Vol. 7, Number 4
cheryl riley, James Freire,
Dr. David Bearman,
Gradi Jordan, Ed Glick,
Sunil K Aggarwal,
Al Byrne, Amanda Reiman,
Jim Greig, Joan Bello,
AAMC El Dorado County CA
AAMC Rhode Island
General use of cannabis for PTSD Symptoms - Raphael Mechoulam, Ph.D.
Dr. Mechoulam is the Israeli scientist who identified THC as the psychoactive compound in marijuana, and decades later he discovered the brain's endocannabinoid system and the endogenous neurotransmitter anandamide. He is one of the most respected Israeli neuroscientists and has been a senior advisor to the Israeli government on marijuana policy and the ethics of research with human subjects. He discussed his experiments demonstrating the neuroprotective effects of the endocannabinoid system in mice that have had traumatic injuries to the brain. He believes the neuroprotective effects of marijuana may eventually have applications for other neurological and psychiatric conditions, including Alzheimer's and Parkinson's disease.
Another fascinating discovery, one with implications for PTSD, is that the cannabinoid system is integrally related to memory, specifically to memory extinction. Memory extinction is the normal, healthy process of removing associations from stimuli. Dr. Mechoulam explained that an animal which has been administered an electric shock after a certain noise will eventually forget about the shock after the noise appears alone for a few days. Mice without cannabinoid systems simply never forget - they continue to cringe at the noise indefinitely.
This has implications for patients with PTSD, who respond to stimuli that remind them of their initial trauma even when it is no longer appropriate. By aiding in memory extinction, marijuana could help patients reduce their association between stimuli (perhaps loud noises or stress) and the traumatic situations in their past. Working with Army psychiatrists, Dr. Mechoulam has obtained the necessary approvals for a study on PTSD in Israeli veterans, and hopes to begin the study soon.
The Alternative Medical Journal: General use of cannabis for PTSD Symptoms.
Despite the anecdotal evidence to the contrary, most of the experimental studies that have been conducted so far indicate that by and large the administration of exogenous cannabinoids such as vaporizing therapeutic cannabis may not be the most reliable nor effective means of utilizing the eCB system to treat anxiety and aversive memories such as those formed in PTSD. For reliable and truly effective treatment of these conditions it appears that restricting eCB breakdown by way of FAAH inhibition is the best target discovered so far within the eCB system. (The other eCB targets include the two primary receptors CB1/CB2, vanilloid receptors, eCB reuptake, as well as eCB production.) To this end, Kadmus Pharmaceuticals, Inc. has started to express serious interest in marketing a new FAAH inhibitor they have developed, currently code-named KDS-4103. KDS-4103 appears to have a lot of potential from a pharmacological perspective. Even though it produces analgesic, anxiolitic, and anti-depressant effects it otherwise does not produce a classic cannabis-like effect profile and animals easily discriminate between THC and KDS-4103. All this indicates that KDS-4103 does not produce a â€œhighâ€ like THC and other direct CB1 agonists. KDS-4103 is orally active in mammals and fails to elicit a systemic toxicity even at repeated dosages of 1,500mg/kg body mass. All other available evidence to date also suggests a very high therapeutic margin for KDS-4103. All in all, considering that the kinds of events which usually precipitate PTSD in most individuals often also involve pain, KDS-4103 seems like it may be just about the perfect medication.
So what should all this mean to the individual? Anecdotal evidence says by and large the use of therapeutic cannabis provides a significant improvement in quality of life both for those suffering from this malady and for their family and friends. Whether or not this is taking the fullest advantage possible of the eCB system in the treatment of PTSD is yet to be seen. Mostly the use of cannabis and THC to treat PTSD in humans appears to provide symptomological relief at best. In and of itself, there is nothing wrong with symptomological relief. That's what taking aspirin for a headache, a diuretic for high blood pressure, opiates to control severe pain, or olanzapine for rapid-cycling mania is all about. We do have the potential, however, to do better than just treating symptoms of PTSD via activation of the cannabinoid receptors. With the right combination of extinction/habituation therapy and the judicious administration of a FAAH inhibitor like KDS-4103 we have the potential to actually cure many cases of PTSD. For the time being though, symptomological treatments are all we have for more generalized anxiety and depression disorders.
If an individual were to want to get the most out of using therapeutic cannabis to improve a PTSD condition they should try to use low to moderate doses with as stable a blood level as possible for general anxiety and depression symptoms. Oral cannabis produces more stable blood levels. Since peak levels will produce the most soporific effect, administration of oral cannabis right before bed should produce the most benefits for improving sleep patterns. If the goal is to use cannabis to facilitate extinction of the response to PTSD triggers than small to moderate doses of cannabis vapors should be administered shortly before planned exposure to the trigger. A series of regular extinction sessions will produce better results than a single session. If cannabis appears to make aversion, fear, or aversive memories worse then the dosage should be lowered. If feelings of fear do not improve with lower dose then discontinue use of cannabis as fear-extinction aide.
In light of all evidence currently available, it is striking that the FDA refuses to investigate cannabinoids for the treatment of anxiety disorders like PTSD yet they have approved studies of MDMA, the club drug Ecstasy, for the treatment of PTSD (Doblin, 2002). Even if you do not accept cannabis as the answer itself, it should be hard to accept that by and large we still have not found effective and reliable ways to utilize the eCB system in modern western medicine. After all, the most potent (meaning it takes the least amount to produce a threshold effect) substance know to humans is not LSD as many still assume but is instead a derivative of fentanyl, know as Carfentanil. The threshold dosages for LSD and Carfentanil are 20-30Âµg (micrograms) and 1Âµg, respectively (Wikipedia, 2 & 3). This makes Carfentanil 10,000 times more potent than morphine, 100 times more potent than fentanyl, and 20-30 times more potent than LSD. At least up until 2005 and unlike LSD, Carfentanil was(is?) regulated as a Schedule II substance in the US (Erowid). For those that do not know, this means that despite perceived extreme dangers from use or abuse of this drug it is still assumed to have medical value. With the lives and well being of so many veterans AND private citizens at stake, those in the scientific community and police makers alike cannot afford to miss the wake up call. Even a child should be able to see the hypocrisy evident in the relative policies concerning cannabinoids and opiates. It is time to fix this appalling imbalance in our policies concerning the pharmacopia or else be the laughing stock of future generations.
Anxiety Disorders Treated With Cannabis - 420InSight
The use of cannabis in the treatment of anxiety disorders was first described by ancient Indian medical literature, which said that cannabis helped its user to be “delivered from all worries and care” (Da Orta 1563).
But as modern-day researchers have discovered, the relationship between marijuana use and anxiety is a lot more complex. For example, while it is true that reduced anxiety is a commonly given reason for using cannabis, reports also show that frequent marijuana users tend to have higher levels of anxiety.
Using cannabis to self-medicate one’s anxiety may help to explain these conflicting findings. However, research suggests that marijuana — at different doses — can have opposite effects on anxiety as well.
What are Anxiety Disorders?
Anxiety disorders come in many different forms, all of which involve excessive worrying, uneasiness, apprehension and fear. Social anxiety, phobias, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) all fall under the category of anxiety disorders.
While anxiety is a natural occurrence for all people, those who suffer from anxiety disorders experience severe impairment from their worries. It is estimated that approximately 18% of Americans and 14% of Europeans suffer from some form of anxiety disorder.
How Can Marijuana Help?
Studies show that the endocannabinoid system – the body’s natural cannabinoid system – plays a major role in regulating anxiety. Cannabinoid receptors – the binding sites of cannabinoids – are highly concentrated in certain parts of the brain that are responsible for anxiety, including the amygdala and hypothalamus.
Interestingly, studies show that patients experience higher levels of anxiety when cannabinoid receptors are blocked by drugs such as rimonabant. Likewise, regular cannabis users report that marijuana helps to reduce their anxiety levels.
Research has also linked the endocannabinoid system to the extinction of bad memories – supporting its potential role in treating post-traumatic stress disorder – as well as the growth of new brain cells (neurogenesis), which is believed to improve anxiety levels.
On the other hand, paranoia and anxiety attacks are some of most commonly reported side-effects of marijuana use, especially in new and infrequent users. Indeed, studies have revealed a complex link between cannabinoids and anxiety, suggesting that marijuana’s effect on anxiety depends on both the dosage taken as well as the type of cannabinoids that are present.
THC’s Effect On Anxiety
Studies conducted on both animals and humans have revealed a surprising effect of THC on anxiety. That is, THC seems to have opposite effects on anxiety levels depending on the dosage, with THC acting to decrease anxiety at lower doses yet increasing anxiety at higher doses.
On the other hand, experts believe that studies involving pure THC fail to accurately portray the effects of marijuana on anxiety, since cannabis contains over 60 different cannabinoid compounds.
Most notably, marijuana contains a compound called cannabidiol (CBD), which has also drawn significant interest as a potential treatment for anxiety disorders.
CBD’s Effect On Anxiety
While THC acts primarily on the CB1 receptors that are found in high concentrations throughout the brain, CBD seems to have little to no effect on CB1 receptors. Still, studies have found CBD to play a major role in regulating anxiety and have even suggested that it may be a more effective treatment than THC for anxiety disorders.
The first study to document CBD’s effect on anxiety was published in 1982. The study found that CBD could block the anxiety provoked by THC among 8 healthy test subjects, implying that CBD-rich marijuana strains may be a better option for relieving anxiety.
Research on CBD’s anti-anxiety effects has picked up again in recent years, with studies confirming its ability to reduce anxiety levels in both healthy and sick individuals.
The first study to investigate its therapeutic role in patients with anxiety disorders was published in 2011 by researchers at the University of Sao Paulo in Brazil. The study involved giving a 400mg dose of CBD to 10 patients diagnosed with social anxiety disorder, who then underwent a brain scan. The results showed that CBD – compared to placebo – was able to significantly decrease subjective anxiety measures as well as activity in certain parts of the brain normally associated with anxiety.
Another study published by the same group of researchers later in 2011 involved 24 patients with social anxiety disorder, who were given a 600 mg dose of CBD before undergoing a simulated public speaking test (meant to induce anxiety). The results showed that a single dose of CBD taken 90 minutes before the public speaking simulation could reduce anxiety as well as cognitive impairment and discomfort during speech performance.
What This Means For Your Health
The results of numerous studies seem to suggest that certain compounds in marijuana could have an anti-anxiety effect, both in healthy individuals and sufferers of anxiety disorders. On the other hand, clinical research is sparse, meaning that medical marijuana is unlikely to be recommended by health practitioners for the treatment of anxiety.
Furthermore, other studies have observed higher levels of anxiety and lower quality of life scores among frequent cannabis users, suggesting that marijuana may not be all that effective in treating anxiety disorders and might even worsen the condition. On the other hand, these results might be explained by a tendency for patients with more severe symptoms of anxiety to use cannabis on a regular basis.
Overall, it is hard to say for certain whether marijuana is indeed useful for anxiety disorders when so little clinical research has been conducted so far.
Alabama: Considering a medical marijuana law.
Arkansas: Considering a medical marijuana law.
Idaho: Considering a medical marijuana law.
Indiana: Considering a medical marijuana law.
Iowa: Considering a medical marijuana law.
Missouri: Considering a medical marijuana law.
North Carolina: Considering a medical marijuana law.
Ohio: Considering a medical marijuana law.
Pennsylvania: Considering a medical marijuana law.
South Carolina: Considering a medical marijuana law.
South Dakota: Medical marijuana petition drive underway.
Tennessee: Considering a medical marijuana law.
Texas: Considering a medical marijuana law.
Wisconsin: Considering a medical marijuana law.
Featured Recipe - Mary Had a Chili Lamb by Jay R. Cavanaugh, PhD
This is a strange but original recipe that sprang to life one afternoon while cleaning out the refrigerator. If you are fortunate enough to cook, then you are blessed with leftovers. In this case we discovered a still very good roast leg of lamb, one barbequed tri-tip steak, and one-half of a pan-fried New York steak au poive. What to do? Chili! Not only mixed up chili but also kicked up chili. This concoction sure gives "Chili Con Cannabis" a run for its money.
Now you may very well not have these exact ingredients but with imagination and substitution you’ll get your own excellent results. For meats you can try roasts, sausage, chicken, turkey, and ham. Don’t try this with seafood.
Ingredients:1 small roasted leg of lamb (ours had mint, garlic, wine on it)
1 barbequed steak (tri-tip and sirloin recommended for texture)
Optional steak au poive (olive oil, garlic, cracked black pepper)
2 15 oz cans of black beans-rinsed
2 15 oz cans of black eyed peas-rinsed
1 15 oz can of large dark red beans
1 medium sweet onion-chopped
8 fresh Roma tomatoes-chopped
1-2 teaspoons minced garlic
1-2 teaspoons California chili power
1-2 teaspoons cracked black pepper
1-2 teaspoons flaked New Mexico red chili
(Optional for the heat freaks- 1-2 chopped fresh Habenero peppers or 3-5 chopped Serrano peppers)
1 cap liquid smoke
2 teaspoons Lea and Perrins
1-tablespoon coarse ground salt
2-4 tablespoons kief butter
1\3 to 1\2 cup of good red wine (Chianti, Cabernet, Zinfandel)
2 teaspoons masa harina
Grated cheddar and jack cheese OR crumbled goats cheese (my favorite- goes great with the lamb)
Heat beans, tomatoes, onions, and garlic. Add spices and chopped peppers. Add the liquid smoke, Lea and Perrins, and red wine. Simmer for one hour with frequent stirring.
Dice the meats in small chunks removing any fat or gristle then add to pot. Simmer for one hour with frequent stirring.
Add kief butter to pot while preparing masa. Slowly drizzle water into a small bowl containing two heaping teaspoons masa harina. Blend until the masa is a gloppy paste. Drizzle the paste into the chili, mixing thoroughly.
Serve hot with chips, inside a hollowed out French roll, in a bowl, or on hot dogs and hamburgers. Garnish with shredded cheddar and jack cheese or go with goat cheese (you’ll love it, I promise).
Recommended beverage: Your choice. Most prefer beer but I like to pick up the wine taste in this chili with a Pinot Noir or a Chianti (also good with fava beans)
May 21-23, 2015
West Palm Beach, Florida USA
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