Understanding CBD Oil: Proof of Potency
Understanding CBD Oil: Proof of Potency
Previously we discussed the basics of industrial hemp. Today we’ll devil into the details of an important part of industrial hemp production when making a product called CBD oil. That step is the use of liquid chromatography.
We now have dozens of companies selling CBD oil. This material can be sourced from the seeds, stalks, leaves and flowers of industrial hemp. Or in many cases hemp stalks are all that’s used. It typically does not come from marijuana with a high CBD content. There are some exceptions like Charlotte’s Web extracts which come from the varietal.
These products are touted as CBD oil which means they are supposed to be rich in CBD, but are they? Sadly, industrial hemp is not rich in CBD. It takes many more chemical steps (and money) to concentrate the CBD from industrial hemp raw materials. Therefore, some unscrupulous firms may cut steps and costs while providing you with an inferior oil. They can do it because there is no legal definition of what CBD oil (or anything else for that matter) is supposed to be.
REQUESTING PROOF OF POTENCY
I have contacted a half-dozen large, popular, companies asking for a third-party, laboratory analysis of their CBD oil. I requested a copy of their report clearly showing the current batch analyzed (batch number), with the date that the analysis took place. The report needs to contain a breakdown of the cannabinoids by percent-usually mg%.
What you usually get from most websites is a photo of their CBD product with a label. If you can read it, the label might say CBD 17%, for example. That means that there are 170 milligrams of CBD per cc of fluid. But they can say anything they want. A label is not proof of anything. We need more than a simple label.
FOLLOWING GMP
All businesses should be doing what the below company claims to be doing.
From the US Hemp Wholesale website:
All of The US Hemp Wholesale CBD oil is manufactured under strict quality controls in an FDA-registered cGMP (FDA Current Good Manufacturing Procedures) certified facility, and is extracted utilizing Supercritical Fluid Extraction (CO2). Independent labs test each batch using high-tech liquid gas chromatography for verification of purity and concentration of CBD (cannabidiol) at various stages of production, from seed to shelf. Additional tests for yeast, molds, E. coli, coliforms, and total aerobic count are also performed for each batch, along with heavy metals testing. No chemical solvents are used in the production of these oils.
The occasional blind-test is done at SC Labs in Santa Cruz, CA, to double check that the product is as advertised.
Claims like this are pretty standard for reputable companies. In the above statement we clearly see that tests are always performed BUT WHERE ARE THE TEST RESULTS? In this particular case I looked everywhere on their site. There was no “lab test” section that I could find. Where are the so-called “blind tests?” I could not find where proof was offered anywhere.
In fairness I did not contact this particular company for proof so they may indeed offer verification upon request. But why do we need to go out of our way, waiting days for a response? It would be better if they had a section which demonstrates proof of their claims.
Like the above, Real Scientific Hemp Oil (RSHO), provides a slick product with a label batch number and concentration on the syringe. Excellent so far. What they don’t provide is proof of authenticity. That requires a copy of their third-party lab analysis.
WHAT IS THE ROLE OF THIRD PARTY TESTING?
When a company produces are product which they claim contains a certain element or chemical in it, they need to have it analyzed for concentration or potency. In this case the testing would involve a highly sophisticated instrument called a high-pressure liquid chromatography machine. It should provide % concentrations of numerous cannabinoids. The below site offers at least 8 cannabinoids for analysis on one of their sample printouts. How many different cannabinoids is up to the lab, how much the consumer wishes to pay, and the sophistication of the machine. All of them will test for the major players CBD and THC.
From the Analytical 360 website:
Analytical 360 employs High Pressure Liquid Chromatography (HPLC) technology to directly quantify the total cannabinoid content of medical cannabis. Beginning with dry-weight determination, we analyze the percentage of water contained in each sample to ensure proper preparation during the curing process. Our quantification process then identifies and measures the amount of total Cannabidiol (CBDA + CBD), Tetrahydrocannabinol (∆9THCA + ∆9THC + ∆8THC), Cannabinol (CBN), Cannabichromene (CBC) and Cannabigerol (CBGA +CBG). We also measure the Terpene content (Linalool, Myrcene, Limonene, Terpinolene, α-Pinene, β-Pinene, Humulene, Caryophyllene, and Caryophyllene oxide). These key Cannabinoids and Terpenes give cannabis many medicinal properties.[ref](http://analytical360.com/cannabis-analysis-laboratory/potency-testing) 06/15/2015[/ref]
The official, certified test is then printed up and given to the company. It might look like the below image:
The printout was produced by Analytical 360 as were the below images which are screen shots of the machine’s monitor. In the next article I’ll give you the results of my requests for laboratory evidence.
Does Cannabis Help Treat Neuropathic Pain?
Does Cannabis Help Treat Neuropathic Pain?
I discovered during my research that there remains a paucity of clinical data on cannabis for treating skin and many other disorders. However, the bandwagon of research clearly is the use of cannabis in treating numerous forms of pain, including a very special type called neuropathic pain. Here, there exists a wealth of information.
WHAT IS NEUROPATHIC PAIN?
From WebMD:
Neuropathic pain is a complex, chronic pain state that usually is accompanied by tissue injury. With neuropathic pain, the nerve fibers themselves may be damaged, dysfunctional, or injured. These damaged nerve fibers send incorrect signals to other pain centers. The impact of nerve fiber injury includes a change in nerve function both at the site of injury and areas around the injury.
One example of neuropathic pain is called phantom limb syndrome. This rare condition occurs when an arm or a leg has been removed because of illness or injury, but the brain still gets pain messages from the nerves that originally carried impulses from the missing limb. These nerves now misfire and cause pain.
Causes of Neuropathic Pain
Neuropathic pain often seems to have no obvious cause; but, some common causes of neuropathic pain include: Alcoholism, Amputation, Back, leg, and hip problems, Chemotherapy, Diabetes, Facial nerve problems, HIV infection or AIDS, Multiple sclerosis, Shingles, Spine surgery
Symptoms of Neuropathic Pain
Neuropathic pain symptoms may include: Shooting and burning pain, Tingling and numbness
I have considerable experience treating neuropathic pain starting at Rancho Los Amigos hospital in Duarte, CA. This was where many gang members ended up after a stabbing or other trauma. It’s where we preformed nerve blocks specially prescribed to help this agonizing condition. Years later, I’d treat patients using acupuncture and Chinese herbs as an effective adjunct to conventional approaches.
Some forms like RSD (see below) are crippling and lead to a high disability rate. Once you have a diagnosis of this condition you will begin treating it like a new career. It’s relentless, very painful, and unresponsive to modern medicine.
Reflex Sympathetic Dystrophy (RSD) leads to a shriveled, cold, painfully sensitive arm (if it occurs there). Over time the limb contracts, loses its hair, the skin becomes shiny and atrophic, it becomes cold, the nails thicken and brown, and of course there’s pain. The pain is unusual too. It’s often shock-like, or tingly, or painfully cold or even hot. The slightest thing like a breeze can be horrifyingly tender to the ultra-sensitive skin. The list goes on.
Sure we can get temporary relief using nerve blocks, opiates, and antidepressants but this is a condition that goes down fighting. They always come back for further therapies because there’s never much relief past about one week using invasive nerve blocks, and that’s the best we have.
If there were ever a reason to use medical marijuana this is the case. The drugs we often use have terrible side effects like dry mouth and excessive sedation. Of course chronic opiate use is still employed which leads to dependence. Yet opiates do not treat this type of pain very effectively.
ENTER CANNABIS
From the World Congress on Pain held in 2014:
Treating Neuropathic Pain with Cannabis: Pro and Con
Debate-style session at World Congress on Pain focuses on safety, efficacy of marijuana for neuropathic pain
A vote for efficacy
The scientific rationale for the use of cannabinoids in pain is clear, Ware explained: Throughout the nervous system, endogenous cannabinoids act as synaptic circuit breakers. These small lipid neuromodulators bind to specific receptors on presynaptic terminals, where they block the release of neurotransmitters. Because their receptors are widespread, cannabinoids, whether endogenous, plant-derived, or synthetic, regulate neurotransmission in many circuits, including in pain-producing pathways (for a complete overview of cannabinoids in pain, see Hohmann and Rice’s Chapter 38 in the Wall and Melzack’s Textbook of Pain, Sixth Edition, 2013). To the extent that neuropathic pain stems from abnormal neuronal activity, it makes sense that cannabinoid receptor (CB) agonists should be analgesic, and their effectiveness has been shown in many models of neuropathic pain in animals, using both natural and synthetic cannabinoids.[ref](http://www.painresearchforum.org/news/48905-treating-neuropathic-pain-cannabis-pro-and-con) 06/18/2015[/ref]
In the next installment I’ll go into much greater detail on the pros and cons of using this new, novel, pain reliever called cannabis.
***
Let’s continue our discussion of cannabis in the treatment of neuropathic pain with a spirited soliloquy from the World Congress on Pain.
Taking the pro side was Mark Ware, a pain clinician at McGill University, Montreal, Canada. Ware is the director of clinical research at the Alan Edwards Pain Management Unit at McGill and director of the nonprofit Canadian Consortium for the Investigation of Cannabinoids (CCIC). On the con side was Andrew S.C. Rice, Professor of Pain Research at Imperial College, London, UK. Rice, who is also a practicing pain clinician, has done research on cannabinoids and their use for pain.[ref](http://www.painresearchforum.org/news/48905-treating-neuropathic-pain-cannabis-pro-and-con) 06/19/2015[/ref]
Compelling evidence already exists in the literature which supports cannabis as an effective and safe medication in the treatment of the relentless pain of neuropathy. We even have a scientists dream: a model that can explain the mechanism of pain relief. For patients who are victims of some of the most dreadful, and agonizing conditions that humanity could ever endure, hope is here!
Once again, endocannabinoids are proving to be worthy allies capable of mentally hamstringing the most truculent drug company scientists. In other words, this humble herb has a syllabus of “cures” that Big Pharma can only look at in astonishment. And all of it is natural.
Dr Ware explained that the cannabinoids act as modulators, “circuit breakers,” on numerous nervous pathways. Within these pathways, CB receptors are located at many key sensory intersections as seen in his Power Point slide of a nerve terminal (below).
Once the nerve is stimulated by an action potential (normal nerve conduction) endocannabinoids such as anandamide flow retrograde up to the PRESYNAPTIC terminal (see top bold arrow) to dampen the forward flow of nervous information. This leads to less pain impulses being generated and perceived. This decrease is interpreted as pain relief.
This model also clearly explains how and why cannabinoids are capable of arresting seizures that are treatment resistant. They decrease the flow of information thus stopping the seizure.
With the ability of the cannabinoids to attenuate nerve impulses it makes perfect sense that these substances could be excellent pain relievers. And they are. We already have proof from dozens of studies. Here’s an example:
Proof of efficacy. Dr Ware quoted an article from his decidedly antagonistic, protagonist Dr Rice (Phillips et al., 2010), which supports the use of smoked cannabis as an efficacious medicine in the treatment of HIV-associated sensory neuropathy (a type of neuropathic pain).
From Dr Ware’s Power Point presentation:
The below slide shows many other neuropathic conditions that respond positively to marijuana ingestion. Many of these are terribly painful conditions.
In clinical trials smoked cannabis is often times too difficult to quantify for scientific studies, Ware continued. That hurdle was somewhat overcome by the advent of vaporizers.
NEW HIGH-TECH DOSING
Perhaps even better that vaping is a new technology being developed which allows the user to inhale “granulated” cannabis much as you would use a rescue inhaler for asthma. This allows precise dosing that keeps blood levels below “recreational” so that the patient is pain free but not high. An example of the inhaler is shown below from Dr Ware’s Power Point presentation.
Dr Ware commented that many patients smoke marijuana because it relieves their pain, this is a patient driven industry, and drug companies are simply following up on promising leads.
Furthermore, the adverse effects of pot come mainly from those wishing to get stoned. Effects like impaired driving, psychosis, sedation, anxiety, tolerance, dependence, changes in cognitive function, orthostatic hypotension, and other effects.
This is not true with your average patient seeking relief from pain. They are not necessarily vying for a recreational stoning.
***
In the last segment from the World Congress on Pain, Dr Ware was featured as the supporter of medical cannabis. On the con side was Dr Rice, who concedes that animal data clearly support the use of cannabis for pain. However, studies involving humans are more equivocal.
Moreover, cannabis is not approved for treating neuropathic pain in any country. Rice does not endorse the use of pot for patients with neuropathic pain. He claims that there is accumulating evidence of long-term harms associated with cannabis use. “Is it safe?” Rice asked. “I don’t know.”
LONG TERM HARMS?
He goes on to quote several studies that show an increased risk for psychosis. A meta-analysis of seven studies demonstrated a three-fold increase in the risk for psychosis among users of marijuana (Semple et al., 2005).
This becomes an even greater concern, he reminds us, since the potency of cannabis has increased fourfold over the last 30 years (Volkow et al., 2014).
There is also some question of cognitive decline as some studies suggested that this occurs in those who start smoking in adolescence and continue into their late 30’s.
Rice then refers to the diet drug Rimonabant (an endocannabinoid antagonist). Sadly, its use led to higher rates of depression and suicide. It was removed from the market several years ago.
That shows the dangers of tinkering with the cannabinoid system in the brain, Rice said. It also highlights the critical need for long-term follow up in future clinical trials of cannabis or cannabinoids.[ref]IBID[/ref]
From the Power Point slide shown below from the World Congress on Pain. Dr Rice’s main concerns are the increased risk for psychosis and cognitive decline. His talking points are summarized in the Power Point slide that he presented (see below).
Stop for a moment and appreciate what neuropathic pain is all about; managing the pain will become your new career. That’s because many forms are excruciating and demand your attention at all times. While there is no effective treatment, you’ll still be taking many drugs in a wretched attempt to placate the anguish.
As Elvis Costello chirped in his bemused fashion: “I used to be disgusted, now I try to be amused.” That might be an appropriate response when we realize that patients are swimming in an ocean of polypharmacy. It’s become a risk factor for increased mortality. A study from Kaiser California showed that the average patient aged 60 is on over 30 medications! We could certainly use safer drugs if we had them.
NOT A VERY CONVINCING ARGUMENT DR RICE
Now can I get a volunteer please? Tell the poor soul ravaged by the scourge of neuropathic pain that you don’t approve of him using cannabis. Tell him no, even if it greatly helps his condition.
When asked why, you’ll tell him there’s a small risk of psychosis (in adolescents only), and after decades of using marijuana your memory or ability to juggle numbers may possibly diminish.
I find that argument amusing. This same doctor would have no problem prescribing, for example, a statin which can cause neurodegeneration and total global amnesia (see Dr Graveline’s book Lipitor Thief of Memory). But lord forbid, don’t prescribe a plant extract with a safety profile better than sugar.
This attitude is very common among community doctors and scientific researchers. It displays a bias toward drug company pharmaceuticals which only slows down our progress in cannabis research.
***
Most of the reluctance to use marijuana is due to a concern among physicians that there is insufficient data to support safety in long-term use of marijuana for neuropathic pain conditions. Those concerns were mostly in the orbit of increased risk for psychosis and cognitive decline.
However, we are not talking about treating kids. Only when kids start smoking pot at an early age is the risk for psychosis great and only to those genetically at risk. But teens and tweens are at greater risk for schizophrenia anyway, with or without using pot. Furthermore, some studies suggest only an association with pot smoking and psychosis not causation. Kids with emerging thought disorders need to avoid marijuana in all of its forms.
Meanwhile, epidemiologic evidence suggests that there is little risk for adults. We have an entire generation of Baby Boomers who love smoking pot. We have no evidence that they suffer from cognitive decline or are at increased risk for psychosis.
We are concerned with adult patients suffering severe and intractable pain which is resistant to conventional therapy. Here the cannabinoids could be a safe and efficacious treatment. From the World Congress on Pain:
Going forward, Rice said, researchers should aim at improving the therapeutic index of cannabinoids, including identifying non-psychoactive analogues and non-brain-penetrant analogues that can produce analgesia at sites outside of the central nervous system. In addition, he pointed to ongoing clinical trials with fatty acid amide hydrolase (FAAH) and monoacylglycerol (MAG) lipase inhibitors, which prevent breakdown of endogenous cannabinoids.[ref](http://www.painresearchforum.org/news/48905-treating-neuropathic-pain-cannabis-pro-and-con) 06/20/2015[/ref]
The above demonstrates laudable goals. I am in total agreement. Yet, these dream drugs are years away. It will take 5-10 years before we would see any of them commercially available.
Dr Ware (from the World Congress on Pain, see previous article) added that although there are very promising pharmaceutical approaches in the pipeline, these desperate patients need something NOW.
We have patients struggling now and need to figure out how to use this today.[ref]IBID[/ref]
Let’s take a closer look at some of the more compelling studies that offer sufficient proof for the average clinician to steer him or her in the direction of a cannabis recommendation.
LOW-DOSE VAPORIZED CANNABIS
In 2013 the Journal of Pain published a study that found the use of low dose vaporized cannabis an effective drug in the management of “treatment-resistant” neuropathic pain. The effects were just as good using low dose THC versus a higher dose which is curious. Based on this study a patient could achieve excellent pain relief without cognitive impairment. A plus for clinician and patient alike.
Vaporized cannabis, even at low doses, may present an effective option for patients with treatment-resistant neuropathic pain…
The analgesia obtained from a low dose of delta-9-tetrahydrocannabinol (1.29%) in patients, most of whom were experiencing neuropathic pain despite conventional treatments, is a clinically significant outcome. In general, the effect sizes on cognitive testing were consistent with this minimal dose. As a result, one might not anticipate a significant impact on daily functioning.[ref]J Pain. 2013 Feb;14(2):136-48.[/ref]
WONDERFUL NEWS FOR NEUROPATHIC PAIN PATIENTS
The AMA Journal of Ethics reported on recent research into the use of cannabis in treating painful peripheral neuropathy. This is a common type of neuropathic pain typically associated with diabetes but can be caused by HIV/AIDS, trauma, MS, adverse drug effects, and toxins.
One of the best drugs available in the treatment of neuropathy is called Elavil. Elavil is an old drug of the tricyclic antidepressant class. It has a “side effect” of relieving neuropathic pain. It’s also pretty debilitating even at low doses. It knocks you out while delivering a titanic “cotton mouth,” effect. It’s much stronger than the worst forms of dry mouth from smoking pot.
There’s a little gem hiding in this report. If you examine the figure below you’ll see that marijuana ranks nearly as powerful in the number needed to treat (NNTT) in order to relieve pain as the best we have, Elavil (under tricyclics).
Note also that the SSRI’s, and the drug company dog in search of a home, gabapentin and its wayward sister lamotrigine, look abysmal compared to cannabis. These pharmaceuticals are nearly worthless and have terrible side effects too.
***
CANNABIS RELIEVES ALLODYNIA
Below is another study out of many that clearly demonstrates the unique and potent ability of cannabis preparations to relieve agonizing neuropathic pain.
The University of Glasgow in the UK reports:
These findings demonstrate that, in a meaningful proportion of otherwise treatment- resistant patients, clinically important improvements in pain, sleep quality and SGIC (Subject Global Impression of Change) of the severity of their condition are obtained with THC/CBD spray,…THC/CBD spray was well tolerated and no new safety concerns were identified.[ref](http://www.unitedpatientsgroup.com/blog/2014/03/13/study-cannabis-effectively-treats-neuropathic-pain/) 06/20/2015[/ref]
This study focused on the relief of a novel form of pain called allodynia which is as maddening as it is crippling. Imagine a cool summer breeze causing your arm to feel as if it were on fire.
Allodynia is pain, generally on the skin, caused by something that wouldn’t normally cause pain. Many people with fibromyalgia report having this symptom. Examples of allodynia are pain caused by mild pressure from clothing, a light touch, gentle massage, or sheets rubbing against the skin.
Allodynia is believed to be a hypersensitive reaction that may result from central sensitization, which is associated with fibromyalgia.[ref](http://chronicfatigue.about.com/od/glossary/g/allodynia.htm) 06/20/2015[/ref]
This disorder is associated with many conditions not just fibromyalgia. As you might imagine, this ailment is terribly uncomfortable. Drugs simply do not help much. Usually by the time you receive some pain relief from pharmaceuticals you are pretty intoxicated and ready for bed. That, the ultra-dry mouth, the blurry vision and urinary retention, are usually enough to preclude one from taking these meds for any length of time.
OTHER TRIALS
The University of Glasgow provided a summary of recent studies supporting the role of cannabis in treating several types of neuropathic pain. We have already covered several of these from the list.
A 2011 study of the effects of smoked cannabis on HIV neuropathy found statistically significant improvement in pain, as well as mood and daily functioning.
According to a 2010 study, post-traumatic and postsurgical neuropathic pain can be effectively treated by smoking cannabis.
In 2011, researchers found that vaporized cannabis, even in low doses, helped with general and peripheral neuropathy in patients who didn’t find relief from traditional treatment.
A 2004 study found a clinically relevant analgesic effect from THC pills on neuropathy associated with multiple sclerosis.[ref](http://www.unitedpatientsgroup.com/blog/2014/03/13/study-cannabis-effectively-treats-neuropathic-pain/) 06/20/2015[/ref]
AND THE WINNER IS
The bottom line is that cannabis is a real winner.
It provides pain relief almost as good as the gold standard Elavil (or a similar TCA) without knocking you into next week. Its safety and side effect profile is unrivaled when compared to the shopping list of expensive, ineffective, and often toxic medications that are the mainstays of conventional medical therapy.
Below is a well-designed schematic approach for physician decision making in jurisdictions where medicinal cannabis is permitted.4 Note once again that this is cannabis WITH THC, not simple CBD oil.
Although smoking a marijuana cigarette is the most common form of self-medication, the authors of the studies cited prefer either an oral spray like Sativex®, or a vaporized product to ensure a safer, metered dose.
In summary, there is increasing evidence that cannabis may represent a useful alternative or adjunct in the management of painful peripheral neuropathy, a condition that can markedly affect life quality. Our society should be able to find ways to separate the medical benefits of making a treatment available to improve lives when indicated from broader social policy on recreational use, marijuana legalization, and unsubstantiated fears that medicinal cannabis will lead to widespread cannabis addiction.[ref](http://journalofethics.ama-assn.org/2013/05/oped1-1305.html) 06/20/2015[/ref]
Well said. Lastly, recall that the prevalence of diabetes is astronomical in the first world. Most of them will develop peripheral neuropathy. Let’s get the word out that these patients finally have a safe and effective drug to relieve their chronic pain.
Understanding Cannabis Terminology: Industrial Hemp and Oils
Understanding Cannabis Terminology: Industrial Hemp and Oils
As a chemist and medical doctor I found the lack of proper nomenclature to be a hindrance in defining how cannabis preparations can help treat medical disorders. For the consumer, it’s very important to know and understand what these terms indicate.
The most compelling reason is that many patients seeking medical applications for their particular condition need to know if they are taking the right medicine for the right job.
For example, what’s the difference between hash oil, cannabis oil, Rick Simpson oil, hemp oil, hemp seed oil, and CBD oil? Can they all treat cancers, what about PTSD, insomnia, or skin rashes? When do we need THC in our preparations, when don’t we? We’ll cover industrial hemp products today, followed by CBD oil in my next article. In a separate piece I’ll review cannabis oil, what it is, why we need it, and how to make it.
INDUSTRIAL HEMP
From the Hemp Industries Association website:
The term “Hemp” refers to the industrial use of the stalk and seed of certain varieties; Cannabis or “marijuana” refers to the smoking or ingesting of the flowers and leaves of certain other varieties.
Psychoactivity requires high levels of THC — Tetrahydrocannabinol. Cannabis contains 5%-10% THC
[or much more]
. Industrial hemp contains only .3%-1.5% THC, yet has a higher concentration of Cannabidiol, or CBD, which maintains an inverse relationship with THC and tends to moderate its effects.[ref](http://www.thehia.org/faq7.html) 06/10/2015[/ref]
Hemp is a schedule 1 substance meaning it has a high abuse potential with no medical uses. Yes, I’m laughing too but that’s what happens when uninformed politicians make our laws. You could smoke hemp all day and have nothing to show for it but kennel cough and a migraine.
The seed products are legal in the US and UK. There are hemp seed products sold as food, they are: whole seed, shelled seed, seed oil, seed meal and presscake. In addition the plant provides non-food oil as lubricants, and many forms of fiber for making paper and textiles. It’s most underutilized application is for fuel. The hemp landscape is slowly changing as several states have legalized growing hemp in the US but it’s off to a glacial pace.
THE CONFUSION
The main problem is the confusion between hemp oil and cannabis oil which has emerged as states passing medical marijuana laws allow for the use of varietals of marijuana that are low in THC and high in CBD.
One example is the varietal called Charlotte’s Web which is quite high in CBD and low in THC. It was bred to be high in CBD for treating “status epilepticus” (seizures that do not respond to conventional therapy). It is not psychoactive. You may or may not achieve success treating seizures using simple CBD oil verses this product.
HEMP OIL, CANNABIS OIL, CBD OIL
Consumers often confuse hemp oil with cannabis oil and with CBD oil. CBD and hemp oil are both much lower in THC and contain CBD. CBD oil is supposed, by definition, to be much higher in the CBD fraction than any other type of oil, hence its name.
Hemp oil sold in stores is hemp seed oil. Rick Simpson calls his cannabis oil “hemp oil.” See how easy it is to get confused?
CBD is not a product or component of hemp seeds, and labeling to that effect is misleading and motivated by the desire to take advantage of the legal gray area of CBD under federal law.[ref]http://www.mintpressnews.com/hemp-oil-versus-cbd-oil-whats-the-difference/193962/) 06/10/2015[/ref]
With the market ablaze, and growing at an alarming rate, it’s crucial that consumers know the difference between hemp oil and CBD extracts. Eric Steenstra, executive director of Hemp Industries Association, had this to say:
Though hemp oil does contain low levels of CBD, typically less than 25 parts per million (ppm), CBD extracts “are produced either directly from cannabis flowers that are up to 15 percent CBD (150,000 ppm), or indirectly as a co-product of the flowers and leaves that are mixed in with the stalks during hemp stalk processing for fiber.[ref]http://www.mintpressnews.com/hemp-oil-versus-cbd-oil-whats-the-difference/193962/) 06/10/2015[/ref]
Treating Sickle Cell Disease with Medical Cannabis
Treating Sickle Cell Disease with Medical Cannabis
Cannabis is known for reducing pain and inflammation in many applications. Recently researchers set out to see if it would help in treating the severe, painful episodes of an acute sickle cell crisis.
WHAT IS SICKLE CELL DISEASE?
Sickle cell disease is a chronic condition that targets the body’s red blood cells and is characterized by episodic pain in the joints, fever, leg ulcers, and jaundice, among other symptoms. In the United States, SCD affects about one in 650 African Americans and about half as many Latin Americans.[ref](http://norml.org/news/2005/09/22/patients-with-sickle-cell-disease-find-relief-from-cannabis-study-says) 06/12/2015[/ref]
During a crisis, red blood cells (RBC) distort into a sickle-shape rather than the normal discoid profile. The RBC’s sickle shape makes it stiffer and less able to squeeze through tiny capillary beds. If enough of them become stuck, blood flow to the distal watershed regions becomes compromised. Should this happen to an upper limb for example, the end result is a sometimes hypoxic, and always a painful arm.
To understand how agonizing this is, try inflating a blood pressure cuff on your arm and leave it inflated for 5 minutes. The pain that develops is from hypoxia as you occlude blood flow to your arm.
As an anesthesiologist, we occasionally administered special “nerve blocks” such as a stellate ganglion block, to vasodilate the arteries in the affected upper limb and to provide powerful pain relief. Of course these procedures carry certain risks and many MD’s will not consult us for them. It’s expensive and time consuming. Otherwise morphine and hydration are standard protocols for sickle cell crisis.
SURVEY REVEALS SICKLE CELL PATIENTS USE CANNABIS FOR PAIN AND ANXIETY RELIEF
A formal survey was completed in London in 2005;
Eighty-six hospitalized patients with SCD participated in the survey. Thirty-six percent of respondents reported having used cannabis in the past 12 months to relieve symptoms associated with the disease. Of these, 52 percent said that they had used cannabis to reduce pain, and 39 percent reported that it mitigated their anxiety and feelings of depression.
The majority of patients (58 percent) expressed their willingness to participate in clinical trials of cannabis as a medicine.
We conclude that research in the use of cannabinoids for pain relief in SCD would be both important and acceptable to adult patients.[ref]Br J Haematol. 2005 Oct;131(1):123-8.[/ref]
PRELIMINARY RESEARCH SHOWS PROMISE
Dr Kalpna Gupta is an associate professor of medicine at the University of Minnesota. She has been conducting research on mice with sickle cell disease and feels that cannabinoids have good outcomes in treating pain.
After being awarded a nearly ten million-dollar grant from the NIH, their team was forced to leave Minnesota where it is illegal to conduct human trials using cannabis, for California.
Here, they will be working with well-known researcher Dr Donald Abrams of UCSF (San Francisco) to conduct phase 1 and 2 clinical trials on 35 selected patients. The trial hopes to answer the following postulates:
1. Inhaled cannabis will significantly reduce chronic pain in patients with SCD.
2. Inhaled cannabis will significantly alter the short-term side effects experienced by patients who take opioids for SCD.
3. Inhaled cannabis will significantly alter markers of inflammation and disease progression in patients with SCD compared to placebo.
After considerable red tape from the FDA, the trial is underway. This is one of the reasons we need to enact federal legislation so that entire research teams do not have to waste time and expenses moving 2000 miles to parachute into cannabis-free territory. It’s ridiculous I know, but something we must endure until a change is made in our regulatory system.
Meanwhile, Georgia is the first state to recognize sickle cell disease as an indication for medical cannabis:
The disease affects over 7,000 Georgians each year, most of whom are African-Americans. With Georgia’s large African-American population, getting sickle cell anemia included as one of the qualifying medical conditions for medical marijuana was of particular need.[ref](http://georgiamarijuana.org/2015/04/25/georgia-medical-marijuana-law-first-to-include-sickle-cell-anemia/) 06/12/2015[/ref]
While insufficient scientific data is available for any conclusions to be drawn on using cannabis in treating the pain and inflammation of a sickle cell crisis, one can always try it and see if it helps in overcoming the severe pain, anxiety and stress that sickle cell patients must endure on a regular basis. Feel free to add comments if this strategy is successful for you.
Can Cannabis Treat Skin Cancer?
Can Cannabis Treat Skin Cancer?
PART 1 – Squamous Cell Carcinoma
When you hear the word skin cancer most people react with fear and consternation, even dread. There has been considerable media attention centered on this subject. But there are different types of skin cancers only one of which is highly invasive and considered deadly.
In this series I will discuss the three main types of skin cancers. I’ll start today’s article on SCC. Then we will examine the applications of cannabis preparations in the treatment of said cancers.
Dear reader, there are apparent cures to be found in using cannabis oil to treat the most common skin cancers. However, the information is anecdotal only. There is very little research and no clinical trials that have examined the possible cures from cannabis oil (CO) for these conditions.
THE MAIN TYPES OF SKIN CANCER
Although there are dozens of subtypes we can broadly list skin cancer under three distinct cell types.
– Squamous cell carcinoma (SCC)
– Basal cell carcinoma (BCC)
– Malignant melanoma (MM)
Cutaneous squamous cell carcinoma (SCC) is a common cancer arising from malignant proliferation of epidermal keratinocytes. The likelihood of developing SCC is dependent upon exposure to risk factors (most importantly ultraviolet light) and patient-specific characteristics, such as age, skin type, and ethnicity.
Incidence — Cutaneous squamous cell carcinoma (SCC) is the second most common type of skin cancer in the United States, behind basal cell carcinoma (BCC), and accounts for approximately 20 percent of nonmelanoma skin cancers.
A 2013 metaanalysis estimated the number of new SCC cases… in the United States white population in 2012 to be between 186,000 and 419,000.[ref](http://www.uptodate.com/contents/epidemiology-and-risk-factors-for-cutaneous-squamous-cell-carcinoma) 06/06/2015[/ref]
Perhaps the most reported case of SCC being cured with CO is the Michael McShane story which is well documented in the lay literature on the Cure Your Own Cancer website.
There are other “stories” one involving a case of highly advanced and invasive SCC refractory to conventional treatments of radiation (see below). In both of these cases CO cured them in about three months of daily applications. The information is presented on the Cannabis Science website. I was not able to find any before and after photos that are supposedly on the site. Here’s the details of this amazing case:
Cannabis Science, Inc. a pioneering U.S. biotech company developing pharmaceutical cannabis (marijuana) products, is pleased to provide new photographs of the existing treatment for patient three who has a “worst case” of treatment resistant, Squamous Cell Carcinoma. Cannabis Science has received positive feedback from both the patient and his Oncologist. These photos show the progressive reduction of the tumor masses that has occurred within the months of treatment.
Oncologists have stated that this is the worst case of squamous cell carcinoma, and last week, the patient’s oncologist said the results from the topical cannabis extract are “astonishing.” So instead of needing any surgery this month he is to go back and see the oncologist in June. The patient’s wife, who could not even look at her husband’s head months ago, has stated that it looks as if 75% of the tumors masses are gone.
Since Cannabis Science has been working with this patient extensively, Dr. Robert Melamede has provided lots of support and expert scientific advice during the treatment process. Patient three came to Cannabis Science with hope to find a treatment that would work. Due to his extremely severe case of squamous cell carcinoma, his surgeon wanted to remove his scalp and a good portion of his skull. Instead he opted for 135 radiation treatments, but the remaining tumors became radiation and chemotherapy resistant. Dr. Robert Melamede informs that, “Cannabis extracts have the unique ability to holistically improve health. They simultaneously modify numerous biochemical pathways to (sic) produces a healthy concerted action.”
In time we should begin to see scientific research supporting or refuting these astonishing cures.
Treating Skin Diseases with Topical Cannabis, as Explained by Dr. Rasmussen
Treating Skin Diseases with Topical Cannabis, as Explained by Dr. Rasmussen
In part one we reviewed applications of cannabis in the treatment of psoriasis. Today we’ll cover other skin diseases that may be positively affected by cannabinoids.
When I was in medical school I recall one of my professors blithely commenting that dermatology was easy. If the lesion is wet dry it, if it’s dry wet it. That’s it.
I’m not convinced however that patients with serious skin disorders would find those comments very reassuring. That’s because skin diseases are legion. They can be difficult to cure, and are a frequently occurring health problem affecting all age groups from neonates to the elderly. They cause harm in a number of ways while contributing to the loss of productivity. Maintaining healthy skin is important for a healthy body, self-esteem and wellbeing.
In part one I revealed to you that a new, previously unknown endocannabinoid system (ECS) exists in the skin. That system can be manipulated with cannabinoid agonists to relieve symptoms of psoriasis. Moreover, it’s influential in the relief of many other skin diseases. In the future we can look forward to the addition of cannabis preparations to the list of topical materials shown below.
CONVENTIONAL TREATMENT OF SKIN DISEASES[ref]Pharmacogn Rev. 2014 Jan-Jun; 8(15): 52–60.[/ref]
The common medications for topical use include:
– Antibacterials: These medicines, like bactroban or cleocin, are often used to treat or prevent infection
– Anthralin (drithocreme, micanol and others): Although not often used, these help to reduce inflammation and can help treat psoriasisAntifungal agents: Lamisil, lotrimin and nizoral are few examples of common topical antifungal drugs used to treat skin conditions such as ringworm and athlete’s foot
– Benzoyl peroxide: Creams and other products containing benzoyl peroxide are used to treat acne
– Coal tar: Coal tar is used to treat conditions including seborrheic dermatitis (usually in shampoos) or psoriasis. Currently, coal tar is seldom used because it can be slow acting and can cause severe staining of personal clothing and bedding
– Corticosteroids: These are used to treat skin conditions including eczema and come in many forms including foams, lotions, ointments and creams
– Retinoids: These medications (such as retin-A and tazorac) are gels or creams derived from vitamin A and are used to treat conditions including acne
– Salicylic acid: Salicylic acid is the active ingredient in many skin care products for the treatment of acne and warts.
– Cannabinoids?
THE APPLICATIONS
Cannabis can be used to treat contact dermatitis, an allergic reaction to an irritating agent when exposed to the skin.
Hebrew University of Jerusalem august 2007:
Administering a substance found in the cannabis plant can help the body’s natural protective system alleviate an allergic skin disease (allergic contact dermatitis), an international group of researchers from Germany, Israel, Italy, Switzerland and the US has found. The results clearly show a protective role for the endocannabinoid system in contact allergy in the skin and suggest that development of cannabinoid compounds based on elements produced from the cannabis plant could enhance therapeutic treatment for humans.
Other disorders where pot may be a useful addition are listed below:
Cannabis sativus (Common name: Charas, Ganja; Family: Cannabinaceae)[ref]IBID[/ref]
The powder of the leaves serves as a dressing for wounds and sores. Ganja is externally applied to relieve pain in itchy skin diseases. Hemp seed oil is useful for treatment of eczema and host of other skin diseases like dermatitis, seborrhoeic dermatitis/cradle cap, varicose eczema, psoriasis, lichen planus and acne roseacea. By using hemp seed oil, the skin is strengthened and made better able to resist bacterial, viral and fungal infections. Crushed leaves are rubbed on the affected areas to control scabies.
SKIN CANCER
Then it gets interesting. Considerable information exists that cannabis oil and other similar preparations can cure skin cancers. There are three main types of skin cancer. Of those only one is usually deadly. It’s called malignant melanoma. But there are other, slower growing, cancers of the skin such as basal cell carcinoma and squamous cell carcinoma. They have caused fatalities but are treatable with surgery and other methods. In an upcoming article I will present amazing studies that clearly demonstrate cannabis oil can help cure skin cancers.
Treating Psoriasis with Topical Cannabis, as Explained by Dr. Rasmussen
Treating Psoriasis with Topical Cannabis, as Explained by Dr. Rasmussen
Previously, I had suggested that people try topical cannabis for herpes simplex infection which seems to work quite nicely. Will wonders never cease?
Along with cannabis’ laundry list of laudable applications let’s add one more: the treatment of psoriasis with topical marijuana preparations. There’s plenty here so I put it into two parts. In the second part of this series we will explore further dermatologic uses.
PSORIASIS
What is psoriasis? From the Mayo Clinic’s definition:
Psoriasis is a common skin condition that changes the life cycle of skin cells. Psoriasis causes cells to build up rapidly on the surface of the skin. The extra skin cells form thick, silvery scales and itchy, dry, red patches that are sometimes painful.
Psoriasis signs and symptoms can vary from person to person but may include one or more of the following:
• Red patches of skin covered with silvery scales
• Small scaling spots (commonly seen in children)
• Dry, cracked skin that may bleed
• Itching, burning or soreness
• Thickened, pitted or ridged nails
• Swollen and stiff joints
There are at least eight different types and there is no cure. Treatments range from nearly a dozen different topical creams to a half dozen “light therapies” to the use of powerful immune modulating medications.
Mayo clinic also lists several “alternative medicine” applications such as fish oil and aloe vera. As usual they conveniently leave out Chinese medicine which can also help immensely.
But let’s face reality. Sufferers of psoriasis are never cured and must repeatedly use one or many of the options listed above.
THE PROBLEM WITH CONVENTIONAL TREATMENTS
Here’s the problem: systemic immuno-modulating drugs (biologics) have an unusual syllabus of adverse drug reactions.
Biologics work by blocking interactions between immune system cells and certain inflammatory pathways. These drugs control the symptoms of psoriasis by decreasing the immune system’s cross talk.
However, that increases the risk of deadly, life-threatening infections among other things. Translated it means that your medication could actually cause death from sepsis. It’s rare but it’s 100% if it happens to you.
THE SKIN ENDOCANNABINOID SYSTEM
It appears that we have a unique and separate ECS system within the subcutaneous structure called the dermis. We can add this to already known central and peripheral pathways: namely the brain and the immune system. Compelling evidence is accumulating that shows promise for substances that stimulate the body’s innate endocannabinoid system (ECS) to treat or even cure skin disorders.
Researchers have discovered a unique and separate CB system located within the skin:
Recent studies have intriguingly suggested the existence of a functional ECS (endocannabinoid system) in the skin and implicated it in various biological processes (e.g. proliferation, growth, differentiation, apoptosis and cytokine, mediator or hormone production of various cell types of the skin and appendages, such as the hair follicle and sebaceous gland). It seems that the main physiological function of the cutaneous ECS is to constitutively control the proper and well-balanced proliferation, differentiation and survival, as well as immune competence and/or tolerance, of skin cells. The disruption of this delicate balance might facilitate the development of multiple pathological conditions and diseases of the skin (e.g. acne, seborrhea, allergic dermatitis, itch and pain, psoriasis, hair growth disorders, systemic sclerosis and cancer).
For example, Wilkinson et al[ref]Journal of Dermatological Science 2006 DOI: http://dx.doi.org/10.1016/j.jdermsci.2006.10.009[/ref] demonstrated that certain CB agonists inhibit the rapid cell proliferation of keratinocytes in tissue culture, the hallmark of psoriasis:
Our results show that cannabinoids inhibit keratinocyte proliferation, and therefore support a potential role for cannabinoids in the treatment of psoriasis.
From the site www.cannabiscure.info there are photographs showing the application of cannabis oil to a patient’s limb 3 times a day for 9 days with startling results (right photograph).[ref](http://www.cannabiscure.info/files/cannabis_treatment_4.htm) 06/10/2015[/ref] The left sided picture is from using the toxic drug methotrexate. As you can plainly see, the cannabis oil therapy was far more effective. I cannot substantiate this case report but it is nonetheless very interesting. Anyone who tries this approach please let me know with your comments.
Physician Discusses the Dangers of Synthetic Cannabis Spice: Kidney Failure
Physician Discusses the Dangers of Synthetic Cannabis Spice: Kidney Failure
ACUTE KIDNEY INJURY
In previous articles I highlighted the dangers of acute stroke, and psychosis associated with the ingestion of a powerful designer drug called Spice. Here I will discuss a newly reported disease caused by smoking Spice called acute kidney injury (AKI).
Acute kidney injury (AKI) has been added to the growing list of deleterious health effects that include psychosis, birth defects, behavioral changes, and acute coronary syndrome associated with use of synthetic marijuana.
A case series study conducted by investigators at the University of Alabama at Birmingham of 4 previously healthy young men linked AKI to ingestion of synthetic marijuana.[ref](medscape.comhttp://www.medscape.com/viewarticle/779161) 05/23/2015[/ref]
The study was published in the March (2013) issue of the Clinical Journal of the American Society of Nephrology.
In the article the investigators discuss four different cases of acute kidney injury (AKI) linked to ingestion of synthetic marijuana.
Synthetic pot preparations bear little resemblance to their parent compounds like THC. These drugs are often times manufactured in filthy black market labs with little to no quality control, and no regard for human safety.
THE CASES
Over a two-month period all four patients presented at differing times with abdominal pain, nausea and vomiting. Three victims reported abnormally minute urinary output, while the fourth had developed significantly decreased blood flow to his kidneys studies revealed.
On admission all patients had kidney biopsies performed which demonstrated the pathological condition of “acute tubular necrosis.”
In other words the biopsies showed that their kidneys were dying. Kidney cell death (necrosis) was occurring from using these hazardous synthetic cannabinoids. If left untreated this condition can progress to permanent renal failure leading to dialysis. Once on dialysis you have only a limited number of years to live.
Luckily in this study all four patients recovered their kidney function and none needed to be dialyzed.
The lead author Dr Jain…noted that given that these preparations often include several additives, it is likely that the causative agent in the AKI cases was an additive rather than the cannabinoid itself.
“It is important to include nephrotoxicity from designer drugs such as Spice and bath salts in the differential diagnosis of AKI, especially in young patients with negative urine drug screens. Increased awareness may ultimately lead to identifications of the nephrotoxin(s).[ref]IBID[/ref]
This becomes all the more troubling when we consider how many people using Spice might also consume OTC drugs, or other prescriptions, which can be nephrotoxic. For example, the overuse of Motrin or other non-steroidal antiinflammatory drugs may act synergistically with Spice, and the contaminants within the product, to markedly increase the risk for kidney failure.
Knowledge is power. Visits to the emergency room for acute poisoning form drugs such as Spice is a big problem that may in fact be waning due to increased awareness of the dangers these drugs pose.
Although data from the American Association of Poison Centers show an increase in reports, from 2906 in 2010 to 6959 in 2011, the rate declined to 5228 in 2012, and the latest report shows 2222 cases as of October 31, 2013.
[The trend] could be because there is more of an awareness of the danger in the products, as well as more enforcement of DEA regulations.[ref]medscape.comhttp://www.medscape.com/viewarticle/817745) 05/23/2015[/ref]
Let’s hope so.
Physician Discusses the Dangers of Synthetic Cannabis Spice: Schizophrenia
Physician Discusses the Dangers of Synthetic Cannabis Spice: Schizophrenia
One thing we know for certain is that we cannot dis-invent psychoactive drugs. They are here to stay while underground nurseries hatch new “highs” every year for the multibillion-dollar world drug market.
All we can do to assure our safety is to learn the truth about them from impartial sources. From there one can avoid these substances or exercise caution with usage.
One of the problems I’ve encountered is trying to discern fact from fiction whenever a new drug hits the streets and starts receiving media attention. For the layperson it’s particularly frustrating. Where do the real facts end and fiction begin?
The popular press often times plays loose with the facts while trumpeting their own agenda. For example, whenever a novel recreational drug becomes vogue the press are usually quick to demonize it by highlighting the most dangerous side effects no matter how rare they are. In this case you might think that using Spice will buy you a quick trip to the county morgue.
They may be right.
JUST THE FACTS M’AM
Enter the synthetic cannabinoids (SC) many of which are available online or in novelty stores. This time the reports from Europe and America concerning the serious adverse drug effects of SC are all saying the same thing. That some of these drugs are exceedingly dangerous.
Here’s the problem: while hundreds of new chemical “highs” are being pushed onto the world market every year, none have had even the most basic toxicity studies performed. That means risk is unpredictable.
Today we’ll talk about a particularly troubling adverse effect: the inducement of psychosis with the recreational use of one SC which is developing an alarming reputation, Spice.
In a study published in 2013 researchers described:
…the symptoms of 50 patients who presented with intoxication from synthetic cannabis.
Nearly all of the patients presented with severe agitation, disorganized thoughts, paranoid delusions, and assaultive behavior. Other common symptoms included suicidal ideation (30%), anxiety (28%), depression (20%), and catatonia (0.05%).[ref](medscape.comhttp://www.medscape.com/viewarticle/817745) 05/23/2015[/ref]
The findings were presented at the American Academy of Addiction Psychiatry’s (AAAP) 24th Annual Meeting & Symposium.
The typical user profile is a young man 18-25 years old who also tests positive for THC and cocaine in addition to synthetic cannabis, and has a past history of psychosis or substance abuse.
SPICE
The synthetic drug Spice is about ten times stronger than natural cannabis. By design, it’s a potent CB1 agonist. Compare this to THC which is only a partial CB1 agonist.
The odd thing is that most patients interviewed felt that these materials were safe since they were sold as “incense” or as a “legal high.” But safety in this setting is a pipe dream, literally.
In addition to the psychoactive effects, synthetic cannabis can cause adverse physical effects, including tachycardia, tachyarrythmia, myocardial infarctions — even in young, healthy adults — cardiotoxicity, chest pain, nausea, vomiting, and death, according to the study. Additionally, there have been reports of acute kidney injury and seizures.
A NEWLY COINED TERM
According to Dr Lee, one of the presenters at the meeting, the symptoms of cannabinoid psychosis have recently been dubbed “Spiceophrenia” (Papanti D et al, Hum Psychopharmacol. 2013;28:379-389) because of their similarity to symptoms of schizophrenia.
In other words patients presenting to the ED after intoxication with Spice, will often look identical to those suffering a psychotic (schizophrenic) break.
As suggested in Dr. Kelly’s findings, Dr. Lee noted that the effects are not always dose dependent.
“The hallucinations and delusions experienced are not only among chronic users but sometimes reported in acute users who may have used it the first time and binged on it.”
Confounding factors are the use of cocaine and marijuana together with Spice as well as a possible genetic predisposition toward psychosis among the victims. Dr Lee related to Medscape Medical News.
Physician Discusses the Dangers Synthetic Cannabinoid Spice: Stroke Risk
Physician Discusses the Dangers Synthetic Cannabinoid Spice: Stroke Risk
I have previously written on the risk of stroke associated with ingesting marijuana. It appears to be a quite rare but devastating event. It’s also not yet proven to be an adverse drug effect among pot smokers. Over the last several years there has emerged some disturbing evidence that supports the role that pot may increase stroke risk in heavy users. However, further studies are desperately needed to confirm this.
There are many other variables that may be contributing to this dangerous disorder. For example, if the relationship is real, scientists currently cannot explain why an entire generation of Baby Boomers haven’t stroked out yet since many of them are regular pot users. It remains a mystery for now.
However, it’s a completely different story when we look at synthetics. Here the literature supports an overwhelming role that some SYNTHETIC cannabinoids are contributing to increased risk for stroke, psychotic breaks, kidney failure and birth defects, among abusers of these dangerous compounds.
WHAT ARE SYNTHETIC CANNABINOIDS?
There are both good and bad synthetic cannabinoids. They are NOT natural compounds, they are made in a laboratory. Many major pharmaceutical houses are falling over each other trying to create synthetic cannabinoid agonists and antagonists hoping to patent a lucrative “Holy Grail” disease-treating compound. Synthetic analogues of CBD for example are being created for treating refractory seizure disorders, or the now shelved CB antagonist Rimonabant for weight loss.
BLACK MARKET
Then there are clandestine labs, black market labs that are involved in the manufacture of cannabis analogues. Here the goal is to make a potent recreational THC-like material. The major difference is that some of the black market cannabinoids appear to be extremely toxic and dangerous.
Reports are appearing worldwide that a certain powerful THC-like drug, one called “Spice,” is driving users into emergency departments like corn through a mill.
SPICE
No folks this is not the heady, mind-expanding precipitate, and the greatest treasure in the universe[ref]Princess Irulan, Frank Herbert’s Dune (2000). (https://en.wikipedia.org/wiki/Arrakis) 05/21/2015[/ref] found only on Arrakis in the Dune Trilogy. No, far from it. This particular drug, also called Spice, contained the powerful schedule I synthetic cannabinoid JWH-018. While Dune’s Spice permitted interdimensional travel, the only transport JWH-018 sanctions is an underwhelming visit to the nearest emergency facility.
CASE REPORT
A 2013 article published in Neurology, the official journal of the American Academy of Neurology, discussed two young and otherwise healthy siblings who experienced acute, embolic-appearing strokes.[ref]Neurology December 10, 2013 vol. 81 no. 24 2090-2093[/ref]
The siblings, patient A is the 21-year-old brother, and patient B is the 19-year-old sister of A. Each developed an embolic stroke, at different times, temporally associated with smoking Spice.
An embolus (in this case) is a piece of a blood clot that breaks off somewhere upstream, possibly from the heart, to occlude a distal artery in the brain causing an ischemic (lack of blood flow and oxygen) stroke.
Patient A was brought to the ED with complaints of sudden-onset inability to speak and weakness of the right face and arm.
Patient B, at a later undisclosed date, arrived in the ED with nearly the exact same complaints as her brother had. Both suffered from a blocked middle cerebral artery (MCA) which can be devastating and often times irreversible.
Although both patients tested positive for regular cannabis and had in the past smoked conventional marijuana, each reported that they had smoked spice shortly prior to onset of the stroke and that they had obtained the drug from the same supplier.[ref]IBID[/ref]
The authors cite tachycardia, vomiting, agitation, confusion, and hallucinations as common side effects of smoking spice. We may now add stroke to the list.
IS SPICE THE CULPRIT?
There are always confounding variables. For example, it could be that the siblings both have a hidden genetic trait that predisposes them to embolic strokes when under the influence of Spice. There is also the very real possibility that contaminants within the Spice preparation were toxic. Or Spice itself is toxic, or any combination of the above.
To further complicate the issue, black market chemists constantly create new, slightly different, molecular analogues to stay one-step ahead of the law. Therefore, any product called Spice last year may now contain different chemical analogues other than the one listed above. Moreover, with a constantly changing chemical makeup it becomes very difficult and frustrating for researchers to glean details on the pathophysiologic effects of “Spice.”
Regardless of where the chips fall, in this particular case I would suggest that readers never partake of black market cannabinoids. The devastating consequences of stroke, heart attack, and many other dangerous complications isn’t worth the risk.