C-PTSD
Mattias Sommers

written by

Mattias Sommers

LJG 2021

reviewed by

Laura Geftman, LCSW

Mattias Sommers

written by

Mattias Sommers

LJG 2021

reviewed by

Laura Geftman, LCSW

Understanding Complex Post-Traumatic Stress Disorder (C-PTSD): How is it diagnosed and treated?

Some individuals with borderline personality disorder (BPD) or post-traumatic stress disorder (PTSD) have never quite felt that their diagnosis described what they were experiencing with their mental health. Maybe some people have wondered about the symptoms they are experiencing, and after reading about BPD and PTSD felt some symptoms portrayed their experience but did not completely explain what was going on. Similar to both these diagnoses but also possessing key differences from them, complex post-traumatic stress disorder (C-PTSD) is a new concept that is being investigated by mental health professionals. This diagnosis consists of symptoms of post-traumatic stress disorder and borderline personality disorder with additional symptoms that characterize it as a separate disorder. If you are wondering if there might be another explanation for your symptoms or want to understand what C-PTSD is and how to treat it, whether for yourself, a loved one, or just to understand it, keep reading to find out!

 

What is Post Traumatic Stress Disorder (PTSD)?

PTSD is a disorder that manifests in specific individuals when they experience a single traumatic event that inhibits a person’s ability to perform daily functioning. Unlike C-PTSD, PTSD is a reaction to a single event, not prolonged trauma over time. Source. Trauma can, unfortunately, happen to any of us, and it is essential to understand that PTSD is not an uncommon response to these incidents and recognize that any of these symptoms can appear that you may need help treating. When this disorder was first recognized, PTSD was mostly linked to war veterans that had experienced terrifying and traumatic situations during their time serving. Even today, whenever anyone mentions PTSD, it is often linked back to war. Over time, it began to be understood that anything traumatic could trigger this disorder.

In many cases, domestic violence is a significant cause of manifestation in women. PTSD, for some people, is the brain’s way of coping with intense amounts of stress and fear and reacting to protect the person from having to endure that pain again. PTSD can manifest as a response to any event a person deems traumatic such as car accidents, near-death experiences, assault, emotional and physical abuse, and natural disasters. It is essential to understand that not everyone will develop PTSD as a response to trauma and that some reactions such as sadness, anger, nightmares, or anxiety are common for anybody who suffers a traumatic experience. To be diagnosed with PTSD, an individual must meet the following criteria:

Experiencing a stressor: A person experiences a stressor, which includes the threat of death, serious injury, or sexual violence that happens to themselves, or the individual can develop it by witnessing it happen to another person. Alternatively, the symptoms can develop within an individual who has a close friend or relative that experienced one of these stressors or is indirectly and repeatedly exposed to details of the event. Source
Intrusive symptoms: This includes intrusive memories, nightmares, dissociative reactions including flashbacks to the event, prolonged distress in response to reminders of the event, and physiological reactions to reminders of the trauma. Source
Avoidance: This means that the individual avoids trauma-related thoughts or feelings and external reminders such as people, places, or situations. Source
Mood Disturbances: Negative alterations to a person’s mood. A person must meet two of the following: Inability to recall key features of the event, distorted negative beliefs and expectations about oneself or the world around them, endless blame of self or others, persisting negative emotions, diminished enjoyment in activities once enjoyed, feeling detached from others and inability to experience positive emotions. Source
Altered Behaviors: Altered reactivity or arousal, including aggressive behavior, self-destructive behavior, hypervigilance, exaggerated startle response, concentration issues, and disturbances in sleep. Source
Furthermore, an individual must experience the symptoms for one month or more, the symptoms must have a negative effect on different areas of life, and the symptoms cannot be explained by other factors such as the medication one is taking, substance abuse or another medical illness one may be diagnosed with. According to the Diagnostic and Statistical Manual of Mental Disorders an individual must experience a stressor, one or more symptoms matching the intrusive symptoms and one or more relating to avoidance, two or more symptoms in mood disturbances and altered behaviors, and meet the duration, functional significance, and exclusion categories outlined above. Source

 

What is Borderline Personality Disorder? (BPD)

A borderline personality disorder is a personality disorder with symptoms that may easily get confused with those of C-PTSD. To understand whether what a person may be experiencing is related to BPD or C-PTSD, we must understand BPD and what differentiates it from the diagnosis of C-PTSD. This diagnosis appears to commonly manifest in late adolescence to early adulthood. Having BPD can immensely impair relationships, work, school, and other aspects of life, but with intense psychiatric treatment through therapy and learning healthier coping skills, it can be treated and eventually no longer meet the criteria for the diagnosis. Like C-PTSD, BPD is commonly linked to prolonged trauma in the form of childhood abuse. To meet the criteria for diagnosis, a person must display five out of the nine symptoms used in clinical assessment. The nine symptoms are:

Frantic efforts to avoid real or imagined abandonment
Unstable and intense interpersonal relationships
An unstable self-image or sense of self
Impulsivity in at least two areas that cause damage to the person (sex, binge-eating, reckless driving, substance abuse or self-harm)
Instability in mood that lasts a couple of hours rather than days at a time (quickly fluctuates) and can be expressed as irritability, anxiety or dysphoria
Chronic feelings of being “empty inside.”
Intense and inappropriate bouts of anger or difficulty controlling anger (outbursts, consistent fighting)
Stress-related paranoia or dissociative symptoms
Source

It is important to note that often those with BPD are highly stigmatized. It is hard for many people to understand their quickly changing moods and fears that often lead them to push others away. Those with BPD were usually exposed to intense suffering and negative situations that warped their ability to form healthy coping and interpersonal skills. Most of their symptoms manifest as a way to protect themselves from fear and hurt that they may have experienced before, similar to C-PTSD Source. It has been said that those with this disorder usually experience heightened emotional responses compared to the average person, so their negative emotions are often severely painful for them Source. If they opt to be consistent with therapy, new coping and interpersonal skills can be taught for them to recover and live more fulfilling lives. 

 

What is Complex Post Traumatic Stress Disorder (CPTSD)?

Complex post-traumatic stress disorder was first suggested by Judith Herman of Harvard University, who believed a new diagnosis was warranted to explain the effects of long-term trauma and abuse. Although one horrific event can cause intense damage to one’s mental health, prolonged suffering can be theorized to have an impact that differs from one single event. Although mentioned, the recognition of C-PTSD as a diagnosis has been rejected for entry into the Diagnostic and Statistical Manual of Mental Disorders by the American Psychological Association, stating that more conclusive research needed to be done. But,  in 2018, it was recognized by The World Health Organization as a diagnosis. WHO considers C-PTSD a “more intense PTSD” but shows that the movement for C-PTSD is becoming a more accepted concept Source. 

C-PTSD is called “complex” because the field of trauma and stress in psychology has labeled multiple, chronic, and developmentally damaging traumatic events as “complex trauma” Source. Those who experience it have often endured extreme psychological abuse or torture or been exposed to horrific and terrifying events for extended durations. Some examples of these traumatic events include domestic violence, physical or sexual abuse, torture, sex trafficking, or imprisonment and are commonly interpersonal in nature. Physical symptoms from C-PTSD are not uncommon, and often victims will experience neck and back pain, headaches, gastrointestinal symptoms, chronic fatigue, and other symptoms that manifest due to the body coping with emotional pain  Source.

Those with C-PTSD will experience the fundamental symptoms of PTSD. The difference is that unlike PTSD, those with C-PTSD may additionally struggle with:

Emotional regulation that includes flashbacks that make one experience the emotions they felt at the time of the trauma, severe depression, suicidal thoughts, and difficulty controlling anger. 
Changes in self-perception that make a person view themselves in a more negative light. 
Fixation and preoccupation with their perpetrator 
Inability to maintain stable personal relationships due to mistrust that leads a person to alienate themselves 
Changes in beliefs and losing faith in humanity 
Behaviors including lashing out at minor criticism, drug or alcohol abuse, becoming “people-pleasers,” and self-harm may or may not be present in an individual. 
Source

 

How is C-PTSD Treated?

Although it may be an uncomfortable, challenging and lengthy process, those with C-PTSD have the potential to recover through intense psychiatric intervention. It is hard to define the disorder as entirely curable. However, it can be managed and improved with treatment so that individuals can live more positive and enjoyable lives. So far, strategies utilized to treat PTSD have shown to be useful for C-PTSD as well. Some examples of the treatment approaches professionals have been taking to help alleviate the symptoms of the disorder are:

Trauma-focused Cognitive Behavioral Therapy: A form of Cognitive Behavioral therapy explicitly developed for PTSD patients. 
Eye movement desensitization and reprocessing (EMDR): This treatment consists of having the patient make rhythmic eye-movements while recalling the trauma they experienced. 
Medication to treat depressive symptoms and sleep problems caused by the disorder or used if the individual is unwilling to try talk therapies, although medication is not often prescribed for PTSD or C-PTSD treatment. If a doctor recommends medication, antidepressants are the most commonly used medication to help manage the symptoms, although it should be noted that PTSD and depression are two separate illnesses. 
Group therapies, art therapy, and Dialectical Behavioral Therapy (DBT) have also had some success in treating those diagnosed with C-PTSD but should not be used on their own. 
Exercise, finding a job, forming new friendships, or taking on a new hobby are all ways one can take steps to begin managing their disorder.
Source

 

Final Thoughts

If you or someone you know has experienced continuous trauma and is exhibiting the symptoms in this article, it is highly encouraged you to reach out to a mental health professional to diagnose and treat the symptoms correctly. Suffering from this disorder can be highly debilitating and discouraging that things will ever get better. However, there are various people, even people you have not met yet who want to support you and see you thrive. It is entirely achievable to recover and live a fulfilling life with the right resources; all you have to do is ask for help! Support is all around you, and that is a vital part of recovery. It may take some patience and be challenging at times, but I know you can do this! If you enjoyed this post or have any questions, please feel free to leave a comment below and keep checking back for new posts!

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Stay calm. Canna-curious is cool! But collect some info first.
If you are:

  • under 25 years old
  • taking any medication
  • at risk for heart disease
  • family history of psychosis
  • family history of mood disorders
  • family history of addiction

…please be sure to consult a medical or mental health professional.

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CBD for anxiety

A pounding heart, sweaty palms, racing thoughts: For those living with an anxiety disorder, these unwelcome symptoms can make everyday life feel debilitating.

One in 13 people around the world live with an anxiety disorder, making them the most common mental health disorder worldwide, according to the World Health Organization (WHO). For those living with anxiety, finding a safe method for managing symptoms is a critical concern.

Quick-acting anti-anxiety medication, such as Xanax and Valium, may offer instant relief but can become addictive. Long-range anxiety medications, such as Prozac, may help reduce symptoms over time, but don’t work for everyone.

Enter cannabidiol, better known as CBD. CBD has recently captured the spotlight as an alternative or complementary treatment for anxiety.

CBD: Snake oil or powerful anxiety treatment?

Clinical research on CBD as a treatment for anxiety disorders has proliferated in recent years with accumulating evidence pointing to its therapeutic potential.

Although most studies on CBD are preclinical and use animal models, clinical studies using human participants are now emerging.

In a double-blind study from 2019, 37 Japanese teenagers with social anxiety disorder (SAD) received 300 mg of CBD oil or a placebo every day for four weeks. The teens were assessed with surveys used to diagnose and measure SAD symptoms. The anti-anxiety properties of CBD reduced symptoms aligned with the disorder, providing relief comparable to Paroxetine, a drug commonly used to treat the condition.

Interestingly, in the follow-up, nine of the seventeen teenagers who received the CBD intervention also declared that they had decided to seek some form of treatment. Teenagers with SAD rarely seek help due to the stigma surrounding the condition and for fear of interacting with therapists.

A 2019 retrospective case study reviewed outpatients at a mental health clinic in Fort Collins, Colorado. Forty-seven of the patients sampled had expressed concerns about anxiety. Over three months, the majority of patients were given 25 mg of CBD daily in addition to treatment.

After the first monthly assessment, 79.2% of patients experienced an improvement in anxiety. After two months, 78.1% of patients reported a further improvement compared with the previous month.

However, there were also patients who reported that the symptoms of their anxiety worsened after taking CBD—15.3% felt their anxiety had become exacerbated after the first month and 19.5% felt their anxiety had worsened further after the second month.

Another study, done in 2018, also suggests that CBD may heighten anxiety. It included a small sample of individuals with paranoid traits and found that CBD exacerbated anxiety among some of the participants. Anxiety was measured through symptoms such as cortisol concentration, heart rate, and systolic blood pressure.

These contradictory findings may be due to factors such as small sample sizes and variations in dosing. CBD is a bidirectional medicine, which means it can cause opposing responses at different doses. We’ll delve deeper into this below.

How should I consume CBD for anxiety?

If you’re curious about using CBD oil as a tool to help manage your anxiety, education is critical. Understanding the pros and cons of the various ingestion methods can help you determine which form of consumption best suits your needs.

tinctures and oils represent a quick, easy, and accurate way to consume CBD. Most tinctures contain CBD in an alcohol base. CBD oils contain CBD extracts infused into a carrier oil, such as coconut or hemp seed oil.

Tinctures and oils are taken using a dropper, which allows you to easily measure intake. The cannabinoid rapidly enters the bloodstream when taken sublingually—results can kick in as quickly as ten minutes and last up to three to four hours.

CBD vape oils can be vaped using a special pen that vaporizes the oil. At present, the safety of vaping has come under intense scrutiny. A serious lung condition known as VAPI, or EVALI, has hospitalized more than 2,000 people and led to the deaths of 42. The federal Centers for Disease Control has found that most cases have been linked to the use of illicit-market THC vape cartridges tainted with vitamin E oil (tocopheryl-acetate).

CBD vape cartridges purchased in legal state-licensed cannabis stores are highly regulated, while CBD cartridges purchased from other sources are completely unregulated. Proceed with caution when considering any vaping product in an unregulated environment.

edibles CBD can be added to almost every food under the sun. While super easy to consume in this form—and often delicious, particularly as gummies—it may take an hour or more before results are felt.

What’s more, the oral bioavailability of CBD can hinder CBD absorption—when you consume CBD orally, it has to pass through your gastrointestinal tract before it is metabolized by the liver. As a result, a limited quantity of CBD makes it into the circulatory system.

It’s important to also note that the FDA has recently deemed food containing CBD illegal. You’ll have to get CBD edibles in state-licensed adult-use markets.

smoking provides an almost instantaneous method for enjoying the effects of CBD. Smoking sends the cannabinoid directly to the alveoli of the lungs, and from there, CBD molecules enter the bloodstream for rapid absorption. However, measuring your CBD intake can be tricky when you smoke, and the act of smoking itself can cause lung inflammation.

Dosing CBD for anxiety

If you read the studies cited above, you’ll notice that the dosing varied significantly between them. The teens in the Japanese study were provided with 300 mg of CBD daily, while the outpatients in the Colorado study received 25 mg. Why such a large discrepancy in dose?

As most scientists and clinicians will readily admit, there is no universally recommended dosage for CBD, and, to date, there haven’t been any large-scale clinical trials to inform dosage guidelines. In addition, the FDA is still learning about CBD—such as its cumulative effects on the body—before it decides on how to regulate it.

This doesn’t necessarily mean CBD is unsafe. Existing research already suggests that it appears to be a safe, well-tolerated treatment. If you’re interested in experimenting with CBD to manage your anxiety symptoms, aim for an informed, cautious approach to dosing (which is always a good idea). Below are some dosing considerations.

General dosing tips

Some basic factors that you should consider when devising a CBD dose include:

👉 body weight

👉 metabolism

👉 concentration of CBD

👉 severity of your anxiety

The concentration of CBD varies between products, and is generally expressed as milligrams (mg) per container.

Once you know the potency of the CBD product you hold, you can use a dosage calculator or an app such as Accugentix to help settle on your perfect dose. Dosage calculations can provide a recommended dose in milligrams based on your body weight and the severity of your symptoms.

Your unique body chemistry also affects how you respond to CBD. Some individuals metabolize medicine faster than others, which can be attributed to genes or lifestyle. If you know that you metabolize medication quickly, it’s possible that you may benefit from a higher dose.

Bidirectional effects

CBD may do different things at different doses, a phenomenon known as bidirectional effects. Overstimulation of the body’s endocannabinoid system may exacerbate symptoms instead of alleviating them.

Additionally, high levels of CBD, such as 300 mg, have been known to promote sleepiness and relaxation. Conversely, low levels of CBD may create an elevating response, inciting wakefulness and alertness. The best way to avoid unwanted bidirectional effects is to follow the adage: start low, go slow.

Start low, go slow

Titration refers to the process of adjusting the dosage of a medication to get its maximum benefits without adverse effects. CBD has been shown to be safe even when taken in high doses (300-600 mg), nonetheless, it’s advisable and more cost-effective to start with a low dose and increase it incrementally, observing how you feel as you go.

This method forces you to pay attention to subtle changes in your body as it responds to the medication. Everyone’s optimal dosage and tolerance is unique, and this process allows you to get acquainted with yours.

Dr. Dustin Sulak, a cannabis medicine expert at Healer, offers educational resources for novice and seasoned cannabis users alike to find their optimal dosage.

Talk to an expert on medical cannabis

If you’re still feeling unsure and you live in a state where you can safely converse with a health professional about CBD, consider scheduling a consultation. Some cannabis dispensaries also have medical experts on hand who can provide you with sound advice and dosage recommendations.

Leafly logo

This article written by Emma Stone was originally posted on Leafly.com.

Blessing, E.M., Steenkamp, M.M., Manzanares, J. et al. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics 12, 825–836 (2015). https://doi.org/10.1007/s13311-015-0387-1

https://adaa.org/understanding-anxiety/facts-statistics

Hundal H, Lister R, Evans N, Antley A, Englund A, Murray RM, Freeman D, Morrison PD. The effects of cannabidiol on persecutory ideation and anxiety in a high trait paranoid group. J Psychopharmacol. 2018 Mar;32(3):276-282. doi: 10.1177/0269881117737400. Epub 2017 Oct 31. PMID: 29086614.

Nobuo, Masataka. Anxiolytic Effects of Repeated Cannabidiol Treatment in Teenagers With Social Anxiety Disorders. Frontiers in Psychology 10, 2466 (2019). DOI=10.3389/fpsyg.2019.02466    

Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente journal, 23, 18–041. https://doi.org/10.7812/TPP/18-041

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If you are:

  • under 25 years old
  • taking any medication
  • at risk for heart disease
  • family history of psychosis
  • family history of mood disorders
  • family history of addiction

…please be sure to consult a medical or mental health professional.

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Cannabis, Cannabinoids, and Your Body: Learn More About Your Medicine
LJG 2021

written by

Laura Geftman, LCSW

Hannah Sadock

reviewed by

Hannah Sadock, MS

LJG 2021

written by

Laura Geftman, LCSW

Hannah Sadock

reviewed by

Hannah Sadock, MS

Much of the recent scientific discoveries revealing the relationship between cannabis and our bodies involve the developing awareness and researched effects related to cannabinoids. This chemical compound is confounding researchers and patients alike. Naturally cannabinoids are found in only two places: obviously cannabis, and invertebrate animals- including mammals, birds, reptiles, and fish. 

Already sounding too sciency? Here is the thing- cannabis chemistry is meant to arm you with a basic knowledge of how cannabis affects the brain and body. So the better you understand your medicine, the more effective the remedy. Let’s make sense of this together… 

What are Cannabinoids?

Cannabinoids are a group of chemical compounds made up of 21 carbon atoms in a 3-ring structure. They bind to receptors throughout the brain and body. Aside from being the most mispronounced word in cannabinoid science- “kuh–nab–uh-noid”- they comprise approximately 100 of the 500 chemical compounds in cannabis, working together to provide a wide range of psychological and physiological effects.

Cannabinoids are neurotransmitters exerting their effects by interacting with specific cannabinoid receptors present on the surface of cells. The effects of cannabinoids depend on the targeted area of either the body or brain. They mediate communication between cells, allowing for immediate response to deficiencies or problems in our endocannabinoid system and halt unpleasant symptoms and physical complications. Simply put, cannabinoids activate receptors to maintain internal stability and health. 

While most cannabinoids are not intoxicating themselves, combinations of their presence can influence how each affects you. Different cannabinoids connect with or influence different receptors to produce different effects to achieve homeostasis or balance. 

Different Types of Cannabinoids

Now that we know what cannabinoids are and how to pronounce the word (😉), let’s break down the different types. Cannabinoids are produced not only in the cannabis plant but also in our bodies and they can be engineered in a lab. Crazy right!? As you may have previously thought, cannabinoids are groups of substances found only in the cannabis plant– well, let’s be real here, as much tetrahydrocannabinol (THC), cannabidiol (CBD), and their friends are important, they are not the stars of show here. Here more info about each kind:

🌿 phytocannabinoids or exogenous cannabinoids are compounds naturally existing in the cannabis sativa plant. If you know any Latin- “phyto” means “of a plant or relating to plants.” Hence the prefix relating this type of cannabinoid. Phytocannabinoids are made in the resin in the plant’s glandular trichomes on the surface of its leaves. For this reason, these cannabinoids are also referred to as “exogenous cannabinoids” as they are developed outside an organism.The plant has over 500 compounds, out of which over 100 belong to this class of cannabinoids. You may be familiar with some the more commonly occurring endocannabinoids:

🌿 tetrahydrocannabinol (THC)

🌿 cannabidiol (CBD)

🌿 cannabidiolic acid (CBDA) 

🌿 tetrahydrocannabinolic acid (THCA)

🌿 cannabinol (CBN)

🌿 cannabigerol (CBG)

🌿 cannabichromene (CBC)

🌿 tetrahydrocannabivarin (THCV)

One of the essential qualities of cannabinoids making them critical to treatment of physical and mental health diagnoses are their homeostatic qualities. When consumed, cannabinoids quickly enact the endocannabinoid system by attaching to the receptors influencing a response to target a symptom(s). They interact with the properties within these chemical compounds to produce effects such as mood enhancement, pain relief, anxiety decrease and stimulation of appetite. 

👤 endocannabinoids or endogenous cannabinoids are cannabinoids produced inside the body. When adding the Latin prefix “endo” – meaning internal or within- we are talking about cannabinoids created in your body. Yes, your very own body makes similar chemical compounds to the cannabis plants. Endocannabinoids are on-demand neurotransmitters, which are produced when needed and can work within seconds and disappear again.

Endocannabinoids lend themselves to rebalancing the most essential systems in the body, such as activators of the immune system. They are synthesized from fatty acids and respond locally from where they were produced. Just like phytocannabinoids, endocannabinoids interact with receptors to initiate a physical response. The two most commonly occurring endocannabinoids are:

👤 N-arachidonoylethanolamine – “anandamide” (AEA)

👤 2-arachidonoylglycerol (2-AG)

Research continues on the exact physiological mechanism promoting or triggering the binding of the receptors to the endocannabinoids. In the meantime, we will all hope our bodies maintain balance.

🧪 synthetic cannabinoids incorporate the commercial production of isolated cannabinoids and novel cannabinoid drugs made to enhance creations by nature. What am I talking about? Pharmaceuticals or cannabis-related compounds. While cannabis remains a Schedule 1 controlled substance, the Food and Drug Administration (FDA) has not approved cannabis for the treatment of any disease or condition, “synthetic cannabinoids” refers to cannabinoids that are synthesized in a lab to create new medicine.

However the FDA has approved one cannabis-derived drug product: 

🧪 Epidiolex (cannabidiol) for the treatment of seizures associated with two rare and severe forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome, in patients two years of age and older.

And three synthetic cannabis-related drug products: 

🧪 Marinol / Dronabinol / Syndros is used to treat loss of appetite and severe nausea and vomiting.

🧪 Nabilone or Cesamet used for chemotherapy-induced nausea/vomiting.

🧪 Sativex used as treatment for unresponsive spasticity in multiple sclerosis (MS) patients

These approved drug products are only available with a prescription from a licensed healthcare provider. As the laws and policies surrounding cannabis evolve with more research, we will undoubtedly see more cannabis derived and related medications from the pharmaceutical companies.

⚠️ In the meantime, there is also an illicit market for synthetic cannabis products to avoid the restriction placed on the legal market. These highly intoxicating and often very toxic designer drugs are sold under the names:

⚠️ Spice 

⚠️ K2

⚠️ herbal smoking blends

⚠️ synthetic marijauna 

These designer drugs are sprayed onto plant matter and commonly cause negative effects including palpitations, paranoia, intense anxiety, nausea, vomiting, confusion, poor coordination, and seizures. There have also been reports of a strong compulsion to re-dose, withdrawal symptoms, persistent cravings, and several deaths have been linked to synthetic cannabinoids. If you believe you have consumed counterfeit cannabis or CBD products and are concerned about negative effects, seek emergency medical care immediately.

In Conclusion

Phytocannabinoids from the plant mimic the naturally occurring endocannabinoids in our bodies. While synthetic cannabinoids are engineered to keep up with the natural production from plants and humans. Whether you choose to supplement your body’s natural process with cannabis or hemp, cannabinoids will continue to assist in finding balance. Just remember- as helpful as cannabis is, so is seeking professional help for any medical concern and staying mindful of the purpose of cannabis or cannabinoids use as it may indirectly postpone seeking treatment. 

Ahn K, et al. (2008). Enzymatic pathways that regulate endocannabinoid signaling in the nervous system. DOI: 1021/cr0782067

Alger BE. (2013). Getting high on the endocannabinoid system. ncbi.nlm.nih.gov/pmc/articles/PMC3997295

Atakan Z. (2012). Cannabis, a complex plant: different compounds and different effects on individuals. Therapeutic advances in psychopharmacology, 2(6), 241–254. https://doi.org/10.1177/2045125312457586

Fine, P. G., & Rosenfeld, M. J. (2013). The endocannabinoid system, cannabinoids, and pain. Rambam Maimonides medical journal, 4(4), e0022. https://doi.org/10.5041/RMMJ.10129

Gomez M, et al. (2008). Cannabinoid signaling system.
ncbi.nlm.nih.gov/pmc/articles/PMC2633685

Gorzkiewicz A, et al. (2018). Brain endocannabinoid signaling exhibits remarkable complexity. DOI: 1016/j.brainresbull.2018.06.012

Human endocannabinoid system. (n.d.). uclahealth.org/cannabis/human-endocannabinoid-system

Lu H-C. (2015). An introduction to the endogenous cannabinoid system. DOI: 1016/j.biopsych.2015.07.028

Nagarkatti, P., Pandey, R., Rieder, S. A., Hegde, V. L., & Nagarkatti, M. (2009). Cannabinoids as novel anti-inflammatory drugs. Future medicinal chemistry, 1(7), 1333–1349. https://doi.org/10.4155/fmc.09.93

Sarris, J., Sinclair, J., Karamacoska, D., Davidson, M., & Firth, J. (2020). Medicinal cannabis for psychiatric disorders: a clinically-focused systematic review. BMC psychiatry, 20(1), 24. https://doi.org/10.1186/s12888-019-2409-8

Zou S, et al. (2018). Cannabinoid receptors and the endocannabinoid system: Signaling and function in the central nervous system. DOI: 3390/ijms19030833

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HEY NEWBIES- START HERE!

KEEP IN MIND

Stay calm. Canna-curious is cool! But collect some info first.
If you are:

  • under 25 years old
  • taking any medication
  • at risk for heart disease
  • family history of psychosis
  • family history of mood disorders
  • family history of addiction

…please be sure to consult a medical or mental health professional.

NAVIAGTE

EXPLORE

New PTSD study finds cannabis safe, but not as effective as assumed

Preliminary results from a long-awaited study indicate that cannabis appears to be a safe and well-tolerated treatment for patients managing post-traumatic stress disorder (PTSD), although researchers did not find strong signals of effectiveness.

The study, led by Marcel Bonn-Miller of the University of Pennsylvania and Sue Sisley of the Scottsdale Research Institute, was funded by a $2.2 million grant from the Colorado Department of Public Health and Environment (CDPHE) to the Multidisciplinary Association of Psychedelic Studies (MAPS). Researchers fought for seven years to obtain approval to conduct the study, and it took three more years to carry it out.

For years, many military veterans have used medical marijuana to manage the symptoms of PTSD. It has been extremely difficult to study the effectiveness of cannabis for PTSD, though, because of federal prohibition and the many roadblocks specifically established to discourage the study of the potential positive health benefits of cannabis. Sisley fought for years to get this study approved, and then struggled to obtain government-approved cannabis of sufficient quality to carry out the research.

76 veterans in the study

The study involved 76 military veterans with PTSD, mostly men between the ages of 24 and 77. Bonn-Miller and Sisley established a two-phase study; the results of the first phase were published in this week’s PLOS One paper.

In the first phase, the 76 veterans were divided into four cohorts. One group self-administered cannabis with 12% THC over three weeks. Another group received an 11% CBD product with minimal THC. A third group received a balanced THC-CBD product, with roughly 8% THC and 8% CBD. A fourth group received a placebo with almost zero active cannabinoids.

Participants were given 1.8 grams per day for 21 days. That’s about the amount of cannabis contained in two to three joints. After three weeks, the subjects stopped consuming cannabis completely for two weeks. Then they were re-randomized in the four cohorts.

No significant difference found

Researchers found little statistical difference between veterans who took the placebo and those given the THC and CBD mixtures. In fact, nearly half of the veterans who received a placebo believed they had been given active cannabis. The study’s authors cited “several confounding factors” that may have contributed to these results. 

They also wrote:

The study sample included participants with a history of cannabis use. The recruitment of active cannabis users might have increased the potential for biased responding. Given the topical nature of the current trial and its relevance for public policy on medical cannabis, participants might have been biased to report positive effects regardless of condition. Despite many participants already having experience with the drug, nearly half of those receiving placebo believed that they received active cannabis. Prior expectations about cannabis’ effects might explain why even those in the placebo condition reported larger than average reductions in PTSD symptoms after only 3 weeks of treatment.

Poor quality of government cannabis could be a factor

Rick Doblin, executive director of MAPS, the organization that facilitated the study, noted that “the difference between anecdotal reports” of the effectiveness of cannabis for PTSD “and these results may be the quality of the marijuana.”

The cannabis in the study’s first part was supplied by the National Institute on Drug Abuse (NIDA), which has the only license in the U.S. for the production of cannabis used in federally-regulated clinical trials.

The quality and potency of that research cannabis has been a major point of contention over the years. NIDA-supplied cannabis has been notoriously awful—some of the lowest-potency and poorest-quality marijuana to be found anywhere in North America. It took years for NIDA to begin growing strains that even approached commercial grade. And even then the agency fell short. A 12% THC strain is roughly half the potency of the product sold in most medical and adult-use dispensaries in 35 states today. When the research team tested the cannabis sent by NIDA, even the 12% strain came up short. It tested at only 9% THC.

“Research quality” cannabis sparked earlier controversy

Early on in the study, criticism over the poor quality and low potency of the NIDA-supplied cannabis prompted Johns Hopkins University to withdraw from the multi-year clinical trials. Despite criticism from cannabis researchers and some Congressional lawmakers, NIDA maintains a government monopoly on all cannabis used in federally-approved cannabis research.

“Higher quality cannabis flower suitable for Food and Drug Administration (FDA) approval is currently unavailable domestically due to restrictions on production imposed by the U.S. Department of Justice and Drug Enforcement Administration and must be imported,” Doblin said.

Moving on to the next phase of research

Sue Sisley, a medical doctor, president of the Scottsdale Research Institute and the study’s principal investigator, is moving ahead with the next phase of the study, with higher-quality and higher-potency imported cannabis. That cannabis is available to adults and patients in any of dozens of states, but federally-approved researchers can’t use it because of federal prohibition. So it must be imported from outside the United States.  

“Despite the absurd restrictions federal prohibitionists have placed on research for more than 50 years,” said Sisley, “we are squarely focused on launching further Phase 2 trials with imported cannabis of tested, higher potency, fresher flowers that will provide a valid comparison for the millions of Veterans and others with PTSD who are looking for new options.”

PTSD widespread in veteran communities

According to MAPS, about 6% to 10% of the general population, and up to 31% of U.S. veterans, have experienced some form of PTSD. Veterans groups advocating for more access to cannabis, meanwhile, are applauding the newly-published study.

“MAPS and Dr. Sue Sisley deserve a medal for the absolute intentional dysfunction they overcame to complete this study and publish its findings,” Sean Kiernan, president of the Weed for Warriors Project, said in an email to Leafly. “All someone has to do is look at the lack of quality cannabis provided by the Federal Government’s monopoly, NIDA, to understand our Government is not taking our healing seriously.”

“When science tells us cannabis is safe,” he added, “common-sense should tell everyone, cannabis is an amazing substitute for opioids, and other legal accessible substances that carry with them the side effects of addiction, overdose, and suicidal ideation. Is it any wonder why millions prefer cannabis over deadly pharmaceuticals and other harmful substances?  It simply is a safer substitute.”

Establishing cannabis as safe

Dale Schafer, a California attorney who specializes in cannabis law, and a Vietnam-era Navy veteran, pointed out that studies such as the MAPS clinical trials are necessary if there is ever to be federal approval of cannabis use for PTSD.

“However, for the multitude of veterans, and average citizens, suffering from PTSD, Stevie Wonder can see that cannabis is medically helpful and thousands of years of use show an incredible safety profile,” he told Leafly. “Let’s move quickly to Phase 3 so veterans can work with the VA directly and not have to play games like cannabis is radioactive.”

Leafly logo

This article written by Bruce Kennedy was originally posted on Leafly.com.

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HEY NEWBIES- START HERE!

KEEP IN MIND

Stay calm. Canna-curious is cool! But collect some info first.
If you are:

  • under 25 years old
  • taking any medication
  • at risk for heart disease
  • family history of psychosis
  • family history of mood disorders
  • family history of addiction

…please be sure to consult a medical or mental health professional.

NAVIAGTE

EXPLORE

Hannah Sadock

written by

Hannah Sadock, MS

LJG 2021

reviewed by

Laura Geftman, LCSW

Hannah Sadock

written by

Hannah Sadock, MS

LJG 2021

reviewed by

Laura Geftman, LCSW

The potent smelling buds known for their psychoactive properties have recently entered into the field of medicine due their simplistic plant anatomy. Easy to reproduce and pollinate, the production of medicinal plants has increased the adaptations of new strains available as treatment. The reason for cannabis’ acceptance and influencing popularity stems from the increase in research suggesting an untapped hidden potential within the plant’s anatomy. 

Cannabis’ still holds a skeptical view within the public sector, which is a valid reason for persons to shy away from modern medicine’s advances. Though for some, specifically researchers and physicians, education has sprung awareness towards a plant-based formula. As cannabis may follow a similar anatomical structure of the common plant, their parts’ functions and features hold significantly different properties that target health symptoms, serving as value in the medical community.  

Of course, the plants all share basic characteristics, such as leaves, stems, and branches, though much like humans, at birth, plants are assigned a biological sex eventually developing specific reproductive organs. To achieve the harvesting of buds from the plants, it is critical to remember both male and female plants are essential to the reproductive cycle and production. Without them, buds will not form leaving you with a nice house plant with a single purpose for decoration. So get ready to learn because we will be targeting:

🪴 cannabis in science 
🪴 connections to the hemp plant
🪴 different species of cannabis
🪴 plant’s reproduction process
🪴 sex specific plant atamony 
🪴 structure and function of plants
🪴 roles of female vs male plants
🪴 role of pollination 
🪴 the role of budding 
🪴 creation of new strain
🪴 differences between CBD and THC 

🪴 cannabis in science 
🪴 connections to the hemp plant
🪴 different species of cannabis
🪴 plant’s reproduction process
🪴 sex specific plant atamony 
🪴 structure and function of plants
🪴 roles of female vs male plants
🪴 role of pollination 
🪴 the role of budding 
🪴 creation of new strain
🪴 differences between CBD and THC 

Cannabaceae- It’s All in the Family

In botany, the Cannabaceae plant family includes the cannabis, hemp, hops (yes, those hops used to make beer) and other related genuses of flowering plants. 

The naming of a plant includes two parts: 

        🪴 genus refers to a larger group of plants such as flowering
        🪴 species is a smaller, more specific type, breed or species found in the same genus

The flowering cannabis plant produces three different types of species aptly named:

🌿 Cannabis Sativa can grow fifteen-feet high making it more suited for outdoor growth to reach its maximum potential. It also grows best in higher temperatures and humidity levels. This may be a concern for mold and other issues but tend not to decrease its popularity due to its higher yield of psychoactive components.

🌱 Keep in mind, Hemp (aka that CBD stuff you see everywhere) is a type of Cannabis Sativa. In accordance with the UN Narcotics Convention, the US federal government classified “industrial hemp” in the 2018 Farm Bill as cannabis containing no more than 0.3% tetrahydrocannabinol (THC- the principal psychoactive constituent) by dry weight. As defined by this law, hemp is being bred to produce minimal levels of THC. 

🌿 Cannabis Indica is a stocky plant, typically growing no higher than 3 to 6 feet tall. This makes it more conducive to growing indoors. Cannabis Indica plants flower fast and present thicker foliage and broader leaves. Cannabis Indica plants tend to have an earthy smell and taste and are often more pungent. This type of plant tends to be tolerant of colder temperatures and relative humidity.

🌿 Cannabis Ruderalis aka “ditch weed” lacks psychotropic effects and is mostly used for breeding hybrids as a source of producing auto-flowering traits. It grows relatively short, reaching a maximum height of approximately two feet. Originating in Siberia, Cannabis Ruderalis is accustomed to colder climates. It has a short life cycle and blooms quickly. 

Anatomy of the Cannabis Plant

Cannabis plants share the same structure and function of other plants. While there is nothing quite like cannabis, the plant itself shares various aspects that are similar to other plants including their look, smell, and texture. Other plants contain similar chemical components making them all natural healers. So that you can differentiate your medicine, let’s be sure to explain how cannabis is unlike any doppelgängers.

The basic parts of the cannabis plant and other common plants include: 

🍃 roots of the plants serve as the base structure, grounding the plant by spreading for nutrients within the soil, allowing them to grow tall to withstand environmental factors. To flourish, ample space is needed for the roots to spread, ensuring sufficient supply of nutrients throughout the root system such as nitrogen, phosphorus, and water.

🍃stems are the main support structure of the cannabis plant. They transport fluids, nutrients, and information from the roots to the rest of the plant. The stem provides a foundation to give fan leaves access to the light they need to facilitate growth and carries the weight of heavy colas.

🍃branches act as the ‘support beams’ for the leaves as they bare the weight of the growing buds, keeping the plant tall and adaptable to crop weight.

As for the cannabis plant itself- each part of the plant serves a purpose and while the whole of a cannabis plant is certainly greater than the sum of its parts. Knowing its parts can inform your experience and appreciation of it. Here’s what you need to know:

🍃 fan leaves are the leaves you see as ways seemingly the universal sign for this plant. Responsible for photosynthesis, they are the main source of energy production for the plant with large leaves located along the main stem and branches to absorb light from the sun and transfer it into energy for growth.

🍃 sugar leaves are found throughout cannabis colas’ cupping buds that are typically trimmed off the flower after harvest. They are called “sugar leaves” because of the high volume of trichomes found on them, which makes it look like the leaves are covered in sugar. Sugar leaf trim can be used to make edibles or concentrates.

🍃 nodes are the intersections of stems and branches in plants. that harvest crops and are the location of determenting sex specific organs. Nodes can hold leaves, offshoots, and are where cannabis plants begin to grow either male pollen sacs or female pistils. 

Okay now it’s time for the birds and bees…or the plant’s sex organs. Let’s start with female specific organs, as they are critical. Only female cannabis plants produce flowers and contain multiple structures and functions responsible for reproduction. Actually since non-pollinated flowers are far superior than pollinated buds, male plants are often killed off in effort to cultivate plants for consumption. These are the parts of the cannabis plant responsible for reproduction and development: 

🍃 bract is an essential feature of reproduction in the female flower. In between the nodes and underneath the sugar leaves of the cola (bud) is the bract. The small leaves that surround the reproductive cells of a female plant. When a female plant is exposed to pollen from a male marijuana plant, the bracts surround and shield the seed pod.

🍃 calyx is what it’s all about- it is the actual bud itself composed of small sugar leaves, tear-shaped nodules, and pistils. It is also where the highest concentration of trichomes can be found.

🍃 pistil is what many describe as the colorful “hairs” that poke out from the bud. They first appear as white and then morph to orange, red, and eventually brown. Pistils are found only on female plants, and function to capture the pollen from a male. Some attribute the bright orange pistils to better quality cannabis but they actually contain very few trichomes.

🍃 cola is the main part of the flower, at the end of a female plant’s stem is composed of many small floral clusters. The cola is the plant’s offspring, and contains bracts, stigmas, trichomes, and sugar leaves. 

🍃 stigmas are female sex organs that look like small wispy hairs sticking out of the female bract. The thin hairs that extend from a female’s bract to catch male pollen. 

🍃 trichomes are hairlike appendages found on the surface of the cannabis plant. Trichomes protect the plant from external stressors and contain resinous glands that create the chemical compounds that give the plant its unique features and effects. Trichomes give cannabis buds a crystal-like sheen and make them sticky.

The Process of Pollination 

Cannabis plants require this form of pollination to produce offspring. Similarly to human reproduction, cannabis plants have their own genetic sequence or DNA, which allows the crossing of different characteristics within the same species, increasing genetic diversity- aka new strains. The cannabis plant requires cross pollination which is reliant on wind, animals, insects, and people to transfer the pollen from the male to another female plant. For cannabis reproduction to be successful, cross pollination must include:

👉🏽 male and female plants of same species 
👉🏽 pollen produced by male plants is carried to female plant
👉🏽  insects increases genetic differences by leaving tracks of pollen on stigmas of other plants 
👉🏽 stigmas collect the grains of pollen at the top of female flowers
👉🏽 multiple transfers of pollen to the stigma, thanks to nature, influences genetic diversity
👉🏽 genetic diversity increases medicinal modalities

Conclusion

The cannabis plant is complex, as it requires a cross pollination process to reproduce within its species and subspecies. Each species and subspecies within cannabis’ family of classification have their own unique characteristics contributing to the creation of medication. The cannabis strains consumed today are a result and combination of the structures of cross pollination between a male and female cannabis plants. With a better understanding of the complexity behind Cannabis sativa and its sister species, we can appreciate what nature undergoes to produce one of the most intricate modern medicinal plants used worldwide.

Andre, C. M., Hausman, J. F., & Guerriero, G. (2016). Cannabis sativa: The Plant of the Thousand and One Molecules. Frontiers in plant science, 7, 19. https://doi.org/10.3389/fpls.2016.00019

H.M.G. van der Werf, J.E. Harsveld van der Veen, A.T.M. Bouma, M. ten Cate, Quality of hemp (Cannabis sativa L.) stems as a raw material for paper, Industrial Crops and Products, Volume 2, Issue 3, 1994, Pages 219-227, ISSN 0926-6690, https://doi.org/10.1016/0926-6690(94)90039-6.

https://www.fs.fed.us/wildflowers/pollinators/What_is_Pollination/birdsandbees.shtml

https://nationalholistic.com/understanding-the-cannabis-plant-physiology

Magalhães PJ, Carvalho DO, Cruz JM, Guido LF, Barros AA. Fundamentals and Health Benefits of Xanthohumol, a Natural Product Derived from Hops and Beer. Natural Product Communications. May 2009. doi:10.1177/1934578X0900400501

McPartland, J.M., Guy, G.W. Models of Cannabis Taxonomy, Cultural Bias, and Conflicts between Scientific and Vernacular Names. Bot. Rev. 83, 327–381 (2017). https://doi.org/10.1007/s12229-017-9187-0.

Spitzer-Rimon, B., Duchin, S., Bernstein, N., & Kamenetsky, R. (2019). Architecture and Florogenesis in Female Cannabis sativaPlants. Frontiers in plant science, 10, 350. https://doi.org/10.3389/fpls.2019.00350

Westmoreland FM, Kusuma P, Bugbee B (2021) Cannabis lighting: Decreasing blue photon fraction increases yield but efficacy is more important for cost effective production of cannabinoids. PLoS ONE 16(3): e0248988. https://doi.org/10.1371/journal.pone.0248988.

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HEY NEWBIES- START HERE!

KEEP IN MIND

Stay calm. Canna-curious is cool! But collect some info first.
If you are:

  • under 25 years old
  • taking any medication
  • at risk for heart disease
  • family history of psychosis
  • family history of mood disorders
  • family history of addiction

…please be sure to consult a medical or mental health professional.

NAVIAGTE

EXPLORE

Alternative Forms of Consumption
Angela Morrison

written by

Angela Morrison

LJG 2021

reviewed by

Laura Geftman, LCSW

Angela Morrison

written by

Angela Morrison

LJG 2021

reviewed by

Laura Geftman, LCSW

If you smoke your cannabis, you’re undoubtedly familiar with bongs, joints, and bowls. However smoking isn’t for everyone and there are many other ways to medicate with cannabis. Whether you’re asthmatic and trying to save the health of your lungs, or just don’t like the smell, alternative forms of cannabis may be for you, too! 

Trying out new forms of cannabis will lead to new experiences as they interact with the body in different ways. There are plenty of reasons to shake it up with Tinctures, Edibles, RSO, and Topicals, and below I’ll get into each one…

From classic stories of homemade “happy” infused brownies to the modern sleek packs of THC:CBD gummy bears, you’ve probably heard of edibles. There’s every resource out there for homemade edible recipes to make all kinds of cannabis infused goodies from boba tea to chicken alfredo pizza. Whether you’re interested in cooking with cannabis or just eating your smoke, it’s worth knowing a bit how they are made, dosing, and labeling of edible products.

Decarbing and Cooking Edibles

If you’ve ever wondered how your food can be your medicine, it all comes down to the infusing process. Before cannabis can be infused, it has to be heated in a method known as decarbing. Raw cannabis plant material that has not been activated by heat of fire actually starts out as a non-active chemical known as THCA. Once it’s heated, THCA converts into THC offering the medicinal qualities you’re more likely pursuing.

Cannabis compounds including THC and other cannabinoids bond best with things like butter or other cooking oils. This makes fat the most essential component of infusing your food. Whether you infuse coconut, avocado, or olive oil, they will need to be incorporated into your infused food recipes. 

Eating and Metabolizing Edibles

So cook it up and get ready for a taste! But please be aware that ingested cannabis takes a different path through your body when being digested. Cannabis is first processed by your liver. Then metabolized into the blood-brain barrier, and eventually affects your mind and body. This is thought to be the defining difference of edibles and inhalation methods of consumption, and the reason edible effects can be particularly potent and long-lasting. When you take an edible, you can expect the effects to start around 2-4 hours and they can last 4-8 hours. This is all depending on personal metabolism and other factors.

The effects of edibles are somewhat renowned, but necessarily in the best light as the onset can be very delayed. This is often cause for eating more infused goodies which too often contributes to greening out- while you can’t overdose on cannabis, you can use too much. So it’s particularly important to warn of the potential adverse impacts of cannabis such as paranoia and anxiety. On a positive note- edibles offer a longer duration of pain-killing effects.

Properly dosing your edible concoctions can be difficult. This applies to edibles made both at home and commercially. Despite the appeal of packaged edibles, it has been found that many edible labels may be incorrect with their dosages. One study of 75 products from 47 different brands found only 17% had accurately labeled THC content. Please use edibles with caution.

Tinctures

Cannabis tinctures are plant material extracts dissolved into a liquid solution of solvent. Most commonly cannabis tinctures are high-proof alcohol based. They can also be made with glycerin but this doesn’t always prove to bond as effectively. Tinctures are a great choice for people who enjoy the effects of edibles but would like a low-calorie or low-effort alternative. Most notably- they have precise forms of measurement! 

Sublingual Tincture Use

The unique aspect of tinctures is the exact ability to dose and their immediate effects. The dosages are typically measured out with a dropper in 1 mL doses. If you’re new to tinctures, start low and slow with dosing. Starting with a small amount of tincture and increasing your dose with each use will allow you to manage the amount that’s best for you!

Tinctures must be taken sublingually for the most immediate effect. So open your mouth, lift up your tongue, and squirt your tincture under it. Don’t swallow right away. Instead allow the tincture to stay under your tongue for a little while…say thirty seconds. In doing this, the cannabinoids- THC, CBD, and more are absorbed into the blood system. You should feel the effects in as little as 15 minutes. 

Eating Your Tincture

Tinctures may have some natural cannabis flavor. If the taste of tinctures isn’t your thing (or if you’d prefer a longer onset), tinctures can easily be mixed into almost any food. The cannabis will enter the body in a similar process as edibles, taking around 1-3+ hours. 

No matter how you take the tincture, the effects of tinctures on you are still unique to the form. Typically a tincture’s effects will last longer than smoking or vaping, but a shorter period of time than edibles. Though the research on tinctures is limited and larger surveys need to be done, it has shown in one study of people with MS (multiple sclerosis) to manage pain, spasticity (muscle stiffening/tightening), neuropathy (nerve damage), and improve sleep. This is based on a small clinical study, testing a THC:CBD ratio oil tincture on 61 participants aged 25+ who took the tincture daily over the course of 3-4 months and rated their symptoms.

RSO

If you know anything about Rick Simpson Oil (RSO), you’re probably familiar with the mysteriousness surrounding it. There’s been a level of folklore to the story behind this type of cannabis. We’re gonna try to make sense of this curious puzzle.

The Story of Rick Simpson Oil

Rick Simpson is Canadian engineer who was diagnosed with skin cancer in 2003. Having previously explored the use of medical cannabis for another injury, Simpson created a thick cannabis concentrate, applied it to his skin topically, and soon found himself cancer free. While there’s little more research than anecdotal information about RSO, Simpson shared his methodology in creating the oil, and it has gained incredible popularity. FYI- the mystery previously mentioned was because Simpson has evaded legal ramifications of his cultivations and use of cannabis prior to legalization.

Using Rick Simpson Oil

RSO can be applied as a topical or ingested with food and drink. Mixed into food for a slow onset akin to edibles. 

RSO can similarly be held in the mouth to have a quick sublingual onset such as tinctures.

Very little research has been done because RSO is often homemade, leading to inconsistencies between the products. In general, cannabinoids (organic cannabis chemicals such as CBD and THC) do not absorb through the skin very well into the system. It may be effective for local treatment of inflammation or pain. Some preclinical studies have shown some signs that RSO can cause apoptosis, or cell death, of skin cancer topically, but substantial evidence is still lacking. 

Topicals

There is an extremely large selection of topical cannabis products, from hand creams to hydrating face mists. Many of these products claim effects that are largely unsubstantiated. But a study was done regarding topical cannabis as a treatment for inflammation-based skin diseases. This study found positive evidence that the topical cannabis extract affected chemicals and processes involved with wound healing and inflammation. Topical usages of marijuana date as far back as 1000 B.C. in India where it was used religiously and medically for, among other things, an antibiotic applied to skin infections.

Topicals are appealing for those who aren’t looking for the intoxicating effects of marijuana, but still want the full spectrum power of THC and CBD together. Typically infused salves, lotions, balms, or oils are applied to the skin for local relief of pain and inflammation. It is believed that the cannabinoids in the product will activate naturally-occuring receptors in the body that are part of the endocannabinoid system. The chemicals do not reach the bloodstream in most topical applications, which is why they lack intoxicating effects. The exception are transdermal patches, which can cause classic psychoactive effects if it has a high enough THC dosage.

Smokeless Cannabis Options

So next time you’re looking for a way to unwind with cannabis, give one of these methods a try and your lungs a break! Always ask for recommendations from your healthcare provider if you’re looking to add cannabis to your treatment, and always be truthful about incorporating cannabis.

Barrus, D. G., Capogrossi, K. L., Cates, S. C., Gourdet, C. K., Peiper, N. C., Novak, S. P., Lefever, T. W., & Wiley, J. L. (2016). Tasty THC: Promises and Challenges of Cannabis Edibles. Methods report (RTI Press), 2016, 10.3768/rtipress.2016.op.0035.1611. https://doi.org/10.3768/rtipress.2016.op.0035.1611

Li, J. Y., & Kampp, J. T. (2019). Review of Common Alternative Herbal “Remedies” for Skin Cancer. Dermatologic Surgery, 45(1), 58-67. doi:10.1097/dss.0000000000001622

Lim, M., & Kirchhof, M. G. (2019). Dermatology-Related Uses of Medical Cannabis Promoted by Dispensaries in Canada, Europe, and the United States . Journal of Cutaneous Medicine and Surgery, 23(2), 178–184. https://doi.org/10.1177/1203475418808761

Sangiovanni, E., Fumagalli, M., Pacchetti, B., Piazza, S., Magnavacca, A., Khalilpour, S., . . . Dellagli, M. (2019). Cannabis Sativa L. Extract and Cannabidiol Inhibit in Vitro Mediators of Skin Inflammation and Wound Injury [Abstract]. Phytotherapy Research, 33(8), 2083-2093. doi:10.1002/ptr.6400

Sieber, A., Werner, K., Carera, K., Thrower, B., & Rosenthal, J. (2020). The Effects of CBD:THC Tincture Oil in Reducing Symptoms and Overall Symptom Management Medication Dosages, in Persons with Multiple Sclerosis [Abstract]. International Journal of MS Care, 22(S2). Retrieved October 10, 2020, from https://web.a.ebscohost.com/abstract?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=15372073&AN=144209749&h=MqI0GXhGRgzpRKM/oj228EaGCPX6IjqD1ybUw6 iqIFtUWsja8Y8EBxvf9vKIaicX5g5H2MkloEd8Vp3tRGR9A==&crl=c&resultNs=AdminWebAuth&resultLocal=ErrCrlNotAuth&crlhashurl=login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=15372073&AN=144209749

Vandrey R, Raber JC, Raber ME, Douglass B, Miller C, Bonn-Miller MO. Cannabinoid Dose and Label Accuracy in Edible Medical Cannabis Products. JAMA. 2015;313(24):2491–2493. doi:10.1001/jama.2015.6613

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HEY NEWBIES- START HERE!

KEEP IN MIND

Stay calm. Canna-curious is cool! But collect some info first.
If you are:

  • under 25 years old
  • taking any medication
  • at risk for heart disease
  • family history of psychosis
  • family history of mood disorders
  • family history of addiction

…please be sure to consult a medical or mental health professional.

NAVIAGTE

EXPLORE

Cannabis, Cannabinoids, and Your Body: Learn More About Your Medicine
LJG 2021

written by

Laura Geftman, LCSW

Hannah Sadock

reviewed by

Hannah Sadock, MS

LJG 2021

written by

Laura Geftman, LCSW

Hannah Sadock

reviewed by

Hannah Sadock, MS

Much of the recent scientific discoveries revealing the relationship between cannabis and our bodies involve the developing awareness and researched effects related to cannabinoids. This chemical compound is confounding researchers and patients alike. Naturally cannabinoids are found in only two places: obviously cannabis, and invertebrate animals- including mammals, birds, reptiles, and fish. 

Already sounding too sciency? Here is the thing- cannabis chemistry is meant to arm you with a basic knowledge of how cannabis affects the brain and body. So the better you understand your medicine, the more effective the remedy. Let’s make sense of this together… 

What are Cannabinoids?

Cannabinoids are a group of chemical compounds made up of 21 carbon atoms in a 3-ring structure. They bind to receptors throughout the brain and body. Aside from being the most mispronounced word in cannabinoid science- “kuh–nab–uh-noid”- they comprise approximately 100 of the 500 chemical compounds in cannabis, working together to provide a wide range of psychological and physiological effects.

Cannabinoids are neurotransmitters exerting their effects by interacting with specific cannabinoid receptors present on the surface of cells. The effects of cannabinoids depend on the targeted area of either the body or brain. They mediate communication between cells, allowing for immediate response to deficiencies or problems in our endocannabinoid system and halt unpleasant symptoms and physical complications. Simply put, cannabinoids activate receptors to maintain internal stability and health. 

While most cannabinoids are not intoxicating themselves, combinations of their presence can influence how each affects you. Different cannabinoids connect with or influence different receptors to produce different effects to achieve homeostasis or balance. 

Different Types of Cannabinoids

Now that we know what cannabinoids are and how to pronounce the word (😉), let’s break down the different types. Cannabinoids are produced not only in the cannabis plant but also in our bodies and they can be engineered in a lab. Crazy right!? As you may have previously thought, cannabinoids are groups of substances found only in the cannabis plant– well, let’s be real here, as much tetrahydrocannabinol (THC), cannabidiol (CBD), and their friends are important, they are not the stars of show here. Here more info about each kind:

🌿 phytocannabinoids or exogenous cannabinoids are compounds naturally existing in the cannabis sativa plant. If you know any Latin- “phyto” means “of a plant or relating to plants.” Hence the prefix relating this type of cannabinoid. Phytocannabinoids are made in the resin in the plant’s glandular trichomes on the surface of its leaves. For this reason, these cannabinoids are also referred to as “exogenous cannabinoids” as they are developed outside an organism.The plant has over 500 compounds, out of which over 100 belong to this class of cannabinoids. You may be familiar with some the more commonly occurring endocannabinoids:

🌿 tetrahydrocannabinol (THC)

🌿 cannabidiol (CBD)

🌿 cannabidiolic acid (CBDA) 

🌿 tetrahydrocannabinolic acid (THCA)

🌿 cannabinol (CBN)

🌿 cannabigerol (CBG)

🌿 cannabichromene (CBC)

🌿 tetrahydrocannabivarin (THCV)

One of the essential qualities of cannabinoids making them critical to treatment of physical and mental health diagnoses are their homeostatic qualities. When consumed, cannabinoids quickly enact the endocannabinoid system by attaching to the receptors influencing a response to target a symptom(s). They interact with the properties within these chemical compounds to produce effects such as mood enhancement, pain relief, anxiety decrease and stimulation of appetite. 

👤 endocannabinoids or endogenous cannabinoids are cannabinoids produced inside the body. When adding the Latin prefix “endo” – meaning internal or within- we are talking about cannabinoids created in your body. Yes, your very own body makes similar chemical compounds to the cannabis plants. Endocannabinoids are on-demand neurotransmitters, which are produced when needed and can work within seconds and disappear again.

Endocannabinoids lend themselves to rebalancing the most essential systems in the body, such as activators of the immune system. They are synthesized from fatty acids and respond locally from where they were produced. Just like phytocannabinoids, endocannabinoids interact with receptors to initiate a physical response. The two most commonly occurring endocannabinoids are:

👤 N-arachidonoylethanolamine – “anandamide” (AEA)

👤 2-arachidonoylglycerol (2-AG)

Research continues on the exact physiological mechanism promoting or triggering the binding of the receptors to the endocannabinoids. In the meantime, we will all hope our bodies maintain balance.

🧪 synthetic cannabinoids incorporate the commercial production of isolated cannabinoids and novel cannabinoid drugs made to enhance creations by nature. What am I talking about? Pharmaceuticals or cannabis-related compounds. While cannabis remains a Schedule 1 controlled substance, the Food and Drug Administration (FDA) has not approved cannabis for the treatment of any disease or condition, “synthetic cannabinoids” refers to cannabinoids that are synthesized in a lab to create new medicine.

However the FDA has approved one cannabis-derived drug product: 

🧪 Epidiolex (cannabidiol) for the treatment of seizures associated with two rare and severe forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome, in patients two years of age and older.

And three synthetic cannabis-related drug products: 

🧪 Marinol / Dronabinol / Syndros is used to treat loss of appetite and severe nausea and vomiting.

🧪 Nabilone or Cesamet used for chemotherapy-induced nausea/vomiting.

🧪 Sativex used as treatment for unresponsive spasticity in multiple sclerosis (MS) patients

These approved drug products are only available with a prescription from a licensed healthcare provider. As the laws and policies surrounding cannabis evolve with more research, we will undoubtedly see more cannabis derived and related medications from the pharmaceutical companies.

⚠️ In the meantime, there is also an illicit market for synthetic cannabis products to avoid the restriction placed on the legal market. These highly intoxicating and often very toxic designer drugs are sold under the names:

⚠️ Spice 

⚠️ K2

⚠️ herbal smoking blends

⚠️ synthetic marijauna 

These designer drugs are sprayed onto plant matter and commonly cause negative effects including palpitations, paranoia, intense anxiety, nausea, vomiting, confusion, poor coordination, and seizures. There have also been reports of a strong compulsion to re-dose, withdrawal symptoms, persistent cravings, and several deaths have been linked to synthetic cannabinoids. If you believe you have consumed counterfeit cannabis or CBD products and are concerned about negative effects, seek emergency medical care immediately.

In Conclusion

Phytocannabinoids from the plant mimic the naturally occurring endocannabinoids in our bodies. While synthetic cannabinoids are engineered to keep up with the natural production from plants and humans. Whether you choose to supplement your body’s natural process with cannabis or hemp, cannabinoids will continue to assist in finding balance. Just remember- as helpful as cannabis is, so is seeking professional help for any medical concern and staying mindful of the purpose of cannabis or cannabinoids use as it may indirectly postpone seeking treatment. 

Ahn K, et al. (2008). Enzymatic pathways that regulate endocannabinoid signaling in the nervous system. DOI: 1021/cr0782067

Alger BE. (2013). Getting high on the endocannabinoid system. ncbi.nlm.nih.gov/pmc/articles/PMC3997295

Atakan Z. (2012). Cannabis, a complex plant: different compounds and different effects on individuals. Therapeutic advances in psychopharmacology, 2(6), 241–254. https://doi.org/10.1177/2045125312457586

Fine, P. G., & Rosenfeld, M. J. (2013). The endocannabinoid system, cannabinoids, and pain. Rambam Maimonides medical journal, 4(4), e0022. https://doi.org/10.5041/RMMJ.10129

Gomez M, et al. (2008). Cannabinoid signaling system.
ncbi.nlm.nih.gov/pmc/articles/PMC2633685

Gorzkiewicz A, et al. (2018). Brain endocannabinoid signaling exhibits remarkable complexity. DOI: 1016/j.brainresbull.2018.06.012

Human endocannabinoid system. (n.d.). uclahealth.org/cannabis/human-endocannabinoid-system

Lu H-C. (2015). An introduction to the endogenous cannabinoid system. DOI: 1016/j.biopsych.2015.07.028

Nagarkatti, P., Pandey, R., Rieder, S. A., Hegde, V. L., & Nagarkatti, M. (2009). Cannabinoids as novel anti-inflammatory drugs. Future medicinal chemistry, 1(7), 1333–1349. https://doi.org/10.4155/fmc.09.93

Sarris, J., Sinclair, J., Karamacoska, D., Davidson, M., & Firth, J. (2020). Medicinal cannabis for psychiatric disorders: a clinically-focused systematic review. BMC psychiatry, 20(1), 24. https://doi.org/10.1186/s12888-019-2409-8

Zou S, et al. (2018). Cannabinoid receptors and the endocannabinoid system: Signaling and function in the central nervous system. DOI: 3390/ijms19030833

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Stay calm. Canna-curious is cool! But collect some info first.
If you are:

  • under 25 years old
  • taking any medication
  • at risk for heart disease
  • family history of psychosis
  • family history of mood disorders
  • family history of addiction

…please be sure to consult a medical or mental health professional.

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CBD for anxiety

A pounding heart, sweaty palms, racing thoughts: For those living with an anxiety disorder, these unwelcome symptoms can make everyday life feel debilitating.

One in 13 people around the world live with an anxiety disorder, making them the most common mental health disorder worldwide, according to the World Health Organization (WHO). For those living with anxiety, finding a safe method for managing symptoms is a critical concern.

Quick-acting anti-anxiety medication, such as Xanax and Valium, may offer instant relief but can become addictive. Long-range anxiety medications, such as Prozac, may help reduce symptoms over time, but don’t work for everyone.

Enter cannabidiol, better known as CBD. CBD has recently captured the spotlight as an alternative or complementary treatment for anxiety.

CBD: Snake oil or powerful anxiety treatment?

Clinical research on CBD as a treatment for anxiety disorders has proliferated in recent years with accumulating evidence pointing to its therapeutic potential.

Although most studies on CBD are preclinical and use animal models, clinical studies using human participants are now emerging.

In a double-blind study from 2019, 37 Japanese teenagers with social anxiety disorder (SAD) received 300 mg of CBD oil or a placebo every day for four weeks. The teens were assessed with surveys used to diagnose and measure SAD symptoms. The anti-anxiety properties of CBD reduced symptoms aligned with the disorder, providing relief comparable to Paroxetine, a drug commonly used to treat the condition.

Interestingly, in the follow-up, nine of the seventeen teenagers who received the CBD intervention also declared that they had decided to seek some form of treatment. Teenagers with SAD rarely seek help due to the stigma surrounding the condition and for fear of interacting with therapists.

A 2019 retrospective case study reviewed outpatients at a mental health clinic in Fort Collins, Colorado. Forty-seven of the patients sampled had expressed concerns about anxiety. Over three months, the majority of patients were given 25 mg of CBD daily in addition to treatment.

After the first monthly assessment, 79.2% of patients experienced an improvement in anxiety. After two months, 78.1% of patients reported a further improvement compared with the previous month.

However, there were also patients who reported that the symptoms of their anxiety worsened after taking CBD—15.3% felt their anxiety had become exacerbated after the first month and 19.5% felt their anxiety had worsened further after the second month.

Another study, done in 2018, also suggests that CBD may heighten anxiety. It included a small sample of individuals with paranoid traits and found that CBD exacerbated anxiety among some of the participants. Anxiety was measured through symptoms such as cortisol concentration, heart rate, and systolic blood pressure.

These contradictory findings may be due to factors such as small sample sizes and variations in dosing. CBD is a bidirectional medicine, which means it can cause opposing responses at different doses. We’ll delve deeper into this below.

How should I consume CBD for anxiety?

If you’re curious about using CBD oil as a tool to help manage your anxiety, education is critical. Understanding the pros and cons of the various ingestion methods can help you determine which form of consumption best suits your needs.

tinctures and oils represent a quick, easy, and accurate way to consume CBD. Most tinctures contain CBD in an alcohol base. CBD oils contain CBD extracts infused into a carrier oil, such as coconut or hemp seed oil.

Tinctures and oils are taken using a dropper, which allows you to easily measure intake. The cannabinoid rapidly enters the bloodstream when taken sublingually—results can kick in as quickly as ten minutes and last up to three to four hours.

CBD vape oils can be vaped using a special pen that vaporizes the oil. At present, the safety of vaping has come under intense scrutiny. A serious lung condition known as VAPI, or EVALI, has hospitalized more than 2,000 people and led to the deaths of 42. The federal Centers for Disease Control has found that most cases have been linked to the use of illicit-market THC vape cartridges tainted with vitamin E oil (tocopheryl-acetate).

CBD vape cartridges purchased in legal state-licensed cannabis stores are highly regulated, while CBD cartridges purchased from other sources are completely unregulated. Proceed with caution when considering any vaping product in an unregulated environment.

edibles CBD can be added to almost every food under the sun. While super easy to consume in this form—and often delicious, particularly as gummies—it may take an hour or more before results are felt.

What’s more, the oral bioavailability of CBD can hinder CBD absorption—when you consume CBD orally, it has to pass through your gastrointestinal tract before it is metabolized by the liver. As a result, a limited quantity of CBD makes it into the circulatory system.

It’s important to also note that the FDA has recently deemed food containing CBD illegal. You’ll have to get CBD edibles in state-licensed adult-use markets.

smoking provides an almost instantaneous method for enjoying the effects of CBD. Smoking sends the cannabinoid directly to the alveoli of the lungs, and from there, CBD molecules enter the bloodstream for rapid absorption. However, measuring your CBD intake can be tricky when you smoke, and the act of smoking itself can cause lung inflammation.

Dosing CBD for anxiety

If you read the studies cited above, you’ll notice that the dosing varied significantly between them. The teens in the Japanese study were provided with 300 mg of CBD daily, while the outpatients in the Colorado study received 25 mg. Why such a large discrepancy in dose?

As most scientists and clinicians will readily admit, there is no universally recommended dosage for CBD, and, to date, there haven’t been any large-scale clinical trials to inform dosage guidelines. In addition, the FDA is still learning about CBD—such as its cumulative effects on the body—before it decides on how to regulate it.

This doesn’t necessarily mean CBD is unsafe. Existing research already suggests that it appears to be a safe, well-tolerated treatment. If you’re interested in experimenting with CBD to manage your anxiety symptoms, aim for an informed, cautious approach to dosing (which is always a good idea). Below are some dosing considerations.

General dosing tips

Some basic factors that you should consider when devising a CBD dose include:

👉 body weight

👉 metabolism

👉 concentration of CBD

👉 severity of your anxiety

The concentration of CBD varies between products, and is generally expressed as milligrams (mg) per container.

Once you know the potency of the CBD product you hold, you can use a dosage calculator or an app such as Accugentix to help settle on your perfect dose. Dosage calculations can provide a recommended dose in milligrams based on your body weight and the severity of your symptoms.

Your unique body chemistry also affects how you respond to CBD. Some individuals metabolize medicine faster than others, which can be attributed to genes or lifestyle. If you know that you metabolize medication quickly, it’s possible that you may benefit from a higher dose.

Bidirectional effects

CBD may do different things at different doses, a phenomenon known as bidirectional effects. Overstimulation of the body’s endocannabinoid system may exacerbate symptoms instead of alleviating them.

Additionally, high levels of CBD, such as 300 mg, have been known to promote sleepiness and relaxation. Conversely, low levels of CBD may create an elevating response, inciting wakefulness and alertness. The best way to avoid unwanted bidirectional effects is to follow the adage: start low, go slow.

Start low, go slow

Titration refers to the process of adjusting the dosage of a medication to get its maximum benefits without adverse effects. CBD has been shown to be safe even when taken in high doses (300-600 mg), nonetheless, it’s advisable and more cost-effective to start with a low dose and increase it incrementally, observing how you feel as you go.

This method forces you to pay attention to subtle changes in your body as it responds to the medication. Everyone’s optimal dosage and tolerance is unique, and this process allows you to get acquainted with yours.

Dr. Dustin Sulak, a cannabis medicine expert at Healer, offers educational resources for novice and seasoned cannabis users alike to find their optimal dosage.

Talk to an expert on medical cannabis

If you’re still feeling unsure and you live in a state where you can safely converse with a health professional about CBD, consider scheduling a consultation. Some cannabis dispensaries also have medical experts on hand who can provide you with sound advice and dosage recommendations.

Leafly logo

This article written by Emma Stone was originally posted on Leafly.com.

Blessing, E.M., Steenkamp, M.M., Manzanares, J. et al. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics 12, 825–836 (2015). https://doi.org/10.1007/s13311-015-0387-1

https://adaa.org/understanding-anxiety/facts-statistics

Hundal H, Lister R, Evans N, Antley A, Englund A, Murray RM, Freeman D, Morrison PD. The effects of cannabidiol on persecutory ideation and anxiety in a high trait paranoid group. J Psychopharmacol. 2018 Mar;32(3):276-282. doi: 10.1177/0269881117737400. Epub 2017 Oct 31. PMID: 29086614.

Nobuo, Masataka. Anxiolytic Effects of Repeated Cannabidiol Treatment in Teenagers With Social Anxiety Disorders. Frontiers in Psychology 10, 2466 (2019). DOI=10.3389/fpsyg.2019.02466    

Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente journal, 23, 18–041. https://doi.org/10.7812/TPP/18-041

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HEY NEWBIES- START HERE!

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Stay calm. Canna-curious is cool! But collect some info first.
If you are:

  • under 25 years old
  • taking any medication
  • at risk for heart disease
  • family history of psychosis
  • family history of mood disorders
  • family history of addiction

…please be sure to consult a medical or mental health professional.

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New PTSD study finds cannabis safe, but not as effective as assumed

Preliminary results from a long-awaited study indicate that cannabis appears to be a safe and well-tolerated treatment for patients managing post-traumatic stress disorder (PTSD), although researchers did not find strong signals of effectiveness.

The study, led by Marcel Bonn-Miller of the University of Pennsylvania and Sue Sisley of the Scottsdale Research Institute, was funded by a $2.2 million grant from the Colorado Department of Public Health and Environment (CDPHE) to the Multidisciplinary Association of Psychedelic Studies (MAPS). Researchers fought for seven years to obtain approval to conduct the study, and it took three more years to carry it out.

For years, many military veterans have used medical marijuana to manage the symptoms of PTSD. It has been extremely difficult to study the effectiveness of cannabis for PTSD, though, because of federal prohibition and the many roadblocks specifically established to discourage the study of the potential positive health benefits of cannabis. Sisley fought for years to get this study approved, and then struggled to obtain government-approved cannabis of sufficient quality to carry out the research.

76 veterans in the study

The study involved 76 military veterans with PTSD, mostly men between the ages of 24 and 77. Bonn-Miller and Sisley established a two-phase study; the results of the first phase were published in this week’s PLOS One paper.

In the first phase, the 76 veterans were divided into four cohorts. One group self-administered cannabis with 12% THC over three weeks. Another group received an 11% CBD product with minimal THC. A third group received a balanced THC-CBD product, with roughly 8% THC and 8% CBD. A fourth group received a placebo with almost zero active cannabinoids.

Participants were given 1.8 grams per day for 21 days. That’s about the amount of cannabis contained in two to three joints. After three weeks, the subjects stopped consuming cannabis completely for two weeks. Then they were re-randomized in the four cohorts.

No significant difference found

Researchers found little statistical difference between veterans who took the placebo and those given the THC and CBD mixtures. In fact, nearly half of the veterans who received a placebo believed they had been given active cannabis. The study’s authors cited “several confounding factors” that may have contributed to these results. 

They also wrote:

The study sample included participants with a history of cannabis use. The recruitment of active cannabis users might have increased the potential for biased responding. Given the topical nature of the current trial and its relevance for public policy on medical cannabis, participants might have been biased to report positive effects regardless of condition. Despite many participants already having experience with the drug, nearly half of those receiving placebo believed that they received active cannabis. Prior expectations about cannabis’ effects might explain why even those in the placebo condition reported larger than average reductions in PTSD symptoms after only 3 weeks of treatment.

Poor quality of government cannabis could be a factor

Rick Doblin, executive director of MAPS, the organization that facilitated the study, noted that “the difference between anecdotal reports” of the effectiveness of cannabis for PTSD “and these results may be the quality of the marijuana.”

The cannabis in the study’s first part was supplied by the National Institute on Drug Abuse (NIDA), which has the only license in the U.S. for the production of cannabis used in federally-regulated clinical trials.

The quality and potency of that research cannabis has been a major point of contention over the years. NIDA-supplied cannabis has been notoriously awful—some of the lowest-potency and poorest-quality marijuana to be found anywhere in North America. It took years for NIDA to begin growing strains that even approached commercial grade. And even then the agency fell short. A 12% THC strain is roughly half the potency of the product sold in most medical and adult-use dispensaries in 35 states today. When the research team tested the cannabis sent by NIDA, even the 12% strain came up short. It tested at only 9% THC.

“Research quality” cannabis sparked earlier controversy

Early on in the study, criticism over the poor quality and low potency of the NIDA-supplied cannabis prompted Johns Hopkins University to withdraw from the multi-year clinical trials. Despite criticism from cannabis researchers and some Congressional lawmakers, NIDA maintains a government monopoly on all cannabis used in federally-approved cannabis research.

“Higher quality cannabis flower suitable for Food and Drug Administration (FDA) approval is currently unavailable domestically due to restrictions on production imposed by the U.S. Department of Justice and Drug Enforcement Administration and must be imported,” Doblin said.

Moving on to the next phase of research

Sue Sisley, a medical doctor, president of the Scottsdale Research Institute and the study’s principal investigator, is moving ahead with the next phase of the study, with higher-quality and higher-potency imported cannabis. That cannabis is available to adults and patients in any of dozens of states, but federally-approved researchers can’t use it because of federal prohibition. So it must be imported from outside the United States.  

“Despite the absurd restrictions federal prohibitionists have placed on research for more than 50 years,” said Sisley, “we are squarely focused on launching further Phase 2 trials with imported cannabis of tested, higher potency, fresher flowers that will provide a valid comparison for the millions of Veterans and others with PTSD who are looking for new options.”

PTSD widespread in veteran communities

According to MAPS, about 6% to 10% of the general population, and up to 31% of U.S. veterans, have experienced some form of PTSD. Veterans groups advocating for more access to cannabis, meanwhile, are applauding the newly-published study.

“MAPS and Dr. Sue Sisley deserve a medal for the absolute intentional dysfunction they overcame to complete this study and publish its findings,” Sean Kiernan, president of the Weed for Warriors Project, said in an email to Leafly. “All someone has to do is look at the lack of quality cannabis provided by the Federal Government’s monopoly, NIDA, to understand our Government is not taking our healing seriously.”

“When science tells us cannabis is safe,” he added, “common-sense should tell everyone, cannabis is an amazing substitute for opioids, and other legal accessible substances that carry with them the side effects of addiction, overdose, and suicidal ideation. Is it any wonder why millions prefer cannabis over deadly pharmaceuticals and other harmful substances?  It simply is a safer substitute.”

Establishing cannabis as safe

Dale Schafer, a California attorney who specializes in cannabis law, and a Vietnam-era Navy veteran, pointed out that studies such as the MAPS clinical trials are necessary if there is ever to be federal approval of cannabis use for PTSD.

“However, for the multitude of veterans, and average citizens, suffering from PTSD, Stevie Wonder can see that cannabis is medically helpful and thousands of years of use show an incredible safety profile,” he told Leafly. “Let’s move quickly to Phase 3 so veterans can work with the VA directly and not have to play games like cannabis is radioactive.”

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This article written by Bruce Kennedy was originally posted on Leafly.com.

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HEY NEWBIES- START HERE!

KEEP IN MIND

Stay calm. Canna-curious is cool! But collect some info first.
If you are:

  • under 25 years old
  • taking any medication
  • at risk for heart disease
  • family history of psychosis
  • family history of mood disorders
  • family history of addiction

…please be sure to consult a medical or mental health professional.

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Hannah Sadock

written by

Hannah Sadock, MS

LJG 2021

reviewed by

Laura Geftman, LCSW

Hannah Sadock

written by

Hannah Sadock, MS

LJG 2021

reviewed by

Laura Geftman, LCSW

The potent smelling buds known for their psychoactive properties have recently entered into the field of medicine due their simplistic plant anatomy. Easy to reproduce and pollinate, the production of medicinal plants has increased the adaptations of new strains available as treatment. The reason for cannabis’ acceptance and influencing popularity stems from the increase in research suggesting an untapped hidden potential within the plant’s anatomy. 

Cannabis’ still holds a skeptical view within the public sector, which is a valid reason for persons to shy away from modern medicine’s advances. Though for some, specifically researchers and physicians, education has sprung awareness towards a plant-based formula. As cannabis may follow a similar anatomical structure of the common plant, their parts’ functions and features hold significantly different properties that target health symptoms, serving as value in the medical community.  

Of course, the plants all share basic characteristics, such as leaves, stems, and branches, though much like humans, at birth, plants are assigned a biological sex eventually developing specific reproductive organs. To achieve the harvesting of buds from the plants, it is critical to remember both male and female plants are essential to the reproductive cycle and production. Without them, buds will not form leaving you with a nice house plant with a single purpose for decoration. So get ready to learn because we will be targeting:

🪴 cannabis in science 
🪴 connections to the hemp plant
🪴 different species of cannabis
🪴 plant’s reproduction process
🪴 sex specific plant atamony 
🪴 structure and function of plants
🪴 roles of female vs male plants
🪴 role of pollination 
🪴 the role of budding 
🪴 creation of new strain
🪴 differences between CBD and THC 

🪴 cannabis in science 
🪴 connections to the hemp plant
🪴 different species of cannabis
🪴 plant’s reproduction process
🪴 sex specific plant atamony 
🪴 structure and function of plants
🪴 roles of female vs male plants
🪴 role of pollination 
🪴 the role of budding 
🪴 creation of new strain
🪴 differences between CBD and THC 

Cannabaceae- It’s All in the Family

In botany, the Cannabaceae plant family includes the cannabis, hemp, hops (yes, those hops used to make beer) and other related genuses of flowering plants. 

The naming of a plant includes two parts: 

        🪴 genus refers to a larger group of plants such as flowering
        🪴 species is a smaller, more specific type, breed or species found in the same genus

The flowering cannabis plant produces three different types of species aptly named:

🌿 Cannabis Sativa can grow fifteen-feet high making it more suited for outdoor growth to reach its maximum potential. It also grows best in higher temperatures and humidity levels. This may be a concern for mold and other issues but tend not to decrease its popularity due to its higher yield of psychoactive components.

🌱 Keep in mind, Hemp (aka that CBD stuff you see everywhere) is a type of Cannabis Sativa. In accordance with the UN Narcotics Convention, the US federal government classified “industrial hemp” in the 2018 Farm Bill as cannabis containing no more than 0.3% tetrahydrocannabinol (THC- the principal psychoactive constituent) by dry weight. As defined by this law, hemp is being bred to produce minimal levels of THC. 

🌿 Cannabis Indica is a stocky plant, typically growing no higher than 3 to 6 feet tall. This makes it more conducive to growing indoors. Cannabis Indica plants flower fast and present thicker foliage and broader leaves. Cannabis Indica plants tend to have an earthy smell and taste and are often more pungent. This type of plant tends to be tolerant of colder temperatures and relative humidity.

🌿 Cannabis Ruderalis aka “ditch weed” lacks psychotropic effects and is mostly used for breeding hybrids as a source of producing auto-flowering traits. It grows relatively short, reaching a maximum height of approximately two feet. Originating in Siberia, Cannabis Ruderalis is accustomed to colder climates. It has a short life cycle and blooms quickly. 

Anatomy of the Cannabis Plant

Cannabis plants share the same structure and function of other plants. While there is nothing quite like cannabis, the plant itself shares various aspects that are similar to other plants including their look, smell, and texture. Other plants contain similar chemical components making them all natural healers. So that you can differentiate your medicine, let’s be sure to explain how cannabis is unlike any doppelgängers.

The basic parts of the cannabis plant and other common plants include: 

🍃 roots of the plants serve as the base structure, grounding the plant by spreading for nutrients within the soil, allowing them to grow tall to withstand environmental factors. To flourish, ample space is needed for the roots to spread, ensuring sufficient supply of nutrients throughout the root system such as nitrogen, phosphorus, and water.

🍃stems are the main support structure of the cannabis plant. They transport fluids, nutrients, and information from the roots to the rest of the plant. The stem provides a foundation to give fan leaves access to the light they need to facilitate growth and carries the weight of heavy colas.

🍃branches act as the ‘support beams’ for the leaves as they bare the weight of the growing buds, keeping the plant tall and adaptable to crop weight.

As for the cannabis plant itself- each part of the plant serves a purpose and while the whole of a cannabis plant is certainly greater than the sum of its parts. Knowing its parts can inform your experience and appreciation of it. Here’s what you need to know:

🍃 fan leaves are the leaves you see as ways seemingly the universal sign for this plant. Responsible for photosynthesis, they are the main source of energy production for the plant with large leaves located along the main stem and branches to absorb light from the sun and transfer it into energy for growth.

🍃 sugar leaves are found throughout cannabis colas’ cupping buds that are typically trimmed off the flower after harvest. They are called “sugar leaves” because of the high volume of trichomes found on them, which makes it look like the leaves are covered in sugar. Sugar leaf trim can be used to make edibles or concentrates.

🍃 nodes are the intersections of stems and branches in plants. that harvest crops and are the location of determenting sex specific organs. Nodes can hold leaves, offshoots, and are where cannabis plants begin to grow either male pollen sacs or female pistils. 

Okay now it’s time for the birds and bees…or the plant’s sex organs. Let’s start with female specific organs, as they are critical. Only female cannabis plants produce flowers and contain multiple structures and functions responsible for reproduction. Actually since non-pollinated flowers are far superior than pollinated buds, male plants are often killed off in effort to cultivate plants for consumption. These are the parts of the cannabis plant responsible for reproduction and development: 

🍃 bract is an essential feature of reproduction in the female flower. In between the nodes and underneath the sugar leaves of the cola (bud) is the bract. The small leaves that surround the reproductive cells of a female plant. When a female plant is exposed to pollen from a male marijuana plant, the bracts surround and shield the seed pod.

🍃 calyx is what it’s all about- it is the actual bud itself composed of small sugar leaves, tear-shaped nodules, and pistils. It is also where the highest concentration of trichomes can be found.

🍃 pistil is what many describe as the colorful “hairs” that poke out from the bud. They first appear as white and then morph to orange, red, and eventually brown. Pistils are found only on female plants, and function to capture the pollen from a male. Some attribute the bright orange pistils to better quality cannabis but they actually contain very few trichomes.

🍃 cola is the main part of the flower, at the end of a female plant’s stem is composed of many small floral clusters. The cola is the plant’s offspring, and contains bracts, stigmas, trichomes, and sugar leaves. 

🍃 stigmas are female sex organs that look like small wispy hairs sticking out of the female bract. The thin hairs that extend from a female’s bract to catch male pollen. 

🍃 trichomes are hairlike appendages found on the surface of the cannabis plant. Trichomes protect the plant from external stressors and contain resinous glands that create the chemical compounds that give the plant its unique features and effects. Trichomes give cannabis buds a crystal-like sheen and make them sticky.

The Process of Pollination 

Cannabis plants require this form of pollination to produce offspring. Similarly to human reproduction, cannabis plants have their own genetic sequence or DNA, which allows the crossing of different characteristics within the same species, increasing genetic diversity- aka new strains. The cannabis plant requires cross pollination which is reliant on wind, animals, insects, and people to transfer the pollen from the male to another female plant. For cannabis reproduction to be successful, cross pollination must include:

👉🏽 male and female plants of same species 
👉🏽 pollen produced by male plants is carried to female plant
👉🏽  insects increases genetic differences by leaving tracks of pollen on stigmas of other plants 
👉🏽 stigmas collect the grains of pollen at the top of female flowers
👉🏽 multiple transfers of pollen to the stigma, thanks to nature, influences genetic diversity
👉🏽 genetic diversity increases medicinal modalities

Conclusion

The cannabis plant is complex, as it requires a cross pollination process to reproduce within its species and subspecies. Each species and subspecies within cannabis’ family of classification have their own unique characteristics contributing to the creation of medication. The cannabis strains consumed today are a result and combination of the structures of cross pollination between a male and female cannabis plants. With a better understanding of the complexity behind Cannabis sativa and its sister species, we can appreciate what nature undergoes to produce one of the most intricate modern medicinal plants used worldwide.

Andre, C. M., Hausman, J. F., & Guerriero, G. (2016). Cannabis sativa: The Plant of the Thousand and One Molecules. Frontiers in plant science, 7, 19. https://doi.org/10.3389/fpls.2016.00019

H.M.G. van der Werf, J.E. Harsveld van der Veen, A.T.M. Bouma, M. ten Cate, Quality of hemp (Cannabis sativa L.) stems as a raw material for paper, Industrial Crops and Products, Volume 2, Issue 3, 1994, Pages 219-227, ISSN 0926-6690, https://doi.org/10.1016/0926-6690(94)90039-6.

https://www.fs.fed.us/wildflowers/pollinators/What_is_Pollination/birdsandbees.shtml

https://nationalholistic.com/understanding-the-cannabis-plant-physiology

Magalhães PJ, Carvalho DO, Cruz JM, Guido LF, Barros AA. Fundamentals and Health Benefits of Xanthohumol, a Natural Product Derived from Hops and Beer. Natural Product Communications. May 2009. doi:10.1177/1934578X0900400501

McPartland, J.M., Guy, G.W. Models of Cannabis Taxonomy, Cultural Bias, and Conflicts between Scientific and Vernacular Names. Bot. Rev. 83, 327–381 (2017). https://doi.org/10.1007/s12229-017-9187-0.

Spitzer-Rimon, B., Duchin, S., Bernstein, N., & Kamenetsky, R. (2019). Architecture and Florogenesis in Female Cannabis sativaPlants. Frontiers in plant science, 10, 350. https://doi.org/10.3389/fpls.2019.00350

Westmoreland FM, Kusuma P, Bugbee B (2021) Cannabis lighting: Decreasing blue photon fraction increases yield but efficacy is more important for cost effective production of cannabinoids. PLoS ONE 16(3): e0248988. https://doi.org/10.1371/journal.pone.0248988.

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HEY NEWBIES- START HERE!

KEEP IN MIND

Stay calm. Canna-curious is cool! But collect some info first.
If you are:

  • under 25 years old
  • taking any medication
  • at risk for heart disease
  • family history of psychosis
  • family history of mood disorders
  • family history of addiction

…please be sure to consult a medical or mental health professional.

NAVIAGTE

EXPLORE

Alternative Forms of Consumption
Angela Morrison

written by

Angela Morrison

LJG 2021

reviewed by

Laura Geftman, LCSW

Angela Morrison

written by

Angela Morrison

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