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.

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For a profession that seems good at one thing, which is claiming to be "best" at viewing something as either a yes or no, or at least in general favor of medical marijuana, I think it's ironic the amount of garbage you wind up dealing with when you do encounter a doctor, nurse, or other member of the medical community.  Okay, whatever on that one.

Is it now "Enter Stage Left the Hippocratic Oath?"  Hardly, when most doctors, and almost no nurses take no kind of oath, Hippocratic or otherwise when graduating medical and/or nursing school.

Anyhow, there is also the anxiety and depression side of the RSD, and one that I think many of us tend to under-rate the effects of.  Or are wanting to admit we have.  Anyone who goes years or even weeks to months of chronic pain following a surgery, for them, that's a pretty high degree of pain.  No group of living, breathing people have got the corner on human suffering.

Including myself.  I had been quite good at causing a lot of my own suffering for a period of time, and that's not an easy task.  One I am quit good at, so I am continually reminded.  Now, by the right people.

When I'd rather hand over an opiate narcotic like methadone for a bag of meds, then I think for some of us, "weed" or hereafter, MMJ, is known as generally speaking, "Medicine."

Some support using Indica to treat pain, anxiety, and also depression.  It isn't all purpose.  I've done some amount of research, and I don't mean experimentation.  Try reading.  For depression, yes, most do choose an Indica, such as Kush, Blackberry Kush, and so on.  Although a popular strain, I favor ones with colors in them-blue, but purple and white mean really serious pain relief.

And a good, strong Sativa for anxiety.  Although typically one that responds to a "downer" or benzodiazepine, I think trying the Sativa, or at least, a high THC (dTHC) % of a 50/50, or for me?

10% Indica
90% Sativa

  EQUALS

Relief from some of the anxiety.  As well, for a time during the day, a good amount of relief from the depression associated with chronic pain.

Usually when aiming high (not stoned, numbers, LOL) I prefer to spend the money well.  I need pain relief, but we all have to sleep too.

I'm not totally sure this is relevant, but as a child, and a young adult, it was questioned as to if I had ADHD, or ADD.  I guess adding to to coffee would be weird?  Not if the doctors were right for a change.

Personally, I favor the "chase the demons away" approach.

Enjoy your meds, folks!!!

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Use Does Not Denote Abuse-In Everyone

First off, use doesn't mean abuse.  Not in everyone.  I think for some, yes, the long-term effects are unpredictable at best, and so are the short term.  The very reason I keep this blog are to keep track of when the meds I get are helpful, and what for.

And it's not always that MMJ (Medical Marijauna) is to blame for the increased problems a patient has, and the gastroenterologist is one reason that I want to pull my own hair out.  Their medications have all failed.  I refuse to take the ones that are supposed to stimulate motility even though I do have a motility disorder.  The reason is the "GP Protocol."  I spent ten miserable days in a hospital barely able to make it to the bathroom, and that's not a pretty set of medications to begin with.  The trouble is that there's too many misperceptions about what people do with MMJ.

It's assumed that if I "present" to a doctor with increased symptoms, they first attack this area of my life, and I totally get why they are concerned, I would be, because mostly I feel that people will abuse cotton if they are allowed to.  But assuming that I am one, it's assuming a lot.  The difficulty lies in finding balance, and knowing when you need to stop.  For me, it's when I feel a sense of thirst.  I get a cup of decaffeinated coffee, and since it does settle the stomach (in small amounts) and I can then be able to move into drinking some additional fluids.

And when I realize that when some do get increased nausea with their meds-it's usually when they have used too much.

Keep it legal.  Know your limits.  That does require some trial and error, but so does using some of the more modern meds, and those too, are also medications that can potentially be abused.

More of them are each passing day.

When someone does perhaps goof off a bit, perhaps they are blowing off steam, but generally they feel the need to for a good reason.

Sometimes, they also need people to cut them a break.  When you live with chronic pain, you can take abuse just for having that label.  I've been handed opiate narcotic policies in an ER that I would never take them from based on the fact I feel they are way too irresponsible with them.  People sleeping it off in the lobby because they are too messed up to take a bus home and have the bus ticket given to them by the ER in their hands?  No one is giving them a hassle about using that medication!

But that's the reality of taking an alternative medication too.  And sometimes understanding that it just goes with the territory and finding a more quiet outlet for blowing off steam-while you are not medicating.

And realizing that this just is not for everyone.  So with that?  Well, there's some wisdom in this!

Happy medicating, and do keep this one in mind:

Oral Surgery Recovery and Medical Marijuana

I have tested now my certification to include oral surgery.

Recently done surgery in three separate surgeries to include the removal/extraction of multiple abscessed teeth (all of them abscessed) in three separate surgeries, the best postoperative pain control for me, has been the MMJ.  I don't care for pain medications in terms of opiate narcotics.  They don't work.  For me, at least.

Also, part of the problem lies in how best to consume the said medication.  The preferable route is the use medibles, I am in agreement with that.

If that's not possible, the next factor to consider is vaporization or smoking.  It really doesn't matter, so long as you are in no way increasing pressure inside the mouth.  That can lead to dry socket, obviously because the clot protecting the operated area is literally sucked out.  If you don't mind this, go ahead.  The other problem is in the heating of the medicine itself.  That's done in vaporization and smoking to release the active ingredients in the flower.

And while it can irritate the area around the operated site, it may be advisable to simply tolerate what must be for a few days, and resume treatment.

Otherwise if you have access to a dispensary (I won't advise anything but doing this when it's legal, or where), I found the teabags that I used provide (with caffeinated teas, as this encourages clot formation, and stops bleeding faster) some pain relief when applied directly to the gum will also provide pain control.  Through direct application.  This also does minimize systemic absorption.

Additionally, it also can be taken from a cup, so drinking a lukewarm cup of tea will help.  One can make their own coffee once you've had a chance to heal up a bit, and stretch the coffee out while home recuperating.

Happy Healing!

Oral Surgery & Medical Marijuana Use

Medibles, whatever: coffee, tea, etc.

It doesn't make swelling worse, heck with RSD, I'm looking like a chipmunk in my own because pain and swelling but later, muscle atrophy.

Also, there are multiple other MMJ products.  A Dodo(r) pen, Rick Simpson oil, the regular hash oil, and so on, that may allow some pain relief in a personally chosen method.  If someone doesn't care for an opiate, then giving it to them anyhow isn't too productive.

If you aren't destroying your own life, or anyone else's, then the general idea is for a provider to consider themselves fortunate that your patient isn't hunting you down over 30 hydrocodone tablets.  Personally, having something-though I am not foolish enough to advertise, because I am quite sick medically, the basic assumption is that I am someone's 24-hour pharmacy.

I'm not.

People when you have something that really isn't responsive to pain medications, and also when taking much of any of them will shut down my gut, I have been fighting to keep it working as you would be able to note from reading the blog entries from these past several months.

 

Back to Basics

I'm posting some of the main numbers reputable dispensaries and why it's in the best interest to get meds this way.

Name

DOB

Name of strain

% Indica and % Sativa

THC %

CBD %

This is crucial to those wishing to do this right.  More to medical marijuana than "getting ripped."

%Indica & % Sativa

Most MMJ are technically a hybrid and there's huge advantages in listening to staff recommendations to target various symptoms.  Indica is great for:

-pain

-nausea & Vomiting

-Reflux

-anxiety

-insomnia

SATIVA

For most this is the stimulating part of MMJ.  I have ADHD so except my GI tract I'm usually highly sensitive.

To any medication, benign ones and I've had mood and psychosis on prednisone to treat asthma but this winter I did a stupid thing in the name of targeting a cause.

Sometimes you just medicate some pain until function returns.  Keep reading.

CBD %

CBD is cannabOID.  The natural steroid in MMJ.  I must obsessively watch values of >0.075% when most can take 0.10-0.25 or 0.30% to calm severe pain and treat inflammation and the cause of pain in autoimmune.

Pain meds calm anxiety but also cover pain, and with pain having a function you have to balance what is tolerable and what you must cover in order to function .

THC %

I aim high at 15% or better but the unpredictable nature of this a good quality strain of 11-12% can surprise me.

I say "Keep an open mind". For example, topicals are great for allodynia, learning to make oils is tricky.  But effective for certain.

Especially for oral surgery and so forth .

So my choices were:

Blueberry Cheesecake 90% Indica, 10% Sativa.  THC is 15.92% CBD <0.07

-pain & muscle spasm

Afgoo x Chem Dawg 90% Indica

THC 17%. CBD negligible

-SLEEP

Blue Hawaiian. 50% Indica/50% Sariva 

THC 11.42%. CBD Negligible

-Vomiting

-stimulates some (for me) gastric motility

    --this is painful

         --use a "salad bowl" to offset pain

Headband 80%Indica/20% Sativa

THC 18%. CBD negligible 

-PAIN

I am one who saves containers a f write on the label what helps what and I can target various symptoms and signs.

Enjoy some relief!!!!

On my "gastric stimulator"

Okay, the gastroparesis responded to using the Sativa to stimulate gut function.

And I am still not doing it or having a fake one put in.

Why, daresay do I decide upon such "suicide."  The answer is simple.  It hurts like heck!

It makes it neither straightforward nor an easy decision, but I am also not one thing, and that is a masochist.  I may weigh in at a smashing 175 and at 6'0 some doctors would say I am maybe a bit thin, but of a healthy weight.

One neurologist would tend to disagree.  He may no longer be mine (jump ship when I need you and I don't tend to stick around), but what I refuse to do is inflict pain on others-or myself.

Am I inflicting more pain by going ahead and not treating?  Call it quality of life issues, and when discussing my own, pain issues, are one, and when in enough physical pain, many people eventually blow the lid.

I plan not to be one~and plan also to remain seizure free long enough to get a driver's license back, and to stop being so irritable.  When I already remain in my home because I prefer to keep company of people who are not going to screw up vaping a half gram or maybe a bowl after I visit with my son, then I plan to remain in the group who experience some pain control.

And for too long, pain is one thing that has been out of control.  I may have medical marijuana, but I'm limited on the steroid issue, but also I am liking the feelings of not feeling like I'm in so much pain I am going to lose it.

Current need for surgery to which a solution is neither easy or also a surgery isn't something I volunteer for without a distinct need.  I have been guesstimated that to be of a totally healthy weight, I need to be around 185 pounds to be considered "healthy."

I still do not care for the increased pain-salad bowls did not help.  So, faced with a hard decision, I decided not to cause too much more damage lead to by increased pain.

Some things are just not worth it.

Smoking resin and cleaning supplies

Like many, and by and large without pre-existing and bad lung damage from smoking tobacco, and given I don't, the bad news is when I'm low on meds, then generally, I have found even small amounts, the "build-up" inside the bong, to be honest, that alone triggers some bad anxiety on my end.  As of 7/29, I feel the increase in pain has been consistent, but the anxiety was mostly due to an infection combined with the resin build-up in the bong, I have since been taking primarily Indica and switched devices, consuming on private property and also in a well-ventilated room or outside.

And Sativa's are quite easy to use (for myself and what works for us each, we discovered it's quite painful, so opting back to the mostly pain management and going with a mostly Indica "diet" of having a primarily Indica medication quantity, though because of the detour in treatment and use of Sativa, the stimulation of a gut that does not function being painful-unplanned, I guarantee you...) but I was not anticipating and had to temporarily increase the Indica to offset the increase in pain.

Such as it is, the following lab numbers are on a month where pain is more like a manageable level and most of the time, we all have some "catching up" from flare-ups, illness and a normal tolerance for the MMJ.

Entering on the saved medicine wrappers, I tacked them (empty of course) to the bulliten board to note what symptoms help, note it, and enter it all into a spreadsheet.  I respond best overall with a no more than 70-100% Indica, but most 100%'s have a higher CBD, so since I respond badly to steroids of any kind, quit doing that part.

A science if you will.

1.  Sativa is activating either way for me, it's not worth the pain to manage this: whatever I am able to actually function, etc!  :)

2.  Allowing resin build-up can give you more resin than realized, and if this is old, then replacing them about every six months seems wise.
            -You can clean the small pipes after use, hand sanitizer or soaking in hot and soapy water, not
              everything comes totally
3.  For me, the intolerable anxiety is what sealed the decision to continue treating as I am currently.

 

Analysis of Labs I use for Information on Meds

Okay, so discussion of the "Endocannaboid System," and some of the various health conditions kind of brings me to the part of what lab values on the MMJ I prefer, and what means what (at least for me, everyone varies some-even opposite of others), and since marijuana can be unpredictable in the human body, staying aware of what you feel, how and when is pretty key in doing this right: and successfully.

No one of us can predict with any degree of certainty how we are going to respond to any medication and MMJ is certainly not an exception.  I have the benefit of the college education, the required courses I had in pharmacology, though medical marijuana's breakdown of ingredients that are active, versus testable values, make simplicity a bit of a necessity too.

THC, dTHC

THC is the first tested active ingredient.  After knowing this, other values are key too.  For "top shelf" typically the cost does vary a bit from dispensary to dispensary.  Private caregivers, I haven't much experience in using, however, the advantage is this is often a "donation point" for many users of this treatment are going to be able to at least try to target various symptoms.

Typically the rage I pick, based on the diagnosis under "chronic pain," is the Reflex Sympathetic Dystrophy.  In this legal document I come to call, as does a friend of myself, "weedwork," and so it is.

When the range of THC content, or aka, dTHC, this is usually the "strength of pain reliever," and for some, the antinausea effects are a bit different.  Indica's typically offer the most pain relief, but this does depend on cause.

Sativa/Indica percentage

INDICA:  For most, the stronger "pain med" is the Indica, though for some, the mellow feeling can also be found in the majority of plants, and Indica is favored by some for antinausea-this depends on the cause.

Some find additional relief in the few 100% Indica strains, that also have a high CBD level.  That's to be discussed.  However, to note that everyone is an individual, so prediction of a response can be given.

• Pain
• Anxiety
• In some, depression
• Nausea & Vomiting
• Topical applications help nerve pain

SATIVA;

I typically see only a minority of totally Indica or totally Sativa.  On occasion, a 100% can and does happen, with probably highly selective "breeding" or cross strains, seed to Flower, as it's called.

The Sativa is more stimulating for most.  I do have ADHD, as well as seizures from the 1983 brain injury that left a couple lesions, resulting in a lifetime of toxic medications, to which are now reduced in number as well, however, it has left me with a bit of nerve damage, and gastroparesis.

Briefly, for me, the Sativa is actually one that mellows me out, but increases gastric motility.  This paradoxical reaction also is typical of the kids who respond to neuro (brain) stimulatants, such as Ritalin. An example, this does not ever advocate for giving MMJ to a child, certainly not even my own.

• a calming effect that reduces anxiety
• a behaviorally stimulating effect that adds to a person's energy level and sense of well being
• depression
• Anxiety
• ADHD (adults)
  

However, some adults, do feel best on a more natural option, I feel at some point, autonomy is the option for most parents, however, for my own, it's not exactly one I advocate.  And a hot issue I plan to leave alone.

CBD/CBN:

The presence of natural steroid, cannaboid.  This number for me, is not usually above 1.0%.  Levels can be much higher, however, some react in very unpredictable ways.  And no one can predict human behavior in few ways, save using history to do so.

But a physical response for me, is the reason I limit myself with respect to some pain relief, however, there is only so much you inflict on yourself, and on others, when I am physically miserable, or even depressed, I make lousy company.

Most do.


Anyhow, the summary-

Sativa is for me, is less behaviorally stimulating, and even the "prednisone taper," is a bit of a joke for some, but those close to me even, have found similar effects.  But mentally, the steroids do affect me, and not for the positive.  And given the half-life before even a UA is going to come up "clean" takes up to a month.  So the effects of a steroid for many are a pleasantly significant drop in pain levels, which allows anyone with a chronic pain condition to relax naturally.

Kind of more in line with Mother Nature.

One friend, she also shares my own reactitvity, and I do recommend trying CBD for the anti-inflammatory effect, but knowing only so much can one person tolerate, and no two people are the same, and let alone all of us.  However, sometimes we can cause more problems than we solve with medicines.  Prednisone left me marked with suffering-I developed Avascular Necrosis, and then surgery to see if the joint stabilized, and the Reflex Sympathetic Dystrophy was diagnosed for the second time later that year.

Kind of a turn off for me.

The Indica is the one many lean on for pain relief.  As well, anxiety, and if coping with an opiate taper, I do recommend that at least some attempt at symptom relief would be found.


Enjoy the day!

Those who are not able to remember the past-are destined to repeat it...

By repeating the past, though, it leaves no room for the future, you are "too busy"... getting tunnel vision.

People change, every day, those unwilling or unable to, well, they have a bigger problem, inability to change with the "changes" that life throws at you, well, that unweilding, unbending attitude, is much more problematic.