Abstract Although prescribing information (PI) is often the initial source of information when identifying potential drug-drug interactions, it may only provide a limited number of exemplars or only reference a class of medications without providing any specific medication examples. In the case of medical cannabis and medicinal cannabinoids, this is further complicated by the fact that the increased therapeutic use of marijuana extracts and cannabidiol oil will not have regulatory agency approved PI. The objective of this study was to provide a detailed and comprehensive drug-drug interaction list that is aligned with cannabinoid manufacturer PI. The cannabinoid drug-drug interaction information is listed in this...

Please use this link to access this publication. Key Points Question  How did marijuana use and cannabis use disorder change during 2008 to 2016 after the legalization of recreational marijuana in the United States? Findings  In this multilevel, difference-in-difference survey study with 505 796 respondents comparing marijuana use before and after the legalization of recreational marijuana in the United States, the proportion of respondents aged 12 to 17 years reporting cannabis use disorder increased from 2.18% to 2.72%, while the proportion of respondents 26 years or older reporting frequent marijuana use increased from 2.13% to 2.62% and those with cannabis use disorder, from 0.90% to 1.23%....

Please use this link to access this publication. Abstract Introduction The use and availability of oral and inhalable products containing cannabidiol (CBD) as the principal constituent has increased with expanded cannabis/hemp legalization. However, few controlled clinical laboratory studies have evaluated the pharmacodynamic effects of oral or vaporized CBD or CBD-dominant cannabis. Methods Eighteen healthy adults (9 men; 9 women) completed four, double-blind, double-dummy, drug administration sessions. Sessions were separated by ≥1 week and included self-administration of 100 mg oral CBD, 100 mg vaporized CBD, vaporized CBD-dominant cannabis (100 mg CBD; 3.7 mg THC), and placebo. Study outcomes included: subjective drug effects, vital signs, cognitive/psychomotor performance, and whole...

Abstract Objective To determine the benefit of a tetrahydrocannabinol (THC)-rich cannabis oil on symptoms and quality of life of fibromyalgia patients. Methods A double-blind, randomized, placebo-controlled clinical trial was conducted for eight weeks to determine the benefit of a THC-rich cannabis oil (24.44 mg/mL of THC and 0.51 mg/mL of cannabidiol [CBD]) on symptoms and quality of life of 17 women with fibromyalgia, residents of a neighborhood with a low socioeconomic profile and a high incidence of violence in the city of Florianopolis, Brazil. The initial dose was one drop (∼1.22 mg of THC and 0.02 mg of CBD) a day with subsequent increases according to symptoms. The...

Abstract Tetrahydrocannabinol (THC) is the primary psychoactive ingredient in cannabis. While the safety of THC and cannabis has been extrapolated from millennia of recreational use, medical marijuana programs have increased exposure among medically complex individuals with comorbid conditions and many co-prescribed medications. Thus, THC should be recognized as a pharmacologically complex compound with potential for drug–drug interactions and adverse drug events. This review summarizes potential adverse drug events related to THC when combined with other medications. Metabolic drug–drug interactions are primarily due to THC conversion by CYP3A4 and CYP2C9, which can be impacted by several common medications. Further, CYP2C9 polymorphisms are highly prevalent in...

Abstract   Background: This study is based on the premise that while consumption of cannabis has increased for medicinal and recreational purposes there has also been an increase in adverse events seemingly associated with cannabis usage.   Objective: This study was designed to investigate the effect of different concentrations of Delta-9-Tetrahydrocannabinol (THC) and Cannabidiol (CBD) separately and in combination on blood flow.   Method: Forty male Sprague-Dawley rats were randomly divided into eight groups consisting of five rats each. Six of the test groups received different concentrations of THC and CBD (1 and 2 mg/kg body weight) respectively, while the seventh group received an extract with a...

Please use this link to access this publication. Abstract I am a head and neck radiation oncologist in a tertiary care practice in Minnesota. I am credentialed in the state of Minnesota to certify patients for medical cannabis. Over the last 6 years, I have certified select patients for medical cannabis as part of management of their cancer-related symptoms and effects of treatment. In this paper, I review my approach to incorporating medical cannabis into the management of patients with head and neck cancer.

Please use this link to access this publication. Abstract Introduction There is a dearth of information on older users (65+ years) of medical cannabis, who may face unique challenges due to altered metabolism with aging, concurrent medication use, and risk of adverse effects. This observational study aimed to describe a large cohort of older medical cannabis users in Canada. Methods From Oct 2014 to Oct 2020, a commercial medical cannabis provider based in Canada collected anonymized data for research purposes from patient volunteers. Data included demographic, social, and health details (at intake) and cannabis products, self-perceived changes in symptoms and change in medications (at...

Please use this link to access this publication. Abstract Most of the pharmacological effects of Cannabis species have been attributed to their cannabinoid constituents, primarily Δ9-tetrahydrocannabinol and cannabidiol. Efficient methods of extraction, purification, and characterization of these compounds are necessary to obtain both enriched preparations and isolated compounds for therapeutic applications. In this study, forensic samples of Cannabis sativa L., Cannabaceae, were subjected to extraction, using maceration in two different solvents, methanol, and diethyl ether. These extracts were subjected to thermal decarboxylation and purification by liquid–liquid fractionation. Δ9-Tetrahydrocannabinol and cannabidiol concentrations from various extracts were quantified by high-performance liquid chromatography with UV detection. Extract cytotoxicity was assayed in...

Abstract Cannabis is the most commonly used illicit drug in the world. However, because of a changing legal landscape and rising interest in therapeutic utility, there is an increasing trend in (long-term) use and possibly cannabis impairment. Importantly, a growing body of evidence suggests that regular cannabis users develop tolerance to the impairing, as well as the rewarding, effects of the drug. However, the neuroadaptations that may underlie cannabis tolerance remain unclear. Therefore, this double-blind, randomized, placebo-controlled, cross-over study assessed the acute influence of cannabis on the brain and behavioral outcomes in two distinct cannabis user groups. Twelve occasional and 12 chronic cannabis users...