In the United States, we're in the middle of a cannabis revolution. Our nation is slowly waking up to the truth that cannabis, what was once dubiously considered a dangerous psychoactive substance, is not only safe but extremely versatile in its medical benefits. This has been reflected in the sales of legal cannabis products, which is expected to grow from $6.6 billion in 2016 to $24.1 billion in 2025.
Cooper recently got funding from the National Institutes of Health for a study looking at cannabinoids — including CBD in isolation — as a substitute for opioids, and numerous other clinical trials of CBD are underway. It will be several years before results are available, but these studies should help clarify both what benefits the substance may provide and any side effects it may come with. Most of the adverse effects so far associated with cannabis, such as impairments in short-term memory, coordination and judgment,2 come from products that contain THC as well as CBD, Cooper said, but we need to do more studies to find out for sure whether CBD has fewer risks. Studies are also needed to identify the best way to administer and dose CBD. “I get emails from people asking me what dose of CBD to use, and the truth is, we really don’t know,” Cooper said.
Epidiolex is the first FDA-approved treatment in the U.S. that contains a purified drug substance derived from marijuana -- CBD -- and the first treatment for Dravet syndrome. In September 2018 the FDA rescheduled cannabidiol from a C-I controlled substance to a C-V controlled substance, meaning it has a proven medical use but a low risk of abuse. This change allows Epidiolex to be marketed in the U.S.
It's important to know that although THC and CBD are the most studied components of cannabis, there are many more chemical compounds found within the plant, such as cannabigerol (CBG), cannabichromene (CBC), cannabidivarin (CBDV), tetrahydrocannabivarin (THCV), terpenes, and flavonoids. While there is still much to learn about these other chemicals, researchers in Israel have discovered that whole-plant cannabis extracts that contain these other chemicals are more beneficial than isolated extracts that contain just CBD or THC.
Hemp oil contains some of the same terpenes as dried cannabis bud. Terpenes are the aroma molecules found in plants. Beta-caryophyllene (pepper) and myrcene (musk) are both been found in hemp oil. According to recent research, beta-caryophyllene acts as a cannabinoid in the body. It engages some of the same cell sites as smoked cannabis. In particular, the terpene interacts with cell receptors that regulate the immune system. Myrcene has been found to have antidepressant and anti-inflammatory effects. It also acts as an antioxidant and helps molecules move across cell membranes. The combination of essential fatty acids, vitamins, antioxidants and healing terpenes make hemp oil one powerful superfood.
To name just a few: Animal research and small-scale human studies have pointed to CBD's anti-anxiety and anti-inflammatory properties, NPR reports. A study is underway to see how CBD helps patients with PTSD and alcohol use disorder, and another is exploring how CBD might help curb drug cravings in people with opioid addiction. Cannabinoids like CBD may also be effective at treating cancer-related side effects, according to the National Institutes of Health.
In 1937, the U.S. Treasury Department introduced the Marihuana Tax Act, which imposed a levy of $1 per ounce for medicinal use of cannabis and $100 per ounce for recreational use. This was opposed by physicians who were not required to pay a special tax for prescribing cannabis, use special order forms to obtain it and keep records detailing its professional use. The American Medical Association believed that evidence of cannabis’ harmful effects was limited and the act would prevent further research into its medicinal worth.
The oil may be further refined by 1) alkali washing, or removing the heavy aromatic carboxylic acids with antibiotic properties, which may cause heartburn, gallbladder and pancreas irritation, and resistance to hemp antibiotics; 2) conversion of CBD to THC. Process 1) consists of dissolving the oil in a nonpolar solvent such as petroleum ether, repeatedly washing (saponifying) with a base such as sodium carbonate solution until the yellow residue disappears from the watery phase, decanting, and washing with water to remove the base and the saponified components (and evaporating the solvents). This process reduces the oil yield, but the resulting oil is less acidic, easier digestible and much more potent (almost pure THC). Process 2) consists of dissolving the oil in a suitable solvent such as absolute ethanol containing 0.05% hydrochloric acid, and boiling the mixture for 2 hours.
This oil is derived from the Cannabis sativa plant that can contain both CBD and THC in varying concentrations. The clear drawback of cannabis oil is that it cannot be purchased outside of a state that has not legalized the sale of cannabis. Cannabis oil can also contain higher amounts of THC, which could be problematic for those not looking for the psychoactive effects of cannabis oil.
Stephanie Kahn, who with her husband, Jeffrey, runs the Takoma Wellness Center, a medical marijuana dispensary in Northwest Washington, says that about half of her 1,200 patients use CBD-rich products. Her dispensary offers several strains of high-CBD cannabis as well as CBD oil, with different ratios of CBD and THC, each of which she recommends for particular conditions. “We get questions about it every day,” she says. “A lot of our patients get relief with this, and a lot of times this works better than pharmaceutical drugs.”
The case study notes that advanced chemotherapeutic agents had failed to control the blast counts (cells in the blood and bone marrow) in the patient and had devastating side effects that ultimately resulted in death. The cannabinoid therapy, on the other hand, had no toxic side effects and only psychosomatic properties, with an increase in the patient’s vitality.
Vandermate said he then proceeded on Tuesday to pull the various products comprised of an extract of the cannabis plant called cannabidiol, or CBD, from both his Rapid City and Spearfish stores. CBD oils are hemp extracts used as chronic pain relievers, for people and pets but are not psychoactive. Hemporium Boutique, until Tuesday morning, sold products from Green Roads, a leading manufacturer of CBD oils, edibles and topical creams.
A CNN program that featured Charlotte's Web cannabis in 2013 brought increased attention to the use of CBD in the treatment of seizure disorders. Since then, 16 states have passed laws to allow the use of CBD products (not exceeding a specified concentration of THC) for the treatment of certain medical conditions. This is in addition to the 30 states that have passed comprehensive medical cannabis laws, which allow for the use of cannabis products with no restrictions on THC content. Of these 30 states, eight have legalized the use and sale of cannabis products without requirement for a doctor's recommendation.
Runners pushing themselves daily might want to try more. Floyd’s of Leadville owner Bob Bell says that the company’s 50-milligram soft gels are its top seller. Talansky says his baseline is a 25-milligram gel, plus applying a strong topical cream three to five times a day if a specific body part is bothering him. He takes more on his hardest training days to speed recovery.
Typically, pharmaceutical companies making cannabis-based medicines have sought to isolate individual compounds from the plant. But Mechoulam strongly suspects that in some cases those chemicals would work much better in concert with other compounds found in marijuana. He calls this the entourage effect, and it’s just one of the many cannabis mysteries that he says require further study.
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