Tests show potential for medicinal cannabis to kill cancer cells

UNIVERSITY NEWS

Laboratory tests conducted at the University of Newcastle and Hunter Medical Research Institute have shown that a modified form of medicinal cannabis can kill or inhibit cancer cells without impacting normal cells, revealing its potential as a treatment rather than simply a relief medication.

Dr Matt Dun

The significant outcome follows three years of investigations by cancer researcher Dr Matt Dun in collaboration with biotech company Australian Natural Therapeutics Group (ANTG), which produces a cannabis variety containing less than 1 per cent THC (tetrahydrocannabinol) – the psychoactive component commonly associated with marijuana. The plant, known as ‘Eve’, has high levels of the compound cannabidiol (CBD).

“ANTG wanted me to test it against cancer, so we initially used leukaemia cells and were really surprised by how sensitive they were,” Dr Dun says. “At the same time, the cannabis didn’t kill normal bone marrow cells, nor normal healthy neutrophils [white blood cells].

“We then realised there was a cancer-selective mechanism involved, and we’ve spent the past couple of years trying to find the answer.”

The Dun team has run comparisons between THC-containing cannabis, and cannabis lacking THC but with elevated levels of CBD. They found that, for both leukaemia and paediatric brainstem glioma, the CBD-enriched variety was more effective at killing cancer cells than THC varieties.

In a recent paper entitled “Can Hemp Help?”, released by international journal Cancers, Dr Dun and his team also undertook a literature review of over 150 academic papers that investigated the health benefits, side-effects, and possible anti-cancer benefits of both CBD and THC.

“There are trials around the world testing cannabis formulations containing THC as a cancer treatment, but if you’re on that therapy your quality of life is impacted,” Dr Dun says. “You can’t drive, for example, and clinicians are justifiably reluctant to prescribe a child something that could cause hallucinations or other side-effects.

“The CBD variety looks to have greater efficacy, low toxicity and fewer side-effects, which potentially makes it an ideal complementary therapy to combine with other anti-cancer compounds.”

The next phase for the study includes investigating what makes cancer cells sensitive and normal cells not, whether it is clinically relevant, and whether a variety of cancers respond.

“We need to understand the mechanism so we can find ways to add other drugs that amplify the effect, and week by week we’re getting more clues. It’s really exciting and important if we want to move this into a therapeutic,” Dr Dun adds, stressing that CBD-enriched cannabis isn’t yet ready for clinical use as an anti-cancer agent.

“Hopefully our work will help to lessen the stigma behind prescribing cannabis, particularly varieties that have minimal side-effects, especially if used in combination with current standard-of-care therapies and radiotherapy. Until then, though, people should continue to seek advice from their usual medical practitioner.”

The study was funded by ANTG and HMRI through the Sandi Rose Foundation.

“We are very pleased to see three years of collaboration with UON and HMRI deliver such exciting findings in the fight against cancer. ANTG remains committed to its patient-centric mission of understanding the massive therapeutic potential of medicinal cannabis," Matthew Cantelo, CEO, Australian Natural Therapeutics Group, said.

"We thank Matt Dun and the team for such encouraging insights into anti-cancer properties of our Australian grown CBD strain, Eve. We are looking forward to moving forward to the next stage of the study and continuing to develop effective, safe and consistent cannabis medicines for Australian patients.”

* Dr Matt Dun is from the University of Newcastle, researching in conjunction with the Hunter Medical Research Institute (HMRI) Cancer Program. HMRI is a partnership between the University of Newcastle, Hunter New England Health and the community.

Cannabis shows potential for mitigating sickle cell disease pain

Source:

University of California - Irvine

Summary:

Cannabis appears to be a safe and potentially effective treatment for the chronic pain that afflicts people with sickle cell disease, according to a new clinical trial.

Cannabis appears to be a safe and potentially effective treatment for the chronic pain that afflicts people with sickle cell disease, according to a new clinical trial co-led by University of California, Irvine researcher Kalpna Gupta and Dr. Donald Abrams of UC San Francisco. The findings appear in JAMA Network Open.

"These trial results show that vaporized cannabis appears to be generally safe," said Gupta, a professor of medicine on the faculty of UCI's Center for the Study of Cannabis. "They also suggest that sickle cell patients may be able to mitigate their pain with cannabis -- and that cannabis might help society address the public health crisis related to opioids. Of course, we still need larger studies with more participants to give us a better picture of how cannabis could benefit people with chronic pain."

Opioids are currently the primary treatment for the chronic and acute pain caused by sickle cell disease. But the rise in opioid-associated deaths has prompted physicians to prescribe them less frequently, leaving sickle cell patients with fewer options.

The double-blind, placebo-controlled, randomized trial was the first to employ such gold-standard methods to assess cannabis's potential for pain alleviation in people with sickle cell disease. The cannabis used in the trial was obtained from the National Institute on Drug Abuse -- part of the National Institutes of Health -- and contained equal parts of THC and CBD.

"Pain causes many people to turn to cannabis and is, in fact, the top reason that people cite for seeking cannabis from dispensaries," Gupta said. "We don't know if all forms of cannabis products will have a similar effect on chronic pain. Vaporized cannabis, which we employed, may be safer than other forms because lower amounts reach the body's circulation. This trial opens the door for testing different forms of medical cannabis to treat chronic pain."

Twenty-three patients with sickle cell disease-related pain completed the trial, inhaling vaporized cannabis or a vaporized placebo during two five-day inpatient sessions that were separated by at least 30 days. This allowed them to act as their own control group.

Researchers assessed participants' pain levels throughout the treatment period and found that the effectiveness of cannabis appeared to increase over time. As the five-day study period progressed, subjects reported that pain interfered less and less with activities, including walking and sleeping, and there was a statistically significant drop in how much pain affected their mood. Although pain levels were generally lower in patients given cannabis than in those given the placebo, the difference was not statistically significant.

Dr. Oz Claims DEA And FDA Blame Each Other For Keeping Marijuana Illegal

By 

Kyle Jaeger

According to celebrity doctor Mehmet Oz—or Dr. Oz—representatives from the Drug Enforcement Administration (DEA) and Food and Drug Administration (FDA) have each told him they’re on board with legalizing marijuana. And the agencies blame each other for blocking efforts to end prohibition.

In a recent interview, Oz was asked about his professional opinion on cannabis. The host of the popular daytime program of his namesake called marijuana “one of the most underused tools in America” and went on to say that he’s had conversations with individuals from both DEA and FDA who generally share his views about the plant.

“We ought to completely change our policy on marijuana. It absolutely works,” he told interviewer Fatman Scoop, adding that another daytime TV host Montel Williams, who has multiple sclerosis, convinced him of the medical utility of cannabis. “Now I’ve seen this helping people with sleep issues, with pain issues for sure, and a lot of people who have serious medical problems getting relief—and here’s the thing, you can’t die from it. I’m unaware of any case when anyone has overdosed.”

“It’s a lot safer than alcohol. It’s safer than narcotics. It ought to be used more widely and we can’t even study it that easily because of the way it’s regulated,” he said. “You know what, I called the DEA—they said, ‘we don’t want this to be illegal. Your government ought to change that. But we got to enforce the law.’ I call the FDA that regulates the drugs, they say, ‘we think it ought to be used, but until the DEA says it’s allowed, we can’t let people prescribe it everywhere.”

While Oz didn’t disclose specifics about his conversations, such as who he spoke to or when the phone calls happened, it is the case that federal marijuana reform outside of Congress falls largely within the jurisdictions of both agencies. And DEA has denied multiple rescheduling requests, justifying the inaction by stating that FDA has determined that cannabis doesn’t have proven medical value and carries a risk of abuse.

Oz, who previously asserted that marijuana could represent a tool to combat the opioid epidemic and has made other public comments about the plant’s therapeutic potential, said “I’m hoping the federal government at some point—someone’s going to say, ‘come on, this is a farce, open it up for the entire country.’ That way, the right people can begin to prescribe it.”

Although Oz advocate for marijuana reform, he also clarified earlier this year that, despite rumors, he is not involved in a CBD company that falsely attributed an endorsement to him.

“I have never smoked pot in my life, never gotten high, and I only bring that up because I’m not someone who’s saying this because I personally would use it,” he said in this latest interview. “I just as a doctor think it make sense.”

The Experiments Revealing How Marijuana Could Treat Dementia

Slightly stoned mice show marijuana may fight age-related memory loss.

By David H. Freedman

(Credit: Leaf: Labrador Photo Video/Shutterstock. 

Neurons: Andrii Vodolazhskyi/Shutterstock)

Two levels below ground, under a small, drab building at the University of Bonn, is a wall of cages containing mice that, according to standard tests, are extraordinarily average. They learn and remember how to run mazes no better nor worse than other mice. It takes them a typical amount of time to figure out how to extricate themselves from a tank of water with hidden exit steps.

There’s nothing out of line about how they interact with other mice, nor their willingness to explore open spaces.

And yet these mice are the center of attention at the lab of Andreas Zimmer. That’s because their boringly average minds may well hold the key to beating Alzheimer’s and elderly dementia.

Many of the mice are 18 months old, roughly equivalent to a 70-year-old human. Mice normally start to show mental decline at around a year old, and by 18 months, struggle with mazes and other mental tasks, as well as with socializing.

But not these rodent seniors. “You can’t tell the difference between them and two-month-old mice,” says Zimmer.

Even more surprising is what Zimmer has done to get these elderly mice remembering and behaving like younger ones. It’s not special genes, a particular training regimen, nor an unusual diet. They don’t get any approved memory drug, nor a new investigational procedure.

Basically, Zimmer keeps them very slightly stoned.

A longtime U.S. National Institutes of Health (NIH) researcher who is now one of Germany’s most respected neuroscientists, Zimmer has been on a long journey to answer a question that few researchers had thought to ask: Is it possible that weed, long seen as the stuff of slackers, might actually contain the secret to sharpening the aging brain?

His findings have suggested that may be the case. As the data continues to stream in, some in the lab have begun quietly encouraging their aging parents to toke away, laws be damned. “I sent my mother recipes for baking pot cookies,” says one researcher in Zimmer’s lab, who asked not to be identified because it’s still illegal in the mother’s country.

In 2005, Zimmer’s research was the first to provide convincing evidence that synthetic THC seems to slow age-related brain degeneration. His results since then, combined with a general renaissance in cannabis research that parallels the growing popular and political acceptance of weed, has added more weight to that theory and spurred the interest of labs around the world. Until recently, most of the research has been conducted on mice. But newer research conducted at Johns Hopkins University, Harvard Medical School-affiliated McLean Hospital, and the University of Colorado, among other places, has already suggested that at least some of the benefits of THC — the component primarily responsible for marijuana’s psychoactive effects — accrue in humans’ aging brains. Taken together, this progress has set off a worldwide race to nail down solid proof that, as unlikely as it may sound, pot works in humans to slow, and possibly reverse, Alzheimer’s and other forms of dementia. It’s a race Zimmer intends to win.

(Credit: Photolona/Shutterstock)

Mouse Brains on THC

There’s a lot happening in Zimmer’s sprawling lab, which takes up much of an upper floor in a research building just across from the facility housing the mice.

Scientists from all over the world work here on a range of research projects, investigating conditions from migraine to chronic stress to nerve damage. But for all the diverse activity at the lab, there’s a clear theme: decoding aging and failing brains by identifying how drugs affect various brain cell receptors. These small blobs of protein stick out of the surfaces of neurons and serve as sort of light switches for the cell, turning different activities in the cell on and off. The key receptor in this lab is known as CB1; CB refers to cannabinoid, the name given to a class of chemicals that includes THC.

How do you get mice high? Anyone who has been to a legal marijuana dispensary has probably seen the bewildering variety of oils, waxy blobs, fine powders, gummy treats and even inhalers. But put aside images of toking or dabbing mice. Rigorously studying the impact of pot requires a more reliable and measurable delivery vehicle. The solution is what’s called an osmotic pump, a plastic capsule the size of a pencil eraser, surgically implanted just under the abdominal skin, that’s designed to leak synthetic THC at a steady rate for 28 days.

The mildly baked mice, along with their THC-free counterparts serving as control subjects, are tested in a sort of rodent psychiatric playground near their cages. Under the gaze of video cameras and red light that’s friendly to nocturnal eyes, the mice navigate various cages and tanks. They face gizmos and structures designed to assess their mental prowess: their powers of recall, facility in learning new tasks, willingness to come out of hiding and interest in finding other mice.

The effect of THC has been clear and striking. Older mice that had forgotten how to run mazes recovered the knack. Mice whose aging brains couldn’t distinguish an empty can from a fellow mouse suddenly relearned the ability. “The effects are extremely robust and easy to see,” says Zimmer. “It works reliably on every measure of cognition we have for mice.”

Know Your Compounds

Despite their similar molecular structures, the two main compounds in marijuana — tetrahydrocannabinol (THC) and cannabidiol (CBD) — have different effects in the human body.

THC: An active ingredient in marijuana that makes you high, THC binds to CB1 receptors in the brain to create a euphoric effect.

CBD: This compound in cannabis is non-psychoactive, meaning it won’t give you a high. It has little affinity for binding with the CB1 or CB2 receptors, and can actually hinder THC’s effects when combined. Instead, CBD can activate other receptors, such as serotonin, and is more often sought out for its potential medicinal benefits, such as pain and anxiety relief.

In a newer series of experiments, the lab has begun mounting cameras on the shaved skulls of mice whose brains have been genetically engineered to literally glow with activity. Zimmer’s team can then image the increase in connections between brain cells in mice on THC — especially in the hippocampus, the part of the brain responsible for memory.

That work fits with mouse research at the Salk Institute for Biological Studies in San Diego and the University of Barcelona. Teams at both institutions have shown that THC clears up some of the tangled brain proteins and clogging plaques that are the biological hallmarks of Alzheimer’s.

THC has also been shown to reduce inflammation in mouse brains, another physical tag of Alzheimer’s. (CBD, THC’s non-psychoactive fellow cannabinoid, also acts as an anti-inflammatory.)

The results of the Zimmer’s THC-charged cognitive findings were published in Nature Medicine in 2017, and soon validated by other labs.

A Knockout Receptor

Marijuana has been on Zimmer’s mind for decades. In 1989, the German native arrived at the National Institute of Mental Health, part of the NIH, as a newly minted neuroscientist. He quickly became an expert in genetically engineering and breeding generations of so-called knockout mice.

These mice lack a particular protein or biological function, such as the ability to produce Carboxypeptidase E, a type of protein building block whose absence results in mice with obesity, or to produce the p53 protein, which leads to mice much more likely to develop any of several types of cancer. Scientists can then either study the protein or function via its absence, or use the mouse as a proxy for humans with similar symptoms. Zimmer was soon collaborating with the NIH team that ended up discovering the CB1 receptor, and eventually its activation by THC. “It sounds boring to try to find out what was activating a receptor,” he says. “But it didn’t turn out that way.”

In fact, the CB1 receptor was far more than just a mechanism for feeling stoned. Most receptors are confined to specific regions of the brain, or only show up in neurons associated with specific brain activities, such as memory, emotion, sight or motor control. But CB1 soon proved to be one of the most ubiquitous brain receptors ever discovered: It was found throughout the brains of humans, mice and most creatures, indicating it was involved with virtually everything that happens in the brain.

Zimmer returned to Germany in 2000, where the University of Bonn created the Institute of Molecular Psychiatry around him, along with providing the resources to build a lab that soon grew to 40 people. There, Zimmer started developing knockout mice that lacked the CB1 receptor. In testing them, one surprising change became apparent: The mice were, well, dumber. They soon forgot how to run mazes and became socially inept. “They were going into premature cognitive decline,” says Zimmer team member neuroscientist Andras Bilkei-Gorzo, who has been researching the aging brain for two decades. Yet the mice were only 6 months old — equivalent to a human at 35.

(Credit: Maze: Tetra Images/Getty Images. Lightbulb: Ton Snoei/Shutterstock)

Researchers at the Free University of Brussels and elsewhere were also studying CB1 knockout mice.

But, bafflingly, they were coming up with the opposite finding: that the knockouts were smarter than normal mice. It was as if two mechanics had removed the same part from two identical cars, and one found the car got better gas mileage and the other saw worse mileage.

Bilkei-Gorzo more closely compared notes with the other researchers, and the difference suddenly leapt out. While the Zimmer mice were always tested as mature adults, the others were using mice 6 weeks old — the age equivalent of human teenagers — to get test data sooner. Further tests at the Zimmer lab confirmed that the elimination of the CB1 receptor tended to dumb down only older mice, not younger ones.

Published in Nature Neuroscience in 2005, the finding mostly served to raise a more interesting question. If blocking CB1 sends mice slipping toward dementia ahead of their time, that implies the receptor does something to help older brains delay that decline — which in turn raised the possibility that increasing CB1’s activity beyond normal ranges might be a bigger benefit for older mice.

 “We thought maybe THC could be a brake on aging of the brain,” says Bilkei-Gorzo.
Suddenly, the lab had a new focus.

Calming the Brain

Zimmer could hardly have tackled a more pressing health problem. Roughly 50 million people worldwide have dementia, according to World Health Organization estimates. The number of dementia cases could skyrocket to 150 million by 2050. Globally, about 1 out of 9 people at least 65 years old has dementia; nearly a third of those 85 and older show some degree of cognitive decline.

More than two-thirds of those with dementia have the Alzheimer’s type. There are four approved drugs for Alzheimer’s, but they are decades old and, on average, barely slow the progress of the disease.

In their CB1 work, scientists had a promising target, and in THC they had their arrow. By 2018, about a dozen labs around the world were looking at THC and its effects on dementia. But Zimmer had the funding and a big enough team to push further and faster with focus. With his 2017 Nature Medicine paper, his lab had become the first to clearly show that a THC treatment turned the clock back on mice’s aging brains. Now it had to shift into higher gear: proving that THC can do for humans what it does for mice.

Unfortunately, the majority of drugs that work well in mice never prove successful in human clinical trials. On the other hand, many studies over the years have shown that marijuana appears to work in similar ways in mice and humans. For example, a study from the University of Birmingham in the U.K. had already shown by 1975 that THC makes mice more social, and a 2010 University of Mississippi study demonstrated THC’s antidepressant effect on mice.

“THC can’t be super-harmful — we’d know about it by now,” says Britta Schürmann, a biologist on the Zimmer team.

In addition, THC has some unusual strengths as a potential Alzheimer’s drug. Most Alzheimer’s drugs aim to reduce either the disease’s inflammation, or brain plaques and tangles. But THC attacks on all three fronts at once. Whether suppressing any or all of these Alzheimer’s indicators diminishes the actual progress of the disease, or just treats the symptoms, is still an open question. But Zimmer believes it’s a question that gives a CB1-based approach its biggest edge, because he thinks it works via a novel approach: managing energy expenditure and reducing excess activity in the brain.

(Credit: Appledesign/Shutterstock)

Think of the brain as a car. In children and teenagers, brains are in the throes of rapid development and change, like a car that tends to speed dangerously. To help calm things down, the brain’s CB1 system naturally steps up and acts as a brake, no external THC needed. This slows down brain activity and ensures a safe drive. (It may also explain why THC could be harmful for young people:

The receptor is highly active on its own, and extra THC may overload the brakes and impair development.)

But with age, the CB1 receptor slowly loses much of its function, becoming less and less internally activated. And that makes sense, from an evolutionary point of view. Why would older people need a brake on brain activity? While evolution might not care, though, it ought to concern us. Like an old car driven too hard, too much energy and activity in the older brain may lead to the neurodegenerative effects of aging, including Alzheimer’s and other forms of dementia. THC seems to restore the cautious braking that keeps the brain in good shape.

THC for Symptom Relief

While the Zimmer lab’s mouse research supports the idea, setting up a human trial specifically for pot as an aging-brain treatment poses challenges. Alzheimer’s trials have to last as long as a decade, because the disease progresses so slowly. And marijuana and THC, natural or synthetic, are still tightly restricted — though it may help that Zimmer’s mice are treated at doses below any measurable psychoactive effects, suggesting that people in the trial wouldn’t have to get high to see the benefits.

Major pharmaceutical companies, meanwhile, tend to ignore the drug because it’s increasingly available from dispensaries or local dealers, or even for free. As Angela Bryan, a neuroscientist at the University of Colorado at Boulder who studies marijuana, puts it, “Why would patients buy it when you can grow it in your backyard?”

Zimmer hopes that despite these issues, the German government will fund a multi-year human trial to determine if the brain-preserving effects of THC seen in mice carry over to people. That’s not a sure thing: “We don’t know when we can start,” he says. Even so, given the obstacles to a clinical trial, a delay of a few years might still leave Zimmer at the front of the pack.

THC is already being used to relieve the most challenging behavioral symptoms of Alzheimer’s.

“Agitation, aggression, violence — this is what drives the severity of the disease, and it’s the burden that causes families to place patients in care facilities,” says Brent Forester, chief of geriatric psychiatry at McLean Hospital. “Almost anyone with dementia exhibits these problems to some extent.”

The FDA hasn’t approved drugs to treat these symptoms, he adds. But several studies have indicated that THC helps with the behavioral symptoms. Forester and colleagues are starting an 80-patient randomized clinical trial to further test the benefits. An unexpected challenge, says Forester, is getting his colleagues to refer their patients to the study — the drug is working so well that they’re afraid their patients will end up in the placebo arm instead of getting THC. “They’d rather just put their patients on THC directly instead of putting them in a trial where they might or might not get it,” he says.

Reducing Alzheimer’s agitation is still a far cry from proving that THC can slow and even reverse cognitive and memory damage, as Zimmer has done with mice. But Forester adds he’s hopeful the benefits will spill into memory restoration. He points out that fellow McLean researcher Staci Gruber found THC-treated older patients improved their performance in a number of cognitive tasks.

Other researchers are seeing similar results. A study by Johns Hopkins researcher Lauren Hersch Nicholas found older people become more likely to stay employed after medical marijuana becomes legal in their states. “Productive engagement in work is an important measure of the impact of a treatment,” says Nicholas. The University of Colorado’s Bryan has also been studying older medical marijuana users. “If anything, they seem to do a little better cognitively,” she says. Perhaps that’s one reason people over 65 are the fastest-growing group of pot users in the U.S.

Zimmer himself won’t yet go as far as recommending that seniors take up pot specifically to treat or fend off dementia. “I’m not a clinician, so on this question I yield to physicians,” he says. “But as a scientist, I’m confronted by my observations on mice, and my knowledge that in the THC field, what works on mice works on humans. And that leaves me quite enthusiastic.”

What Science Knows About Marijuana's Health Benefits

What marijuana research in humans tells us so far about the drug’s benefits and drawbacks.

By Jennifer Walter

(Credit: Poylock19/Shutterstock)

It’s mid-October, and Staci Gruber is preparing to testify before Congress. It’s not the first time she’s brought her expertise before policymakers; she’s studied marijuana in brains young and old for the better part of three decades.

Besides being on the psychiatry faculty at Harvard University, Gruber is the director of Marijuana Investigations for Neuroscientific Discovery (MIND) and the director of the Cognitive and Clinical Neuroimaging Core at McLean Hospital outside of Boston. Her research focuses on clinical studies in marijuana users, often employing functional MRI (fMRI) technology to see exactly what parts of the brain the drug affects.

“The important part is to try to leave the emotional rhetoric aside,” she says, ahead of her testimony before lawmakers. “What matters is what the data and the science tell us.”

And the research landscape, so far, is about as complicated as the drug itself. Some studies show that marijuana may provide relief for patients with a slew of conditions, such as anxiety, chronic pain and even cancer. Yet others find that the drug can slow cognitive function and may worsen some mental health conditions.

We also still don’t have a clear picture of how marijuana works in different people, Gruber says. Just five years ago, when she started MIND, Gruber spotted a research gap — virtually no clinical studies were conducted on the effects of medical marijuana on the brain. “I could find nothing in the literature,” she says.

Data on how marijuana works in people over time are sparse. U.S. research on cannabis remains bottlenecked because of limitations on studying the Cannabis sativa plant, some parts of which remain a Schedule I drug. Even though medical marijuana containing the psychoactive compound THC is legal now in 33 states and the District of Columbia, the Drug Enforcement Administration still defines it as a substance with “no currently accepted medical use” and a “high potential for abuse.” Policymakers, eager to better understand how to regulate the drug, occasionally hold sessions with scientists, including Gruber. But with scarce clinical results, she and her American peers find it hard to draw broad conclusions. In countries like Israel and Canada, where barriers to studying cannabis are lower, piecing together the puzzle of who marijuana affects, and how, is only slightly easier.

Complicated Cognition

How does weed affect cognition? That might depend on how and when people use it. Some teenagers who use marijuana recreationally appear to have slower brain function and lower IQs. On the other hand, people with medical conditions who stay slightly baked to manage their symptoms may actually see an increase in brain function.

In a 2011 report on recreational users, Gruber and her team recruited 34 chronic marijuana smokers and divided them into two groups according to when they started using. They were then given a number of cognitive tests. The team found that those in the study who started using marijuana before age 16 had the worst test performances — and smoked twice as often as other users.

But a 2018 clinical study on medical marijuana users showed very different effects on the brain. The study looked at patients with a variety of conditions, including pain, anxiety, sleep disorders and gastrointestinal problems, before and after taking marijuana via their preferred method of use — s
moking, eating or topically applying. Three months after patients started treatment, varying from one or two doses a week to multiple doses per day, the researchers observed that their brains had more activity in the prefrontal cortex, the area associated with cognition, decision-making and executive function. They also saw an increase in task performance among the users, signifying a boost in cognitive function.

In addition, the treatment quelled their symptoms — most medical marijuana users in the study saw an increase in quality of life and alleviation of their ailments. The results weren’t a huge shock for Gruber.

“Recreational consumers and medical users just aren’t the same,” she says. “The goal of use is totally different.”

That could explain why some recreational users seek out super-loaded quantities of tetrahydrocannabinol (THC) in the strains they smoke. THC is what makes users high; its sister component, cannabidiol (CBD), does not. From 1995 to 2014, THC content in recreational marijuana increased from 4 to 12 percent, while the CBD content in modern-day weed is barely 0.15 percent.

CBD, on the other hand, is growing in popularity as a medicinal treatment for inflammation, pain and anxiety. But the jury’s still out on how well the compound works as a remedy. In 2018, Gruber’s team began the first clinical trial on CBD in patients with anxiety, with results expected as early as this year.

Mind Under Matter

Our understanding of marijuana’s effect on mental health is murky. Some studies suggest it might exacerbate conditions like schizophrenia or psychosis, but the results aren’t always black and white. 

In a 2017 clinical trial of 88 patients with schizophrenia, researchers in the U.K. administered 1,000 milligrams of CBD each day to about half of the study participants. They took the supplement along with their typical regimen of antipsychotic medications. At the end of six weeks of treatment, the people who received CBD reported greater alleviation of symptoms than those who only stuck to their normal medications.

But another study from just this year found that weed might actually correlate with an onset of psychosis. Researchers in the U.K. surveyed more than 900 patients who had been diagnosed with their first psychotic episode, and over 1,200 participants who had not been diagnosed with psychosis.

They asked about lifetime cannabis use and found that daily marijuana users had the highest risk of developing the condition.

That risk may be linked to the concentration of THC in a particular cannabis product, however. In the same study, researchers split weed users into two groups: those who typically smoked marijuana with a THC concentration of less than 10 percent, and those who used high-potency pot with a concentration of 10 percent or higher. They found that high-potency users had a fivefold increased chance of developing psychosis. Taken together, these findings help show that our brains have very different reactions to CBD and THC — which might be why medicinal users often experience such different results from recreational users.

Grandpa’s Weed

Marijuana use is skyrocketing among the elderly — reports have suggested it has increased as much as tenfold among seniors over the past decade. And the drug might be an effective measure to treating chronic pain and chemotherapy side effects like nausea, which could explain the climbing usage rates.

A small clinical study published in the German journal Der Schmerz indicated that an oral medication form of synthetic marijuana, known as dronabinol, helped relieve pain in patients older than 80.

According to the results, released in October, more than half of patients experienced some level of pain relief after a year of taking the medication.

And a much larger study found positive results among a slightly younger crowd. In Israel, a team of researchers administered a questionnaire about quality of life before and after patients at a specific clinic started using cannabis. The results compiled data from over 2,700 patients older than 65, most of whom had chronic pain or cancer symptoms. More than 90 percent of patients noted an improvement in their condition after six months of using the drug.

In another study, the same researchers also analyzed data from cancer patients who routinely used medical marijuana to manage their symptoms. Drawing results from just over 1,200 patients, they found that over 95 percent reported an improvement in their symptoms, which ranged from sleep problems and lack of appetite to weakness, nausea and pain.

The German and Israeli studies concluded that the drug was safe and effective in older populations seeking relief from pain or cancer-related symptoms. Marijuana might be a positive alternative for older folks looking for relief — although not every medical condition responds as drastically to treatment as others.

A Mixed Bag for MS

While a handful of studies have found marijuana to be a potential treatment for the pain and spasticity that come with multiple sclerosis (MS), not all clinical research shows a benefit.

The largest randomized clinical study on MS and marijuana to date, according to the National Multiple Sclerosis Society, found that different oral THC medications helped patients manage symptoms like spasticity and sleep struggles, while there was no improvement in tremor or bladder symptoms. And another clinical study done in the U.K. in 2013 showed that oral THC, while not unsafe, didn’t slow the progression of the disease.

But a 2012 study did find that short-term marijuana use may help with those physical symptoms.

Researchers at the Center for Medicinal Cannabis Research at the University of California, San Diego, studied the effects of inhaled cannabis on pain levels and spasticity control. Thirty participants smoked marijuana once a day for three days, and noted that their spasticity and pain levels decreased more than for those who took a placebo.

Preliminary results from a 2019 study show the picture is different when it comes to the mental effects of marijuana on MS patients. Researchers in Canada followed study participants, who had been smoking at least four times a week for many years, as they abstained from marijuana for 28 days. The research team took fMRI scans as they were weaned off the drug, and noted that they showed an increase in cognitive function. Certain areas of the brain that were normally inactive in the participants started to reawaken, and their performances improved in cognition tests.

Smoke in the Wind

The bottom line is this: Research on marijuana remains inconclusive. Results differ from person to person, depending on why and how they use the drug.

To date, only a few medications — dronabinol, nabilone and cannabidiol — have received FDA approval. But they’re intended for use by a select group of patients: those with rare forms of epilepsy, those who have side effects from chemotherapy or those with severe weight loss caused by AIDS.

Dronabinol and nabilone, which are both oral synthetic forms of cannabis, are defined as Schedule II and III drugs. That means the DEA sees a moderate to high potential for dependence or abuse, although certain patients are still allowed to use the drug for its medicinal benefits. In 2018, a CBD-derived oral medication called Epidiolex was approved as a Schedule V, meaning it is regulated as a drug with the least potential for abuse.

But with recreational marijuana use on the rise, researchers like Gruber are pushing for more concrete evidence on the drug’s effects. She’s certain that it’s far from vanishing from the public eye.

“It’s like rock ’n’ roll,” she says. “It’s here to stay.”

Jamaica to lower cannabis industry entry barriers for small farmers

By Matt Lamers

Jamaica is preparing to lower entry barriers to the medical cannabis industry for small and subsistence farmers.

A proposed new permit would cut fees for those farmers and allow for variations to strict infrastructure and security requirements.

The Cannabis Licensing Authority (CLA) is undertaking consultations on the draft policy, called the Cultivator’s (transitional) Special Permit Policy, which is currently in an advanced stage of completion.

The CLA said the permit is geared toward small or subsistence farmers who find the current licensing system for cannabis cultivators to be too challenging or expensive to navigate. Subsistence farmers typically grow crops for use by their families.

“This policy intends to provide this group of farmers with an additional avenue to enter the medical cannabis industry as well as an opportunity to transition from being the ‘holder of a special permit’ to the ‘holder of a license,’” the CLA said in a news release.

The policy proposes that the permit be valid for two years.

In that time, the CLA said it expects permit holders to use their profits to make preparations to transition to licensed status upon expiration of the permit.

The CLA is holding a series of consultation sessions on the proposal.

Feedback will be used to refine the policy before relevant regulations are finalized.

The agency is proposing that all fees will be 50% lower than the current fee for a Tier 1 License.

That would make a special permit $1,000.

Tier 1 cultivation licenses limit canopy space to 1 acre or less.

The draft policy also proposes that applicants may apply for a waiver, deferment or payment plan if the reduced fees are too high.

A “means test” will be utilized by the CLA to ensure the special permit is utilized by the intended groups.

The first consultation was held June 26 with members of the Jamaica Licensed Cannabis Association, and more sessions are planned for the coming weeks.

Older cannabis consumers have lower body mass indexes and are more likely to work out

Maria Loreto

Photo: ViktorCap/Getty Images

The lazy stoner stereotype is one of the most prevalent ones when it comes to marijuana use. Making appearances in movies and college, it’s a stereotype that’s meant to be funny and used by people who don’t know much about the drug.

Science has shown, a few times now, that regular cannabis use doesn’t imply a sedentary lifestyle, however. Turns out that people can get high and lead active lives.

A study conducted on older Americans found that those who consumed cannabis engaged in more workouts and physical activities than non-consumers. Researchers surveyed participants over a period of four months, conducting an exercise intervention program. Participants who consumed cannabis had lower body mass indexes (BMI) and were more likely to commit to their workout routines when compared to other participants.

“These findings suggest that it may be easier for older adults who endorse using cannabis to increase and maintain their exercise behavior, potentially because cannabis users have lower body weight than their non-using peers,” write the authors of the study. “At minimum, the evidence suggests that cannabis use does not hinder older adults’ ability to engage in physical activity, to participate in a supervised exercise program, or to increase their fitness as a result of physical activity.”

While the connection between cannabis and lower body mass indexes remains unknown, these types of studies continue to show that cannabis is more than a drug that gives people the munchies and encourages them to laze around. Anecdotal and scientific data shows that marijuana can be a helpful and motivating tool for staying active, a big issue that plagues Americans, especially those over the age of 50.

As scientists and users of different ages and lifestyles spend more time with the drug, more information is discovered. While it’s unknown if the drug could help people work out more, studies like these are at least discouraging the spread of outdated stereotypes.