NORML is pleased to present the latest expanded/updated edition of the publication Emerging Clinical Applications for Cannabis & Cannabinoids — a comprehensive review of the latest peer-reviewed science specific to the safety and therapeutic efficacy of whole-plant cannabis and/or its components.
The 2015 updated edition includes two additional disease profiles (Parkinson’s disease and PTS) and includes summaries of an additional 50+ relevant clinical and/or preclinical trials specific to cannabinoids’ therapeutic utility. Several existing sections, such as Chronic Pain, Diabetes, and Epilepsy, have been significantly expanded since the last edition (January 2013). Also updated is the Introduction to the Endocannabinoid System (authored by Dustin Sulak, DO) and Why I Recommend Medical Cannabis (authored by Estelle Goldstein, MD).
With summaries and citations of well over 250 recent peer-reviewed studies, this updated publication is one of the most thorough and up-to-date source-books available specific to documenting the established therapeutic qualities of cannabis. The updated publication is available online here.
Individual sections of this publication may be accessed at the links below:
Introduction to the Endocannabinoid System
Why I Recommend Medical Cannabis
Amyotrophic Lateral Sclerosis
Human Immunodeficiency Virus
Methicillin-resistant Staphyloccus aureus (MRSA)
One-quarter of patients with multiple sclerosis report having used cannabis therapeutically and nearly one out of six (16 percent) currently use it to treat symptoms of the disease, according to survey data commissioned by the North American Research Committee on MS.
Over 5,600 MS patients participated in the survey, the results of which were presented last week at the Consortium of Multiple Sclerosis Center 2015 Annual Meeting.
Most subjects who had tried marijuana said it mitigated disease symptoms, such as spasticity or pain. Only five percent of patients surveyed said that cannabis said it did not provide some level of relief.
Those with more advanced symptoms of MS were more likely to report using cannabis therapeutically.
Of those surveyed, 82 percent said that they would consider cannabis therapy if it were a legal option in their state.
Clinical trials have previously reported that cannabis inhalation is superior to placebo in reducing pain and spasticity in patients with treatment-resistant MS. Other studies indicate that long-term use of cannabinoid therapy may potentially modify MS progression.
Previously survey data published in the journal Neurology reported that 14 percent of MS patients used cannabis for symptom management.
Study: Hemp Seed Oil Associated With Improved Clinical and Immunological Parameters In Multiple Sclerosis PatientsMay 24, 2013
The consumption of legal hemp seed nutritional oil, in conjunction with the intake of evening primrose oils and a restricted diet high in Hot-natured foods (such as pepper) and low in saturated fats and sugars, is associated with “significant improvement” in symptom management and immunological characteristics in subjects with multiple sclerosis, according to clinical trial data published this month in the scientific journal BioImpacts.
Researchers at Tabriz University of Medical Sciences in Iran assessed the impact of hemp seed oil, evening primrose oils, and a restricted diet for a period of six months in 23 patients diagnosed with relapsing remitting MS. Researchers reported that participants at the study’s completion “were healthier in comparison to baseline,” concluding that “clinical and immunological parameters showed improvement in the patients after the intervention.” They noted that hemp seed oil possesses potent antioxidative properties and also likely acts on specific signaling pathways that regulate inflammatory responses — two characteristics that would presumably make it beneficial in the treatment of MS.
Authors concluded: “After 6 months, significant improvements in extended disability status score were found. … [O]ur study demonstrates for the first time in the literature a decrease in both clinical and pro- inflammatory disease activity in MS patients during periods of dietary intervention. Our data demonstrated that co-supplemented hemp seed and evening primrose oils with Hot-natured diet intervention may decrease the risk of developing MS.”
Previously published clinical trials assessing the impact of inhaled cannabis and extracted organic cannabinoids in patients with MS have demonstrated that plant cannabinoids can alleviate disease symptoms — such as involuntary spasticity, neuropathy, and bladder dysfunction — and, in some subjects, may actually moderate disease progression. Nonetheless, the National MS Society shares little enthusiasm for cannabis or cannabis-derived products as a therapeutic option for MS patients, stating on its website: “[B]ased on the studies to date — and the fact that long-term use of marijuana may be associated with significant, serious side effects — it is the opinion of the National Multiple Sclerosis Society’s Medical Advisory Board that there are currently insufficient data to recommend marijuana or its derivatives as a treatment for MS symptoms.”
#1 Colorado and Washington Vote To Legalize Marijuana
Voters in Colorado and Washington made history by approving ballot measures allowing for the personal possession and consumption of cannabis by adults. Washington’s law, which removes criminal penalties for the possession of up to one ounce of cannabis for personal use (as well as the possession of up to 16 ounces of marijuana-infused product in solid form, and 72 ounces of marijuana-infused product in liquid form), took effect on December 6. Colorado’s law, which allows for the legal possession of up to one ounce of marijuana and/or the cultivation of up to six cannabis plants in private by those persons age 21 and over, took effect on December 10. Regulators in both states are now in the process of drafting rules to allow for state-licensed proprietors to commercially produce and sell cannabis.
#2 Most Americans Favor Legalization, Want The Feds To Butt Out
A majority of Americans support legalizing the use of cannabis by adults, according to national polls by Public Policy Polling, Angus Reid, Quinnipiac University, and others. A record high 83 percent of US citizens favor allowing doctors to authorize specified amounts of marijuana for patients suffering from serious illnesses. And nearly two-thirds of Americans oppose federal interference in state laws that allow for legal marijuana use by adults.
#3 Connecticut, Massachusetts Legalize Cannabis Therapy
Connecticut and Massachusetts became the 17th and 18th states to allow for the use of cannabis when recommended by a physician. Connecticut lawmakers in May approved Public Act 12-55, An Act Concerning the Palliative Use of Marijuana. The new law took effect on October 1. On Election Day, 63 percent of Massachusetts voters approved Question 3, eliminating statewide criminal and civil penalties related to the possession and use of up to a 60-day supply of cannabis by qualified patients. The law takes effect on January 1, 2013.
#4 Schedule I Prohibitive Status For Pot “Untenable,” Scientists Say
The classification of cannabis and its organic compounds as Schedule I prohibited substances under federal law is scientifically indefensible, according to a review published online in May in The Open Neurology Journal. Investigators at the University of California at San Diego and the University of California, Davis reviewed the results of several recent clinical trials assessing the safety and efficacy of inhaled or vaporized cannabis. They concluded: “Based on evidence currently available the Schedule I classification is not tenable; it is not accurate that cannabis has no medical value, or that information on safety is lacking.”
#5 Marijuana Arrests Decline, But Still Total Half Of All Illicit Drug Violations
Police made 757,969 arrests in 2011 for marijuana-related offenses, according to the Federal Bureau of Investigation’s annual Uniform Crime Report. The total marked a decline from previous years. Of those charged in 2011 with marijuana law violations, 663,032 (86 percent) were arrested for marijuana offenses involving possession only. According to the report, approximately 43 percent of all drug violations in 2011 were for cannabis possession.
#6 Long-Term Cannabis Exposure Not Associated With Adverse Lung Function
Exposure to moderate levels of cannabis smoke, even over the long-term, is not associated with adverse effects on pulmonary function, according to clinical trial data published in January in the Journal of the American Medical Association. Investigators at the University of California, San Francisco analyzed the association between marijuana exposure and pulmonary function over a 20-year period in a cohort of 5,115 men and women in four US cities. They concluded: “With up to 7 joint-years of lifetime exposure (e.g., 1 joint/d for 7 years or 1 joint/wk for 49 years), we found no evidence that increasing exposure to marijuana adversely affects pulmonary function. … Our findings suggest that occasional use of marijuana … may not be associated with adverse consequences on pulmonary function.”
#7 Cannabis Use Associated With Decreased Prevalence Of Diabetes
Adults with a history of marijuana use have a lower prevalence of type 2 diabetes and possess a lower risk of contracting the disease than do those with no history of cannabis consumption, according to clinical trial data published in the British Medical Journal. Investigators at the University of California, Los Angeles assessed the association between diabetes mellitus (DM) and marijuana use among adults aged 20 to 59 in a nationally representative sample of the US population of 10,896 adults. Investigators concluded, “Our analysis of adults aged 20-59 years … Showed that participants who used marijuana had a lower prevalence of DM and lower odds of DM relative to non-marijuana users.”
#8 Medical Cannabis Dispensaries Not Associated With Neighborhood Crime
The establishment of medical cannabis dispensaries does not adversely impact local crime rates, according to a federally funded study published in the July issue of the Journal of Studies on Alcohol and Drugs. Researchers reported: “There were no observed cross-sectional associations between the density of medical marijuana dispensaries and either violent or property crime rates in this study.”
#9 Rhode Island Becomes The 15th State To Decriminalize Pot Possession Penalties
Governor Lincoln Chafee signed legislation into law in June amending marijuana possession penalties for those age 18 or older from a criminal misdemeanor (punishable by one year in jail and a $500 maximum fine) to a non-arrestable civil offense — punishable by a $150 fine, no jail time, and no criminal record. The decriminalization law takes effect on April 1, 2013.
#10 Cannabis Reduces Symptoms In Patients With Treatment-Resistant MS
Cannabis inhalation mitigates spasticity and pain in patients with treatment-resistant multiple sclerosis (MS), according to clinical trial data published online in May in the Journal of the Canadian Medical Association. Investigators at the University of California, San Diego assessed the use of inhaled cannabis versus placebo in 30 patients with MS who were unresponsive to conventional treatments. “Smoked cannabis was superior to placebo in symptom and pain reduction in patients with treatment-resistant spasticity,” authors concluded.
Scientific Review: “There Is Now Clear Evidence That Cannabinoids Are Useful For The Treatment Of Various Medical Conditions”August 9, 2012
For the second time in recent months, a scientific paper published in a peer-reviewed journal has thoroughly rebutted the present Schedule I status of cannabis under US federal law, which states that the plant and its organic constituents possess a “high potential for abuse,” and that they lack “accepted medical use” and “accepted safety … under medical supervision.”
According to a just published review in the German scientific journal Deutsches Ärzteblatt International, scientific findings from over 100 controlled clinical trials involving either cannabis or its constituents provide “clear evidence that cannabinoids are useful for the treatment of various medical conditions.”
Investigators from the nova-Institute and the Hannover Medical School in Germany reviewed over 100 controlled trials assessing the safety and efficacy of cannabis and cannabinoids.
Researchers reported: “Knowledge about the therapeutic potential of cannabis products has been greatly improved by a large number of clinical trials in recent years. … There is now clear evidence that cannabinoids are useful for the treatment of various medical conditions,” including chronic neuropathy (nerve pain), multiple sclerosis, HIV/AIDS, Gilles de la Tourette syndrome, and other indications.
Regarding the safety profile of cannabis and cannabinoids, investigators determined: “The most common side effects of cannabinoids are tiredness and dizziness (in more than ten percent of patients), psychological effects, and dry mouth. Tolerance to these side effects nearly always develops within a short time. Withdrawal symptoms are hardly ever a problem in the therapeutic setting.”
Authors did express concern that cannabis could pose additional health risks for adolescents and/or pregnant or breast-feeding women, as well as individuals diagnosed with Hepatitis C, severe cardiovascular disease, addictive disorders, or those vulnerable to certain psychiatric disorders, such as schizophrenia.
Investigators acknowledged that cannabis dosing may adversely impact psychomotor skills. However, they noted, “Patients who take cannabinoids at a constant dosage over an extensive period of time often develop tolerance to the impairment of psychomotor performance, so that they can drive vehicles safely.”
They concluded, “No acute deaths have been described that could be unequivocally attributed solely to cannabis consumption or treatment with cannabinoids.”
This most recent paper follows the publication of a similar review, published in May in The Open Neurology Journal. In that paper, investigators with the University of California at San Diego and the University of California, Davis concluded: “Evidence is accumulating that cannabinoids may be useful medicine for certain indications. Based on evidence currently available, the (federal) Schedule I classification (of cannabis) is not tenable; it is not accurate that cannabis has no medical value, or that information on safety is lacking.”
In 2011, the Obama administration — via the United States Drug Enforcement Administration (DEA) — formally denied a nine-year-old administrative petition filed by NORML and a coalition of public interest organizations calling on the agency to initiate hearings to reassess the present classification of marijuana as a schedule I controlled substance. In her denial of the petition, DEA administrator Michele Leonhart alleged: “[T]here are no adequate and well-controlled studies proving (marijuana’s) efficacy; the drug is not accepted by qualified experts. … At this time, the known risks of marijuana use have not been shown to be outweighed by specific benefits in well-controlled clinical trials that scientifically evaluate safety and efficacy.”
Coalition advocates are presently appealing the DEA’s denial of their petition in federal court.
Full text of the most recent study, “The therapeutic potential of cannabinoids,” is available online here.