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Tuesday, July 5, 2022

Terms of the “legacy” of medical cannabis

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The science of cannabis touches an astonishingly wide range of topics. With cannabinoids—endogenous, plant-derived, and synthetic—and their receptors centered in the hub, research in the field spins in all directions like spokes on a bicycle wheel.

But unlike the completely “real” wheel, some of these wires carry more weight than others. They may have a stronger evidence base, as in the link between cannabis and inflammatory processes. Others have received more attention over the years from patients and activists outside academia, such as medical marijuana’s “inherited” cases of glaucoma, nausea, and insomnia.

Recent scientific studies validate the old claims about the therapeutic efficacy of each of these conditions that helped launch medical marijuana into the mainstream, but there is still more to learn. Here are some new papers on these wheel master switches.

Glaucoma

Glaucoma offers a comforting rhyme in Peter Tosh’s famous 1978 song “The Bush Doctor” (So Legalize Marijuana/Here in Jamaica/It’s the Only Cure for Glaucoma) and a cheap package at the expense of medical marijuana in many new movies and Television offers. But it is also a serious condition that affects about 70 million people and can cause irreversible vision loss.

Largely thanks to the efforts and judicial victory of Washington in 1976, Capital Activist Robert Randall, it has long been known that cannabis provides short-term relief by reducing intraocular pressure. In fact, glaucoma was the first indication that we The government introduced medical cannabis to a handful of patients (including Randall) beginning in the late 1970s.

But after nearly half a century, the exact molecular mechanism of action of cannabis has become uncertain, and the development of cannabis-based glaucoma drugs remains a challenge. In a research paper published in March 2022 in the journal Planta Medica1and researchers in Germany TU The University of Dortmund reviews the latest results, focusing on new pharmaceuticals. Among other things, it addresses the relative ability of different cannabinoids to reduce intraocular pressure (THC And the CBN better performance than Convention on Biological Diversitywhich in one experiment actually increased stress in mice) and distributed CB1 And the CB2 receptors TRPV Channels and other cannabinoid targets are throughout the human eye (they are just about everywhere).

The authors also provide a list of remaining research needs: more clinical studies in humans, since most to date have been in rats, pigs, or rabbits; greater understanding of the role of the larger endocannabinoid system in the pathophysiology of the eye; And just as important, the development of formulations for the delivery of eye drops of cannabinoids, which are poorly soluble in water.

Nausea

Nausea is one of the most common and longest-lasting medical indications. The plant has been used to treat nausea for thousands of years, and its ability to offset the harsh side effects of cancer chemotherapy and lozenges It was pivotal to the emergence and success of the medical marijuana movement in the 1990s. But even here more work is needed, researchers from the University of New Mexico argued in their April 2022 paper Journal of Gastroenterology.2 They wrote that few studies have measured the real-time effects of common, commercially available cannabis-based products.

their solution? To analyze more than three years of data submitted to a smartphone app called Releaf that helps users track and improve their cannabis consumption. Between June 2016 and July 2019, 886 people used the app to observe a total of 2,220 self-administered inhaled cannabis sessions aimed at treating nausea. These records include baseline and incremental ratings of nausea, allowing researchers to retrospectively assess symptom change over time—and most importantly, to look for associations between rate or degree of improvement and product type or strain.

More than 96 percent of users feel symptom relief within one hour, and often within five minutes. Among the characteristics of the product, the authors wrote: “Flower and concentrates gave the strongest results, but they are similar.” “Products labeled as indica cannabis underperformed those labeled as Cannabis sativa or hybrid, and joints were associated with greater symptom relief than tubes or vaporizers.”

In sessions using a flower, higher THC and less Convention on Biological Diversity The content was generally associated with greater symptom relief. This is a second reminder that even beyond its obvious psychological effects, some physiological consequences THC It appears to have more therapeutic value than its prominent cousin.

Sleeps

Historically, insomnia has been another major driver of medicinal cannabis use. In a recent survey of nearly 27,000 adults in the United States and Canada, more than a quarter reported using cannabis for medical reasons; Of those, 46 percent cited sleep problems as a reason for use — just below the first two answers, pain (53 percent) and anxiety (52 percent).3). (Remember this in case family feud He always asks what the survey “says” about why people use the pot.)

But does it really help? “Increasing evidence indicates a role for the endocannabinoid system in regulating the circadian sleep-wake cycle”…but “studies strongly designed to verify efficacy in populations with sleep disturbances are limited,” Australia-based authors write for a new review article in the journal. chest4. While some studies have shown that cannabis is indeed beneficial for insomnia and obstructive sleep apnea, most studies to date are limited by small sample sizes, a lack of tightly controlled study designs, and a high risk of bias, they add.

Bottom line? “While the current interest and use of medical cannabis to treat sleep disorders may have overtaken the evidence base, there is a strong reason for continued investigation into the therapeutic potential of cannabis.” And so the wheel continues to spin.

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