SEATTLE — Marijuana has been shown to help ease pain and a few other health problems, yet two-thirds of U.S. states have decided pot should be legal to treat many other conditions with little scientific backing.
At least 1.4 million Americans are using marijuana for their health, according to an Associated Press analysis of states that track medical marijuana patients.
The number of medical marijuana cardholders more than tripled in the last five years as more states jumped on the bandwagon. The analysis is based on data from 26 states and the District of Columbia. The total climbs to 2.6 million patients if California, Washington and Maine are included, the AP estimates.
States that expanded the use of medical pot for common ailments such as severe pain, post-traumatic stress disorder and anxiety saw a boost in enrollment, the AP found.
The U.S. government, meanwhile, both considers marijuana an illegal drug and a therapeutic herb worth more study.
A look at the health claims and research on medical marijuana:
Besides chronic pain, there’s strong evidence marijuana or its ingredients can ease nausea and vomiting from chemotherapy and help with symptoms of multiple sclerosis.
Several European countries have approved Sativex, a mouth spray containing THC and CBD, for multiple sclerosis symptoms. Last year, U.S. regulators approved Epidiolex, made from CBD, to treat two rare seizure disorders. THC causes marijuana’s mind-altering effect; CBD doesn’t get people high.
British drugmaker GW Pharmaceuticals is seeking U.S. approval for Sativex. Other companies are pursuing Food and Drug Administration backing for products based on marijuana ingredients.
Arizona-based Insys Therapeutics, which filed for bankruptcy protection Monday as it faced fallout over its marketing of an addictive opioid painkiller, is developing CBD drugs for two types of childhood epilepsy and a rare genetic disorder. Pennsylvania-based Zynerba Pharmaceuticals is working on a CBD skin patch for autism and fragile X syndrome, a genetic condition.
Prescription drugs already on the market use synthetic THC to treat weight loss, nausea and vomiting in patients with AIDS or cancer. And researchers continue to study whether marijuana helps with PTSD, back pain and other problems.
New York, New Jersey, Pennsylvania and New Mexico allow medical marijuana for opioid addiction despite little evidence it works.
But marijuana may be helpful in reducing use of opioid painkillers. The National Center for Complementary and Integrative Health, better known for its research on herbs and yoga, has set aside $3 million for studies to determine which of marijuana’s 400-plus chemicals help with pain.
THC was excluded however.
Its mood-altering effects and potential for addiction and abuse make it less useful for pain, said Dr. David Shurtleff, the agency’s deputy director. And THC has been studied more than the lesser-known compounds.
CURE FOR CANCER?
Despite online claims, there’s only weak evidence that marijuana’s ingredients might one day be used to treat cancer. Most studies have been in animals or in the lab. Results have been mixed.
In one study, nine patients with an aggressive form of brain cancer had THC injected into their tumors; any effect on their survival was unclear. Another study found worrying evidence that marijuana might interfere with some cancer drugs, making them less effective.
RESEARCHING AN OUTLAW MEDICINE
The U.S. government grows marijuana for research at a farm in Mississippi and generally bans grant-funded studies of real-world products.
But a mobile lab inside a white Dodge van allows University of Colorado Boulder researchers to study the potent strains of marijuana many patients consume without running afoul of the law.
Study participants use marijuana in their homes, coming to the van for blood draws and other tests before and after using, said Cinnamon Bidwell who has federal grants to study marijuana’s effects on lower back pain and anxiety.
With increased demand for research pot, the Drug Enforcement Administration created an application process for growers, but has not acted on more than two dozen applications.
Such challenges are common for scientists studying an outlaw medicine, said Dr. Igor Grant, who directs the oldest marijuana research center in the U.S. at the University of California, San Diego.
There, scientists are studying marijuana chemicals for children with autism and adults with a brain disorder that causes uncontrollable shaking. Established by state law in 2000, the Center for Medicinal Cannabis Research once relied solely on California for funding. The center now has support from private foundations, a sign of growing public acceptance of the research.
Minnesota medical marijuana patients must regularly fill out surveys about their symptoms and side effects. That allows researchers to study how people with cancer react to marijuana.
In one study, a third of cancer patients made only one purchase and didn’t come back during a four-month period. They may have died, or decided marijuana was too expensive or didn’t work. Of the rest, most reported improvements in vomiting, pain, disturbed sleep, anxiety and depression with few side effects.
Marijuana can ease many symptoms “all at one time,” but more study is needed, said study co-author Dr. Dylan Zylla of the health care system HealthPartners. He has no financial ties to cannabis companies.
Zylla is studying whether cancer patients can decrease their prescription opioid use while using marijuana.
Marijuana “does seem to help patients,” he said, “but so much is unknown about the risks, side effects and drug interactions.”
Slowly but surely, the Lone Star State is beginning to back down on herbal prohibition. Finally, cannabis with THC levels below 0.3 percent are now legal in Texas.
Texas Governor Greg Abbott signed a new law this Monday legalizing hemp and hemp-derived products, a historic moment for a state long renowned for its opposition to cannabis reform.
The new law will allow any farmer to apply to the state’s Department of Agriculture for a license to grow and cultivate industrial hemp. The Department of Agriculture now has 60 days to develop regulations for hemp cultivation, including fee collections, inspections, and testing procedures. It is expected that cultivation licenses will be granted by the end of this year, allowing crops to be planted at the top of next year.
The federal government legalized hemp and its byproducts late last year with the passage of the 2018 Farm Bill. This law officially removed hemp from the Controlled Substances Act, allowing hemp farmers to apply for federal insurance, as well as bank loans. Individual states need to pass their own laws to legalize this once-prohibited plant in their jurisdictions, and Texas just became the 43rd state to do so.
“I am excited that we have taken one more step towards giving producers in Texas the opportunity to grow hemp,” Agriculture Commissioner Sid Miller said, according to Dallas News. “Texas will be a leader in hemp production, and we will be submitting our plan and writing rules to follow the 2018 Farm Bill and the law recently enacted in Texas. This will be another tool for farmers that are looking to diversify their farming operations.”
Texas’ new hemp law also clears up longstanding confusion over CBD. The state previously categorized all forms of cannabis as marijuana, and CBD products containing even the slightest trace of THC were technically illegal. At Dallas Fort-Worth Airport, customs officers have been seizing record amounts of CBD medicines and arresting travelers possessing these items.
Hemp-derived CBD products are now completely legal in Texas, as long as they contain less than 0.3 percent THC, the limit established by federal law. Retail stores wishing to sell these products must register with the state’s Health Department, however.
“The Texas Legislature got at least one thing right this session when they legalized hemp,” Heather Fazio, director of Texans for Responsible Marijuana Policy, said in a statement to Dallas News. “Finally, Texas farmers are no longer cut out of this lucrative agricultural market. Plus, Texans are now free to use CBD without fear of arrest.”
Although Texas has at last joined the vast majority of states that legalized the use of industrial hemp, state lawmakers’ opinion on recreational marijuana remains unchanged. A recent bill to decriminalize minor cannabis possession recently failed in Texas, but lawmakers did pass a bill that modestly expands the state’s medical marijuana program. The bill, which adds terminal cancer, Alzheimer’s, autism, and several other ailments to the list of qualifying conditions for the program, is still being considered by Gov. Abbott, who has until Sunday to veto or sign it into law.
NEW YORK, June 18, 2019 /PRNewswire/ — Patients suffering from fibromyalgia experience significant improvement in pain, sleep, and depression symptoms after treatment with Tikun Olam medical cannabis, a new study published in the Journal of Clinical Medicine confirms.
The six-month study “Safety and Efficacy of Medical Cannabis in Fibromyalgia,” comprised 367 fibromyalgia patients, making it one of the largest of its kind. The study was conducted at the Tikun Olam cannabis clinic in Tel Aviv where patients were treated with Tikun science-backed varietals, including high-CBD brand Avidekel and high-THC Alaska.
The study found a significant improvement in pain intensity and patients′ overall quality of life and fibromyalgia‐related symptoms after six months of Tikun Olam’s medical cannabis therapy:
61.9% reported improved “quality of life” components including appetite and sexual activity.
Women comprised over 80% of the patients studied, a figure that proportionately corresponds to fibromyalgia sufferers in general.
The most stunning result from the study showed that most patients ceased, reduced, or at least did not change the dosage of their chronic drugs for fibromyalgia while receiving Tikun medical cannabis, and 22.2% stopped or reduced their dosage of opioids–which included Morphine, Fentanyl, Oxycodone, and Percocet.
“It is commonly accepted that chronic pain can be treated with cannabis, but there is scarce evidence to support the role of medical cannabis in the treatment of fibromyalgia specifically,” says Lihi Bar-Lev Schleider, head research scientist at Tikun Olam. “We hope these findings will lead to more research and acceptance of cannabis as a safe and effective treatment for pain and other symptoms associated with fibromyalgia.”
About Tikun Olam Tikun Olam (Hebrew for “repair the world”) is a leading cannabis brand and globally recognized as the pioneer of modern medical cannabis. The company’s global mission is to research, develop and provide efficacious, data-based cannabis treatments to help sufferers. Operating as a commercial venture for 15 years, Tikun Olam’s products have been used since 2010 in ongoing clinical trials in Israel’s regulated medical cannabis market, treating over 20,000 patients for a variety of symptoms of medical conditions such as cancer, PTSD, AIDS, epilepsy, Crohn’s Disease/colitis, multiple sclerosis, cerebral palsy, chronic pain and neuropathy. Through this access to patients, medical personnel and data collection, Tikun Olam has developed multiple proprietary strains, including the first-ever, high-CBD, “high-less” strain Avidekel. Tikun Olam’s U.S. operations, established in 2015 as T.O. Global LLC, is a joint venture with Tikun Olam Ltd. (Israel). Tikun Olam also operates similar partnerships in Canada , Australia, United Kingdom and Greece. Visitwww.tikunolamusa.com.
AUSTIN (Nexstar) — Industrial hemp will now be a market Texas farmers can explore in the state.
Gov. Greg Abbott signed a bill legalizing the cultivation and processing of industrial hemp in Texas this week. Federal changes through the 2018 Farm Bill removed hemp from the list of Schedule I substances, paving the way for states to form state-regulated industrial hemp programs.
House Bill 1325, led by Rep. Tracy King, D-Batesville, and Sen. Charles Perry, R-Lubbock, allows farmers to grow industrial hemp under a state-regulated program. The bill also legalizes hemp-derived products like CBD oil. Hemp and its by-products contain less than 0.3% THC, unlike marijuana.
“The hemp industry is rapidly growing and we need to ensure our farmers are able to participate. We hope this agricultural commodity will help boost rural communities now that there is a new viable crop option for our farmers,” Perry previously said in a statement when the bill passed the Senate.
The bill requires the Texas Department of Agriculture to submit a plan to the United States Department of Agriculture outlining the state’s plan for monitoring and regulating the production of hemp. Texas Agriculture Commissioner Sid Miller is a supporter of industrial hemp production as a possible market for farmers in the state.
“This crop can be a true game-changer for our agriculture community and rural communities,” the Texas Hemp Industries Association said in a statement online.
The Texas Farm Bureau agrees.
“Texas Farm Bureau is very pleased with the passage and signing of the hemp bill,” Gene Hall, director of communications, said. “Hemp is a crop that should grow well in Texas and has multiple uses. It is already grown in more than 40 states. This will give Texas farmers and ranchers another crop option. This is especially important now, with a struggling farm economy.”
A small group of scientists and doctors believe a lack of endocannabinoids could explain the causes behind little-understood medical conditions like fibromyalgia, IBS, and migraines.
Cannabis seems to treat an impressively wide range of medical conditions, from chronic pain to eating disorders to depression to cancer. Researchers suggest that weed may appear to be a universal panacea — a miracle drug, if you will — because the plant’s compounds may help maintain our body’s endocannabinoid system.A refresher: The endocannabinoid system is a physiological system like the respiratory system or the nervous system. Although scientists only discovered it about three decades ago, it may be one of — if not the — most important developments in medical history.
The endocannabinoid system regulates our body’s homeostasis, a state of harmonic balance where everything works as it should. It’s also key to our nervous system’s ability to communicate with other cells, tissues, and organs. Learning, memory formation, appetite, immune response, and healing are all controlled by the endocannabinoid system. Think of it as the part of our bodies that connects the brain with everything else, both inside of us and out in our surrounding environments. Without this system, the evolution of ‘higher’ lifeforms likely wouldn’t have happened (at least, not according to our current understanding of biology).
“We all have an endocannabinoid system,” said Robert Melamede, PhD, during a recent talk at Harvard University. Melamede is a molecular biologist and cannabis activist who’s served as a scientific advisor to NORML and other cannabis advocacy groups.
“The miracle of this is that the endocannabinoid system regulates everything in your body — immune, digestive, cardiovascular, skin, bone, reproductive — from your conception until your death.”
To self-regulate the endocannabinoid system, our bodies naturally produce chemicals called endocannabinoids (endo- for “inside” and –cannabinoid for “related to cannabis”). Two of the most studied endocannabinoids are anandamide and 2-AG, which interact with the same cannabinoid receptors on our cells that plant cannabinoids such as THC and CBD also act on.
Cannabinoids bind to cell proteins called cannabinoid, or CB, receptors. CB receptors act as locks on a cell, and cannabinoids essentially unlock them to trigger cell signaling. One of these receptors, CB1, mainly resides in the nervous system. Another receptor, CB2, can be found in the spleen and on immune cells.
THC, the cannabis compound that gets people stoned, binds tighter to CB1 receptors in the brain than it does to CB2 receptors in the immune system. This may be why THC couch-locks tokers and CBD doesn’t.
If we take this model a step further, anandamide may be our body’s version of THC, whereas 2-AG could be the body’s version of CBD. How do we know? Anandamide and 2-AG both bind to the CB1 and CB2 receptors, but anandamide binds better to CB1 (like THC) and 2-AG binds best to CB2 (like CBD).
Raphael Mechoulam, PhD, the “godfather of cannabis science” who first isolated and characterized THC in the late 1960s, believes anandamide behaves just like THC in the body. He suspects that anandamide, administered in the correct amounts, could even generate a “high” identical to THC’s, though, to date, no human subjects have been given pure anandamide to test this out.
According to one neurologist, certain medical conditions — namely fibromyalgia, migraines, and irritable bowel syndrome (IBS) — share one thing in common: the patients typically exhibit low endocannabinoid levels. Furthermore, these three conditions are comorbid, meaning patients diagnosed with one usually have another, if not all three.
In 2001, while working as a scientific advisor to GW Pharmaceuticals, Dr. Ethan Russo first proposed what he calls “clinical endocannabinoid deficiency,” or CECD, in a paper about migraines. In recent years, this term started going by another name, “endocannabinoid deficiency syndrome,” or ECDS (Russo prefers the former). Both terms refer to the same hypothetical condition.
What is endocannabinoid deficiency syndrome, and what are its symptoms? Many of the details are still being worked out, but chronic pain, rampant inflammation, insomnia, fatigue, depression, lack of appetite, and irritability are common issues associated with it.
Rather than being a disease that always triggers a specific set of symptoms, ECDS may manifest differently among patients, depending on their environments, lifestyles, diets, and genetic make up.
But what if there’s more to this? What if these various maladies are all connected somehow? And what if cannabis, by restoring endocannabinoid function, could successfully treat conditions caused by low endocannabinoid levels, conditions that have proven difficult, if not impossible, to control through conventional medicine?
A Medical Diagnosis Based on the Body’s ‘Natural Marijuana’
Initially, Russo suggested that migraines could be caused by low anandamide levels in the brain. Because sharp, throbbing pains always accompany migraines, research suggests a pain-killing compound like anandamide could keep them at bay. Both anandamide and THC — the intoxicating part of cannabis — activate the endocannabinoid receptors in our nerves. In other words, migraine patients who consume marijuana may be self-medicating by adding the plant’s version of anandamide back into their bodies.
Since Russo first proposed endocannabinoid deficiency syndrome, its related disorders expanded to include several other ailments. And their causes have eluded medical science, not unlike fibromyalgia and IBS. But given news that medical schools didn’t teach their students about the endocannabinoid system until the last few years, is the medical community even aware of this syndrome?
“There’s an awareness of this condition, and it is getting noticed. And there’s a good deal of research that’s been done on it,” Russo told MERRY JANE over the phone. “What’s happened in the ensuing 18 years [since proposing ECDS/ECDS] is we’ve gradually built up objective evidence showing that people with some of these syndromes [like IBS or fibromyalgia] do have differences between their endocannabinoid content either in their blood or in the cerebrospinal fluid in their brain.”
Russo cited a few eye-opening studies that back him up. One 2013 paper looked at people diagnosed with PTSD shortly after witnessing (or outright experiencing) the 9/11 terrorist attacks in New York. Serum analysis showed these patients produced less anandamide and 2-AG, which are both crucial for regulating stress responses.
Additional studies confirmed that constant stress dulls the endocannabinoid receptors from responding to chemical signals, which may explain why the body reduces its anandamide and 2-AG production when life gets extremely difficult.
How does ECDS explain these disorders, and how can cannabis treat them? Let’s take a look at one endocannabinoid deficiency-related condition, irritable bowel syndrome, to get a better understanding of how cannabis could treat it on multiple levels.
IBS and ECDS: How Are the Conditions Related?
Irritable bowel syndrome or irritable bowel disorder is a common ailment that affects anywhere between 25 million to 45 million Americans. Two-thirds of IBS patients are female, and the condition appears in patients across all age groups.
IBS’s symptoms include bloating, digestive inflammation, rampant flatulence, upset stomach, diarrhea at random hours (especially in the middle of the night), constipation, ulcers, and a hypersensitivity to all sorts of everyday foods and food additives. Untreated, IBS can lead to anemia, iron deficiency, or dehydration.
The symptoms of IBS have been thoroughly identified, but how it happens remains a mystery. Doctors know that genetics, immune response, serotonin dysregulation, and the digestive system’s microbiota all play a role. But to what extent these factors influence IBS, and how they’re all connected, is unknown.
Enter a new perspective on IBS, one viewed through the lens of ECDS.
According to Russo, the endocannabinoid system regulates every level of IBS, from anti-inflammatory signals to serotonin signaling to maintaining the delicate balance of bacteria in the gut. Traditional medicine takes an inefficient approach to dealing with IBS. Doctors typically treat it by prescribing drugs for its various symptoms: a pill to reduce the gas and bloating, another pill to reduce inflammation, another pill to reduce gastric acid, another pill to make the ulcers go away, a laxative for constipation, and so on.
Yet, if ECDS can explain why IBS even happens, then consuming some cannabis could both replace all those pills and correct the condition’s root cause, a dysfunctional endocannabinoid system.
Medical syndromes, like the proposed ECDS, are not disease-states in and of themselves. Rather, they describe a set of symptoms that share underlying causes, usually genetic in nature. Since the genetic science behind endocannabinoid activity is still in its infancy, endocannabinoid deficiency syndrome remains hypothetical. Doctors can’t diagnose it because it’s not officially recognized by the big-name medical associations.
If the science pans out, and Russo’s hypothesis is proven correct, then cannabis could be one of the most prevalent and effective medicines for treating ECDS and its related conditions. Depending on where the research takes us, it’s possible that cannabis breeders could produce new marijuana strains tailored to endocannabinoid-deficient conditions like fibromyalgia or IBS.
Of course, pharmaceutical companies will want in on the game, too. (Just kidding: They’re already in the game.) Pharmie-grade mixtures of less common cannabinoids — like CBG, CBN, or THCV — could alleviate the chronic symptoms of fibromyalgia, migraines, IBS, or other issues related to ECDS that conventional pharmaceuticals have failed to treat.
And it’s also possible that new drugs or designer weed may not be necessary for avoiding some endocannabinoid deficiencies. Researchers like Robert Melamede believe endocannabinoid deficiency can be prevented by adding more omega-3s and plant-derived cannabinoids to one’s diet.
“We should view cannabis not as a medicine, but as an essential nutrient,” Melamede said during the Harvard lecture. “Every illness that cannabis helps reflects a nutritional deficiency.”
Supplementing a balanced diet with omega-3s helps the body produce more endocannabinoids — which is why doctors and health-nuts promote omega-3s, even if they don’t know why, exactly. Omega-3 fatty acids, such as those found in avocados, coconut oil, grass-fed beef, and fish, are the precursors to our own endocannabinoids. Our body basically makes its own weed from healthy fats.
But the body can only produce so many endocannabinoids at a time, regardless of how many fish oil capsules you pop. For those who suffer from persistent endocannabinoid deficiencies, consuming cannabis could make up for the gaps, since the cannabinoids in cannabis could, potentially, supplement the body’s life-sustaining endocannabinoids.
What Would It Take for ECDS to Become a True Diagnosis?
So let’s assume that ECDS is a real thing. How would medical scientists get the syndrome into medical textbooks?
“There’s abundant evidence now, but it’s not widely recognized or necessarily accepted by the medical community,” Russo said. Achieving said recognition may prove difficult, as he described the same medical community as one “which has managed to ignore a lot of high-quality work on cannabis-based medicines.”
As an example of American medicine’s denial of marijuana’s therapeutic potential, Russo mentioned Marinol, a synthetic THC formulation used to treat spasticity and nausea. Marinol doesn’t contain THC extracted from the cannabis plant. Rather, its active ingredient is a purely artificial, human-made version of THC. The drug, which received FDA approval in the early 1990s, is currently classified as a Schedule III drug, whereas plant-derived THC remains at the most-restrictive category of Schedule I. This is despite the THC in Marinol being nearly identical, chemically, to the THC found in cannabis.
“To be honest,” he continued, “given the availability of Marinol in the US, a prerequisite to [getting ECDS recognized] would be clinical trials showing safety and efficacy [of cannabinoid-based medicines]. That’s what most physicians would accept.”
In other words, if you’re waiting to get a medical cannabis recommendation for ECDS, you might have to wait a few years. Or more. With the exception of experimental drugs admitted into the FDA’s Fast Track program, it can take nearly a decade before a pharmaceutical receives FDA approval. Even with Fast Track designation, drug approval can require years of investigation. With cannabis-based medicines containing plant-derived THC, approval could take even longer.
For starters, clinical trials aren’t simple to conduct. Research doctors must apply to the FDA to legally perform the trials on living, breathing human subjects. To even get to the point of testing something on people, drug researchers must pass preliminary clinical trials on animals like rats or monkeys.
If a cannabinoid medicine appears safe in animals, doctors can potentially try it on humans, but only after receiving FDA approval — which the FDA can be pretty stingy about, especially when it comes to cannabis. To date, the FDA has only approved one drug made from cannabis, Epidiolex, which is only prescribed to seizure patients. All other CBD products sold in the US are not FDA-approved nor are they regulated by any federal agency.
However, there’s another cannabis-derived pharmaceutical out there, Sativex. Sativex, made by the same company that made Epidiolex, GW Pharmaceuticals, is a mixture of THC and CBD. While it’s available in Europe, parts of Asia, and the Middle East, it’s not available in the US. In 2017, the CEO of GW Pharmaceuticals told MERRY JANE that the company didn’t pursue FDA approval for Sativex in the US because there were too many bureaucratic hurdles, and Sativex likely wouldn’t receive FDA approval in a timely manner simply because it contains plant-derived THC.
On top of obstructionist red-tape, conducting clinical trials is incredibly expensive. Just testing a medicine can cost anywhere from $2 million to over $300 million.
Until medical science achieves a better understanding of the endocannabinoid system and any ailments related to its dysfunction, Russo recommends plant-based therapies instead of pharmaceuticals like Marinol.
“Throughout my career, I’ve always favored whole-plant extracts over isolates,” he said. “We have Marinol, but THC alone is a lousy drug. It’s never been popular or widely used.”
What’s the big difference among whole-plant cannabis products and all the others, like isolates? As Russo explained in this 2006 paper, any cannabinoid delivered in relative isolation — whether it’s a THC-loaded shatter wax or a pure CBD tincture — doesn’t provide the benefit of the thousands of other beneficial cannabis plant components. In terms of THC vs. CBD, studies show CBD is far more effective when combined with THC. And as Russo noted above, THC alone, regardless of whether it came from the plant or a lab, doesn’t seem to work well unless combined with CBD, either.
According to Russo and other cannabis researchers, such as Raphael Mechoulam, cannabis operates through an “entourage effect,” sometimes referred to as the “ensemble effect.” Under the entourage model, all of the plant’s cannabinoids, terpenes, flavonoids, enzymes, and other components work together to heal the body. Conventional pharmaceutical science prefers to isolate an individual chemical from a plant, package it, then sell it as a drug. Suggesting that patients smoke buds or take drops of full-extract cannabis oil (FECO) runs counter to US pharmaceutical regulations, which requires all medicines to be made with specific doses of individual chemicals.
Another Doctor’s Take on ECDS
Russo has studied cannabis as a medicine for over two decades, and ECDS is a theory that could change medicine forever. However, not every doctor is convinced it’s real, and — as Russo himself said — they want to see more data, evidence, and models.
Dr. Zareth Irwin is an emergency medicine specialist based in Portland, Oregon. Although he’s skeptical of ECDS being a true syndrome deserving of an official diagnosis, he says more research could change his mind.
“Different people are affected differently by abnormal levels of potassium or other substances in their body,” Irwin wrote to MERRY JANE in an email. “Making things more difficult in this case, we don’t have good lab assays to easily measure the levels of the endocannabinoids in the body, and have yet to determine all the effects these substances even have on the body.”
Since chemists don’t have reliable methods for accurately measuring endocannabinoids, “we can only postulate whether a deficiency syndrome exists,” Irwin continued. “It certainly may, but I would reserve judgment at this point. I think the argument remains somewhat theoretical.”
Irwin admitted he’s not an expert on endocannabinoid deficiency since his main focus is working in emergency rooms. He does, however, have experience with another cannabis-related syndrome, one possibly caused by too many cannabinoids in the body — cannabinoid hyperemesis syndrome (CHS), the ‘mysterious’ vomiting illness seemingly triggered by heavy cannabis use.
Irwin said he sees patients with CHS visit his ER every week. While medical research hasn’t caught up to CHS’s underlying causes, or even how to treat it, he approaches CHS like any other disease-state recognized by modern medicine.
“It seems like a leap,” he said regarding the ECDS links among fibromyalgia, migraines, and IBS. “But then there’s another disorder, cannabinoid hyperemesis syndrome, one that I don’t understand on a molecular level, but I believe in it and treat it.”
So, for now, it looks like we have two hypothetical medical disorders related to endocannabinoid function. In the case of ECDS, the body produces too few of the essential endocannabinoids required for normal neurological functioning. To treat it, doctors could feasibly supplement a lack of anandamide with THC, anandamide’s closest relative outside of the human body (chemically speaking).
In the case of CHS, overstimulation by phytocannabinoids could wreak havoc on natural..
Late Friday, the Illinois legislature approved recreational marijuana use for adults. It’s the first state to do so by legislature, as opposed to a voter referendum. With Gov. J.B. Priztker promising his signature, Illinois’ move restores momentum to the advance of cannabis legalization after recreational pot bills suffered surprising failures earlier this year in New York and New Jersey. The Chicago-based cannabis operators Green Thumb Industries (GTII.Canada or GTBIF) and Cresco Labs (CL.Canada or CRLBF) said they’ll be ready if sales begin in January 2020 as expected.
“The state of Illinois just made history,” Priztker said Friday in a statement.
On the same day, the U.S. Food and Drug Administration held a lengthy hearing on the regulation of cannabidiol—commonly known as CBD—the nonintoxicating cannabis ingredient that Congress decriminalized in December. Companies like CV Sciences (CVSI) joined more than 100 witnesses in urging the agency to mark a path for vendors to sell CBD foods and over-the-counter products without running afoul of FDA rules.
Analyst Rob Fagan, of Canada’s GMP Securities, noted that Illinois’ bill would double the number of stores that each license allows, from five to 10, with current holders of medical dispensary licenses first in line. That could give incumbents a 6 to 12 month head start over new applicants in the country’s fifth most populous state.
Adding recreational volumes to the existing sales of medical cannabis will expand the Illinois market by an order of magnitude, Aaron Grey of Alliance Global Partners wrote in a Monday note. He believes that in five years’ time, the state could be generating $2.9 billion in annual sales for cannabis producers. As the 11th state to allow recreational pot, Grey thinks Illinois’s move will pressure legislatures in other big states, and even Congress.
“We believe the passing of adult-use retail sales in Illinois could serve as a catalyst for other states,” Grey said, “and also put further pressure to address the disconnect between state and federal law as 29% of the U.S. population will now live in a state where adult use cannabis is legal.”
In December, the 2018 Farm Bill decriminalized CBD and the cannabis plant variety called hemp that is a source of the soothing but non-psychoactive ingredient. But the FDA says CBD remains subject to the agency’s oversight when it’s added to foods and over-the-counter ingestibles, or when marketers make medical claims for CBD’s benefits.
So almost two-dozen CBD manufacturers spoke up at Friday’s FDA hearing. Some asked the agency to require testing and rid the market of bad actors who make unsubstantiated claims or sell adulterated products.
Formal FDA rules could take years, Cowen analyst Vivien Azer said in a Monday morning note. So companies like CV Sciences asked the agency to delineate regulatory “swim lanes” that would allow CBD in foods and supplements, under existing rules, without the onerous approvals required for drugs.
“Industry presenters and regulators seem to be aligned in the need for a formal regulatory framework,” Azer wrote.
PHOENIX (FOX 10) – It is now officially legal for farmers to grow hemp in the state of Arizona.
The Arizona Hemp Program, which launched Saturday, falls under the jurisdiction of the state’s agriculture department. The program allows hemp to be used to manufacture products and allows them to be shipped across state lines.
Summer is the best time to grow the product and many believe Arizona is the best place to grow hemp. One farmer we spoke with says he’s been in the farming industry his entire life, devoting at least three acres to test the waters. J.L. Echeverria has been growing cotton, alfalfa, grains, barley and more. While he won’t be going all in, he’ll start small.
“We’re very excited about this crop since it’s new and the price of seed is significantly higher,” Echeverria said. “So we want to take it slow and ease into it.”
Right now, hemp is a very lucrative industry. Many farmers in the state are heading in the same direction – jumping on board to grow the crop.
“It looks like there’s a lot of potential in the hemp,” Echeverria said. “The numbers that are being talked about right now are significantly greater than this alfalfa and cotton game we’ve been playing forever. It’s exciting to be on the front end of something – kind of like a pioneer – people that came before. I think it’s a crop that’s going to fit well for our weather, water, and soil types.”
Those on board want to remind people that while hemp does come from the cannabis plant, it doesn’t get you high like marijuana. Hemp is a natural anti-inflammatory which reduces anxiety and pain – it’s commonly used to make CBD oils. THC concentration cannot be more than three-tenths of a percent for the hemp to remain legal.
Arizona is among the handful of states joining the lucrative hemp industry. More than 200 people have applied for licenses across the state.
“We think in the first few years out here in Arizona, most hemp will probably be grown for CBD oils,” said Sully Sullivan. “The CBD industry is huge right now – it’s over a $1 billion industry and it’s expected to grow twentyfold to $20 billion by 2020.”
But there is still a taboo about hemp to many because several people don’t know the difference between hemp and marijuana. While they derive from the cannabis plant, hemp will not get you high like marijuana. Why? Because of the THC levels.
“Hemp is defined as the cannabis plant below 0.3 percent THC – anything above is considered marijuana,” Sullivan said. “Hemp and CBD [are great alternatives] for what where they can receive the healing properties of the plant without having a narcotic effect.”
The department described how U.S hemp farmers can legally import hemp seed from Canada and elsewhere.
While the roll-out of hemp regulations in the wake of the 2018 Farm Bill is continuing in fits and starts, the U.S. Department of Agriculture did open the door to hemp seed imports.
Jessica Wasserman, a partner in Greenspoon Marder’s cannabis law practice, tells Cannabis Business Times that it’s a welcome development for U.S. farmers eager to get to work. “The farmers have been pushing for this, definitely, because they need more seed,” she says. “Canada has been active longer than the U.S. and has good seed stock that the farm community very much wanted.”
Hemp seed may be imported from Canada with the following accompaniments: a phytosanitary certification from Canada’s national plant protection organization (“to verify the origin of the seed and confirm that no plant pests are detected”) and a Federal Seed Analysis Certificate for hemp seeds grown in Canada.
U.S. farmers may also source and import hemp seed from other countries, of course; those seed packages must also be tagged with the phytosanitary certification of whichever state agency heads up plant protection in a given country.
All hemp seed imports remain subject to inspection by U.S. Customs and Border Protection (CBP). That’s where the issue gets into less clear territory.
“[This guidance] does not at all help on any of the importation or trade or interstate commerce issues arising from the whole question about 0.3-percent THC by dry weight,” Wasserman says, referring to the legal threshold at which point a cannabis plant is known as “hemp” (under 0.3-percent THC content) or, in some jurisdictions, “marijuana.”
“Hemp seeds have zero THC—and zero CBD, for that matter,” Wasserman says. “This didn’t require any DEA input, necessarily.”
The 2018 Farm Bill removed hemp from the U.S. list of schedule substances (it had been on Schedule I, along with marijuana). But the bill did not remove any hemp-derived cannabinoids from the list of Schedule-I substances.
Despite the passage of the Farm Bill, CBP has continued to follow DEA’s strict orders on CBD by seizing products. While hemp seed now falls outside the purview of DEA oversight, hemp-derived compounds have languished in a certain regulatory limbo. The chemical compound—CBD, in most cases—continues to be illegal. But when it’s derived from hemp, which is legal, what happens then?
A recent federal court ruling in California strikes an interesting chord and insists that hemp-derived CBD products “will not be subject to seizure.”
According to U.S. District Judge Jesus Bernal, “Section 12619 of the 2018 Farm Bill amended the CSA definition of marijuana so that it now includes an exemption for hemp, defined as ‘any part’ of the Cannabis sativa L. plant ‘with a delta-9 tetrahydrocannabinol concentration of not more than 0.3 percent on a dry weight basis.’ Under this new exemption, any future shipments of industrial hemp product containing less than 0.3% THC by dry weight will clearly fall outside the CSA definition of marijuana and will not be subject to seizure.”
The phrase “any part” is key. Bernal is pointing to hemp-derived CBD products—those containing the chemical constituents of a plant legally considered “hemp.” The USDA, in its guidance on imports this month, is pointing to the more fundamental products for U.S. farmers: the hemp seed itself.
All of this is to say that U.S. hemp legalization is being sorted out via incremental legislation, federal litigation and regulatory agency memos.
As far as any broader regulatory structure for the domestic hemp industry, the USDA intends to issue those rules no earlier than the fall of 2019. The goal, officials have stated, is to have that guidance in place for the 2020 growing season.
Some U.S. states are developing their own rules for the hemp industry, which must then be approved by the USDA. The federal department will also be developing an overarching set of federal regulations for the hemp industry, under which all hemp businesses must operate.
For now, states, tribes and higher education institutions may continue to work under the guidance of the 2014 Farm Bill, which allowed for the development of hemp research pilot programs.
Our understanding of the human body and the advancements in healthcare have produced a population that lives twice as long as it did just 100 hundred years ago. We now have the knowledge and technology to optimize our bodies to their near full potential. Getting a clear understanding of balance, as it relates to your body and its fundamental functions, will help you along this path.
What is balance and why is it important? Your body works tirelessly to maintain homeostasis to keep you happy, healthy, and disease free. The endocannabinoid system is integral to this work, as are other important systems like the endocrine, renal, and lymphatic systems. Internal balance is as integral to your overall health and well-being as external balance is, and as you probably know, the two are interdependent. Now, this isn’t meant to be a self-help book, but this concept is essential to grab hold of. Being able to wake up and be present, comfortable, and pain-free within your body will enable you to show up and put your best foot forward each and every day.
The American diet can contain up to 70% highly processed foods. If you are like three-quarters of the US population, you have a bottle of multivitamins sitting in your kitchen cabinet. Because of an inadequate diet or to fight off a bad cold, many of us feel like we need the added boost of vitamins to stay out of the doctor’s office and get out the door to work each day. If taken at the right times and with the right foods, supplements are an important step you can take to improve your health. After the generic multivitamin, omega-3/DHA, glucosamine, echinacea, flaxseed oil, and ginseng are among the top dietary supplements in the country.
Are you looking for an improvement in your overall health and wellness? More energy? More mental clarity and focus? Less anxiety? Better sleep? If you have a need, chances are there is a health supplement for that.
Because of the way they are used by our bodies, cannabinoids can do the job of many supplements (and some pharmaceuticals, to boot). It has been my observation over the past decade as a registered nurse that the use of cannabinoids can significantly improve the quality of life of most individuals. When it comes down to it, can we ask for anything more fundamental than that?
So let’s turn our attention to one cannabinoid in particular: cannabidiol. The future of CBD is bright! The myriad ways that CBD works its wonders in the body coupled with its nonintoxicating properties make it an extremely valuable therapeutic compound, and as the scientific study of CBD ramps up we are uncovering new and exciting possibilities for CBD all the time. We already know with a good degree of scientific certainty that CBD can be used to treat a number of symptoms and conditions, and we’ve outlined these for you in the following section.
We’ve put together a list of the concerns and conditions that have the most science backing them up, but there are several others that show real potential based on preclinical study. And did you know that CBD can help your furry friends too? It’s true; CBD is being used to treat a variety of health issues for pets.
We used Uwe Blesching’s The Cannabis Health Index as a jumping-off point. Blesching is a medical journalist who developed the The Cannabis Health Index as an “evidence-based rating system that shows degrees of confidence in cannabis as an effective treatment for a specific condition.” Blesching painstakingly collected the credible scientific studies available for each condition, rated each study on its overall quality and credibility, and tabulated the results to create a 5-point rating scale, ranging from possible to actual in terms of efficacy. Blesching looked at cannabis as a whole and did not break it down as far as individual cannabinoids like THC or CBD.
From there we cross-referenced his ratings in the The Cannabis Health Index with CBD-specific studies to give you information on conditions that have the most evidence to support CBD’s use. Many thanks go to the fine folks at Project CBD for their comprehensive list of scientific studies as they relate to CBD and specific conditions.
The Transportation Security Administration (TSA) updated its policy on cannabis over the Memorial Day weekend, changing the medical marijuana section of its “What Can I Bring?” webpage from reading “no” to “yes” (with “special instructions”).
Specifically, the agency is clarifying that hemp-derived CBD products may now be carried on planes under certain circumstances.
Previously, TSA made no distinction between marijuana and hemp-derived preparations and warned on its website that cannabis products cannot be taken as carry-on items or in checked bags. But since the 2018 Farm Bill federally legalized hemp and its derivatives, that’s no longer the case.
Now the agency’s webpage specifies that possession of “certain” cannabis products are illegal under federal law, and TSA agents are required to report suspected violations such as possession of “certain” products to law enforcement.
Here’s the new policy as it appears on TSA’s website:
“Products/medications that contain hemp-derived CBD or are approved by the FDA are legal as long as it is produced within the regulations defined by the law under the Agriculture Improvement Act 2018,” a new section states.
Here’s what the TSA policy looked like prior to the update:
It’s not clear how the agency plans to enforce the new policy, unless it intends to train agents to test CBD preparations for the presence of THC and maintain a database of products that are approved by the Food and Drug Administration.
A TSA spokesperson told Marijuana Moment in an email that the policy change was spurred by FDA’s approval of a cannabis-derived anti-seizure medication, Epidiolex.
“TSA was made aware of an FDA-approved drug that contains CBD oil for children who experience seizures from pediatric epilepsy,” the spokesperson wrote. “To avoid confusion as to whether families can travel with this drug, TSA immediately updated TSA.gov once we became aware of the issue.”
But FDA approved the CBD prescription drug nearly a year ago—calling into question the notion that TSA acted “immediately.”
And the representative was not immediately able to comment on part of the TSA website update that now references the broader legalization of hemp-derived CBD under the Farm Bill, which was enacted in December.
The rest of the TSA page on cannabis mostly retains language from the earlier version. The agency’s efforts are “focused on security and are designed to detect potential threats to aviation and passengers,” it says, so it doesn’t use resources to seek out illicit drugs.
However, “if any illegal substance is discovered during security screening, TSA will refer the matter to a law enforcement officer.”
TSA has gone back-and-forth on its marijuana policy as more states opt to legalize the plant for medical or adult use. In April 2017, the agency took advocates by surprise after it updated the medical marijuana section of the “What Can I Bring?” page to include a green “yes,” indicating that medical cannabis was permitted in carry ons or checked bags.
“TSA security officers do not search for marijuana or other drugs,” the page said at the time. “In the event a substance that appears to be marijuana is observed during security screening, TSA will refer the matter to a law enforcement officer.”
But shortly after the page started attracting press attention, TSA temporarily removed the medical cannabis section and tweeted that a “mistake was made in the database.”
We’re sorry for any confusion. A mistake was made in the database of our new “What can I bring?” tool.
The agency later posted an updated version of the page, which specified that marijuana was not in fact allowed on planes.
“Whether or not marijuana is considered legal under local laws is not relevant to TSA screening because TSA is governed by federal law,” TSA wrote. “Federal law provides no basis to treat medical marijuana any differently than non-medical marijuana.”
But with the legalization of industrial hemp and its derivatives, multiple federal agencies are now revisiting their policies to clarify what is and isn’t allowed.