MEDICAL CANNABIS: Symptom Management
|
|
- Dorthy Beasley
- 5 years ago
- Views:
Transcription
1 MEDICAL CANNABIS: Symptom Management Diana Martins Welch, MD Division of Geriatrics and Palliative Medicine Northwell Health June 9, 2017 May 25, DISCLOSURES None May 25,
2 OBJECTIVES Understand the history of medicinal cannabis Learn the basics of the human endocannabinoid system Review the major phytocannabinoids and learn their medicinal properties Review the evidence, and lack thereof, for cannabis therapeutic effects Learn about the NY State Medical Marijuana Program May 25, As of November 2016 May 25,
3 May 25, BIOLOGICAL COMPONENTS OF CANNABIS Cannabinoids THC, CBD Minor Cannabinoids CBC, CBG, CBN, THC V, CBD V, CBC V Terpenes trans caryophyllene, α caryophyllene, α pinene, β pinene, terpinolene, myrcene, limonene, linalool, phytol, squalene Carotenoids β carotene Fatty Acids Linoleic acid, palmitoleic acid, linolenic acid, palmitic acid, oleic acid, stearic acid, myristic acid, arachidonic acid Sterols β sitosterol, campesterol, stigmasterol Vitamin E Triglycerides May 25,
4 PHYTOCANNABINOIDS Gaoni Y, Mechoulam R. J Am Chem Soc 1964;86: May 25, PHYTOCANNABINOIDS Phytocannabinoids have pharmacological activity due to their receptor based effects on the endocannabinoid system Additional pharmacological effects, such as antiinflammatory mechanisms may be non receptor mediated. May 25,
5 May 25, RISK OF DEPENDENCE DRUG LIFETIME RISK OF DEPENDENCE Nicotine 32% Heroin 23% Cocaine 17% Alcohol 15% Marijuana 9% Bostwick, 2012 May 25,
6 May 25, MEDICAL CANNABIS LEGALITY LINKED TO FEWER OPIOID OVERDOSE DEATHS JAMA, 2014 A time series analysis was conducted of medical cannabis laws and state level death certificate data in the United States from 1999 to 2010; all 50 states were included. Examination of the association between medical cannabis laws and opioid analgesic overdose mortality in each year after implementation of the law showed that such laws were associated with a lower rate of overdose mortality that generally strengthened over me: year 1 ( 19.9%), year 2 ( 25.2%), year 3 ( 23.6%), year 4 ( 20.2%), year 5 ( 33.7%), and year 6 ( 33.3%). In secondary analyses, the findings remained similar. May 25,
7 SCIENTIFIC LITERATURE INDEXED BY PubMed Sommers, C. The Future of Clinical Cannabis: Part May 25, History of Cannabis May 25,
8 HISTORY OF CANNABIS 2900 BC Chinese emperor Fu Hsi references Ma (cannabis) as a popular medicine 2700 BC Father of Chinese medicine Emperor Shen Nung discovers healing properties of cannabis 1213 BC Egyptians use cannabis for glaucoma, inflammation 1000 BC Bhang (mix of cannabis and milk) used as medicine in India 200 BC Medical cannabis used in ancient Greece May 25, HISTORY OF CANNABIS 1500s The Spanish brought cannabis to the Americas 1839 Sir William O Shaughnessy researched cannabis in India 1850 United States Pharmacopeia classifies marijuana as a legitimate medical compound 1936 The American propaganda film Reefer Madness was made to scare American youth away from using cannabis Marijuana Tax Act banned cannabis use and sales 1970 Controlled Substances Act Schedule I May 25,
9 CANNABIS PROHIBITION IN THE U.S. Harry Anslinger First director of the Federal Bureau of Narcotics in 1930 Launched a vigilant campaign against cannabis over the 3 decades he remained in office. The term marihuana (Spanish in origin) was used in anti cannabis propaganda to make it sound more foreign. There are 100,000 total marijuana smokers in the US, and most are Negroes, Hispanics, Filipinos and entertainers. Their Satanic music, jazz and swing, result from marijuana usage. This marijuana causes white women to seek sexual relations with Negroes, entertainers and any others. Harry Anslinger, testifying before Congress in 1937 May 25, FEDERAL CANNABIS The U.S. federal government currently grows and provides cannabis for a small number of patients. In 1976 the federal government created the Investigational New Drug (IND) compassionate access research program to allow patients to receive up to nine pounds of cannabis from the government each year. Today, five surviving patients still receive medical cannabis from the federal government, paid for by federal tax dollars. Americans for Safe Access May 25,
10 Back to the science May 25, ENDOCANNABINOID SYSTEM Ubiquitous network in the nervous system that regulates synaptic neurotransmission in both excitatory and inhibitory circuits Humans naturally produce cannabinoids endocannabinoids Endocannabinoids interact with specific receptors found on neurons and immune cells Act to reduce excess nerve activity and suppress inflammation Functions in parallel and in conjunction with adrenergic, cholinergic, and dopaminergic systems in both the central and autonomic nervous systems May 25,
11 ENDOCANNABINOID SYSTEM Three main components: Endocannabinoids (endogenous lipid ligands) Anandamide & 2 AG Receptors CB 1 & CB 2 (G protein coupled), TRPV1 Regulatory Enzymes Synthesis and hydrolysis of endocannabinoids (ex: fatty acid amidohydrolase, FAAH; monoacylglycerol lipase, MAGL) May 25, ENDOCANNABINOIDS Anandamide (AEA) Partial agonist of CB1 receptors, low affinity to CB2 (1992) 2 AG Fully efficacious agonist of both CB1 and CB2 receptors (1995) May 25,
12 CANNABINOID RECEPTORS CB1 receptor G protein receptor that serves as a target for both endocannabinoids and phytocannabinoids. 10 times more prevalent in the CNS as compared to the μ opioid receptor. Found in high densities in the neuron terminals of the basal ganglia (affecting motor activity), cerebellum (motor coordination), hippocampus (short term memory), neocortex (thinking), and hypothalamus and limbic cortex (appetite and sedation). To a lesser extent, the CB1 receptors are found in periaqueductal gray dorsal horn (pain), immune cells, liver, thyroid, uterus, bones and testicular tissue May 25, May 25,
13 6/2/2017 CANNABINOID RECEPTORS CB2 receptor (CB2r) Found on immune cells and tissues, is primarily immunomodulatory and anti inflammatory Expressed on the cell membranes of B and T cells, macrophages and spleen. When signaled, CB2r are generally inhibitory to immune cell activation. CB2r expression is inducible, their number is increased by inflammation. Reduced CB2r signaling results in increased severity of inflammation as found in studies in mice. May 25, May 25,
14 Medicinal effects of Cannabis May 25, Modulating endocannabinoid activity may have therapeutic potential in almost all diseases affecting humans, including obesity/metabolic syndrome, diabetes and diabetic complications, neurodegenerative, inflammatory, cardiovascular, liver, gastrointestinal, skin diseases, pain, psychiatric disorders, cachexia, cancer, chemotherapy induced nausea and vomiting, among many others. Pacher and Kunos FEBS J May; 280(9): May 25,
15 REASONS FOR MEDICAL CANNABIS USE REASON FOR USE % REPORTING REASON Pain Relief 82.6% To Sleep 70.6% To Relax 55.6% Muscle Spasms 41.3% Anxiety 38.1% To Stimulate Appetite 38.0% Nausea 27.7% Depression 26.1% Reinarman et al., 2011 May 25, POTENTIAL THERAPEUTIC BENEFITS OF CANNABIS Nausea and Vomiting Anorexia and Cachexia Spasticity Movement Disorders Pain Glaucoma Epilepsy Asthma Autoimmune Diseases and Inflammation Psychiatric Symptoms Miscellaneous, Mixed Syndromes: Pruritus, Chronic Fatigue Syndrome, Attention Deficit Disorder, Restless Leg Syndrome, Hiccups May 25,
16 PHARMACOLOGIC EFFECTS OF THC Psychotropic Initial euphoria and relaxation followed by depressant period Alterations in memory and cognitive perceptual abilities Immunosuppressive/immunomodulatory Cardiovascular Tachycardia, orthostatic hypotension, peripheral vasodilation Analgesic Anti emetic Appetite stimulation May 25, PHARMACOLOGIC ACTIONS OF CBD Anticonvulsive Analgesic Anti anxiety Anti depressant Anti psychotic Anti inflammatory Immunosuppressive Inhibits FAAH enzyme Potential benefit in Parkinson s, Alzheimer s disease, Diabetes mellitus, Cancer May 25,
17 CANNABINOID MEDICINES Dronabinol (Schedule III) Chemo induced nausea/vomiting (1985) Anorexia associated with weight loss from AIDS (1992) Nabilone (Schedule II) Chemo induced nausea/vomiting (1985) Nabiximols (not FDA approved) Cannabis derived liquid extract formulated from 2 strains of Cannabis sativa into an oromucosal spray. Approved in 10 countries for: Spasticity from MS Neuropathic pain in MS patients Intractable cancer pain Rimonabant (CB1 antagonist) Anorectic antiobesity drug Taken off market due to serious psychiatric effects May 25, Dronabinol, nabiximols, nabilone, CBD. Only 2 studies evaluated cannabis 79 trials included (6462 participants) Most trials showed improvement in symptoms (not all statistically significant) Compared with placebo, cannabinoids were associated with a greater average number of patients showing: a complete nausea and vomiting response; 3 trials, reduction in pain; 8 trials, a greater average reduction in numerical rating scale pain assessment; 6 trials, average reduction in the Ashworth spasticity scale; 5 trials, There was an increased risk of short term AEs with cannabinoids, including serious AEs. Common AEs included dizziness, dry mouth, nausea, fatigue, somnolence, euphoria, vomiting, disorientation, drowsiness, confusion, loss of balance, and hallucination. May 25,
18 2011 Included neuropathic pain, fibromyalgia, RA and mixed chronic pain 18 RCTs ( ), 766 total participants Overall quality of trials was excellent 15 or the 18 trials that met inclusion criteria demonstrated a significant analgesic effect of cannabinoid as compared to placebo, several reported significant improvements in sleep. There were no serious adverse side effects. This systematic review of 18 recent good quality randomized trials demonstrates that cannabinoids are a modestly effective and safe treatment option for chronic non cancer (predominantly neuropathic) pain. Given the prevalence of chronic pain, its impact on function and the paucity of effective therapeutic interventions, additional treatment options are urgently needed. More large scale trials of longer duration reporting on pain and level of function are required. May 25, SYNERGY WITH OPIOIDS Abrams et al (2011) studied 21 individuals with chronic pain, on a regimen of twice daily doses of sustained release Morphine or Oxycodone Admitted participants for 5 day inpatient stay Participants were asked to inhale vaporized cannabis in the evening of day 1, three times a day on days 2 4, and in the morning of day 5. Blood sampling was performed at 12 h intervals on days 1 and 5. Extent of chronic pain was assessed daily. Pharmacokinetic investigations revealed no significant change in the area under the plasma concentration time curves for either morphine or oxycodone after exposure to cannabis. Pain was significantly decreased (average 27%) after the addition of vaporized cannabis. Concluded that vaporized cannabis augments the analgesic effects of opioids without significantly altering plasma opioid levels. The combination may allow for opioid treatment at lower doses with fewer side effects May 25,
19 NEUROPATHIC PAIN FIVE RCTs Wilsey et al: A Randomized, Placebo Controlled, Crossover Trial of Cannabis Cigarettes in Neuropathic Pain. J Pain June ; 9(6): Ellis et al: Smoked Medicinal Cannabis for Neuropathic Pain in HIV: A Randomized, Crossover Clinical Trial February ; 34(3): Wallace et al: Efficacy of Inhaled Cannabis on Painful Diabetic Neuropathy. J Pain July ; 16(7): Ware et al: Smoked Cannabis for Chronic Neuropathic Pain: A randomized controlled trial. CMAJ Oct 5;182(14):E Abrams et al: Cannabis in Painful HIV Associated Sensory Neuropathy: a randomized placebo controlled trial. Neurology Feb 13;68(7): May 25, CANNABIS FOR NAUSEA AND VOMITING Central regulation of emesis occurs via the: Dorsal Vagal Complex (DVC) Area Postrema located outside BBB, provides communication between blood borne signals Nucleus of the solitary tract Dorsal motor nucleus of the vagus } Contain CB1 receptors Meta analysis of 3 RCTs (Machado, et al, 2008) showed statistically significant benefit of Dronabinol on CINV. Scarcity of data comparing cannabis to first line anti emetics May 25,
20 CANNABIS FOR CANCER ASSOCIATED PAIN The CB1r is found in the CNS and in peripheral nerve terminals. Elevated levels of the CB1r (like opioid receptors) are found in areas of the brain that modulate nociceptive processing. Cannabinoids may contribute to pain modulation through an anti inflammatory mechanism a CB2 effect with cannabinoids acting on mast cell receptors to attenuate the release of inflammatory agents such as histamine and serotonin and on keratinocytes to enhance the release of analgesic opioids. May 25, CANNABIS FOR CANCER ASSOCIATED PAIN Johnson, et al (2010) performed a placebo controlled RCT comparing THC:CBD extract to THC only extract to placebo. 2x as many patients taking THC:CBD showed a reduction of more than 30% from baseline pain numerical rating scale (NRS) score when compared with placebo The number of THC only group responders was similar to placebo and did not reach statistical significance. No change from baseline in median dose of opioid background medication or mean number of doses of breakthrough medication across treatment groups. THC:CBD extract is efficacious for relief of pain in patients with advanced cancer pain not fully relieved by strong opioids May 25,
21 CANNABIS FOR ANOREXIA/CACHEXIA SYNDROME Numerous nuclei in the medulla are involved in the regulation of appetite and nausea coordinate sensory input from the brainstem, vagal complex, vestibular organs, and peripheral organs. CB1r are present in the hypothalamus (controls food intake) and in mesolimbic reward system which may be involved in the motivational/reward aspects of eating. Endocannabinoids and CB1 agonists inhibit vagal fibers to promote eating and CB1 antagonists to decrease or inhibit food intake. Trials conducted in the 1970s in healthy controls found that smoked cannabis (especially when used in a social/communal setting) led to an increase in caloric intake, predominantly in the form of between meal snacks, (mainly fatty and sweet foods). Lack of clinical studies showing benefit in cancer patients May 25, CANNABIS FOR MUSCLE SPASTICITY Meta analysis by Whiting et al (2015): Fourteen studies (33 reports; 2280 participants) assessed spasticity due to MS or paraplegia Studies generally suggested that cannabinoids were associated with improvements in spasticity, but this failed to reach statistical significance in most studies Cannabinoids (nabiximols, dronabinol, and THC/CBD) were associated with a greater average improvement on the Ashworth scale for spasticity compared with placebo, although this did not reach statistical significance. The average number of patients who reported an improvement on a global impression of change score was also greater with nabiximols than placebo. May 25,
22 CANNABIS FOR SEIZURE DISORDERS Strong evidence indicates the anticonvulsant activity of CBD compounds (Wallace et al., 2001; Blair et al., 2015) Activation of CB1 receptor has proven to dampen neurotransmission and produce an overall reduction in neuronal excitability. In many clinical trials cannabis was administered in tandem with the patient s previously prescribed medications. Some of the patients were able to lower the dosage of the medications, and in some cases completely stop them, with no increase in seizures during the trial period. Reddy and Golub, J Pharmacol Exp Ther 357:45 55, April 2016 May 25, CANNABIS AS AN ANTI NEOPLASTIC AGENT Antiproliferative effects were originally reported in 1975 by Munson et al. who demonstrated that delta 9 THC, delta 8 THC, and cannabinol inhibited Lewis lung adenocarcinoma cell growth in vitro as well as in mice. Cannabinoids may exert their antitumor effects by a number of different mechanisms, including: direct induction of transformed cell death, direct inhibition of transformed cell growth, inhibition of tumor angiogenesis and metastasis Research on cannabis as an anti neoplastic medication in humans is lacking May 25,
23 THE ENTOURAGE EFFECT The enhancement of cannabinoid effects by non cannabinoid components. May 25, FACTORS INFLUENCING CANNABIS EFFECTS Dose of cannabis consumed Ratio of the various cannabinoids in the cannabis product Route of administration Time since consumption Health status of the patient Age of the patient Co administration of other drugs/medicines Whether or not the patient has been using cannabis recreationally (or receiving cannabis therapy) long term or if the patient is cannabis naïve May 25,
24 Cart3726 May 25, CONTRAINDICATIONS Absolute Contraindications Acute psychosis and other unstable psychiatric conditions Relative Contraindications Severe cardiovascular, immunological, liver or kidney disease Cannabis may exacerbate arrhythmia or a history of arrhythmias May 25,
25 SIDE EFFECTS/ADVERSE EFFECTS OF CANNABIS USE Distorted perception Loss of motor coordination Difficulty with concentration/problem solving Dry mouth Tachycardia Psychosis and Schizophrenia (increased risk with personal/family hx) Infertility In vivo and in vitro studies have shown that cannabis may disrupt the hypothalamus pituitary gonadal axis, spermatogenesis, and sperm function Cannabinoid hyperemesis syndrome Impaired driving May 25, CANNABIS USE DISORDER A problematic pattern of cannabis use leading to clinically significant impairment or distress. Manifested by at least 2 of the following within a 12 month period (DSM V): Cannabis is often taken in larger amounts or over a longer period than was intended. Persistent desire or unsuccessful efforts to cut down or control cannabis use. Great deal of time spent obtaining, using or recovering from effects of cannabis. Craving, or a strong desire or urge to use cannabis. Recurrent cannabis use resulting in a failure to fulfill major obligations. Continued cannabis use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of cannabis. Important activities are given up or reduced because of cannabis use. Recurrent cannabis use in situations in which it is physically hazardous. Continued use despite knowledge of problems caused or exacerbated by cannabis. Tolerance Withdrawal symptoms May 25,
26 CANNABIS WITHDRAWAL SYNDROME Includes restlessness, irritability, mild agitation, insomnia, strange dreams, appetite loss, nausea, and cramping. Regular cannabis intake is related to a desensitization and downregulation CB1 receptors. Starts to reverse within the first 2 days of abstinence; receptors return to normal functioning within 4 weeks of abstinence. CWS severity is dependent on the amount of cannabis used precessation, gender, and heritable and several environmental factors. Bonnet U, et al May 25, New York State Medical Marijuana Program May 25,
27 COMPASSIONATE CARE ACT Governor Cuomo passed bill (Compassionate Care Act) on June 19, 2014 Program launched on January 7, 2016 Five registered organizations, 4 dispensaries each Bloomfield Industries Inc. Columbia Care NY LLC Etain, LLC PharmaCann LLC Vireo Health of New York LLC May 25, PRACTITIONER QUALIFICATIONS Be qualified to treat patients with one or more of the serious conditions. Be licensed, in good standing as a physician/np/pa and practicing medicine Have completed a four hour course approved by the Commissioner Have registered with the New York State Department of Health (NYSDOH). May 25,
28 ELIGIBILITY CRITERIA Serious Medical Condition Clinically Associated Condition Cancer HIV +/ AIDS ALS Parkinson s MS Spinal cord injury with spasticity Epilepsy IBD Neuropathy Huntington s Disease Chronic Pain Seizures Severe nausea Severe or persistent muscle spasms Severe or chronic pain resulting in substantial limitation of function Cachexia or wasting syndrome May 25, APPROVED MODES OF ADMINISTRATION 1. Liquid or oil preparations for metered oromucosal or sublingual administration (Onset: 30 min; duration 4 6 hours) 2. Metered liquid or oil preparations for vaporization (Onset: Immediate to 5 min; duration 2 4 hours) 3. Capsules for oral administration (Onset: 1 2 hours; duration 6 8 hours) Smoking medical cannabis is expressively prohibited and edible cannabis containing products are not approved in NY State May 25,
29 DOSES AVAILABLE IN NYS 1:20 THC:CBD 1:1 THC:CBD 20:1 THC:CBD Maximum of 10mg THC/dose May 25, CERTIFICATION PROCESS 1. Practitioner makes recommendation via HCS website 2. Prints and signs Certificate for patient Certification expires 1 year after date of issuance unless patient is terminally ill 3. Patient registers on NY.gov website $50 fee (waived for financial hardship) 4. If application is approved, DOH issues a registry card to patient May 25,
30 May 25, NYS NUMBERS TO DATE.. As of May 30, 2017: 1,040 practitioners have registered with the NYS Medical Marijuana Program, and 20,494 patients have been certified. May 25,
31 LEGAL CONSIDERATIONS FOR PRACTITIONERS ACP statement, 2008: ACP strongly supports exemption from federal criminal prosecution, civil liability, or professional sanctioning, such as loss of licensure or credentialing, for physicians who prescribe or dispense medical marijuana in accordance with state law. US Attorney General Eric Holder in 2009 announced that legally pursuing people who were using medical marijuana was not a priority, differentiating between illicit drug users and patients/caregivers who are abiding by state laws. The Justice Department in 2013 declared US Attorneys would no longer pursue actions against physicians for recommending medical marijuana in states where it has been made legal. May 25, LEGAL CONSIDERATIONS Federal employees barred from medical cannabis use Driving under the influence May 25,
32 MORE TO COME NY Commissioner of Health reviewing scientific evidence for medical marijuana for: PTSD Alzheimer s Disease Muscular Dystrophy Dystonia Rheumatoid Arthritis May 25, OBSTACLES Lack of validated studies on the various benefits of medical cannabis Cannabis remains classified as a Schedule I drug Schedule I drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse. FDA requires Phase 3 studies to be done with the same drug that the sponsor is seeking to market As long as the DEA/NIDA monopoly on cannabis research exists it will not be possible to develop an FDA approved prescription medicine with NIDA cannabis. May 25,
33 THE FUTURE OF CANNABIS RESEARCH Identification of compounds that retain therapeutic effects without the side effects Alternative methods of delivery Manipulation of the endocannabinoidsystem A selective transporter for the re uptake of anandamide may exist (evidence mixed at present, controversial) May 25, MRS. B May 25,
34 May 25, REFERENCES 1. Atakan Z. Ther Adv Psychopharmacol (2012) 2(6) Bakas T, et al. Pharmacol Res May;119: Blair RE, et al. Expert Opin Pharmacother. 2015; 16(13): Bonnet U et al. Substance Abuse and Rehabilitation 2017: Borgelt, L, et al. Pharmacotherapy (2013) Vol 33:2. 6. Bostwick JM. Mayo Clin Proc. 87(2): Johnson JR, et al. J Pain Symptom Manage Feb;39(2): Madras B. Update of Cannabis and its Medical Use. 37th ECDD (2015) Agenda item Pertwee, RG. RG. International Journal of Obesity (2006) 30, S13 S Reddy D. J Pharmacol Exp Ther 357:45 55, April Reinarman C, et al. J Psychoactive Drugs Apr Jun;43(2): Stout and Cimino Turgeman I, et al. Cannabis Use in Palliative Oncology. Isr Med Assoc J Feb;19(2): Velasco G, et al. Prog Neuropsychoparmacol Biol Psychiatry : Wallace MJ, et al. Eur J Pharmacol Sep 28;428(1): Watson SJ, et al. Arch Gen Psychiatry. 2000;57(6): Weiss S, et al. International Journal of Dru Policy 42 (2017) Whiting, et al. JAMA. 2015;313(24): Yamaori, et al 2012, Watanabe et al New York State Practitioner Education Medical Use of Marijuana Course. TheAnswerPage.com. May 25,
35 Thank You By forcing marijuana to languish as a Schedule I drug with a high potential for abuse, no accepted medical use, and no accepted safety for use in medically supervised treatment, the federal government thumbs an illogical nose at contemporary public sentiment, recent scientific discoveries, and potentially head to toe therapeutic breakthroughs. This reclassification would be a first step toward reconciling federal and state law and permitting long stifled research into a potential trove of therapeutic applications to commence. Bostwick JM, Mayo Clin Proc 2012 May 25,
Medical Marijuana Martin P. Eason MD, JD Associate Chief of Staff for Education Mountain Home VA Medical Center. Disclosure.
Medical Marijuana Martin P. Eason MD, JD Associate Chief of Staff for Education Mountain Home VA Medical Center Controversies in Pain Management Conference Johnson City, TN November 13, 2015 Disclosure
More informationThe Effects known & unknown of Marijuana in Older Adults. Danielle Fixen, PharmD, BCGP, BCPS University of Colorado School of Pharmacy
The Effects known & unknown of Marijuana in Older Adults Danielle Fixen, PharmD, BCGP, BCPS University of Colorado School of Pharmacy Learning Objectives 1. Review various dosing strategies for medical
More informationClinical Education Initiative MEDICAL MARIJUANA 101. Speaker: Patricia Reed, PharmD
Clinical Education Initiative Support@ceitraining.org MEDICAL MARIJUANA 101 Speaker: Patricia Reed, PharmD 8/2/2017 Medical Marijuana 101 [video transcript] 00:00:12 - So we'll get started. Disclosures
More informationHistory Of Medical Cannabis
History Of Medical Cannabis Historical and archaeological evidence of widespread use in ancient times as medicine, food, textiles & for sacraments, rituals Possibly first domesticated crop Introduction
More informationCANNABIS FOR THE RHEUMATOLOGIST
CANNABIS FOR THE RHEUMATOLOGIST Dr Jagtar Singh Nijjar NIHR Clinical Lecturer in Rheumatology Disclosures None 1 Overview The history of cannabis use Anecdotal use of cannabis in chronic pain The biology
More informationA look at Marijuana in 2014
A look at Marijuana in 2014 Paul Snyder MA., LADC Overview and Objectives Discuss the mental and physical effects of marijuana use Describe the criteria for Cannabis use disorder according to the DSM 5
More informationCurious about Cannabis? Navigating the cannabis landscape in Pennsylvania LINDSEY MESTON, PHARMD ASHLEY FIRM, PHARMD
Curious about Cannabis? Navigating the cannabis landscape in Pennsylvania LINDSEY MESTON, PHARMD ASHLEY FIRM, PHARMD Speaker Disclosures We have/had no financial relationships with any commercial interests
More informationMedical Marijuana for Pain How Does Cannabis Work on Your Body?
Medical Marijuana for Pain How Does Cannabis Work on Your Body? Jeremy Spiegel, MD Medical Director - Casco Bay Medical Westbury, Long Island, New York Intro Brief History of Cannabis Physiology of Cannabis
More informationAcknowledgements: What it is What it s not. Cannabis Evidence Series. Evidence-informed decision-making
Cannabis Evidence Series What it is What it s not Acknowledgements: The evidence presented is from the Cannabis evidence series authored by the HTA unit at the University of Calgary and from Rapid response
More informationMedical Cannabis Program. Dr. Maureen Small Co Medical Director Andrea Sundberg Program Coordinator
Medical Cannabis Program Dr. Maureen Small Co Medical Director Andrea Sundberg Program Coordinator Disclaimer The following information is based upon research of current studies. The Department of Health
More informationMedical Marijuana: Hype versus Evidence
Medical Marijuana: Hype versus Evidence Monica Malec, MD The University of Chicago, Department of Medicine Section of Geriatrics and Palliative Medicine Objectives Understand the requirements for physician
More informationMedical Marijuana Consent Form
Medical Marijuana Consent Form A qualified physician may not delegate the responsibility of obtaining written informed consent to another person. The qualified patient or the patient s parent or legal
More informationMedicinal cannabinoids where does it fit in Palliative Care? Janet Hardy Phillip Good Georgie Cupples Matthew Spitzer
Medicinal cannabinoids where does it fit in Palliative Care? Janet Hardy Phillip Good Georgie Cupples Matthew Spitzer Medicinal cannabis Substantial public interest Legalised by the Qld Government Guidance
More informationJuly 15 TH, ANDREW MEDVEDOVSKY, M.D. Board Certified Neurologist & Pain Medicine Specialist Director New Jersey Alternative Medicine
MEDICAL CANNABIS FOR NEUROLOGICAL DISEASES July 15 TH, 2017 ANDREW MEDVEDOVSKY, M.D. Board Certified Neurologist & Pain Medicine Specialist Director New Jersey Alternative Medicine GOALS AND OBJECTIVES
More informationCBD and Your Health.
CBD and Your Health. Cannabidiol (CBD) is a molecule found in plant species such as agricultural (or industrial) hemp, and Echinacea. CBD is one of at least 489 distinct compounds within hemp: it is clear
More informationMedical Marijuana Update Chris Belletieri, DO
Dr. Belletieri has provided no disclosures. Graduated PCOM in 1996 In private practice since 1999 Board Certified in FP since 1999 Program Director of FP residency at Lower Bucks Hospital in Bristol, PA
More informationStephen Dahmer, MD Chief Medical Officer Vireo Health. Assistant Clinical Professor Family Medicine & Community Health ICAHN
Stephen Dahmer, MD Chief Medical Officer Vireo Health Assistant Clinical Professor Family Medicine & Community Health ICAHN 1 Many Names 2 Stigma IF CANNABIS were unknown, and bioprospectors were suddenly
More informationCannabis. Member of the Cannabaceae family of flowering plants (along with hops) Cannabis sativa (v. sativa, indica, afghanica, ruderalis)
Member of the Cannabaceae family of flowering plants (along with hops) sativa (v. sativa, indica, afghanica, ruderalis) Only females flowers contain high concentrations of psychoactive oils (cannabinoids)
More informationMedical Marijuana. Navigating Medical Marijuana in Workers Compensation
Medical Marijuana Navigating Medical Marijuana in Workers Compensation Agenda Federal and State Laws Public Health Adverse Effects & Concerns Clinical Use Implications for Employers Implications for Workers
More informationHEALTH WELLNESS COMMUNITY
HEALTH WELLNESS COMMUNITY As with all modern medicines, our understanding of cannabis and its benefits has deepened over time thanks to groundbreaking advancements in research and technology. At Trilogy
More informationUse of Cannabinoids in Medical Practice
Use of Cannabinoids in Medical Practice Annual Scientific Assembly Family Medicine Review 2016 Murray Opdahl BSPE, MD, CCFP Objectives Briefly present: An overview of available cannabinoids Concerns voiced
More informationMEDICAL CANNABIS PATIENT COUNSELING. Krissy Bernazani, RPh Clinical Director Zen Leaf
MEDICAL CANNABIS PATIENT COUNSELING Krissy Bernazani, RPh Clinical Director Zen Leaf DISCLOSURE Krissy Bernazani is a paid employee of Freestate Wellness, dba Zen Leaf Maryland, a medical cannabis dispensary.
More informationThe Return of Medicinal Cannabis
The Return of Medicinal Cannabis George Kolodner, M.D. DLFAPA FASAM Chief Clinical Officer Clinical Professor of Psychiatry Georgetown University School of Medicine University of Maryland School of Medicine
More informationAct 16 and Medical Cannabis in Pennsylvania
Act 16 and Medical Cannabis in Pennsylvania Charles V. Pollack, Jr., MA, MD, FACEP, FAAEM, FAHA, FESC, FCPP Associate Provost and Professor of Emergency Medicine Director, Institute of Emerging Health
More informationPATIENT INTAKE FORM. Name: Address: Town: State: Zip Code: MMJ Card #: Exp. Date: Drivers License #: Exp. Date: Home Phone: Cell:
PATIENT INTAKE FORM Name: Last Name First Name Date of Birth: / / Gender: Male Female Address: Town: State: Zip Code: MMJ Card #: Exp. Date: Drivers License #: Exp. Date: Home Phone: Cell: Email: Primary
More informationMedical Cannabis. Danial Schecter, MD, CCFP. Vocational Rehabilitation Association November 7th, Executive Director Cannabinoid Medical Clinic
Medical Cannabis Danial Schecter, MD, CCFP Executive Director Cannabinoid Medical Clinic Vocational Rehabilitation Association November 7th, 2014 Conflict of Interest This program has not received financial
More informationMedical Cannabis MATT WEBSTER DO, MS
Medical Cannabis MATT WEBSTER DO, MS Cannabis Sativa One of the oldest used drugs and medicinal remedies Most commonly abused illicit drug in the US There has been increasing access for medicinal MJ use
More informationSteven G. Kinsey, PhD Associate Professor, Department of Psychology West Virginia University
Steven G. Kinsey, PhD Associate Professor, Department of Psychology West Virginia University sgkinsey@mail.wvu.edu Any opinions expressed are my own and do not reflect any official position of WVU beanpot.co
More informationINITIAL PATIENT INTAKE FORM
INITIAL PATIENT INTAKE FORM Name: Last Name First Name Date of Birth: MM / DD / YYYY Gender: Male Female Address: Town: State: Zip Code: Preferred method of contact. For internal promotional use only.
More informationObjectives. 1. Review controversy 2. Pathophysiology 3. Indications for Use 4. Adverse Effects 5. How Patients Access
Medical Marijuana Deb Evans, RN, MScN, CON(C), CHPCN(C) Clinical Nurse Specialist Pain and Symptom Management Team Juravinski Cancer Centre May 29, 2014 Objectives 1. Review controversy 2. Pathophysiology
More informationWeeding Through the Science of Cannabis. Ryan Vandrey, PhD
Weeding Through the Science of Cannabis Ryan Vandrey, PhD What is Cannabis? Basic Plant Information Cannabis is a genus of plants with 3 species: Cannabis Sativa Cannabis Indica Cannabis Ruderalis Plant
More informationDr. G. Michael (Michael) Allan EDMONTON AB Dr. Christina (Tina) S. Korownyk EDMONTON AB MEDICAL CANNABANOIDS IN PRIMARY CARE
Society of Rural Physicians of Canada 26TH ANNUAL RURAL AND REMOTE MEDICINE COURSE ST. JOHN'S NEWFOUNDLAND AND LABRADOR APRIL 12-14, 2018 262 Dr. G. Michael (Michael) Allan EDMONTON AB Dr. Christina (Tina)
More informationMEDICAL MARIJUANA: WHAT S THE EVIDENCE?
MEDICAL MARIJUANA: WHAT S THE EVIDENCE? L A U R A A. M A R K L E Y, M D B O A R D - C E R T I F I E D I N P E D I A T R I C S / G E N E R A L P S Y C H I A T R Y / C H I L D & A D O L E S C E N T P S Y
More informationMedical Cannabinoids for the Management of Chronic Noncancer Pain
Medical Cannabinoids for the Management of Chronic Noncancer Pain Dr Mark A. Ware MBBS MSc McGill University 12 June 2018 Disclosures Grants: CanniMed Consulting: CHI Inc Emmes 1 Canadian Consortium for
More informationUse of Medical Marijuana in Cancer Treatment & Care
Use of Medical Marijuana in Cancer Treatment & Care Ronald Stram,MD Stram Center for Integrative Medicine April 2016 Introduction Board Certified Medical Doctor, Integrative and Functional Medicine 28
More informationMedical Cannabis use in the Older Patient
Medical Cannabis use in the Older Patient Dr. Amanjot Sidhu Division of Geriatric Medicine McMaster University Audience Poll What is the fastest-growing demographic of cannabis users? a) Ages 14-23 b)
More informationMedical Cannabis: A Patient Primer
Medical Cannabis: A Patient Primer This primer is meant for documented patients who are using medicinal cannabis or considering using it in the future. The information provided about this medication in
More informationFederal Law: Marijuana
Federal Law: Marijuana Marijuana is a Schedule I drug under Federal Controlled Substances Act Makes possession, usage, purchase, sale, and/or cultivation of marijuana illegal at the federal level May not
More informationCannabis and the Endocannabinoid System
Cannabis and the Endocannabinoid System September 7, 2018 Bangkok, Thailand David Bearman, MD Goleta, California Executive VP, American Academy of Cannabinoid Medicine AACMSITE.org Shen Nung Ping
More informationI would like to begin by acknowledging that we are on the ancestral grounds of the Beothuk people
I would like to begin by acknowledging that we are on the ancestral grounds of the Beothuk people Introduction to the Cannabinoid System And Medical Use Dr Alia Norman Radiation Oncologist Cannabinoid
More informationJames McCormack BSc (Pharm), PharmD Professor Faculty of Pharmaceutical Sciences University of British Columbia Vancouver, BC, Canada
James McCormack BSc (Pharm), PharmD Professor Faculty of Pharmaceutical Sciences University of British Columbia Vancouver, BC, Canada My Agenda Discuss the best available evidence Put the evidence into
More informationMedicinal cannabis. What is medicinal cannabis? What are cannabinoids? The endocannabinoid system
Medicinal cannabis What is medicinal cannabis? Broadly speaking, medicinal cannabis is cannabis prescribed to relieve the symptoms of a medical condition, such as epilepsy. It is important to make the
More informationMarijuana and Adolescents: Truth and Consequences. Disclosure Statement OBJECTIVES. Secondary Objectives. State of Marijuana in US
Marijuana and Adolescents: Truth and Consequences Clinical Advances in Pediatrics Symposium Children s Mercy Park September 28, 2017 Disclosure Statement I have no actual or potential conflict of interest
More informationMARIJUANA in MEDICAL CARE READY or RISKY. HINDI MERMELSTEIN, MD FAPM Beth Israel Medical Center, NYC Dec
MARIJUANA in MEDICAL CARE READY or RISKY HINDI MERMELSTEIN, MD FAPM drhmermelstein @optimum.net Beth Israel Medical Center, NYC Dec 11 2015 HISTORY MARIJUANA (CANNABIS SAVITA) HAS LONG BEEN PART OF RELIGIOUS
More informationMedical Marijuana. Speaker Disclosure Requirements. Share with a Partner 4/10/2015
Medical Marijuana Kent W. Peterson, MD, FACOEM Occupational Health Strategies, Inc. Charlottesville, VA Speaker Disclosure Requirements 1. Do not dispense, prescribe, refer or recommend MMJ 2. Have no
More informationThe Endocannabinoid System
The Endocannabinoid System Think of this system as the wizard behind the curtain. It underlies all the other systems, including the Autonomic Nervous System. Overall it influences well-being and the perception
More informationMedical Marijuana. 1. is a plant species, variety known as hemp. 3. Tetrahydrocannabinol is an aromatic with low water solubility.
Medical Marijuana Questions from Part 1: 1. is a plant species, variety known as hemp. a. Cannabis sativa Linnaeus b. Cannabis sativa c. Cannabis indica d. Cannabis Lemark 2. The major psychoactive compound
More informationCannabinoids: access and symptom management in cancer
Cannabinoids: access and symptom management in cancer Appetite stimulation Anecdotal reports suggest marijuana stimulates appetite AIDS/HIV dronabinol 2.5 mg bd v placebo (n=88) increase in appetite 38%
More informationThe Scientific Side of Medical Marijuana
The Scientific Side of Medical Marijuana Ken Mackie, MD Indiana University Bloomington, IN December 3, 2009 kmackie@indiana.edu Financial disclosures NIH (NIDA) - research grants Alzheimer s Association
More informationThe Sale of Cannabis in Pharmacies. Michael H. Ghobrial, PharmD, JD Associate Director, Health Policy American Pharmacists Association
The Sale of Cannabis in Pharmacies Michael H. Ghobrial, PharmD, JD Associate Director, Health Policy American Pharmacists Association Development This activity was developed by the American Pharmacists
More informationResearch on Cannabis and PD: Is there any evidence?
Research on Cannabis and PD: Is there any evidence? Benzi M. Kluger, MD, MS Associate Professor of Neurology and Psychiatry Director Movement Disorders Center University of Colorado Denver DISCLOSURES
More informationMedical Cannabis. Christine Yoshioka, NP
Medical Cannabis Christine Yoshioka, NP Objectives Brief history of Cannabis in cultures Review of the Endocanabinoid system Exogenous cannabis Medical research involving cannabis and federal restrictions
More information8/31/2016. Workplace Implications of Marijuana in the US. Goal
Workplace Implications of Marijuana in the US Copyright 420 Medicated.com Goal Inform and provoke discussion about the future for patients, staff and employers in regard to this rapidly evolving and important
More informationCannabis for RDNs (Who Don t Know their CBD from their THC!)
Cannabis for RDNs (Who Don t Know their CBD from their THC!) Janice Newell Bissex, MS, RDN Holistic Cannabis Practitioner Today s Talk What is cannabis? History of use Components of cannabis Condi@ons
More informationEndocannabinoid System Cannabinoid Drugs
Cannabinoid Drugs STCM Conference Bern 22.1.2013 Rudolf Brenneisen University of Bern, DKF 1 www.phytopharm.dkf.unibe.ch rudolf.brenneisen@dkf.unibe.ch Milestones 1988: First cannabinoid receptor (rat
More informationCase4:11-cv SBA Document37 Filed12/13/11 Page1 of 7
Case:-cv-0-SBA Document Filed// Page of 0 0 MATTHEW KUMIN, State Bar No. KUMIN SOMMERS LLP 0 Market Street, Suite San Francisco, CA 0 Telephone: ( -00 Facsimile: ( - e-mail: matt@kuminsommers.com DAVID
More informationThe Highs and Lows of Medical Marijuana
The Highs and Lows of Medical Marijuana Jill Vargo Cavalet, MHS, PA-C Marijuana use is prevalent worldwide yet remains controversial in health care. The general public often regards marijuana as a benign
More informationTrends, Tactics and Toxicity: Marijuana Movement on Missouri College Campuses. Janice Putnam PhD, RN Amy Kiger MS, ABD Kelly Skinner DNP, FNP-C
Trends, Tactics and Toxicity: Marijuana Movement on Missouri College Campuses Janice Putnam PhD, RN Amy Kiger MS, ABD Kelly Skinner DNP, FNP-C 1 Marijuana/Cannabis Marijuana use is growing in popularity
More informationMEDICAL CANNABIS IN MINNESOTA
MEDICAL CANNABIS IN MINNESOTA MINNESOTA ACADEMY OF PHYSICIAN ASSISTANTS MARCH 18, 2016 TOM ARNESON, MD, MPH MDH OFFICE OF MEDICAL CANNABIS 2014: Minnesota becomes 22 nd state with a medical cannabis program
More informationADVANCED CLINICAL CANNABINOID PROVIDER EXAM ACCP
ADVANCED CLINICAL CANNABINOID PROVIDER EXAM ACCP Page 1 1. In what year did the possession and transfer of cannabis for recreational use become illegal in the United States? A. 1937 B. 1941 C. 1933 2.
More informationCDHA 2016 Fall Symposium. Speaker Handout Files. For registered attendees only
CDHA 2016 Fall Symposium Speaker Handout Files For registered attendees only Providing Care in a Marijuana Legal World Heather Rogers, BSDH heatherrdh@heatherrdh.com Objectives We will discuss some of
More informationMedical Marijuana A Brief Overview of the Program in Ohio and Pharmacology of Cannabinoids
Medical Marijuana A Brief Overview of the Program in Ohio and Pharmacology of Cannabinoids Stephanie Abel, PharmD, BCPS Palliative Medicine Clinical Pharmacy Specialist James Cancer Hospital The Ohio State
More informationMedical Marijuana A Brief Overview of the Program in Ohio and Pharmacology of Cannabinoids
Medical Marijuana A Brief Overview of the Program in Ohio and Pharmacology of Cannabinoids Stephanie Abel, PharmD, BCPS Palliative Medicine Clinical Pharmacy Specialist James Cancer Hospital The Ohio State
More informationMedical Marijuana A Primer for Pharmacists
Medical Marijuana A Primer for Pharmacists Emory S. Martin, PharmD FASHP Texas Society of Health System Pharmacists Learning Objectives Recognize key components of the endocannabinoid system Identify possible
More informationCANNABIS AND PAIN. Debra Kimless, M.D. Medical Director, ForwardGro MAOP Annual Meeting September 14, 2018
CANNABIS AND PAIN Debra Kimless, M.D. Medical Director, ForwardGro MAOP Annual Meeting September 14, 2018 FDA APPROVAL: PREGABALIN, DULOXETINE, MILNACIPRAN FOR FIBROMYALGIA PREGABALIN, DULOXETINE FOR
More informationNew Mexico. Prescribing and Dispensing Profile. Research current through November 2015.
Prescribing and Dispensing Profile New Mexico Research current through November 2015. This project was supported by Grant No. G1599ONDCP03A, awarded by the Office of National Drug Control Policy. Points
More informationNew York. Prescribing and Dispensing Profile. Research current through November 2015.
Prescribing and Dispensing Profile New York Research current through November 2015. This project was supported by Grant No. G1599ONDCP03A, awarded by the Office of National Drug Control Policy. Points
More information9/13/2017. Marijuana and the Brain Matthew Wong, MD Assistant Professor, Department of Neurology, Epilepsy Section. Disclosures.
Marijuana and the Brain Matthew Wong, MD Assistant Professor, Department of Neurology, Epilepsy Section Disclosures Site principal investigator of studies of cannabidiol(epidiolex) in the treatment of
More informationImportant Information
Important Information Please work through the following pages with your patient or the patient s chart as necessary. Fax completed documents to 1 888 629-4722. Keep the original in your chart / file. Fee:
More informationMedical Cannabis use in the Older Patient. Amanjot Sidhu, MD, FRCPC Division of Geriatric Medicine McMaster University
Medical Cannabis use in the Older Patient Amanjot Sidhu, MD, FRCPC Division of Geriatric Medicine McMaster University Disclosure Relationships with commercial interests: Grants/Research Support: none Speakers
More informationCannabinoids (CB): Outline. CB: Epidemiology. CB: Categorization. CB: Pharmacodynamics. Part #1: Cannabinoid (CB) Primer.
Cannabinoids (CB): Outline 1 2 PART #1: CB Primer Epidemiology Categorization: Endogenous vs. exogenous Natural vs. synthetic Pharmacodynamics (PD) Pharmacokinetics (PK) CB receptor system CNS regional
More informationWelcome to MedWell. MedWell Health and Wellness Centers. Don t live with PAIN Live WELL MedWell. o Newspaper o Referred by.
1 Welcome to MedWell Patient Information Date: Name: Date of Birth: / / Address: City: State: Zip Code: Home Phone: ( ) - Cell Phone: ( ) - Email: Gender: o Male o Female State Drivers License: Social
More informationNorthern California Chapter, ACP Update In Medicine
Northern California Chapter, ACP Update In Medicine Kathleen A. Kenny MD Clinical Associate Professor of Medicine Primary Care and Population Health November 3, 2018 UPDATE ON MARIJUANA Kathleen A. Kenny
More informationMedical vs Recreational Use of Cannabis. 11 th December 2017
1 Medical vs Recreational Use of Cannabis 11 th December 2017 2 Defining Cannabis and Chemical Constituents Cannabis is a plant species. Two main Cannabis sub-species are Cannabis Sativa and Cannabis Indica.
More informationWHO Expert Committee on Drug Dependence Pre-Review: Extracts and tinctures of cannabis. Expert Peer Review 2
WHO Expert Committee on Drug Dependence Pre-Review: Extracts and tinctures of cannabis Expert Peer Review 2 1. Comments based on the review report a. Evidence on dependence and abuse potential Extracts
More informationMedicinal cannabis use among PLWH in the era of legalization
Medicinal cannabis use among PLWH in the era of legalization June 8, 2017 David Grelotti, MD Assistant Professor University of California, San Diego Center for Medicinal Cannabis Research Outline Overview
More informationMain Questions. Why study addiction? Substance Use Disorders, Part 1 Alecia Schweinsburg, MA Abnromal Psychology, Fall Substance Use Disorders
Substance Use Disorders Main Questions Why study addiction? What is addiction? Why do people become addicted? What do alcohol and drugs do? How do we treat substance use disorders? Why study addiction?
More information9/18/2014 NOTHING TO DISCLOSE
Doris C. Gundersen MD Medical Director Colorado Physician Health Program Georgia Professional Health Program CME Event Macon, Georgia November 7, 2014 Doris C. Gundersen MD Medical Director Colorado Physician
More informationIs there a role for medical marijuana in the management of IBD? Jami A. Kinnucan, MD Division of Gastroenterology University of Michigan Hospital
Is there a role for medical marijuana in the management of IBD? Jami A. Kinnucan, MD Division of Gastroenterology University of Michigan Hospital Disclosures No relevant financial or relationship disclosures
More informationThis questionnaire will ask you about approved medical use of extracts and tinctures of cannabis at national level.
Introduction This questionnaire will ask you about approved medical use of extracts and tinctures of cannabis at national level. Definition: The term "extracts and tinctures" refers to substances that
More informationFaculty/Presenter Disclosure
Faculty/Presenter Disclosure Faculty: Philippe Lucas Relationships with commercial interests: Philippe Lucas is a Research Affilliate with the Centre for Addictions Research of BC, as well as VP, Patient
More informationLegalized Marijuana: Uses, Misuses & Abuses. Disclosures. Objectives. Kennon Heard University of Colorado SOM Dept Of Emergency Medicine
Legalized Marijuana: Uses, Misuses & Abuses Kennon Heard University of Colorado SOM Dept Of Emergency Medicine Disclosures Research grants McNeil Consumer Healthcare (Acetaminophen) Rare Disease Therapeutics
More informationCannabis Use Disorder: What Nurses Need to Know. Bari K Platter, MS, RN, PMHCNS-BC Clinical Nurse Specialist
Cannabis Use Disorder: What Nurses Need to Know Bari K Platter, MS, RN, PMHCNS-BC Clinical Nurse Specialist MARIJUANA POTENCY Average THC and CBD Levels in the U.S. 1960-2011 14 12 10 8 6 4 THC: Psychoactive
More informationReefer Madness version 3.0*
Reefer Madness version 3.0* Presenter Disclosure *Original Reefer Madness: FMF 2014 by R. Dubin, Sharon Cirone and Mel Kahan Update on Health Canada s MMPR and the use of cannabis for medical conditions
More informationEMERGENCE OF CANNABIDIOL IN MEDICINE
EMERGENCE OF CANNABIDIOL IN MEDICINE Sarah Katta, DO Hematology/Oncology Associate Professor of Medicine-University of Central Florida Southwest Cancer Center Orlando, Florida BACKGROUND Cannabis-There
More informationConsumer Information Cannabis (Marihuana, marijuana)
Consumer Information Cannabis (Marihuana, marijuana) The courts in Canada have ruled that the federal government must provide reasonable access to a legal source of marijuana for medical purposes. The
More informationOutcome. Educating Ohio Providers On The Basics Related To Recommending Medical Marijuana. Connie J. Cerilli, APRN, FNP-C
Educating Ohio Providers On The Basics Related To Recommending Medical Marijuana Connie J. Cerilli, APRN, FNP-C Outcome Participants will be able to list 3 approved medical conditions Participants will
More informationEducating Ohio Providers On The Basics Related To Recommending Medical Marijuana. Connie J. Cerilli, APRN, FNP-C
Educating Ohio Providers On The Basics Related To Recommending Medical Marijuana Connie J. Cerilli, APRN, FNP-C Outcome Participants will be able to list 3 approved medical conditions Participants will
More informationMARIJUANA AND THE HEART. Katrinka Kip, MD Northern Nevada Heart Conference April 21, 2018
MARIJUANA AND THE HEART Katrinka Kip, MD Northern Nevada Heart Conference April 21, 2018 BEANS, BEANS ARE GOOD FOR YOUR HEART.. (The more you eat, the more you.) But what about marijuana? A DAD CALLED..
More informationWHO Expert Committee on Drug Dependence Pre-Review: Cannabis plant and resin. Expert Peer Review 2
WHO Expert Committee on Drug Dependence Pre-Review: Cannabis plant and resin Expert Peer Review 2 1. Comments based on the review report a. Evidence on dependence and abuse potential Dependence potential:
More informationMEDICAL CANNABIS IN MINNESOTA
MEDICAL CANNABIS IN MINNESOTA EPILEPSY & SEIZURES WELLNESS EXPO APRIL 16, 2016 MICHELLE LARSON, MPA MDH OFFICE OF MEDICAL CANNABIS 2014: Minnesota becomes 22 nd state with a medical cannabis program State
More informationRequirement for Certification from a Health Care Practitioner. Requirement for Certification from a Health Care Practitioner
Johnson County Pharmacists Association Current Status of the Iowa Ronald A. Herman, Ph.D. 1 Objectives Identify the current status of Iowa medical cannabis regulations. List the current disease conditions
More informationMedical Marijuana in the Workforce. What This Is...And What It Isn t
Medical Marijuana in the Workforce Recommendations for the Occupational Physician Robert S. Goldsmith, M.D., M.P.H. June, 2014 What This Is...And What It Isn t IS: Historical context Legal and social context
More informationGI Pharmacology -4 Irritable Bowel Syndrome and Antiemetics. Dr. Alia Shatanawi
GI Pharmacology -4 Irritable Bowel Syndrome and Antiemetics Dr. Alia Shatanawi 11-04-2018 Drugs used in Irritable Bowel Syndrome Idiopathic, chronic, relapsing disorder characterized by abdominal discomfort
More informationCBD Oil: Benefits, Top Products, Where To Buy, And More
CBD Oil: Benefits, Top Products, Where To Buy, And More CBD hemp oil has a huge range of potential health benefits and uses, including reducing pain, soothing anxiety, fighting cancer, improving mood,
More informationMedicinal Marijuana: The Canadian Journey
Medicinal Marijuana: The Canadian Journey Nady el-guebaly MD Professor & Head, Addiction Division, UofC Research Director, Alberta Gambling Research Institute Chief Examiner, ISAM Certification Disclosures:
More informationNeurobiology of Drug Abuse and Addiction PSYC 450
Neurobiology of Drug Abuse and Addiction PSYC 450 Healthy Control Drug Abuser Illicit drug use, lifetime and past year, in Canada 50 Canabis only Any drug Any of 5 drugs (without canabis) (CADUMS 2012)
More informationThe Shifting Federal Regulation of Cannabis Products
The Durham Bar 2019 CLE Program The Shifting Federal Regulation of Cannabis Products Erica M. Jackson, FDA Partner K&L Gates February 6, 2019 Copyright 2018 by K&L Gates LLP. All rights reserved. OVERVIEW
More informationDurban Poison (Pure Indica) Hindu Kush (Pure Sativa) Northern Lights (Ruderalis-Indica Hybrid) Royal Dwarf (Ruderalis-Sativa Hybrid) 11 Adapted from Figure 1. The endocannabinoid System in the Nervous
More informationSusan Allen-Evenson Hosts: Laura Lagano, MS, RDN, CDN Prepare for the Next Level: Incorporating Holistic Cannabis in the Nutrition Practice
Susan Allen-Evenson Hosts: Laura Lagano, MS, RDN, CDN Prepare for the Next Level: Incorporating Holistic Cannabis in the Nutrition Practice Integrative Clinical Nutritionist, Laura Lagano MS, RDN, CDN
More information