting few side effects, supporting the initiation of clinical trials testing the efficacy of CBD-based compounds for the treatment of mood disorders. 

The serotonergic mechanism of CBD is distinct from commonly used antidepressant medications in that it does not appear to produce symptoms of withdrawal. CBD has also been shown to synergize with other serotonergic medications. Data suggests that CBD could facilitate the antidepressant effect induced by these antidepressant drugs, therefore allowing the SSRIs to be administered at lower doses, resulting in fewer side effects. 

In a recently published observational study, it was found that medicinal cannabis use was associated with lower self-reported depression. Initiation of medicinal cannabis during the follow-up period was associated with significantly decreased anxiety and depressive symptoms, an effect that was not observed in Controls who had not initiated cannabis use. 

A qualitative analysis published in 2022 paid close attention to the notable quality of life improvements attributed to medicinal cannabis use. The two overarching categories were “enhanced well-being” and “improved daily functioning”. Enhanced well-being includes feelings such as regaining a sense of hope, enjoying family life, and laughing more often. A woman from the study with Lyme Disease was quoted saying, “People such as myself are able to become productive and valued members of society again when we can have the quality of life improved so simply.” 

Benefits reported through RoC research

The goal of the third published paper by Realm of Caring (RoC) was to provide insight into the effects of medicinal cannabis use for symptoms of anxiety and depression.

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

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

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

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

Limiting stress to limit depression

Depression itself is considered a chronic stressor, as too much stress may lead to major depression. CBD has shown to reduce the cardiovascular response to models of stress. Stress can spike blood pressure, heart rate, and stroke volume. In studies done with healthy volunteers exposed to stress; it has been found that CBD may maintain cardiac output by lowering blood pressure, increasing heart rate, and decreasing stroke volume – which are inversely related actions to balance that cardiac output.

Call for future research and finding support

Though antidepressant effects of CBD are consistently reported in preclinical observations, further studies are necessary to confirm best dosing practices to achieve antidepressant effects.

Getting started with cannabinoid therapy can be overwhelming. If you are seeking data-driven answers to your questions about cannabinoid therapy and depression, 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 info@realmofcaring.org, or by scheduling an appointment.

Disclaimer: The following blog is for informational purposes only and is intended for individuals in regions where the use of cannabis is legal. It is important to know and follow the laws and regulations of your area regarding the use of cannabis.

9 Steps to Rolling the Perfect Joint

Rolling a joint is a classic way of consuming cannabis, and for many, it’s a ritualistic experience that has been passed down from generation to generation. While there are many methods and techniques to rolling a joint, we’ll break it down into simple steps so you can create your own perfect joint.

Step 1: Gather Your Supplies

To roll a joint, you’ll need a few things:

• Rolling papers: These are typically made from thin, lightweight paper and come in a variety of sizes and flavors. Popular brands include RAW, Zig-Zag, and Juicy Jays.

• Filter: This is an optional item, but it’s recommended as it helps to prevent cannabis from getting into your mouth while smoking. You can use a pre-made filter or make your own from a piece of cardboard or an index card.

• Cannabis: Choose your preferred strain of cannabis. For a 1 ¼-inch paper, you will use about a half gram of bud. You can add more as you get better at rolling or filling a longer paper.

• Grinder: This is an optional item, but can be used to grind up the flower so it’s easier to work with.

• Rolling tray: This is an optional item, but it can be helpful to keep your rolling materials organized and to prevent any messes.

Step 2: Grind or Break Up the Flower

A joint that smokes evenly the whole way through is rolled with “shake”. ​​To create shake, use a grinder to grind your cannabis. Grinding your weed produces a uniform consistency, facilitating the filling and rolling of the joint while ensuring it burns evenly from all angles. Additionally, a grinder prevents your hands from becoming adhesive and sticking to the rolling paper. If you don’t have a grinder, you can break up the cannabis with your fingers or scissors, as finely as possible.

Step 3: Prepare Your Rolling Paper

Place the rolling paper on the rolling tray or another flat surface with the adhesive side facing up. If your rolling paper has a watermark, make sure it’s facing you.

Step 4: Add the Filter

If you’re using a filter, place it on the end of the rolling paper closest to you. Make sure it’s centered and straight.

Step 5: Add Your Cannabis

Arrange the shake along the center of the rolling paper, beginning from the crutch and moving outward, while holding the paper in a U shape with the adhesive edge facing upwards. It is essential to distribute the bud evenly to promote an even burn and prevent lumps from forming. The amount of cannabis you use depends on how big you want your joint to be. Start with a small amount and work your way up. 

Step 6: Roll the Joint

Start by pinching the rolling paper with your index finger and thumb, shaping it around the bud. Next, while holding the paper firmly, roll and tuck it around the crutch, using a small amount of saliva to secure the paper in that area. Avoid over-wetting the paper with saliva to prevent the adhesive from coming off entirely, requiring you to restart the rolling process.

Step 7 : Seal the Joint

Lick the adhesive strip on the rolling paper and stick it to the other side of the paper, creating a seal. Gently press down on the paper to ensure the seal is tight and secure.

Step 8: Twist the Ends

Twist the end of the joint that doesn’t have the filter to keep the cannabis from falling out. You can also use a pen or pencil to pack the cannabis down further into the joint. You might also pack the weed down by tapping the crutch end on a flat surface.

Step 9: Enjoy Your Joint

Now that your joint is rolled, it’s time to light it up and enjoy! Take a few slow, deep breaths and savor the flavor of the cannabis. Remember to inhale deeply and exhale slowly for the best experience.

Rolling a joint takes practice, but once you’ve got the hang of it, it can be a relaxing and enjoyable experience. Remember to always be safe, use cannabis responsibly, and follow the laws and regulations of your area. 

Finding Support for Cannabinoid Therapy

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

Since January, several bills have been introduced in Washington state to ban the sale of full-spectrum CBD products, both in stores and online. SB 5367 passed both chambers of the Washington Legislature and is now being sent to Governor Inslee’s desk for signature. If signed, CBD will be prohibited for all users across the state.

What does this mean for you? 

This means no CBD purchases may be made in stores or online to be shipped to your door. Specifically, this bill makes the sale of any hemp product containing even trace amounts of THC illegal in the state of Washington.

Protect hemp today

Please protect the safe hemp products that have been available to Washington residents by filling out this form and sending it to the Governor’s office. Additional ways to take action may be found at CharlottesWeb.com and Change.org

Almost exactly one year ago today we called on you to take action on Colorado Bill SB22-205 that threatened to strip you and I of our access to hemp products across the state. You took heroic action and as a direct result Realm of Caring took part in the SB 205 task force for the remainder of 2022. 

Now, we are calling on you to help us ensure that those protections we fought to put in place remain. 

The newly drafted SB 205 (now SB23-271) ensures:

• CBD products may remain to be sold at a 15:1 ratio, with no more than 2.5mg of THC per serving size

• There will be no THC container limits 

• CBD may be purchased without age restrictions

• Strengthened regulation and enforcement against non-compliant and intoxicating products

What does this mean for you? 

It means that if, and only if, this bill passes, you will be able to continue to purchase the same quality, safe, full-spectrum products that have been available to us for a decade

Is there a risk?

YES. The bill is out of task force hands and headed to the legislature today, which means our access to hemp remains vulnerable until the bill is signed as is. 

Protect hemp today

Please protect the safe hemp products that have been available to Coloradans for over a decade by filling out this form and sending it to the bill sponsors – Senator Roberts and Senator Van Winkle:

There are currently 6.7 million Americans living with Alzheimer’s disease, a number that is expected to rise to 13 million by 2050. Alzheimer’s disease is the most common cause of dementia that affects memory, thinking, and behavior, accounting for 60-80% of dementia cases. The greatest known risk factor is increasing age, with the majority of those suffering from Alzheimer’s aged 65 and older. It is a progressive disease, with no known cure, however treatments may slow the progression and improve the quality of life for those living with Alzheimer’s and their caregivers. 

Neuroprotection

Neuropsychiatric symptoms occur frequently in individuals living with Alzheimer’s disease. These symptoms include: psychosis, agitation, aggression, depression, anxiety, and apathy. Frequent prescriptions to target these symptoms include neuroleptics, antidepressants, sedatives, hypnotics, and anxiolytics; which all may have issues related to tolerability and side effects. It has been well documented that benzodiazepines to target agitation in patients may increase cognitive decline and make them vulnerable to injurious falls. Despite decades of research, reliable treatments for neuropsychiatric symptoms have not been found. 

It is likely that regimens that target Alzheimer’s disease require a number of therapeutic strategies to target various stages of development, including neuroprotective intervention. The concept of delaying onset or slowing progression, may eliminate symptomatic Alzheimer’s disease as a significant factor in advanced age. 

Neuroprotection is the ability for a therapy to prevent neuronal cell death by intervening in and inhibiting the pathogenic cascade that results in cell dysfunction and eventual death. Neuroprotective methods often target oxidative stress and excitotoxicity

Antioxidant benefits of cannabidiol (CBD)

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. Insufficient levels of antioxidants in the body also lead to oxidative stress, resulting in damage to cell structure, function, and chronic excessive inflammation. 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 to be 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 on toxic glutamate levels were comparable to the industrial antioxidant known as BHT, suggesting its role as an effective antioxidant. This also shows promise for the CBD as a neuroprotectant.

Effect of cannabinoids on CB2 receptors

In addition to antioxidant benefits, cannabinoids may also have neuroprotective benefits in how they interact with CB2 receptors, mainly found in microglia cells. Microglia cells are known as the immune cells of the central nervous system and play important roles in brain infections and inflammation. CB2 receptors have become interesting targets for the treatment of neurological diseases as their activation has been related to a delayed progression of neurodegenerative events. Research has shown that in resting, healthy brains, microglia move constantly to survey the brain. Activation of CB2 receptors, and likewise active microglia, may rapidly respond to pathological insults that may lead to disease progression by providing neuronal protection. 

Targeting specific behavioral disturbances with Cannabinoid Therapy: sleep, agitation, depression

Sleep 

Sleep disorders are among the most behavioral disturbances in individuals living with Alzheimer’s disease. CBD has therapeutic properties that have the potential to mitigate symptoms that interfere with sleep. It also has the potential to improve sleep-wake cycles leading to an increase in the percentage of total quality sleep overtime.

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

Anxiety and Agitation 

Anxiety and agitation symptoms affect 25-70% of the dementia population, though there are no FDA-approved medications that treat these behavioral symptoms associated with Alzheimer’s disease.

An observational study published in 2023, evaluated 30 patients diagnosed with mild, moderate, or severe Alzheimer’s disease aged 65-90 years. After dosing a THC:CBD cannabis extract twice a day for 12 weeks, findings showed reduced behavioral misconduct, such as agitation and cognitive impairment.

Depression 

It has been suggested that the endocannabinoid system may be involved in the pathophysiology of depression. Evidence shows that endocannabinoids and CB1 receptors are widely distributed in the brain areas that are often related to mood disorders and that their expression is regulated by antidepressants. 

The 5-HT1A receptor is a serotonin receptor that is located in presynaptic and postsynaptic regions. Activating these receptors have been involved in the mechanism of action of anti-anxiety, antidepressant, and antipsychotic medications. Data indicate that repeated administration of CBD may produce an effect that is consistent with results from studies testing traditional antidepressant medications.

Realm of Caring was able to collect and publish data on cannabis use for anxiety and/or depression. 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.

Future research

There are a number of agents with potential to provide neuroprotective effects, however before determining their capability to delay onset or slow disease progression, additional clinical testing will be required. However, key findings across several studies show promising therapeutic actions of cannabinoids as neuroprotective agents and for symptom relief from Alzheimer’s disease. 

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. 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.

Finding Support

Finding free one-on-one support with cannabinoid therapy can be difficult, but that is where Realm of Caring may step in to help. Our care specialists are trained to help with product and practical administration suggestions – whether you be an experienced user or novice. In general, cannabis is safe but responsible use and guidance, as well as oversight by a healthcare professional, are always recommended. We are here to help start and facilitate those conversations along the way through these extremely difficult times. 

If you want to reach out to our care team to discuss anything cannabinoid therapy related one on one – we are here for you! You can call our free hotline at 719-347-5400, email info@realmofcaring.org, or schedule an appointment.