Higher Potency Cannabis Associated With Greater Risk of Addiction

PainRelief.com Interview with:
Kat Petrilli, PhD Student
Addiction and Mental Health Group (AIM)
Department of Psychology
University of Bath

PainRelief.com:  What is the background for this study? 

cannabis marijuana weed pot

Response: Cannabis is the third most used drug globally, after alcohol and nicotine. Experimental studies show that THC, the main psychoactive component, causes intoxication, cognitive impairments, as well as symptoms of anxiety and psychosis-like experiences and these effects are dose-dependent, which means that higher potency cannabis products (products with high THC concentrations) could increase the risk of harm to cannabis users. 

Previous studies have shown that concentrations of THC in cannabis have increased over the years. In the US and Europe concentrations of THC in cannabis have more than doubled over the past 10 years. In addition, new legal markets have facilitated the appearance of cannabis products with higher potencies than earlier products, such as cannabis concentrates. We also know from previous studies that cannabis use is associated with mental health disorders and 22% of people who use cannabis are estimated to meet the criteria for cannabis use disorder (CUD) or cannabis addiction. 

International increases in cannabis potency and the availability of higher potency cannabis products makes it especially pressing to understand the association of cannabis potency with mental health outcomes. 

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Real World Study Evaluates Medical Cannabis for Cancer Pain Relief

PainRelief.com Interview with:
David (Dedi) Meiri PhD
Principal Investigato
Laboratory of Cancer Biology and Cannabinoid Research
Technion
Israel Institute of Technology

PainRelief.com:  What is the background for this study? 

Response: We encountered numerous cancer patients that asked us whether medical cannabis treatment can benefit their health, however, while there is a lot of anecdotal evidence regarding the effectiveness of medical cannabis for pain, not much was known regarding its effectiveness in particular for the treatment of cancer-related pain; and there were no validated clinical studies. This motivated us to conduct an organized and thorough study that can serve patients and government ministries alike.

This study, which was conducted by Dr. Joshua Aviram as part of his postdoctoral fellowship, is the first to assess the possible benefits of medical cannabis for cancer-related pain in oncology patients, gathering information from right before they started the treatment and with repeated follow-ups for an extended period of time. Over a span of six months, we investigated the effectiveness and safety of medical cannabis treatment based on sound real-world evidence.

Australian Study Finds Most Medical Cannabis Obtained Without Prescription

PainRelief.com Interview with:
Janni Leung, PhD
National Health and Medical Research Council Emerging Leadership Fellow
National Centre for Youth Substance Use Research (NCYSUR)
The University of Queensland

PainRelief.com:  What is the background for this study? 

Response: It is important to know the prevalence and source of medical cannabis use because non-prescribed use may put individuals at risk.

More Kids Poisoned by Cannabis Since Legalization

PainRelief.com Interview with:
Daniel Myran, MD, MPH, CCFP, FRCPC
Family and Public Health and Preventive Medicine Physician 
CIHR Fellow, Ottawa Hospital Research Institute 
Department of Family Medicine Innovation Fellow
University of Ottawa 

Dr. Myran

PainRelief.com:  What is the background for this study? 

Response: Canada legalized recreational, or non-medical, cannabis in October 2018. Canada took phased approach to legalization initially only allowing flower-based cannabis products and oils and after one year permitting the sale of commercial cannabis edibles (e.g. THC containing candies, baked goods, and drinks). In this study we took advantage of this phased roll out of legal cannabis to understand the impact of legalization on cannabis exposures or poisonings in children aged 0-9 years and the contribution of different types of cannabis products to these events. 

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Study Finds Medical Cannabis Not Likely to Solve Opioid Crisis for Pain Patients

PainRelief.com Interview with:
Carsten Hjorthøj, senior Researcher
Copenhagen Research Center for Mental Health – CORE, Mental Health Center Copenhagen, Copenhagen University Hospital
University of Copenhagen, Department of Public Health
Section of Epidemiology, Copenhagen, Denmark.

PainRelief.com:  What is the background for this study?  What are the main findings?

Response: Denmark introduced a pilot program of medical cannabis in 2018. Medical cannabis, and cannabis-based medicine, has gained a lot of both attention and controversy as a possible way to treat pain disorders, but the evidence base is still sparse. The Danish nationwide unselected registers allow us to perform a high quality pharmacoepidemiologic study with propensity score matched controls.

The main findings are that medical cannabis and cannabis-based medicine did not reduce the use of opioids in pain patients, and might actually lead to an increase in use of opioids. However, patients with neuropathic pain disorders appeared to reduce their use of gabapentin, their use of overall medication (but not opioids!), and the number of days spent in hospital, compared with controls.

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Study Evaluates Placebo Effect of CBD on Pain Relief

PainRelief.com Interview with:
Martin De Vita, CPT, MS, USA
Doctoral Candidate
Clinical Psychology Department
Syracuse University

PainRelief.com:  What is the background for this study?  What are the main findings?

Response: Seemingly out of nowhere, cannabidiol (CBD) products became immensely popular. Cross-sectional studies showed widespread use among the public for various clinical conditions. Pain was by far the most commonly reason cited for using CBD. However, no human experimental pain studies had been conducted to evaluate the analgesic effects of CBD. A lot of people questioned whether CBD effects on pain were just a placebo.

To answer this question, we tested people’s baseline pain responding using sophisticated equipment capable of delivering safe, but painful stimulation that activates and evaluates human nervous system processes. Then we administered either CBD or a placebo and re-tested these pain outcomes to see how they changed. We took it a step further and manipulated the information that participants were given about which substance they received. So in some conditions, participants were told they got CBD, even though it was just a placebo. In other conditions, participants were told they got an inactive substance, despite actually receiving CBD. This way, we could test whether simply telling someone that they had received CBD would have an effect on their pain. These are called expectancy effects and there is a large body of literature that supports this phenomenon.

When we looked at the data, we found that CBD analgesia was actually driven by both expectancies (placebo analgesia) and pharmacological action. We also found that these manipulations affected different pain outcomes. We found that both CBD and expectancies reduced pain unpleasantness but not pain intensity. The results were complex in that CBD and expectancies for receiving CBD differentially affected various outcomes. This was exciting because we are left with even more questions to investigate in future research.

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Peptide May Allow Cannabis to Provide Pain Relief Without Unwanted Side Effects

PainRelief.com Interview with:
David Andreu, PhD
Professor of Chemistry
Department of Experimental & Health Sciences
Pompeu Fabra University
Barcelona Biomedical Research Park
Barcelona, Spain

Prof. David Andreu (right)
Maria Gallo,
(first author)
Prof. Rafael Maldonado

PainRelief.com:  What is the background for this study?  What are the main findings?

Response: Background is the (earlier) finding of a cross-talk between CB1 and 5HT2A receptors (two GPCRs forming a heterodimer) that can be acted upon (disrupted) by peptides that allow to dissociate analgesic (CB1-mediated) from (unwanted) cognitive effects ( CB1/5HT2A heterodimer-mediated, memory impairment etc); this is reference 18 of our paper.

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