A Vet Weighs In on CBD Oil for Dogs

This article is presented by Honest Paws, providing pet owners with all natural, lab-tested CBD oil, infused chews, and other treats for dogs and cats.


With a growing list of potential health benefits and no known side effects, CBD is gaining in popularity among US consumers and their pets. While the research is more robust for humans, promising results are starting to come in for the use of CBD in treating ailments of cats and dogs.

With CBD products for pets easily available online from companies like Honest Paws, more and more pet parents are finding they have questions about this cannabinoid.

A recent Cornell University study found that once the right dosage is determined for a pet, cannabidiol can improve pain stemming from arthritis. In addition, some consumers have had success in using CBD oil for dogs to help relieve a variety of ailments. It was that sort of success in fact, that led to the founding of Honest Paws.

The company was born when co-founder Chelsea Rivera saw its effects firsthand in her dog Baby Rose. Now 13 years old, Baby Rose is healthy and thriving, but that wasn’t always the case. From a young age, the malti-poo suffered from serious seizures. In her efforts to treat this condition, Chelsea decided to try CBD. A month later, Baby Rose’s seizures had stopped, and her health and quality of life was on the upswing. Having seen the impact that it had for her pup, Rivera and her co-founders started working to bring CBD to more pet owners.

In most states, veterinarians are not allowed to prescribe or recommend a cannabis product for your pet. But some vets have seen the benefits of CBD in animals up close and have opinions about its use. For example, Dr. Gary Richter, a holistic veterinarian practicing out of Oakland, California, found that cannabis had extraordinary results for his own dog, Leo, who also suffered from seizures.

We asked Dr. Richter about what is understood about cannabis for pets and how to safely unleash the benefits of CBD for your furry friends.

dog posed next to Honest Paws CBD oil
(Courtesy of Honest Paws)

What conditions may CBD be beneficial for in dogs?

“While I cannot personally prescribe it, I have seen CBD and other forms of cannabis be a very effective alternative treatment option,” said Dr. Richter.

While current research on CBD for dogs is focused on arthritis, many pet owners–and vets–have found it to be effective for other off-label uses.

According to Dr. Richter, “it can help with everything from pain and soreness to stress and anxiety, upset stomach…and seizures.”

What’s the difference between CBD and cannabis?

“People don’t understand the difference between CBD and medical cannabis,” explained Dr. Richter. “CBD is a single component found within cannabis.”

Before it’s used in pet products, CBD is extracted from hemp cannabis. While raw cannabis flower can be toxic to dogs, “CBD from hemp is considered to be very, very safe,” according to Dr. Richter.

What should people look for in CBD products for their pets?

Getting products that have been transparently tested is key, says Dr. Richter. “Ask for a certificate of analysis to show the product contains what it claims on the label,” he advises. “Check the [certificate] to confirm there are no pesticides, fungicides, fungal toxins, etc.”

CBD oil and hemp cannabis flower
(Courtesy of Honest Paws)

Can CBD oil interfere or interact with other medications?

“[CBD] can absolutely be used in conjunction with traditional medicine or, in some circumstances, it can replace the need for Western medications,” said Dr. Richter.

It’s always best to discuss with your own vet to determine whether CBD is a good fit for your pet, though. If your vet is not well-versed in CBD, the Honest Paws team recommends that you seek counsel from a holistic vet who has experience recommending cannabis-derived products for pets.

What do we understand about CBD oil dosing in dogs, and what are we still learning?

There’s going to be a certain amount of trial and error in finding the right therapeutic dose for your pet, but a good starting point is going to depend on your pet’s size and age, and what you’re treating with CBD.

To get you started, you can plug some factors into a calculator like the one developed by Honest Paws. As when discussing prescription interactions, it’s worthwhile to find a veterinarian versed in CBD who can offer experienced insights on dosing issues.

How can I get my dog to take their CBD oil?

“The most effective way to administer cannabis to pets is orally, either with an oil or given as treats,” said Dr. Richter. While snacks like Honest Paws dog treats can be an easy starting point, Dr. Richter says oil is typically a more effective way to administer CBD.

“CBD is not particularly well absorbed through the gastrointestinal tract so ideally an oil is best, as some of it will be absorbed transmucosally–through the tissues in the mouth,” explained Dr. Richter. That’s why Honest Paws also offers an array of CBD oil for small, medium, and large dogs–as well as CBD oil for cats.

Are there any potential side effects of CBD oil that we know about?

The currently known side effects of CBD are mild. “As long as the product is of high quality, the worst side effect is likely to be a little drowsiness if the dosing is too high,” said Dr. Richter.

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Cooking with Cannabis: Tips From a Red Seal Chef

In a survey conducted by the US-based National Restaurant Association in late 2018, almost 700 professional chefs predicted that CBD-infused drinks and CBD-infused foods would be the most popular trends in dining in the coming year.

They predicted that infusing foods with cannabis would create unique culinary opportunities and establish a new dining experience. Many industry insiders expect the same scenario to unfold in Canada after edibles and concentrates become legal nationwide.

People don’t scrutinize cannabis the way they scrutinize food, but they should.

Chef John MacNeil

In anticipation of that development, Zenabis, a licensed producer of medical and recreational cannabis based in Vancouver, BC, has teamed up with Red Seal chef John MacNeil. A chef earns a Red Seal accreditation by demonstrating superior skills and knowledge, and passing a national exam.

MacNeil is from Cape Breton, NS, but worked at Michelin-rated restaurants in Europe and then made a name for himself in Calgary, where he was an executive chef of the award-winning Italian restaurant, Teatro Ristorante. He opened The Black Pig Bistro in the city’s trendy Bridgeland area five years ago. He later sold it to his business partners and started reTreat Edibles, which sells baking mixes formulated to accommodate the addition of cannabis.

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Aware of his credentials, many Canadians approach MacNeil, an expert in molecular gastronomy, to discuss cooking with cannabis. He starts by emphasizing the importance of origin. “You should only use legally produced cannabis to ensure it’s clean and safe,” he says. “People don’t scrutinize cannabis the way they scrutinize food, but they should.”

He fields many questions in those conversations. Here are some of the most common:

How does cannabis affect the flavour of a dish?

Like wine grapes, cannabis comes in countless strains with various flavours including, for example, citrus, berry, mint and pine. These flavours are created by aromatic oils called terpenes, which are secreted in the same glands that produce cannabis compounds including Tetrahydrocannabinol (THC) and Cannabidiol (CBD). Terpenes form part of the flavour profile of a cannabis-infused dish so it’s important to select ones that complement the other ingredients.

How much cannabis should be included in a dish?

MacNeil compares learning how much cannabis to include in a dish to learning how to cook steak properly. You overcook then undercook before learning to make it just right. It takes practice to find out where the sweet spot is, he says.

Dosing varies from one individual to the next depending on a person’s previous history of cannabis consumption, gastrointestinal factors, and the sensitivity of his or her endocannabinoid system. Most experts recommend a starting dose of no more than 2.5 mg of bud for beginners. However, since effects vary based on each person consuming, MacNeil does not make dosing recommendations.

Also, it takes awhile for edibles to take effect so beginners often make the mistake of ingesting too much too soon. MacNeil and other experts advise beginners to wait around two hours before deciding whether to take a second dose.

What is one of the most popular cannabis-infused items people make at home?

Many people express an interest in cannabis-infused brownies. MacNeil recommends using Thai coconut milk and French chocolate.

To infuse cannabis into chocolate brownies and other baked goods, many people use the whole plant, drying, curing and then grinding it into a flour-like substance and combining it with cooking oil or butter.

When should THC and CBD be consumed?

This is entirely up to the individual consuming it. Depending on the desired outcome, some prefer consuming high THC, a psychoactive compound, while others prefer high CBD for less of a high. In short, pick a strain based on your desired effect.

Cooking with Cannabis Recipes by Chef John MacNeil

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THC-Blood Levels Can’t Be Determined Postmortem, Research Finds

The role of cannabis in vehicular crashes remains one of the most controversial aspects of legalization. A new study produced by a Colorado researcher threatens to upset one of the supposed scientific certainties about impairment and blood-THC levels.

A new study threatens to upset one of the supposed scientific certainties about impairment and blood-THC levels.

Andrea Tully, a graduate student researcher at the University of Colorado, looked at the blood draw methods and THC level results from 100 recently deceased subjects at the El Paso County Coroner’s Office in Colorado Springs.

Each subject tested positive for THC, but when comparing blood drawn from different parts of the body, Tully found dramatic disparities in THC levels. She also found disparities in THC levels drawn soon after death, compared to blood drawn hours or days later from the same subject.

Her conclusions throw doubt on the growing pool of data in legal states on fatal vehicle crashes supposed caused by THC impairment. “Reaching a verdict on the level of impairment of a deceased individual,” Tully wrote, “can prove to be risky and possibly reckless,” due to the many uncontrolled variables she uncovered in postmortem blood draws.

This has the potential to be a politically explosive statement.

THC-Impairment Data as a Political Weapon

Anti-legalization groups like SAM and the Rocky Mountain High Intensity Drug Trafficking Area group have gone to great lengths to publicize a purported rise in the number of fatal traffic crashes due to THC impairment. That data is often based on postmortem blood draws taken from drivers involved in a fatal crash.

Most legal states have adopted 5 ng/mL (nanograms per milliliter) of THC in the blood as the per se limit. Anything under that is considered legal; over that is grounds for arrest on a DUI charge, regardless of the actual impairment of the driver. When a driver killed in an auto crash is suspected of being impaired, their blood is drawn postmortem, sometimes hours or days after death.

As the Body Decays, THC Migrates

In her research, Tully found that delay skewed the data. The longer the time interval between death and the blood draw, the higher the THC level in the blood. She attributed that to the phenomenon of postmortem redistribution.

“Postmortem redistribution describes the movement of drugs within the body after death,” Tully noted, “with the result that the blood concentration of a drug is significantly higher at autopsy than immediately after death.”

That redistribution happens in part because organs that contain high concentrations of THC (such as the lungs and liver) release THC into nearby blood vessels at death.

THC levels also vary widely in different parts of the body. Tully found that blood draws from one subject varied from 2.1 ng/mL (under the legal limit) to 6.6 ng/mL (above the legal limit) depending on where blood was drawn in the body, while another subject’s THC levels varied from 2.9 ng/mL to 40.9 ng/mL.

Quality of Blood Sample Affects THC Level

Regarding the condition of the blood samples taken, Tully also found that “as the quality of the sample decreases, the concentration of THC increases.”

For example: One draw that contained a high amount of fat registered a high level of THC, most likely due to the fact that THC is highly lipophilic, so it tends to concentrate in fat cells. That fat-heavy sample registered nearly three times the THC level as a cleaner blood sample taken from the same subject.

Her research offers no conclusions about THC and impairment in living drivers, only about the accuracy of blood-THC levels gathered from postmortem blood draws. “Colorado has a statewide DUID limit of 5 ng/mL of parent THC in blood,” which is calculated based on blood samples taken from living drivers, Tully wrote. “However, making such a judgment call in deceased individuals is not so simple.”

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Cannabis and the Immune System: A Complex Balancing Act

Cannabis sativa has been consumed for health and nutritional purposes for thousands of years. Many ancient civilizations – from the Chinese to the Greeks – included cannabis in their pharmacopoeia. Back then, no one questioned how or why cannabis relieved pain and calmed the spirits. It was a helpful ally – that’s all that mattered.

Fast forward to the 21st century. Scientists are trying to understand not only the molecular makeup of cannabis, but also how it interacts with the complex web of biological systems in our bodies. Yet, despite many exciting discoveries, we still know relatively little, especially when it comes to the interplay between cannabis and the immune system.

Some studies suggest that cannabinoids like THC and CBD are immunosuppressant, which can explain the relief experienced by medical cannabis users with autoimmune diseases and chronic inflammation. Other studies have shown that regular cannabis use can increase white blood cell counts in immunodeficiency disorders such as HIV, suggesting an immune-boosting effect.

It gets even more complicated when we consider that the effects of cannabis are mediated primarily by the endocannabinoid system, which scientists believe interacts with all biological activity, including our immune system.

The bottom line is that much remains to be discovered about how cannabis affects our immune system. Here’s some of what we know so far.

Our Immune System – an Overview

We are constantly exposed to infectious diseases, bacteria and viruses (antigens), all intent on running amok and wreaking havoc. Without any inbuilt defences to keep these invaders at bay, we’d all last about five minutes on this planet. Thank goodness we have an immune system: the complex network of cells, tissues and organs, running with military precision to keep us healthy.

A key player in the immune system’s arsenal are white blood cells or leukocytes, which seek out and destroy any unwanted visitors. Leukocytes can be divided into two groups: 1) lymphocytes (B cells and T cells) that destroy antigens and help the body to remember previous attackers; and 2) phagocytes that absorb and neutralize foreign intruders.

Many of us are familiar with T cells because of their relationship with the HIV virus, which wipes them out; this is what makes HIV patients vulnerable to normally harmless infections.

Our immune system also plays a key role in detecting malfunctioning cells inside our bodies, and, through the process of apoptosis or cell death, ensures that these cells do not continue to grow and become tumors.

Killing cells is a crucial element of a healthy functioning immune system, which maintains a delicate balance between growth and death. If, for example, there is too much cell death, autoimmune diseases can result, while too little can create the perfect environment for cancer.

The Endocannabinoid System and the Immune System

Optimum immune function entails a complex balancing act that relies on constant communication between our immune cells, tissues, and organs. With the discovery of the endocannabinoid system (ECS) in the 1990s, scientists have found another key piece of the puzzle.

The endocannabinoid system comprises two main G protein-coupled receptors (CB1 and CB2), endogenous ligands known as endocannabinoids (anandamide and 2-AG), plus the proteins that transport our endocannabinoids and the enzymes that break them down in the body.

Endocannabinoids are produced on demand, travelling backwards across chemical synapses and modulating cell activity. This partly explains why the ECS has been termed a homeostatic regulator – continually working to maintain a state of biological balance.

The ECS regulates a plethora of physiological processes, including immune function and inflammation. Both CB1 and CB2 receptors can be found on immune cells, although there are between 10-100 times more CB2 receptors than CB1. Endocannabinoids act upon immune cells directly through the CB2 receptor.

CB2 receptor activation creates an anti-inflammatory effect and is therefore a therapeutic target for autoimmune disorders and neurodegenerative disease.1 However, any ECS immunosuppressant activity is thought to be transient, and can be overridden when necessary in the presence of infection.2

Scientists know that plant cannabinoids like tetrahydrocannabinol (THC) and cannabidiol (CBD) impact our health by interacting in different ways with the endocannabinoid system. Thus, it makes sense that consuming medical cannabis will also directly affect our immune system. But researchers are struggling to understand exactly how.

Cannabis and the Immune System

When we talk about cannabis, we’re dealing with upwards of 400 different molecules. These include the more frequently studied cannabinoids like THC and CBD, more than 100 other minor cannabinoids, dozens of terpenes, and a host of flavonoids – the combination of which varies according to the cannabis strain.

While most work has been carried out on individual cannabinoids, in particular THC and CBD, if you’re looking for some solid conclusions about how they affect the immune system, think again.

THC has been the focus of the bulk of research. THC binds to the CB2 receptor and activates it, which has an anti-inflammatory effect. This suggests that THC is immunosuppressant. Accordingly, THC is thought to show promise for autoimmune diseases, such as Crohn’s and multiple sclerosis. CBD, despite little binding affinity with cannabinoid receptors, is also considered to be immunosuppressant, reducing cytokine production3 and inhibiting T-cell function4.

But that’s only part of the story. A new wave of research and mounting anecdotal evidence points towards cannabinoids having an adaptive, immunomodulating effect, rather than just suppressing immune activity.

Cannabis and HIV

Medical cannabis is a well-established palliative treatment for HIV thanks to the plant’s ability to reduce anxiety, improve appetite, and ease pain. But recent research takes THC’s role even further, suggesting that it can actually upregulate the immune system, potentially improving patient outcomes.

Initially, preclinical research had corroborated the view that THC was immunosuppressant in HIV, increasing viral load and worsening the disease.5 More recent research, however, has suggested immune-stimulating effects.

A 2011 study by Lousiana State University scientists revealed astonishing results when monkeys were given THC over 28 days prior to SIV infection (the simian version of the virus). THC appeared to have some kind of protective effect, lengthening the lives of the monkeys and reducing viral load.6

Additional research by the same team in 2014 took these findings one step further. This time monkeys were given THC for a period of seventeen months before SIV infection. Not only was there an increase in T-cells and a reduction in viral load, but THC appeared to have protected the monkeys against the intestinal damage commonly caused by the virus.7

These exciting results have also been replicated in humans. In a study conducted by researchers at universities in Virginia and Florida, CD4 and CD8 white blood cell counts were compared in a sample of 95 HIV patients, some of whom were chronic cannabis users.8 Scientists discovered that both types of infection-fighting immune counts were higher in patients using cannabis, suggesting their immune systems had been bolstered by the plant.

Cannabis, Cancer, and the Immune System

Cancer will affect one in two of us at some point in our lifetime. There’s no hard and fast rule why it appears, but most cancers share the same mechanism.

Our immune system is primed to spot rogue cells and, through mechanisms such as apoptosis, eliminate any that might become tumors. Unfortunately, cancer cells can outwit our immune system by getting it to work in their favour.

Esther Martinez, a cannabinoid research scientist at Madrid’s Complutense University, describes a kind of crosstalk between cancer cells and the immune system. “When the tumor talks with immune cells, it reverses the signal,” she told Project CBD. “So, it’s like, ‘I’m here, and now I want you to work for me.’ And instead of attacking the tumor, it gives pro-survival signals, so the immune system around the cancer goes through a change. The tumors have the capacity to shut off the immune system.”

image

Cannabis oil, fresh cannabis flower, and a pink ribbon on a white background.

With the immune system unarmed, cancer cells grow uncontrollably. Until recently, the only approved anticancer weapons have been treatments like chemotherapy, which destroy not just the cancer cells, but also fast-growing, healthy cells.

It’s no surprise, then, that tremendous excitement lies around the antitumoral properties of the cannabis plant, in particular THC and CBD. In fact, it was Esther’s colleagues at the Complutense University, Manuel Guzman and Cristina Sanchez, who paved the way in investigating the cancer-killing effects of cannabinoids, primarily, but not exclusively through apoptosis.9

However, very little is known about the relationship between the immune system and cannabinoids in this process. One reason is that in many preclinical trials, human tumors grafted onto immunosuppressed mice are used to avoid rejection by their rodent hosts.

Some studies do exist using immune competent mice, such as Dr Wai Liu’s 2014 report, which examined the effects of THC and CBD on brain tumors when combined with radiotherapy. Not only were the tumors significantly reduced, but little if no immune suppression was witnessed in the study, according to Dr Liu, a London-based Research Fellow and cannabinoid Scientist.10

This is welcome news, as cannabinoids can also cause apoptosis in lymphocyte cells, potentially suppressing the immune system. The ability of cannabinoids to both suppress and bolster immune function lends credence to the idea that the endocannabinoid system is involved in immunomodulation, as Dr. Liu told Project CBD: “I suspect that cannabinoids are having a double-punch effect of 1) direct killing and 2) enhancing immunity by suppressing those immune cells that serve to hold back the immune-based killing cells.”

Immunotherapy for Cancer

Uncertainty about the interaction between cannabinoids and the immune system raises doubts regarding the use of medical cannabis during immunotherapy. Proclaimed the wonder cancer treatment of the future, immunotherapy retrains white blood cells to detect and kill cancer in the body. Thus far, however, there has only been one study examining how cannabinoids may affect this process – and the results were problematic.

Conducted at the Rambam Medical Centre in Haifa, Israel, patients taking medical cannabis alongside the immunotherapy cancer drug Nivolumab responded 50% less compared to those on immunotherapy alone.11 Curiously, subjects taking medical cannabis high in THC responded better to immunotherapy than those on a low strength THC product. No significant change in overall survival rates for patients was noted.

There are also anecdotal reports from California cancer patients who maintain that they benefited by combining immunotherapy with a low-dose, CBD-rich cannabis oil regimen under a doctor’s supervision. In addition, a small but growing body of preclinical data suggests that combining CBD and THC with conventional chemotherapy and radiation could have a powerful synergistic effect as an anticancer treatment. But these findings have not been replicated in human trials.

Despite a lack of clarity regarding cannabinoids and immunotherapy, the preponderance of scientific data suggests that it’s time to abandon the antiquated and misleading immunosuppressant label and embrace the idea that cannabinoids are bidirectional immunomodulators. This is what Dr. Mariano Garcia de Palau, a Spanish cannabis clinician and member of the Spanish Medical Cannabis Observatory, has seen in his practice.

“I believe [cannabis] is immunosuppressive when there is hyper-immune response,” says Dr. Garcia de Palau, “but otherwise it regulates and corrects the immune system. In fact, you could say it functions like the endocannabinoid system, bringing equilibrium to the organism.”

What does this mean in practical terms if you regularly use cannabis, have a compromised immune system or are starting immunotherapy? Where possible consult with your medical practitioner. In the meantime, we can only hope that more research will shed light on the complex relationship between the endocannabinoid system, our immune response, and compounds in the cannabis plant.


Mary Biles is a journalist, blogger and educator with a background in holistic health. Based between the UK and Spain, she is committed to accurately reporting advances in medical cannabis research. This is her first article for Project CBD.


Sources

1. Caroline Turcotte, Marie-Renee Blanchet, Michel Laviolette, and Nicolas Flamand. The CB2 receptor and its role as a regulator of inflammation. Cellular and Molecular Life Sciences. 2016; 73(23): 4449-4470. doi: 10.1007/s00018-016-2300-4
2. Rupal Pandey, Khalida Mousawy, Mitzi Nagarkatti, and Prakash Nagarkatti. Endocannabinoids and immune regulation. Pharmacol Res. 2009 Aug; 60(2): 85-92, doi: 10.1016/j.phrs.2009.03.019
3. Francieli Vuolo, Fabricia Petronilho, Beatriz Sonai, Cristiane Ritter, Jaime E. C. Hallak, Antonio Waldo Zuardi, Jose A. Crippa, and Felipe Dal-Pizzol. Evaluation of Serum Cytokines Levels and the Role of Cannabidiol Treatment in Animal Model of Asthma. Mediators of Inflammation. 2015; 2015: 538670. doi: 10.1155/2015/538670
4. Barbara L. F. Kaplan, Alison E. B. Springs, and Norbert E. Kaminski. The Profile of Immune Modulation by Cannabidiol (CBD) Involves Deregulation of Nuclear Factor of Activated T Cells (NFAT). Biochem Pharmacol. 2008 Sep 15; 76(6): 726-737. doi: 10.1016/j.bcp.2008.06.022
5. Roth MD, Tashkin DP, Whittaker KM, Choi R, Baldwin GC. Tetrahydrocannabinol suppresses immune function and enhances HIV replication in the huPBL-SCID mouse. Life Sciences. 2005 Aug 19;77(14):1711-22.
6. Patricia E. Molina Peter Winsauer Ping Zhang Edith Walker Leslie Birke Angela Amedee Curtis Vande Stouwe Dana Troxclair Robin McGoey Kurt Varner Lauri Byerley Lynn LaMotte. Cannabinoid Administration Attenuates the Progression of Simian Immunodeficiency Virus. AIDS Research and Human Retroviruses Vol. 27, No. 6. https://doi.org/10.1089/aid.2010.0218
7. Patricia E. Molina,Angela M. Amedee, Nicole J. LeCapitaine, Jovanny Zabaleta, Mahesh Mohan, Peter J. Winsauer, Curtis Vande Stouwe, Robin R. McGoey, Matthew W. Auten, Lynn LaMotte, Lawrance C. Chandra, and Leslie L. Birke. Modulation of Gut-Specific Mechanisms by Chronic ?9-Tetrahydrocannabinol Administration in Male Rhesus Macaques Infected with Simian Immunodeficiency Virus: A Systems Biology Analysis. AIDS Res Hum Retroviruses. 2014 Jun 1; 30(6): 567-578. doi: 10.1089/aid.2013.0182
8. Keen L, Abbate A, Blanden G, Priddie C, Moeller FG, Rathore M. Confirmed marijuana use and lymphocyte count in black people living with HIV. Drug Alcohol Depend. 2017 Nov 1;180:22-25. doi: 10.1016/j.drugalcdep.2017.07.026.
9. Guzman M. M J Duarte, C Blazquez, J Ravina, M C Rosa, I Galve-Roperh, C Sanchez, G Velasco, and L Gonzalez-Feria. A pilot clinical study of ?9-tetrahydrocannabinol in patients with recurrent glioblastoma multiforme. Br J Cancer. 2006 Jul 17; 95(2): 197-203. doi: 10.1038/sj.bjc.6603236
10. Katherine A. Scott, Angus G. Dalgleish and Wai M. Liu. The Combination of Cannabidiol and ?9-Tetrahydrocannabinol Enhances the Anticancer Effects of Radiation in an Orthotopic Murine Glioma Model. Molecular Cancer Therapeutics. MCT-14-0402 doi: 10.1158/1535-7163
11. Taha T, Meiri D, Talhamy S, Wollner M, Peer A, Bar-Sela G. Cannabis Impacts Tumor Response Rate to Nivolumab in Patients with Advanced Malignancies. Oncologist. 2019 Jan 22. pii: theoncologist.2018-0383. doi: 10.1634/theoncologist.2018-0383.


Copyright, Project CBD. May not be reprinted without permission.


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Cannabis Can Make You More Creative–But It’s Complicated

Cannabis and creativity are often portrayed as linked, with their connection seeming culturally agreed upon. From creativity-themed cannabis products, to stunning hand-blown bongs, artist testimonials, and the popularity of “puff and paint” art classes, anecdotal evidence overwhelmingly says creativity and cannabis are kindred indeed.

But people have a lot less to say when it comes to the why’s and how’s behind this commonly-accepted phenomenon. Is the link between cannabis and creativity authentic? Here’s what current science has to say about it.

Blood to Your Creative Bits

Research has revealed that creativity is associated with the brain’s frontal lobe, and that cannabis consumption increases cerebral blood flow (CBF) to this area, which makes it more active. As reported by Jasen Talise in the Berkeley Medical Journal, experiments done in 1992 found that CBF increased after cannabis consumption. (These findings were confirmed by further research done in 2002.)

Talise spoke with Alice Flaherty from the Department of Neurology at Harvard Medical School, who said of CBF, “When subjects with high and low creativity are compared, the former have both higher baseline frontal lobe activity and greater frontal increase while performing creative tasks.”

Such activity stimulates creative output in two ways. First, it activates the area near the brain’s nucleus accumbens, which Flaherty found correlates to increased creativity. Secondly, the frontal lobe serves as the headquarters for something called “creative divergent thinking.”

Divergent Thinking vs. Creativity

Divergent thinking is a common scientific measure of creativity. It is a type of thinking that explores many possible solutions and typically occurs in a spontaneous, free-flowing, non-linear manner. Put in other words, divergent thinking employs methods like brainstorming, creative thinking, and free writing to come up with outside-the-box ideas.

For an example of why scientists connect this kind of thinking to cannabis use, we’ll quickly travel back to 2001. In high school, a friend of mine’s room was a 420 oasis, home to many people’s early cannabis experiences–and the walls were covered with evidence of this exposure, thoughts scribbled in marker, so creative I can still remember a few nearly two decades later:

“I feel like I’m running through Jell-O.”

“Levametation.”

“I’m a butterflyyyyyyyyyy.” (Drawn in the shape of butterfly. Author may have been involved.)

When it comes to cannabis and creativity, dosage is key.

“Levametation,” the word in the second example, was created for a decidedly outside-the-box game show proposed by its author. It combines “levitate” and “elevation” to describe a process in which cannabis smoke would hang in the air after rising from the floor below, subtly smoking out the contestants. (Cleverest whilst unwittingly stoned wins!) So in this case, divergent thinking came in the form of brainstorming various names to describe an invented process that’s as dubious as it is imaginative.

In day-to-day life, divergent thinking is commonly employed whenever you list numerous possibilities to come up with innovative options; from how to raise Q2 fiscal earnings, to how best use that Costco supply of albacore tuna. Or more broadly, you use divergent thinking whenever you’re working to open your mind in various directions and to new potential solutions. We’ll go over a few widely-referenced studies that measure this kind of thinking to discern how cannabis use affects creativity.

Low Doses Help, Big Doses Hinder

Leafly covered one such study in 2014; it concluded that when it comes to cannabis and creativity, dosage is key. The study found that in low doses (5.5 mg THC), cannabis slightly improved two aspects of divergent thinking: fluency, or the number of responses provided, and flexibility, or the variation in answers.

And, not surprisingly, scores were significantly raised for originality, or the uniqueness of responses. However, when the dose was increased to 22 mg of THC, scores were markedly lower in most categories. (Elaboration, or the amount of detail provided in explaining a response, was low all around–but was slightly higher in the placebo group.)

Getting Low Creatives High

Another study done in 2012 divided participants into high creativity and low creativity groups, then tested them both sober as well as under the effect of cannabis. The researchers had participants bring their own cannabis, so keep in mind that some variation in potency and chemical composition is to be expected here. Cannabis had little effect on the high creativity group, but after partaking, the scores of the low creativity group were actually boosted compared to those of the high creatives.

Basically, this study found that if you’re not already creatively skilled, then cannabis might help you to get creating. And if you’re already creative, this study says cannabis isn’t going to affect your creativity very much.

A Chicken and Egg Situation

The results from this final 2017 study suggest that the people hanging out in my friend’s marker-covered bedroom may have been more creative to begin with. It found that cannabis users both self-reported being more creative as well as veritably scoring higher when their creativity was tested.

However, the study also tested personality types. It used a popular measure called the Big 5, and found that cannabis users scored higher on “openness to experience.” Because this measure reflects high creativity and imagination traits, these findings lead the study to conclude, “While cannabis users appear to demonstrate enhanced creativity, these effects are an artifact of their heightened levels of openness to experience.”

These results pose a bit of a chicken-egg dilemma: does cannabis use improve creativity or do creative people just tend to like cannabis?

In the End, See What Works for You

As with other areas of cannabis research, there’s a lot of work to be done in regard to studying the link between cannabis and creativity. But, in summary, research suggests:

  • Cannabis increases cerebral blood flow, which points to stimulated creative output.
  • However, too much THC can actually hinder creativity, while a smaller dose has been found to help a little.
  • Cannabis can make less creative people more so, but has little effect on those who are already creatively advanced.
  • There are more creatively advanced people within the population of cannabis consumers.

In the end, scientists don’t have a hard conclusion on this very abstract matter. So if you’re already creative and attest that cannabis does further increase your ability, or if you do your best work after 20 mg of THC, then how scientists predict you’ll score on a specific verbal fluency test isn’t particularly relevant.

Do what works for you. And if you’re still figuring out how cannabis affects you creatively, try playing with different dosages, creative activities, strains, and environments to see if cannabis can help you tap into your inner artist.

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Allergies Buggin’ Out? Cannabis Can Help, or Hurt

It’s allergy season again, and it’s no fun at all. If you’ve got seasonal allergies, it’s a familiar story. The weather is finally nice enough to be outside, but you can’t enjoy it because you’re spending the whole time sneezing and looking through blurry, watery eyes!

If the standard decongestants and nose sprays haven’t worked for you yet, don’t lose hope. You might be surprised to find help in an unlikely place–the cannabis plant!

“I certainly have some people say that it helps their allergies.”

Dr. Frank Lucido, cannabis clinician, Berkeley, CA

That’s right–while cannabis can sometimes cause its own allergies, studies are showing that it can also help to curb the effects of allergic responses.

Learn the science and find out whether cannabis can help you defeat your seasonal allergies!

How Allergies Work

Allergies are the body’s way of protecting us from invaders, but allergic reactions often get triggered by harmless substances. When something like a piece of dust, mold, or pollen gets into your system, your body reacts, producing custom antibodies to attack the ‘invader’. These antibodies trigger chemicals like histamine which bring on our familiar allergy symptoms like sneezing, runny or stuffy nose, itching, watery eyes, ear congestion, inflammation, wheezing, coughing, or even asthma.

This is no small problem. An estimated 40% of the world’s population has allergic responses to foreign proteins in their environment, and 10-30% are affected by allergic rhinitis–the allergic response in the nose that gets triggered by inhaling allergens.

Can Cannabis Help Reduce Allergies?

It’s clear allergies can be rough. So can cannabis help?

Some experts say “yes.” Cannabis may be able to help when it comes to reducing allergies, and some cannabis consumers have already noticed the connection.

“I certainly have some people say that it helps their allergies.” explains Dr. Frank Lucido, a cannabis clinician from Berkeley, CA. As a doctor who regularly interacts with cannabis patients, Dr. Lucido says that he rarely see patients who suffer from cannabis-related allergies, but does have some clients who report using cannabis eases their allergic reactions.

Still, other doctor’s say cannabis has potential but may not be all that effective in its current form.

Cannabis for Asthma Control?! See What Strains Leafly Reviewers Prefer

Dr. Peter Grinspoon, a primary care physician at Massachusetts General Hospital, instructor at Harvard Medical School and board member of the advocacy group Doctors For Cannabis Regulation, says that while he knows that some people use cannabis for allergies, he hasn’t come across that use in his patients.

Still he explains that, “some of the cannabinoids have a lot of anti inflammatory properties… so hypothetically, it could help.”

Whether you are dealing nasal inflammation, airway hyperreactivity, allergic asthma, or an immune overreaction, using anti inflammatory agents is usually helpful.

Still, Dr. Grinspoon cautions that just taking cannabis might not be as effective the standard over-the-counter allergy remedies.

“I don’t think cannabis, as we’re taking it now, is nearly as strong as, for example, Flonase.”

Dr. Peter Grinspoon, Massachusetts General Hospital

“I don’t think cannabis, as we’re taking it now, is nearly as strong as, for example, Flonase.” He explains, adding, “I don’t think it’s a great treatment per se for allergies. That isn’t to say it doesn’t help people. If it helps people, that’s great.”

But cannabis for allergies is not something he’s recommending to his patients.

Dr. Grinspoon says he could envision a nasal spray in the future made from concentrated anti-inflammatory cannabinoids and terpenes. With something more targeted at the source of the allergies, he says he could see cannabis, “having the hypothetical potential for being a very effective treatment in the future.”

Still, for those who say cannabis helps them when their allergies get out of control, it can make a difference. It can be amazing to notice the quick reduction in all that sneezing and itching.

So what does the scientific research have to say? Unfortunately, we don’t have enough controlled human studies to say definitively whether cannabis can help with your allergies. But, there are quite a few studies that support the idea that cannabis can play helpful role in reducing allergies. Here are the facts:

Cannabis Vs. Histamine

One of the main ways that cannabis can help with allergies is through reducing the level of histamine released into your system. Histamine, which is triggered by antibodies, brings on a whole host of allergic responses. So preventing or reducing histamine release can make a big difference. One way cannabis can do this is through reducing the antibodies that trigger histamine.

For example, A 2009 study found that cannabinoids impaired activation of mouse T-cells (a type of white blood cell). Since T-cell activation increases antibody responses, it leads to increased histamine and thus, increased allergic reactions. By impairing this activation, cannabinoids are able to reduce the antibody response and help lesson your allergy symptoms.

And it’s not just cannabinoids that can help. Terpenes play a role as well. In a 2014 study, researchers found that alpha-pinene, a common terpene in cannabis, may also be able to help reduce antibody levels. Mice who were treated with the terpene showed decreased clinical symptoms of allergies, like rubbing their nose, eyes, and ears. But they also had significantly lower levels of nasal immunoglobulin E, an important antibody that triggers histamine release.

A cell study from 2005 suggests cannabis can also prevent increased histamine responses through a different route. This study found that exposure to THC could suppress mast cell activation. Mast cells are found in connective tissue and their activation triggers the release of histamine.

So suppressing mast cell activation could prevent or reduce the severity of your allergies.

Cannabis Vs. Inflammation

When allergies hit, inflammation plays a big role, so one way that cannabis may be able to help reduce allergy symptoms is through preventing or reducing inflammation.

“Cannabis seems to inhibit the inflammatory pathway.” explains Dr. Sue Sisley, a cannabis researcher currently conducting controlled human studies on cannabis’ effects. “And that certainly does relate to allergies because if you can cut the inflammatory pathway, then it could certainly help the untreated allergies, all the classic symptoms, the itchy, runny nose, itchiness, hives, all those kinds of things.”

Still, Dr. Sisley cautions that this is still theoretical. “It makes sense. It’s just that I can’t back it up with science,” she explains. “It’s like most things in cannabis research, we have a mountain of anecdotal reports, but very little objective controlled data to back it up.”

Her study, which is investigating cannabis’ use for veterans with PTSD, will also take a closer look at cytokines–a marker for inflammation.

“We’re treating the veterans with all different varieties. So there’s a high-THC, a high-CBD, there’s a 1:1 ratio of THC to CBD. So we’ll be able to see how smoking these different varieties of flower affect the levels of their cytokines,” Dr. Sisley explains. “We’ve never really measured that, so in this study were drawing all these cytokines, and measuring their concentration.”

While the study isn’t designed to look at allergies, the research on cytokines may shed light on cannabis effects on inflammation – and this route towards easing allergic responses.

THC Vs. Allergic Skin Reactions

THC may also be able to help when it comes to allergic skin reactions. In a study from 2007, scientists looked at whether THC-based drugs could help reduce allergic responses in the skin. Researchers applied synthetic THC to the skin of mice with severe skin allergies and found that the skin cells of the treated mice had less cytokines–a chemical responsible for signaling immune cells to come to an irritated area. Researchers say this means cannabis could be helpful for reducing allergic reactions in skin.

CBD and THC Open Up Airways

In addition to reducing the symptoms of your runny nose and itchy skin, cannabis can also help with more severe allergy symptoms like asthma. Both THC and CBD have been shown to be effective bronchodilators in animal models–meaning that they are able to open up constricted airways. You can even find THC inhalers designed to help frequent asthma sufferers. Still, asthma can be a dangerous condition and needs to be treated with care. Make sure to talk to a doctor before making any changes to your asthma treatment plan.

While research on cannabis for allergies is still in an early phase, there is some evidence to support the idea that cannabis can help with your allergies. Whether it’s reducing your congestion and itching, calming your skin, or opening up your airways – cannabis may help.

But don’t take our word for it! Try it out the next time you get those springtime sniffles. You might be surprised at how much better you feel.

Rising Cases of Cannabis Allergy

While cannabis can definitely help ease allergy symptoms, like many pollen-rich plants it’s also been known to cause it’s own allergic responses. And as legal cannabis use increases, reports of cannabis allergies have increased as well, with commonly reported symptoms like increased congestion, runny nose, watery eyes, post-nasal drip, and itchy eyes or nose. In more rare cases, other symptoms may arise as well. Some folks complain about migraines when they smell cannabis. Some report skin rashes from contact with cannabis resin. In more severe cases, cannabis allergies can worsen asthma or even cause anaphylactic shock.

In addition, some researchers have begun to notice a trend of cross-reactivity with allergies to cannabis or hemp and certain other plants such as tobacco, natural latex, plant-food-derived alcoholic beverages, and tomatoes. This means that those allergic to cannabis are more likely to also be allergic to these other plants-derived substances. Research is still unclear whether halting cannabis use can reduce allergic responses to these other plants.

While these allergic responses are more commonly reported amongst cannabis users, they may also affect those who are exposed passively to cannabis in their home environment (such as those who live with a cannabis smoker, or live near a cannabis grow site) or those who are exposed in occupational settings.

Until federal prohibition’s end makes research easier, allergy sufferers will have to do the research, and experiment for themselves.

How does cannabis affect your allergies? Let the Leafly community know in the comments below!

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BUG OFF! A True Story About CBD & MRSA

As you gaze upon these words, dear reader, a horde of alien marauders are ransacking all corners of the globe, chewing through the latest pharmaceutical defenses and leaving behind a gruesome trail of dead and weakened victims. According to a recent report by the World Health Organization (WHO), ferocious tribes of bacteria, parasites, viruses and fungi are on the rampage, and some are proving virtually invincible to the so-called “last resort” antibiotics.

WHO has identified the proliferation of antibiotic-resistant “superbugs” as one of the major looming heath crises of the 21st century. These crafty, elusive shape-shifters are not only capable of surviving an onslaught of antibiotics, but they continually reinvent themselves by genetic mutation, horizontal gene transfer and natural selection, developing new tactics against even the most powerful drugs and spawning malignant offspring that wreak havoc with devastating vitality. They even share their genetic material with other pernicious bugs.

The major offenders in this perilous conflict are not just the superbugs themselves but the rampant overuse of antibiotics. It’s estimated that 30% of all prescribed antibiotics are unnecessary, a testament to our culture’s desire for quick-fix solutions to our health woes. (This doesn’t take into account the fact that the bulk of all antibiotics used in the United States are given to livestock, a whole other ball of worms.) The practice of scribbling a script for every little sniffle has helped create a vicious circle of weakened immune systems, ravaged gut microbiomes, and the escalating spread of dangerous diseases by people, animals, and agricultural crops.

When the U.S. Center for Disease Control (CDC) throws words around like “nightmare” and “sound the alarm,” it’s time to take notice. “Without urgent action,” the CDC warns, “many modern medicines could become obsolete, turning even common infections into deadly threats.” The CDC’s recent antibiotic resistance initiative includes a key goal: to cut inappropriate prescribing practices by 50% in doctors’ office and 20% in hospitals. And while this protocol has helped to rein in some infectious foes, others are on a frightening upswing.

MRSA kills

One of the most treacherous malefactors on the prowl is Methicillin-resistant Staphylococcus Aureus, or MRSA. This highly contagious bacterial infection is commonly associated with people who have compromised immune systems, like hospital patients and the elderly. Over the past decade, an even more menacing strain of community-associated MRSA (CA-MRSA) has muscled its way into healthier populations, popping up like a malevolent jack-in-the-box in places and situations where people are packed tight– contact sports teams; gyms and locker rooms; schools and daycare facilities; prisons, homeless shelters, and military barracks. CA-MRSA is even turning up in spas, resorts, cruise ships, and nail salons.

One out of every hundred hospitalizations in the United States is due to a MRSA infection, and about a quarter of those become seriously invasive, killing 20,000 people each year. A recent report by the CDC indicates that hospitals have made progress in reducing rates of MRSA, but CA-MRSA rates have not declined and now comprise 80% of all MRSA infections. The disease has become so prevalent that October 2 is depressingly called “World MRSA Day.”

According to researchers, CA-MRSA is a cunning bacterial strain with a bunch of biological tricks up its sleeve. It has the unique ability to hide and disguise itself against neutrophils. Neutrophils are commonly known as white blood cells, specifically the ones tasked with fighting off these Machiavellian villains. Even more sinister, CA-MRSA secretes a nasty little peptide that wreaks havoc in two ways: it helps build a biofilm, a slimy structure that enables the bug to stick to its host and spread rapidly, and even creepier, it commits a heinous bio-crime called lysis, infiltrating neutrophils and actually causing them to explode, thereby shattering the body’s immune defense mechanism.

Left untreated, CA-MRSA can lead to sepsis, endocarditis, pneumonia and necrotizing fasciitis (necrosis comes from the Greek nekrosis, “to make dead”). All of these complications are potentially fatal, and the beta-lactam antibiotics typically prescribed for staph (single-molecule drugs such as penicillin, cephalosporins, monobactams, and carbapenems) are proving to be no longer effective. Even Vancomycin, an “antibiotic of last resort,” is losing the fight against CA-MRSA. To complicate matters even more, the use of antibiotics – and the resulting disruption of the body’s healthy gut bacteria – is increasingly shown to contribute to future health problems.

Angry red pustules

The first time I heard of MRSA was in the late 1990’s. A dear childhood friend contracted the infection, and it had become dangerously systemic. After doctors tried every available treatment – including a powerful course of IV antibiotics that turned my friend beet-red, covered him in hives, ravaged his kidneys, and made him so dizzy and nauseous he couldn’t keep food down -he died from associated complications.

What does it mean to protect ourselves in a world crawling with MRSA and other superbugs? Beyond the obvious like washing our hands, we need effective options to fight infections that don’t rely solely on antibiotics. Scientists are researching new treatments that target bacterial bad guys in novel ways, but this is a laborious and time-consuming process. In the meantime, there are other weapons we can wield to protect ourselves from these insidious infiltrators – as I learned the hard way when I myself was infected by MRSA a few years ago.

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I’d spent a pleasurable California weekend in the nearby resort town of Calistoga, soaking in healthful, mineral-rich waters. I returned home fully rejuvenated and free of stress. Or so I thought. Two days later, my body was bitmapped in boils and I was losing my mind. A platoon of angry red pustules had taken up residence across my back. For a mild skin condition, I would typically reach for a plant-based treatment, but this bacterial ambush was so sudden and aggressive – and so disgusting – I wasn’t going to mess around.

I went straight to my GP, who diagnosed a staph infection and prescribed an antibacterial skin cleanser and a topical antibiotic ointment. At first, I was somewhat relieved that this treatment wouldn’t involve carpet-bombing my friendly neighborhood of gut bacteria, given the importance of an up-to-snuff microbiome in so many aspects of our health. But after a week of washing my occupied territory as directed and applying the ointment twice daily, my betes noires show no sign of retreating. Like Napolean’s army, they were conquering new territory and morphing into something even more repugnant.

I felt contaminated, radioactive. I avoided people and slunk around like Quasimodo, lurking in the shadows. And I worried. Covered by crusty carbuncles, I was becoming a modern-day version of Baba Yaga, the boil-ridden witch of Russian folklore who lived deep in the forest in a hut that stood on a pair of chicken legs. Alas, I had her pus-filled boils, but none of her magic powers.

Cannabis & antibiotic resistance

Alarmed at my lack of improvement, my doctor prescribed a course of oral antibiotics. I knew about the association of the microbiome with mental health, and now pictured myself rotting away in an asylum, my mind gone to mush after all of my gut bacteria had been wiped out. There had to be a better way. Increasingly desperate, I started looking into whatever research was available about cannabis and antibiotic-resistant bacteria.

Unfortunately, due to marijuana prohibition, there’s not much out there on this subject. (Thanks again, Feds, for the lack of science.) I found a few relevant articles in peer-reviewed journals, which underscored the complex and nuanced effect cannabis has on immune function. In a recent review in NeuroImmunoModulation, a team of Mexican scientists reported that cannabinoids demonstrated a statistically significant antibiotic effect on some infectious diseases, and actually impaired the body’s immune system for others.

The good news is that several plant cannabinoids have been shown to wreak havoc against Staphylococcus aureus – the very bug I was fighting. A 2008 study in the Journal of Natural Products, published by the American Chemical Society, found that cannabidiol (CBD) and cannabigerol (CBG), two nonintoxicating cannabinoids, “showed potent activity against a variety of MRSA strains.” Three other plant cannabinoids – tetrahydrocannabinol (THC), cannabinol (CBN) and cannabichromene (CBC) – also showed encouraging results in preclinical research. How the cannabinoids work is not fully understood, but it appears to be due to natural antimicrobial defense mechanisms.

The journal concluded: “Given the availability of C. sativa strains producing high concentrations of nonpsychotropic cannabinoids, this plant represents an interesting source of antibacterial agents to address the problem of multidrug resistance in MRSA and other pathogenic bacteria. This issue has enormous clinical implications, since MRSA is spreading throughout the world and, in the United States, currently accounts for more deaths each year than AIDS. Although the use of cannabinoids as systemic antibacterial agents awaits rigorous clinical trials … their topical application to reduce skin colonization by MRSA seems promising.”

CBD and manuka honey to the rescue

I also heard about the potent antibiotic properties of manuka honey, and I thought about combining it with a CBD-rich cannabis extract. While honey has been known since ancient times for its antibiotic and wound-healing properties, manuka is something special. Made by bees from the nectar of Leptospermum scoparium (more commonly known as tea tree, a plant indigenous to New Zealand and Australia), manuka honey has unique bacteria-busting abilities that scientists have only recently begun to investigate.

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honey

A 2016 article published in Frontiers in Microbiology discusses how manuka honey disrupts invading bacteria’s ability to produce biofilms. In another study, manuka was shown to prevent bacterial subdivision, and it appears to evade bacterial resistance. Not only is manuka honey effective on its own, but it also works synergistically with other antibiotics, increasing their effectiveness.

So, I took matters into my own hands and made my own bacteria-killing juice. I decarboxylated the dried flowers of a CBD-rich cannabis strain called Blue Jay Way, which was lab-tested to show a 2-to-1 ratio of CBD-to-THC (14% CBD and 7% THC). I infused some olive oil using the old hippie Crockpot method. After straining out the plant material, I added some beeswax for its thickening properties. And when the infusion was mostly cool, I mixed in a generous amount of New Zealand manuka honey with 20+ bioactivity.

I applied this salve to my skin infection twice per day. It was a little sticky, but that was the worst of it. Within 24 hours, it started working! Like the water-splashed Wicked Witch of the West in the Wizard of Oz, the lesions began shrinking and drying up. Over the next few days, I gleefully watched as the skin on my back became a killing field where all those little, white-blood-cell-exploding staph-holes were obliterated forever. Within a week, the infection had resolved completely, leaving my gut flora intact.

Unlike my experience with pharmaceutical antibiotics, whole-plant CBD-rich cannabis combined with manuka honey did not cause any adverse side effects. Nor did it trigger a backlash of antibacterial resistance, which is threatening the very foundations of Western medicine. We’ve become increasingly dependent upon medical conveniences, quick fixes and silver bullets, while often ignoring their broader consequences. In our impatience to get on with the business of life, we don’t always pay attention to the subtler conversations our bodies carry on, day and night, in our microbiomes and beyond. Maybe it’s time to listen.


Melinda Misuraca is a Project CBD contributing writer with a past life as an old-school cannabis farmer specializing in CBD-rich cultivars. Her articles have appeared in High Times, Alternet, and several other publications.


Sources

Almasaudi SB, Al-Nahari AAM, Abd El-Ghany ESM, Barbour E, Al Muhayawi SM, Al-Jaouni S, Azhar E, Qari M, Qari YA, Harakeh S. Antimicrobial effect of different types of honey on Staphylococcus aureus. Saudi J Biol Sci. 2017 Sep;24(6):1255-1261. doi: 10.1016/j.sjbs.2016.08.007. Epub 2016 Aug 30. PubMed PMID: 28855819; PubMed Central PMCID: PMC5562472.

Alvarez-Suarez JM, Gasparrini M, Forbes-Hernandez TY, Mazzoni L, Giampieri F. The Composition and Biological Activity of Honey: A Focus on Manuka Honey. Foods. 2014 Jul 21;3(3):420-432. doi: 10.3390/foods3030420. Review. PubMed PMID: 28234328; PubMed Central PMCID: PMC5302252.

Appendino G, Gibbons S, Giana A, Pagani A, Grassi G, Stavri M, Smith E, Rahman MM. Antibacterial cannabinoids from Cannabis sativa: a structure-activity study. J Nat Prod. 2008 Aug;71(8):1427-30. doi: 10.1021/np8002673. Epub 2008 Aug 6. PubMed PMID: 18681481.

Feldman M, Smoum R, Mechoulam R, Steinberg D. Antimicrobial potential of endocannabinoid and endocannabinoid-like compounds against methicillin-resistant Staphylococcus aureus. Sci Rep. 2018 Dec 6;8(1):17696. doi: 10.1038/s41598-018-35793-7. PubMed PMID: 30523307; PubMed Central PMCID: PMC6283871.

Rigby KM, DeLeo FR. Neutrophils in innate host defense against Staphylococcus aureus infections. Semin Immunopathol. 2012 Mar;34(2):237-59. doi: 10.1007/s00281-011-0295-3. Epub 2011 Nov 12. Review. PubMed PMID: 22080185; PubMed Central PMCID: PMC3271231.

Ventola CL. The antibiotic resistance crisis: part 1: causes and threats. P T. 2015 Apr;40(4):277-83. PubMed PMID: 25859123; PubMed Central PMCID: PMC4378521.

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The FDA Is About to Deal With CBD–and Wants to Hear From You

Cannabidiol, or CBD, has become wildly popular in recent years–and widely available, both online and in stores across the country. But despite the belief by some that the 2018 farm bill broadly legalized the cannabinoid, the truth is that federal agencies are still scrambling to determine their next steps.

Want a say in the process? Now’s your chance.

The US Food and Drug Administration oversees the nation’s food, pharmaceutical drugs, and cosmetics–three categories of products that have recently been overwhelmed by CBD and various claims about its benefits. As the FDA begins to craft regulations around CBD and infused products, the agency is asking for public comment on how to proceed.

“While the use of cannabis and cannabis-derived products, including hemp and hemp-derived products, has increased dramatically in recent years, questions remain regarding the safety considerations raised by the widespread use of these products,” wrote Lowell Schiller, the FDA’s acting associate commissioner for policy, in a Federal Register filing published Tuesday. “These questions could impact the approaches we consider taking in regulating the development and marketing of products.”

Ahead of a public hearing on CBD scheduled for May 31 near Washington, DC, the agency is asking for public comment on three specific aspects of CBD and infused products: health and safety risks; manufacturing and product quality; and marketing, labeling, and sales.

Thoughts on CBD Regulation? File a Comment With the FDA

More information is available on the federal government’s Regulations.gov website (click here to go directly to the comment form). Written comments can be sent to:

Dockets Management Staff (HFA-305)
Food and Drug Administration
5630 Fishers Lane, Rm. 1061
Rockville, MD 20852

Requests to speak or make a presentation at the May 31 hearing must be received by May 10, while written or electronically filed comments can be filed until much later: July 2.

It’s hard to gauge how the FDA might proceed with regulating CBD. On one hand, the agency has been far more responsive to scientific evidence around cannabinoids than the US Drug Enforcement Administration. Late last year, FDA officials wrote to their counterparts at the DEA explaining that “CBD and its salts … do not have a significant potential for abuse and could be removed from the [Controlled Substances Act].” Meanwhile, the DEA has repeatedly insisted that any CBD product other than the pharmaceutical drug Epidiolex remains a Schedule I controlled substance.

But while the FDA seems more sympathetic to CBD, the agency is also trying to rein in an industry that has exploded in recent years. Hundreds of startups have exploited the legal uncertainty around CBD by insisting that cannabidiol products are already “legal in all 50 states” and promising relief for all types of ailments, whether backed by evidence or not.

“There’s too much money to be made for problems not to come up.”

Justin Polkis, Virginia Commonwealth University

That does not sit well with FDA officials. Earlier this week they took action, sending warning letters to three CBD companies–Nutra Pure, PotNetwork Holdings, and Advanced Spine and Pain–that agency officials say were making false claims about the use of CBD to treat diseases such as cancer and Alzheimer’s disease.

“According to their advertisements, the products can effectively treat diseases, including cancer, Alzheimer’s disease, fibromyalgia, and ‘neuropsychiatric disorders,'” the FDA and FTC said in a joint statement.

“We’ve seen, or heard of interest in, products containing cannabis or cannabis derivatives that are marketed as human drugs, dietary supplements, conventional foods, animal foods and drugs, and cosmetics, among other things,” FDA Commissioner Dr. Scott Gottlieb said in the statement. (Gottlieb, who has pressed his agency to take action on CBD, is scheduled to step down from his post later this month.)

After last year’s passage of the farm bill, the FDA issued a statement saying that CBD in food products is prohibited under the federal Food, Drug, and Cosmetic Act. As a result, national drug store chains such as CVS have begun to carry CBD products, but only in non-edible form.

In the Federal Register post about the upcoming hearing, the FDA also raised concerns about the possibility of liver damage as the result of taking high doses of CBD (20 millilgrams of CBD per kilogram of body weight per day, or about 1,360 mg for a 150-lb. person). It says the risk was determined as part of the FDA approval process for Epidiolex, a purified form of CBD approved last year to treat certain forms of epilepsy.

“This is a potentially serious risk that can be managed when the product is taken under medical supervision in accordance with the FDA approved labeling for the product, but it is less clear how this risk might be managed if this substance is used far more widely, without medical supervision, and not in accordance with FDA-approved labeling,” the Federal Register filing says.

For reference, acetaminophen–a popular pain reliever and fever reducer found in over-the-counter drugs such as Tylenol and Nyquil–is a leading cause of acute liver failure across much of the globe. “Harmless at low doses, acetaminophen has direct hepatotoxic potential when taken as an overdose and can cause acute liver injury and death from acute liver failure,” according to the National Institutes of Health.

The current unregulated nature of CBD has also raised concerns among consumers and outside observers for other reasons. Among them, a study last year by researchers at Virginia Commonwealth University (VCU) found unlabeled contaminants in a number of products sold by Diamond CBD, a retailer owned by PotNetwork Holdings. The unexpected chemicals included dextromethorphan (DXM)–a well-known cough medicine with a history of recreational abuse and health dangers–and 5F-ADB, one of a growing group of synthetic cannabinoids often known as K2 or Spice.

“Somebody needs to step in and regulate this stuff,” Justin Polkis, the lead author of the VCU study told Leafly last year. “There’s too much money to be made for problems not to come up.”

Diamond CEO Kevin Hagen told Leafly at the time that he welcomed regulation.

“All companies make big claims about their products,” Hagen said. “It’s the FDA’s job to ask for [better] labeling.”

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Using Marijuana With Your Partner Increases The Likelihood Of Intimacy, Study Finds

Researchers have linked heavy alcohol use with higher rates of domestic violence and divorce. But what do we know about marijuana use in relationships? Until recently, not that much.

As legalization–and thus, normalization–makes its way across the U.S., social scientists have begun digging a little deeper into the immediate effects of personal cannabis use. According to a new study published in the journal Cannabis, in certain circumstances marijuana use can lead to positive experiences for couples.

To better understand whether marijuana–either used with a partner or independently–leads to increased intimacy in the short term, the study’s authors asked 183 married or cohabiting couples who consumed regularly to track their use for 30 days. Participants filed a report via their smartphones every time they started using cannabis and again when they finished.

“Simultaneous marijuana use (male and female partners reported use at the same hour) increased the likelihood of an intimate experience for both men and women.”

Additionally, participants also filed a report each morning indicating whether they had “an interaction or meaningful conversation with [their] partner that involved intimacy, love, caring, or support” the day before, and if so, the time. This allowed researchers to determine if there was a correlation between when participants used marijuana and when they experienced intimacy. (To be clear, although the term “intimacy” is often equated with sex, the study’s authors did not specifically define it as such.)

In their analysis, the study’s authors determined that shared cannabis experiences increased the likelihood of intimacy within two hours of use. Additionally, they found that these positive experiences were also more likely to occur if only one person toked up as compared to neither partner reporting use.

To get a better understanding of the difference between the impact of simultaneous use and independent use, the researchers conducted a second analysis using data on whether or not a partner was present at the time a person used marijuana.

“Results of this analysis…show positive Actor and Partner effects associated with using marijuana in the presence of the partner for both men and women,” they wrote. “For example, Laura is more likely to report an intimacy event within 2 hours of using marijuana in Mike’s presence (an Actor effect) than when she doesn’t use marijuana. Laura is also more likely to report an intimacy event within 2 hours of Mike reporting marijuana use in Laura’s presence (a Partner effect).”

“However, marijuana use when the partner was not present neither increased nor decreased the likelihood of experiencing intimacy relative to no marijuana use,” the study found.

Past research has suggested drug use may be a significant source of stress for a couple, especially if only one person consumes. The current study, however, found no such evidence–though the authors admit that the couples in their study may not be bothered by their partner’s solo marijuana use because of how regularly they themselves consume.

It’s possible, of course, that people in relationships with problematic users may not experience these same positive effects. As the study’s authors point out, their research using daily reporting sheds some light on the short-term effects of marijuana use, but more studies are needed.

For now, what we do know is that marijuana use appears to improve sex–at least for women. A separate recent study found that cannabis positively affects women’s sexual experiences in a number of ways, including an increase in satisfying orgasms.

Marijuana Use Before Sex Leads To More Satisfying Orgasms, Study Finds

Photo courtesy of Isaac Cabezas.

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