CANNABIDIOL FOR CHRON'S DISEASE

Cannabidiol for Chron's Disease (test link)

 Cannabidiol for Crohn’s
CPN Institute is honored to be the recipients for the 2013 Red Carpet Charity Ball hosted by the Northwest Cannabis Market.  The proceeds from this event will go far to helping CPN Institute achieve its 2014 Cannabis Education & Research Goals!

Cannabis Patient Network (CPN) expected to draw a great deal of attention when we launched a National Membership Organization in 2013!  As a testimony to the support CPN Institute has found since our launch on 8-8-13: CPN Institute has since gained more than 1200 members from all 50 of the U.S. States and 12 International Countries!  It appears many share in our mission of helping cannabis patients worldwide!  Based on our current growth CPN Institute anticipates having more than 2500 members by year’s end!

CPN Institute’s mission is to empower patients to take an active part in their healthcare, their recovery, and in research that highlights their knowledge and embodied experience as patients with an endocannabinoid system, who use cannabis as medicine.

A large focus of our mission is providing public education on the endocannabinoid system (ECS).  After all, we all have an ECS; therefore, we all have a stake in learning more about how cannabis works as medicine.  This year we exhibited at a number of events that placed us directly in the public:  The Colorado State Fair, the Denver Rock n’ Roll Marathon Health & Fitness Expo, the Colorado ACCORD—all events that position CPN Institute to participate in similar events across the country, even in non-medical states.  Co-Founder, Regina Nelson, also spoke at a number of Academic and Healthcare conferences, including the Tobias Leadership Conference and the International Leadership Association’s Inaugural Women in Leadership Conference, as well as the American’s for Safe Access and International Drug Policy Alliance Reform Conferences. Our participation at each of these events marked a turning point in our nation’s acceptance of cannabis therapy and truly illustrates the important role CPN Institute has in public education regarding cannabis. 

Another important aspect of our mission is connecting patients with valid research projects that increase the knowledge of cannabis’ use as medicine.  CPN Institute co-Founder, Mark Pedersen understands this well, after all he’s traveled the country since 2006 collecting cannabis patient testimonies from hundreds of patients—most in non-medical states.  His archive of patient stories is available on YouTube.  Many of the stories have been included in documentaries and shown before State Legislators.  Combined with Regina’s academic research background, CPN is positioned to connect patients and researchers across a wide-variety of projects.  Already CPN Institute is conducting surveys and polls to be included in research projects.  As well, we are working with several research teams seeking funding for projects that include: Veterans, Seniors, and Children.  The support of the Northwest Cannabis Market’s and guests of the Red Carpet Charity Ball will help support programs that will touch cannabis patients across the country!

Over the course of the next year, CPN Institute is launching a national education program.  The program is a combination of events, workshops, and seminars for the public, cannabis patients, cannabis industry professionals, and medical professionals.  Currently, we are in the process of accrediting several of the courses before a formal announcement is made but keep your eyes open for more information, next spring we plan to return to Washington with a full-array of courses and free public education.  As part of our Cannabidiol for Crohn’s Program we will be focusing on cannabidiol (CBD) and other non-THC cannabinoids, a wide-variety of chronic illnesses, including Crohn’s, and quality of life issues all chronically ill patients struggle to overcome.  We also seek to connect Crohn’s patients with research projects focusing on raw cannabis use as well as cannabidiol for symptom relief.

To support CPN Institute and the Cannabidiol for Crohn’s Project, please consider joining us as a CPN Institute Member and adding your voice to the choir—and please Donate this holiday season—we are a publicly funded organization!

Join or Donate to CPN Institute by following this link:

Join: Click on Registration

Legalization and Decriminalization (test link) 

Real World Ramifications of Cannabis Legalization and Decriminalization

Editor's Note: As more states begin to debate the question of legally controlling marijuana, many lawmakers are posing questions to NORML regarding what effect, if any, such a policy change may have upon the public's use of cannabis and/or young people's attitudes toward it.The following paper reviews various studies** that have examined this issue in regions that have either a) regulated marijuana use and sales for all adults; b) decriminalized the possession of small quantities of marijuana for adults; c) medicalized the use of marijuana to certain authorized individuals; or d) deprioritized the enforcement of marijuana laws. This paper also proposes general guidelines to govern marijuana use, production, and distribution in a legal, regulated manner.
**This paper expands upon the studies initially referenced by NORML in its paper, Marijuana Decriminalization & Its Impact on Use.

• Criminal Marijuana Prohibition Is A Failure
• The Case For Legalization/Regulation
• Defining Marijuana Legalization/ Regulation
• Marijuana Legalization And Its Impact On Use
• Marijuana Decriminalization And Its Impact On Us

Criminal Marijuana Prohibition Is A Failure

By any objective standard, marijuana prohibition is an abject failure.
Nationwide, U.S. law enforcement have arrested over 20 million American citizens for marijuana offenses since 1965, yet today marijuana is more prevalent than ever before, adolescents have easier access to marijuana than ever before, the drug is on average more potent than ever before, and there is more violence associated with the illegal marijuana trade than ever before.
Over 100 million Americans nationally have used marijuana despite prohibition, and one in ten – according to current government survey data – use it regularly. The criminal prohibition of marijuana has not dissuaded anyone from using marijuana or reduced its availability; however, the strict enforcement of this policy has adversely impacted the lives and careers of millions of people who simply elected to use a substance to relax that is objectively safer than alcohol.

NORML believes that the time has come to amend criminal prohibition and replace it with a system of legalization, taxation, regulation, and education.

The Case For Legalization/Regulation

Regulation = Controls

• Controls regarding who can legally produce marijuana
• Controls regarding who can legally distribute marijuana
• Controls regarding who can legally consume marijuana
• Controls regarding where adults can legally use marijuana and under what circumstances is such use legally permitted

Prohibition = the absence of controls – This absence of control jeopardizes rather than promotes public safety

• Prohibition abdicates the control of marijuana production and distribution to criminal entrepreneurs, such as drug cartels, street gangs, drug dealers who push additional illegal substances
• Prohibition provides young people with easier access to marijuana than alcohol (CASA, 2009)
• Prohibition promotes the use of marijuana in inappropriate settings, such as in automobiles, in public parks, or in public restrooms.
• Prohibition promotes disrespect for the law, and reinforces ethnic and generation divides between the public and law enforcement. (For example, according to a recent NORML report, an estimated 75 percent of all marijuana arrestees are under age 30; further, African Americans account for only 12 percent of marijuana users but comprise 23 percent of all possession arrests)

Defining Marijuana Legalization/Regulation

What would marijuana regulation look like?

• There are many models of regulation; depending on the substance being regulated these regulations can be very loose (apples, tomatoes) or very strict (alcohol, tobacco, prescription drugs)

The alcohol model of regulation:

• Commercial production is limited to licensed producers (though non-retail, home production is also allowed)
• Quality control and potency is regulated by the state, and the potency of the product is made publicly available to the consumer
• Retail sale of the product is limited to state licensed distributors (liquor stores, restaurants, bars, package stores, etc.)
• The state imposes strict controls on who may obtain the product (no minors), where they may legally purchase it (package store, liquor store, etc.), when they may legally purchase it (sales limited to certain hours of the day), and how much they may purchase at one time (bars/restaurants may not legally service patrons who are visibly intoxicated, states like Pennsylvania limit how much alcohol a patron may purchase at a licensed store, etc.).
• The state imposes strict regulations prohibiting use in public (no open container in public parks, or beaches, or in an automobile) and/or furnishing the product to minors
• The state imposes strict regulations limiting the commercial advertising of the product (limits have been imposed on the type of marketing and where such marketing may appear)
• States and counties retain the right to revoke the retail sale of the product, or certain types of alcohol (grain alcohol, malt liquor, etc), altogether (dry counties)

A regulatory scheme for marijuana that is similar to the scheme described above for alcohol would be favorable compared to the present prohibition. Ideally, such a regulatory scheme for marijuana would maintain the existing controls that presently govern commercial alcohol production, distribution, and use – while potentially imposing even stricter limits regarding the commercialization, advertising, and mass marketing of the product.

Marijuana Legalization And Its Impact On Use

Real-world examples of marijuana regulation:

India (prior to 1985)

• Federal government imposed no national criminal prohibitions on marijuana cultivation, production, sale, possession, consumption, or commerce prior to the mid 1980s
• • "The incidence of the habit as estimated ... after extensive studies in the field ranged between 0.5% and 1.0% of the population." (United Nations Bulletin on Narcotics, 1957)
  • "So far as premeditated crime is concerned, particularly that of a violent nature, the role of cannabis in our experience is quite distinctive. In some cases these drugs not only do not lead to it, but actually act as deterrents. We have already observed that one of the important actions of these drugs is to quiet and stupefy the individual so that there is no tendency to violence, as is not infrequently found in cases of alcoholic intoxication." (United Nations Bulletin on Narcotics, 1957)

The Netherlands (30+ year history)

• Retail sale of limited quantities of marijuana (5 grams or less) is allowed in licensed retail outlets for patrons age 18 or over
• Ministry of Health also licenses production and distribution of marijuana for qualified patrons
• • "These data are consistent with reports showing that adult cannabis use is no higher in the Netherlands than in the United States and inconsistent with the demand theory that strict laws and enforcement prevent adolescent cannabis use." (International Journal of Drug Policy, 2010)
  • "Our findings suggest that the Dutch system of regulated sales has achieved a substantial separation of markets. ... As expected, most Amsterdam respondents obtained their cannabis in licensed coffee shops, and 85% reported that they could not purchase other illicit drugs at their source for cannabis. San Francisco respondents were three times more likely to report being able to purchase other illicit drugs from their cannabis sources." (International Journal of Drug Policy, 2009)
  • "Proponents of criminalization attribute their preferred drug-control regime a special power to affect user behavior. Our findings cast doubt on such attributions. Despite widespread lawful availability of cannabis in Amsterdam, there were no differences between the 2 cities (Amsterdam and San Francisco) in age at onset of use, age at first regular use, or age at the start of maximum use. ... Our findings do not support claims that criminalization reduces cannabis use and that decriminalization increases cannabis use" (American Journal of Public Health, 2004)
  • "The Dutch experience ... provides a moderate empirical case that removal of criminal prohibitions on cannabis possession will not increase the prevalence of marijuana or any other drug." (British Journal of Psychiatry, 2001)

Canada, Germany, Israel (3-10 year history)

• Federal health department oversees the licensed production and distribution of marijuana to qualified patrons
• No evidence this limited regulatory model has led to an increase in general marijuana use or attitudes among the public
• • "The data provide no evidence that strict cannabis laws in the United States provide protective effects compared to the similarly restrictive but less vigorously enforced laws in place in Canada, and the regulated access approach in the Netherlands." (International Journal of Drug Policy, 2010)

California, Colorado, New Mexico (1 year to 10+ year history)

• County/city licensing of outlets overseeing distribution of marijuana to qualified patrons
• • "Our results indicate that the introduction of medical cannabis laws was not associated with an increase in cannabis use among either arrestees or emergency department patients in cities and metropolitan areas located in four states in the USA (California, Colorado, Oregon, and Washington). ... Consistent with other studies of the liberalization of cannabis laws, medical cannabis laws do not appear to increase use of the drug." (International Journal of Drug Policy, 2007)

Marijuana Decriminalization And Its Impact On Use

Real-world examples of marijuana decriminalization (removing the threat of arrest for the personal possession or cultivation of marijuana, but maintaining prohibitions on commercial cultivation and retail sale):

Europe (Spain, Italy, Portugal, Luxemburg, etc.)

• "Following decriminalization, Portugal had the lowest rate of lifetime marijuana use in people over 15 in the E.U. ... The U.S. has long championed a hard-line drug policy, supporting only international agreements that enforce drug prohibition and imposing on its citizens some of the world's harshest penalties for drug possession and sales. Yet American has the highest rates of cocaine and marijuana use in the world, and while most of the E.U. (including Holland) has more liberal drug laws than the U.S., it also has less drug use." (Time.com, 2009)
• "Globally, drug use is not distributed evenly, and is simply not related to drug policy. ... The U.S. ... stands out with higher levels of use of alcohol, cocaine, and cannabis, despite punitive illegal drug policies. ... The Netherlands, with a less criminally punitive approach to cannabis use than the U.S., has experienced lower levels of use, particularly among younger adults. Clearly, by itself, a punitive policy towards possession and use accounts for limited variation in national rates of illegal drug use." (PLOS Medicine, 2008)
• "This paper has shown that ... decriminalization does not result in lower prices and higher consumption rates, nor in more sever patterns of cannabis use, ... and that criminalization may reduce the legitimacy of the judicial system." (Current Opinion in Psychiatry, 2008)
• "While the Dutch case and other analogies have flaws, they appear to converge in suggesting that reductions in criminal penalties have limited effects on drug use, at least for marijuana." (Science, 1997)

Australia (20+ year history)

• "There is no evidence to date that the (expiation/decriminalization) system ... has increased levels of regular cannabis use or rates of experimentation among young adults. These results are broadly in accord with our earlier analysis of trends in cannabis use in Australia. ... They are also consistent with the results of similar analysis in the United States and the Netherlands." (Australian Government Publishing Service, 1999)

Great Britain (2004-2008)

• "Cannabis use among young people has fallen significantly since its controversial reclassification in 2004, according to the latest British Crime Survey figures published today. The Home Office figures showed the proportion of 16 to 24-year-olds who had used cannabis in the past year fell from 25% when the change in the law was introduced to 21% in 2006/07" (The Guardian, 2007)

United States

• Decriminalization (12 states, 30+ year history)
• • "In sum, there is little evidence that decriminalization of marijuana use necessarily leads to a substantial increase in use" (U.S. National Academy of Science, 1999)
  • "The available evidence indicates that the decriminalization of marijuana possession had little or no impact on rates of use. Although rates of marijuana use increased in those U.S. states [that] reduced maximum penalties for possession to a fine, the prevalence of use increased at similar or higher rates in those states [that] retained more severe penalties. There were also no discernible impacts on the health care systems. On the other hand, the so-called 'decriminalization' measures did result in substantial savings in the criminal justice system." (Journal of Public Health, 1989)
  • "Overall, the preponderance of the evidence which we have gathered and examined points to the conclusion that decriminalization has had virtually no effect either on the marijuana use or on related attitudes and beliefs about marijuana use among American young people. The data show no evidence of any increase, relative to the control states, in the proportion of the age group who ever tried marijuana. In fact, both groups of experimental states showed a small, cumulative net decline in annual prevalence after decriminalization" (U.S. Institute for Social Research, 1981)

• Medicalization (13 states, 2-13 year history)
• • "More than a decade after the passage of the nation's first state medical marijuana law, California's Prop. 215, a considerable body of data shows that no state with a medical marijuana law has experienced an increase in youth marijuana use since its law's enactment. All states have reported overall decreases – exceeding 50% in some age groups – strongly suggesting that the enactment of state medical marijuana laws does not increase marijuana use" (MPP, 2005, 2008)

• LLEP/Deprioritization (various municipalities nationwide including Seattle, WA; Denver, CO; Oakland, CA; Missoula, MT; Columbia, MO, etc.)
• • "Many states and localities have either decriminalized marijuana or deprioritized the enforcement of marijuana laws. There is no evidence that the decriminalization of marijuana by certain states or the deprioritization of marijuana enforcement in Seattle and other municipalities caused an increase in marijuana use or related problems. This conclusion is consistent with the findings of numerous studies indicating that the increasing enforcement of marijuana laws has little impact on marijuana use rates and that the decriminalization of marijuana in U.S. states and elsewhere did not increase marijuana use" (Beckett/ACLU, 2009)

Conclusions

• Strict government legalization/regulation of marijuana is unlikely to increase the public's use of marijuana or significantly influence attitudes.
• Decriminalization is unlikely to increase the public's use of marijuana or significantly influence attitudes.
• Free market legalization of marijuana without strict government restrictions on commercialization and marketing is likely to increase marijuana use among the public; however, given that the United States already has the highest per capita marijuana use rates in the world, this increase is likely to be marginal relative to other nation's experiences.

References

Simons-Morton et al. 2010. Cross-national comparison of adolescent drinking and cannabis use in the United States, Canada, and the Netherlands. International Journal of Drug Policy 21: 64-69.
Reinarman et al. 2009. Cannabis policies and user practices: market separation, price, potency, and accessibility in Amsterdam and San Francisco. International Journal of Drug Policy 20: 28-37.
Time.com. "Drugs in Portugal: did decriminalization work?" April 26, 2009.
Beckett et al. 2009. The Consequences and Costs of Marijuana Prohibition. University of Washington: Seattle.
National Center on Addiction and Substance Abuse at Columbia University. 2009. National Survey on American Attitudes on Substance Abuse XIV: Teens and Parents. Columbia University: New York.
Figure 2.5 Marijuana Use in Past Year among Persons Age 12 or Older. U.S. Office of Applied Studies, 2009.
Table 13 Trends in Availability of Drugs as Perceived by 12th Graders. Monitoring the Future: Institute for Social Research, University of Michigan: Ann Arbor, 2008
Degenhardt et al. 2008. Toward a global view of alcohol, tobacco, cannabis, and cocaine use: findings from the WHO world mental health surveys. PLOS Medicine 5: 1053-1067.
Van den Brink. 2008. Decriminalization of cannabis. Current Opinion in Psychiatry 21: 122-126.
Terry-McElrath et al. 2008. Saying no to marijuana: why American youth report quitting or abstaining. Journal of Studies on Alcohol and Drugs 29: 796-805.
Earleywine et al. 2005/2008. Marijuana Use by Young People: The Impact of State Medical Marijuana Laws. Marijuana Policy Project: Washington, DC.
Gorman et al. 2007. Do medical cannabis laws encourage cannabis use? International Journal of Drug Policy 18: 160-167.
The Guardian. "Fewer young people using cannabis after reclassification." October 25, 2007.
Reinarman et al. 2004. The limited relevance of drug policy: cannabis in Amsterdam and San Francisco. American Journal of Public Health 94: 836-842.
MacCoun et al. 2001. Evaluating alternative cannabis regimes. British Journal of Psychiatry 178: 123-128.
National Academy of Sciences, Institute of Medicine. 1999. Marijuana and Medicine: Assessing the Science Base. Washington, DC.
MacCoun et al. 1997. Interpreting Dutch cannabis policy: reasoning by analogy in the legalization debate. Science 278: 47-52.
Donnelly et al. 1999. Effects of the Cannabis Expiation Notice Scheme on Levels and Patterns of Cannabis use in South Australia: Evidence from the National Drug Strategy Household Surveys 1985-1995. Australian Government Publishing Service: Canberra.
Single. 1989. The impact of marijuana decriminalization: an update. Journal of Public Health 10: 456-466.
Johnson et al. 1981. Marijuana decriminalization: the impact on youth 1975-1980. Monitoring the Future, Occasional Paper Series: Institute for Social Research, University of Michigan: Ann Arbor.
Chopra. 1957. The Use of Cannabis Drugs in India. United Nations Bulletin on Narcotics: Vienna.

Organizations Supporting Immediate Access of Medical Cannibis

NORML List of Medical Organizations Supporting Legalization for Medical Marijuana 

Health Endorsements

Quick Reference listed by positionDetailed Listing listed by name

Opponents of medical marijuana law reform often argue that few or no health authorities recognize cannabis as a legitimate therapeutic agent. Most recently, this notion was repeated by DEA Director Asa Hutchinson, who stated, "We all have sympathy for folks that need medication, but we have to listen to the scientific and medical community, and they're saying that marijuana has no legitimate medical purpose." This contention, however, is altogether untrue. In reality, numerous health and medical organizations from both the United States and abroad support the use of marijuana as a medicine.
The following list is a sampling of the various health and scientific organizations that back patient access to medical marijuana. Though it is not meant to be comprehensive, it is intended to provide a cross-section of the medical community's broad support for medical cannabis, and present a referenced, fact-based response to those who claim otherwise. As the medical cannabis issue continues to stimulate political debate, reformers and legislators need to consider the positions of the medical community to better make informed policy decisions regarding the medical use of marijuana.

Health Organizations Supporting Immediate Legal Access to Medical Marijuana
International and National Organizations
AIDS Action Council
AIDS Treatment News
American Academy of Family Physicians
American Medical Student Association
American Nurses Association
American Preventive Medical Association
American Public Health Association
American Society of Addiction Medicine
Arthritis Research Campaign (United Kingdom)
Australian Medical Association (New South Wales) Limited
Australian National Task Force on Cannabis
Belgian Ministry of Health
British House of Lords Select Committee on Science and Technology
British House of Lords Select Committee On Science and Technology (Second Report)
British Medical Association
Canadian AIDS Society
Canadian Special Senate Committee on Illegal Drugs
Dr. Dean Edell (surgeon and nationally syndicated radio host)
French Ministry of Health
Health Canada
Kaiser Permanente
Lymphoma Foundation of America
The Montel Williams MS Foundation
Multiple Sclerosis Society (Canada)
The Multiple Sclerosis Society (United Kingdom)
National Academy of Sciences Institute Of Medicine (IOM)
National Association for Public Health PolicyNational Nurses Society on Addictions
Netherlands Ministry of Health
New England Journal of Medicine
New South Wales (Australia) Parliamentary Working Party on the Use of Cannabis for Medical PurposesDr. Andrew Weil (nationally recognized professor of internal medicine and founder of the National Integrative Medicine Council)
 
State and Local Organizations
Alaska Nurses AssociationBeing Alive: People With HIV/AIDS Action Committee (San Diego, CA)California Academy of Family Physicians
California Nurses AssociationCalifornia Pharmacists AssociationColorado Nurses Association
Connecticut Nurses Association
Florida Governor's Red Ribbon Panel on AIDS
Florida Medical AssociationHawaii Nurses Association
Illinois Nurses Association
Life Extension Foundation
Medical Society of the State of New York
Mississippi Nurses Association
New Jersey State Nurses Association
New Mexico Medical Society
New Mexico Nurses Association
New York County Medical Society
New York State Nurses Association
North Carolina Nurses Association
Rhode Island Medical Society
Rhode Island State Nurses Association
San Francisco Mayor's Summit on AIDS and HIV
San Francisco Medical Society
Vermont Medical Marijuana Study Committee
Virginia Nurses Association
Whitman-Walker Clinic (Washington, DC)
Wisconsin Nurses Association

Additional AIDS Organizations
The following organizations are signatories to a February 17, 1999 letter to the US Department of Health petitioning the federal government to "make marijuana legally available … to people living with AIDS."
AIDS Action Council
AIDS Foundation of Chicago
AIDS National Interfaith Network (Washington, DC)
AIDS Project Arizona
AIDS Project Los Angeles
Being Alive: People with HIV/AIDS Action Committee (San Diego, CA)
Boulder County AIDS Project (Boulder, CO)
Colorado AIDS Project
Center for AIDS Services (Oakland, CA)
Health Force: Women and Men Against AIDS (New York, NY)
Latino Commission on AIDS
Mobilization Against AIDS (San Francisco, CA)
Mothers Voices to End AIDS (New York, NY)
National Latina/o Lesbian, Gay, Bisexual And Transgender Association
National Native American AIDS Prevention Center
Northwest AIDS Foundation
People of Color Against AIDS Network (Seattle, WA)
San Francisco AIDS Foundation
Whitman-Walker Clinic (Washington, DC)

Other Health Organizations
The following organizations are signatories to a June 2001 letter to the US Department of Health petitioning the federal government to "allow people suffering from serious illnesses … to apply to the federal government for special permission to use marijuana to treat their symptoms."
Addiction Treatment Alternatives
AIDS Treatment Initiatives (Atlanta, GA)
American Public Health Association
American Preventive Medical Association
Bay Area Physicians for Human Rights (San Francisco, CA)
California Legislative Council for Older Americans
California Nurses Association
California Pharmacists Association
Embrace Life (Santa Cruz, CA)
Gay and Lesbian Medical Association
Hawaii Nurses Association
Hepatitis C Action and Advisory Coalition
Life Extension Foundation
Maine AIDS Alliance
Minnesota Nurses Association
Mississippi Nurses Association
National Association of People with AIDS
National Association for Public Health Policy
National Women's Health Network
Nebraska AIDS Project
New Mexico Nurses Association
New York City AIDS Housing Network
New York State Nurses Association Ohio Patient Network Okaloosa AIDS Support and Information Services (Fort Walton, FL)
Physicians for Social Responsibility - Oregon
San Francisco AIDS Foundation
Virginia Nurses Association
Wisconsin Nurses Association

Health Organizations Supporting Medical Marijuana Research
  International and National Organizations
American Cancer Society
American Medical Association
British Medical Journal
California Medical Association
California Society on Addiction Medicine
Congress of Nursing Practice
Gay and Lesbian Medical Association
Jamaican National Commission on Ganja
National Institutes of Health (NIH) Workshop on the Medical Utility of Marijuana
Texas Medical Association
Vermont Medical Society
Wisconsin State Medical Society

Discussion of Hyperalgesic Effects

The two re-posted studies are samples of what suggests that if a person is needing the effects of both opiate pain relief, as well as that provided by the multiple ingredients of medically grown cannabis, it suggests without question that there is less of a hyperalgesic effects but actually together, even when taken with opiates, studies sugges lower opiate dosing.  As well as it suggests that with medically grown cannibis as well, that there isn't the effect of increased pain or hyperalgesia, as if often the case with things such as Central Nervous System Disorders.  In many cases, neuropathic pain can be worsened by opiate/opoid treatment.

A good portion of the literature including the articles below, suggest that also the presence of medical cannibis also lessens the probability of worsening of the pain, as is sometimes caused by use of opiates chronically.

Dropping dosages, added to increased effect-everyone wins.  Relief from pain, not obliteration being the overall goal.

Best to everyone, it is hoped a brief translation would be helpful.

Cannaboid, Antinociceptive effects, and Neuropathic Pain-Presentation of Two Studies (Discussion to follow)-MEDLINE (RE-POST)

http://www.ncbi.nlm.nih.gov/pubmed/18618522

Phytother Res. 2008 Aug;22(8):1017-24. doi: 10.1002/ptr.2401.

Antihyperalgesic effect of a Cannabis sativa extract in a rat model of neuropathic pain: mechanisms involved.

Comelli F, Giagnoni G, Bettoni I, Colleoni M, Costa B.

Source

Department of Biotechnology and Bioscience, University of Milano-Bicocca, Piazza della Scienza 2, 20126 Milano, Italy.

Abstract

This study aimed to give a rationale for the employment of phytocannabinoid formulations to treat neuropathic pain. It was found that a controlled cannabis extract, containing multiple cannabinoids, in a defined ratio, and other non-cannabinoid fractions (terpenes and flavonoids) provided better antinociceptive efficacy than the single cannabinoid given alone, when tested in a rat model of neuropathic pain. The results also demonstrated that such an antihyperalgesic effect did not involve the cannabinoid CB1 and CB2 receptors, whereas it was mediated by vanilloid receptors TRPV1. The non-psychoactive compound, cannabidiol, is the only component present at a high level in the extract able to bind to this receptor: thus cannabidiol was the drug responsible for the antinociceptive behaviour observed. In addition, the results showed that after chronic oral treatment with cannabis extract the hepatic total content of cytochrome P450 was strongly inhibited as well as the intestinal P-glycoprotein activity. It is suggested that the inhibition of hepatic metabolism determined an increased bioavailability of cannabidiol resulting in a greater effect. However, in the light of the well known antioxidant and antiinflammatory properties of terpenes and flavonoids which could significantly contribute to the therapeutic effects, it cannot be excluded that the synergism observed might be achieved also in the absence of the cytochrome P450 inhibition.

PMID:

18618522

[PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/16316650

Eur J Pharmacol. 2005 Dec 28;528(1-3):65-72. Epub 2005 Nov 28.

A role for cannabinoid receptors, but not endogenous opioids, in the antinociceptive activity of the CB2-selective agonist, GW405833.

Whiteside GT, Gottshall SL, Boulet JM, Chaffer SM, Harrison JE, Pearson MS, Turchin PI, Mark L, Garrison AE, Valenzano KJ.

Source

Purdue Pharma Discovery Research, 6 Cedar Brook Drive, Cranbury, NJ 08512, USA. whitesg@wyeth.com

Abstract

Several recent reports have demonstrated a role for selective cannabinoid CB2 receptor agonists in pain modulation, showing both analgesic and antihyperalgesic activities. While the mechanism of action is poorly understood, it has been postulated that these effects may be indirect, involving release of endogenous opioids. We have previously reported that administration of the selective cannabinoid CB2 receptor agonist GW405833 (2,3-dichloro-phenyl)-[5-methoxy-2-methyl-3-(2-morpholin-4-yl-ethyl)-indol-1-yl]-methanone) to rats elicits potent and efficacious antihyperalgesic effects against neuropathic and inflammatory pain and, at high dose (100 mg/kg), is analgesic and ataxic [Valenzano, K.J., Tafesse, L., Lee, G., Harrison, J.E., Boulet, J., Gottshall, S.L., Mark, L., Pearson, M.S., Miller, W., Shan, S., Rabadi, L., Rotstheyn, Y., Chaffer, S.M., Turchin, P.I., Elsemore, D.A., Toth, M., Koetzner, L., Whiteside, G.T., 2005. Pharmacological and pharmacokinetic characterization of the cannabinoid receptor 2 agonist, GW405833, utilizing rodent models of acute and chronic pain, anxiety, ataxia and catalepsy. Neuropharmacology 48, 658-672]. In the current study, we confirm these properties using mouse models and investigate the role of cannabinoid CB2 receptors using knockout animals. Furthermore, we provide evidence that the antinociceptive properties of GW405833 are opioid independent. GW405833 elicited robust antihyperalgesic effects in mouse models of inflammatory (Freund's complete adjuvant) and neuropathic (Seltzer) pain. In contrast, GW405833 showed no antihyperalgesic activity against Freund's complete adjuvant-mediated inflammatory pain in cannabinoid CB2 receptor knockout mice. As in rats, high-dose GW405833 (100 mg/kg) showed both analgesic and sedative activities in wild-type mice, activities that were also apparent in cannabinoid CB2 receptor knockout mice. In rats, neither the antihyperalgesic effect in the Freund's complete adjuvant model nor the analgesic effects in tail flick and hot plate assays were inhibited by pre-treatment with the non-selective opioid receptor antagonist, naltrexone. These data demonstrate that the antihyperalgesic effects of GW405833 are mediated via the cannabinoid CB2 receptor, whereas the analgesic and sedative effects are not. Furthermore, these data suggest that the mechanism of action for GW405833 does not depend on the release of endogenous opioids.

PMID:

16316650

[PubMed - indexed for MEDLINE]

Chronic Pain and Medical Marijuana-The Effects on Hyperanalgesia

http://norml.org/library/item/chronic-pain (TEST link)

Chronic Pain

As many as one in five Americans lives with chronic pain.[1] Many of these people suffer from neuropathic pain (nerve-related pain) -- a condition that is associated with numerous diseases, including diabetes, cancer, multiple sclerosis, and HIV. In most cases, the use of standard analgesic medications such as opiates and NSAIDS (non-steroidal anti-inflammatory drugs) is ineffective at relieving neuropathic pain. Further, long-term use of most conventional pain relievers, including acetaminophen, opioids, and NSAIDs, is associated with a host of potential adverse side effects, including stroke, erectile dysfunction, heart-attack, hepatoxicity, and accidental overdose death.
Survey data indicates that the use of cannabis is common in chronic pain populations[2] and several recent FDA-designed clinical trials indicate that inhaled marijuana can significantly alleviate neuropathic pain. These include a pair of randomized, placebo-controlled clinical trials demonstrating that smoking cannabis reduces neuropathy in patients with HIV by more than 30 percent compared to placebo.[3-4] (Additional details on these studies appear in the HIV section of this book.) In addition, a 2007 University of California at San Diego double-blind, placebo-controlled trial reported that inhaled cannabis significantly reduced capsaicin-induced pain in healthy volunteers.[5] A 2008 University of California at Davis double-blind, randomized clinical trial reported both high and low doses of inhaled cannabis reduced neuropathic pain of diverse causes in subjects unresponsive to standard pain therapies.[6] Finally, a 2010 McGill University study finding that smoked cannabis significantly improved measures of pain, sleep quality and anxiety in participants with refractory pain for which conventional therapies had failed.[7]
A review of these and other trials in 2011 in the British Journal of Clinical Pharmacology concluded, "[I]t is reasonable to consider cannabinoids as a treatment option for the management of chronic neuropathic pain with evidence of efficacy in other types of chronic pain such as fibromyalgia and rheumatoid arthritis as well."[8] A separate review published in 2012 in The Clinical Journal of Pain further concluded, “Overall, based on the existing clinical trials database, cannabinergic pain medicines have been shown to be modestly effective and safe treatments in patients with a variety of chronic pain conditions. ... Incorporating cannabinergic medicine topics into pain medicine education seems warranted and continuing clinical research and empiric treatment trials are appropriate."[9]
Preclinical data indicates that cannabinoids, when administered in concert with one another, are more effective at ameliorating neuropathic pain than the use of a single agent. Investigators at the University of Milan reported in 2008 that the administration of single cannabinoids such as THC or CBD produce limited relief compared to the administration of plant extracts containing multiple cannabinoids, terpenes (oils), and flavonoids (pigments).
Researchers concluded: "[T]he use of a standardized extract of Cannabis sativa ... evoked a total relief of thermal hyperalgesia, in an experimental model of neuropathic pain, ... ameliorating the effect of single cannabinoids," investigators concluded. ... "Collectively, these findings strongly support the idea that the combination of cannabinoid and non-cannabinoid compounds, as present in [plant-derived] extracts, provide significant advantages in the relief of neuropathic pain compared with pure cannabinoids alone."[10]
In 2009, an international team of investigators from the United Kingdom, Belgium and Romania affirmed these preclinical findings in a clinical study of intractable cancer pain patients. They concluded: "[I]n this study, the THC/CBD extract showed a more promising efficacy profile than the THC extract alone. This finding is supported by evidence of additional synergy between THC and CBD. CBD may enhance the analgesic potential of THC by means of potent inverse agonism at CB2 receptors, which may produce anti-inflammatory effects, along with its ability to inhibit immune cell migration. ... These results are very encouraging and merit further study."[11]
A 2011 clinical trial assessing the administration of vaporized plant cannabis in chronic pain patients on a daily regimen of morphine or oxycodone reported that inhaled "cannabis augments the analgesic effect of opioids." Authors concluded, "The combination (of opioids and cannabinoids) may allow for opioid treatment at lower doses with fewer side effects."[12]
Based on these findings, some pain experts are now advising that physicians recommend cannabis therapy in addition to or in lieu of opiate medications to "reduce the morbidity and mortality rates associated with prescription pain medications."[13]
REFERENCES
[1] New York Times. October 21, 1994. "Study says 1 in 5 Americans suffers from chronic pain."
[2] Cone et al. 2008. Urine drug testing of chronic pain patients: licit and illicit drug patterns. Journal of Analytical Toxicology 32: 532-543.
[3] Abrams et al. 2007. Cannabis in painful HIV-associated sensory neuropathy: a randomized placebo-controlled trial. Neurology 68: 515-521.
[4] Ellis et al. 2008. Smoked medicinal cannabis for neuropathic pain in HIV: a randomized, crossover clinical trial. Neuropsychopharmacology 34: 672-80.
[5] Wallace et al. 2007. Dose-dependent effects of smoked cannabis on Capsaicin-induced pain and hyperalgesia in healthy volunteers Anesthesiology 107: 785-796.
[6] Wilsey et al. 2008. A randomized, placebo-controlled, crossover trial of cannabis cigarettes in neuropathic pain. Journal of Pain 9: 506-521.
[7] Ware et al. 2010. Smoked cannabis for chronic neuropathic pain: a randomized controlled trial. CMAJ 182: 694-701.
[8] Lynch and Campbell. 2011. Cannabinoids for treatment of chronic non-cancer pain; a systematic review of randomized trials. British Journal of Clinical Pharmacology 72: 735-744.
[9] Sunil Aggerwal. 2012. Cannabinergic pain medicine: a concise clinical primer and survey of randomized-controlled trial results. The Clinical Journal of Pain [E-pub ahead of print].
[10] Comelli et al. 2008. Antihyperalgesic effect of a Cannabis sativa extract in a rat model of neuropathic pain. Phytotherapy Research 22: 1017-1024.
[11] Johnson et al. 2009. Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety and tolerability of THC: CBD extract in patients with intractable cancer-related pain. Journal of Symptom Management 39: 167-179.
[12]Abrams et al. 2011. Cannabiniod-opioid interaction in chronic pain. Clinical Pharmacology & Therapeutics 90: 844-851.
[13] Mark Collen. 2012. Prescribing cannabis for harm reduction. Harm Reduction Journal 9:

Marijuana and the Anxiety & Depression link

Recently, I began considering the possibility that perhaps I had set aside the ability to at least look at controlling some mood, as well as anxiety symptoms with the medically grown marijuana.

There is recent evidence that after a time, things that grow on as, even a habit, or behavior associated with chronic pain, or chronic illness, that do suggest the presence of psychiatric illness or psychological factors that play a role in the idea of pain being chronic over time and mood as well as anxiety.  Anti-anxiety medications all seem to head one way.

To an antidepressant.  When I took those, I grew even sicker.  They lead to a manic-induced psychosis.  However, that does not always mean a person is "bipolar."

You may spend time on it if you choose, and learn to cope with the side effects of the medications that some do need.

Psychiatric drugs I am probably sure,. are heavy hitting medications.  I don't doubt that there are many who do need those medications.  And I know that most of the people I meet who take some medications that I would have questioned as a prescriber as whether or not they needed to be on those kinds of heavy-hitting medications.

Sometimes, many people report after years of troubling side effects, that they would prefer to have never been given the atypical antipsychotics, or even some, anti-depressant medications, and given that the drying effects can right there cause enough damage to the GI system that loss of function can happen.  For myself, I take some small amount of anticonvulsant medications, but there are few that I would agree to at this point.

In alleviating anxiety, I would have to agree that a good Sativa does help with more acute levels of anxiety.  Over time, I also can safely say they can serve as a decent anti-depressant as well.  Balance some of the effects of the THC and d-THC, by using a strong Indica, perhaps.

One cannot go wrong, at least not in people who do well on the marijuana.

Does the pharmeceutical industry have a vested interest in keeping people on medications?  When the care for a person who's life is ruined by the over-use of such medications?  I would advise anyone to tread lightly.

For some, medical marijuana use can undoubtedly be helpful.  For others still, I think modern science has certainly been of benefit.  Knowing one's limits is always of crucial importance for success in doing either.

Use of medical marijuana, however, it does also seem to lower the person's desire to use pain medications, such as the opiates.  I would think the "good doctors" would have appreciated less paperwork.