Recent studies have shown that even low amounts of D9-tetrahydrocannbinol (THC) within a cannabidiol (CBD) product can result in positive 11-nor-9-carboxy-D9- tetrahydrocannabinol (THC-COOH; a metabolite of THC) urine drug screens. One study reported positive drug screening in 2/6 participants after acute administration of vaporized CBD-dominant cannabis flower (10.5% CBD; 0.39% THC) using liquid chromatography tandem mass spectrometry (LC-MS/MS; which distinguishes between THC-COOH and other cannabinoids/metabolites) at a criterion of greater than or equal to 15 ng/mL THC-COOH. Another study found that 7/14 patients who used a hemp-derived CBD extract (0.02% THC) for 4 weeks yielded positive 50 ng/mL drug screens, 6 of which were...

Abstract Despite current therapeutic strategies for immunomodulation and relief of symptoms in multiple sclerosis (MS), remyelination falls short due to dynamic neuropathologic deterioration and relapses, leading to accrual of disability and associated patient dissatisfaction. The potential of cannabinoids includes add-on immunosuppressive, analgesic, neuroprotective, and remyelinative effects. This study evaluates the efficacy of medical marijuana in MS and its experimental animal models. A systematic review was conducted by a literature search through PubMed, ProQuest, and EBSCO electronic databases for studies reported since 2007 on the use of cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC) in MS and in experimental autoimmune encephalomyelitis (EAE), Theiler’s murine encephalomyelitis virus-induced demyelinating...

A large proportion of patients with multiple sclerosis (MS) have spasticity, which has a marked impact on their quality of life. Anecdotal evidence suggests a beneficial effect of cannabis on spasticity as well as pain. Recently, randomized, double-blind, placebocontrolled studies have confirmed the clinical efficacy of cannabinoids for the treatment of spasticity in patients with MS. Based on these data, nabiximols (Sativex), a 1:1 mix of ∆-9-tetrahydrocannabinol and cannabidiol extracted from cloned Cannabis sativa chemovars, received approval for treating MS-related spasticity in various countries around the globe. In this article we review the current understanding of cannabinoid biology and the value of cannabinoids as...