Marijuana and Adolescents: Truth and Consequences. Disclosure Statement OBJECTIVES. Secondary Objectives. State of Marijuana in US

Size: px
Start display at page:

Download "Marijuana and Adolescents: Truth and Consequences. Disclosure Statement OBJECTIVES. Secondary Objectives. State of Marijuana in US"

Transcription

1 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 in relation to this program William P. Adelman MD, FAAP Division Director, Adolescent Medicine Children s Mercy Kansas City Associate Professor of Pediatrics wpadelman@cmh.edu 2 The Children's Mercy Hospital, /14 OBJECTIVES Secondary Objectives 1) Identify adolescence as uniquely vulnerable to the neurotoxic effects of marijuana 2) Recognize the current legal status of marijuana in the United States and its practical implications for adolescents 3 1. Identify the AAP evidence-based Position on marijuana including medical marijuana 2. Define terms associated with marijuana for precise discussion by pediatricians 3. Describe mechanisms of action of marijuana and cannabinoids on the brain 4. Understand some of the known harms of marijuana on the developing brain 4 State of Marijuana in US Numerous states have legalized or are considering legalization of marijuana AAP has published an evidence-based position paper and clinical report Many providers are not aware of the current state of the evidence regarding the effects of marijuana and how to discuss these issues with patients and their families 5 6 1

2 2015 Adolescent Substance Use (used in the last 30 days) Pediatrics 135:3 March % 22% 7% 13%.3% 2% Pediatrics 135:3 March 2015 Pediatrics 139:3 March AAP Marijuana Policy Statement: Recommendation #1* Adolescents Are Vulnerable Given the data supporting the negative health and brain development effects of marijuana in children and adolescents, ages 0 through 21 years, the AAP is opposed to marijuana use in this population. *There are 10 total recommendations Early substance use = high risk addiction Adolescent immaturity during critical development period = vulnerability Impulsiveness and excitement seeking Difficulty delaying gratification Poor executive function and inhibitory control Image Source: PNAS 101: , 2004 National Academy of Scinces, U.S.A

3 As Brain develops, there is NO safe age for marijuana THC Receptors Toddler: Cerebellum Balance, Walking, Coordination, sensory processing Preschool: Amygdala Emotional Regulation School Age: Nucleus Accumbens Motivation, Achievement Adolescent: Prefrontal Cortex Planning, organizing, Impulse Control THC Receptors in Functional Areas of Brain Vulnerability in youth Pooled longitudinal studies. N =2537 to N=3765. Silens et al. Lancet Psychiatry, 1,: , 2014S 15 Conditional risk of use disorder in adolescents as high as 40% Daily use of MJ <age 17 associated with substantially increased risk of: Persistent MJ Dependence (OR=18) High school drop out (OR=3) Use of other drugs (OR=8) Suicide attempts (OR=7) 16 Clinical consequences of cannabis MJ use associated with depressive symptoms Significant Evidence Base Documenting Harms 18 The Children's Mercy Hospital, /14 3

4 Marijuana causes damage to corpus callosum Increased risk of psychosis Cannabis and psychosis Prospective exposure cohort study 10 yr prospective cohort of 1923 German youth (14-24 at baseline) Examination of change over 3 time points OR = 2.2 Kuepper et al British Med J OR = 1.9 Cannabis and cognitive impairment IQ measured age 13, 38; N=1037 MJ use measured age 18, 21, 26, 32, 38 IQ decline associated with regular use and dependence, dose response related to persistence None Some use 1 wave 2 waves 3+ waves Regular use Dependence No difference with controls for education, recent use, other substances, schizophrenia Meier et al. PNAS Adolescent onset worse, -8 points for 3+waves 22 Measurable IQ deficits in Users MJ Use Disorders Addiction spectrum problems 23 The Children's Mercy Hospital, /14 4

5 Functional problems in youth School failure and academic problems Early pregnancy Criminal behavior Vocational problems Progression to other substance use Psychiatric symptoms 25 AAP Opposes Marijuana Use (In anyone with a brain) Known Harms outweigh any known benefit 26 Recommendation #2 The AAP opposes medical marijuana outside the regulatory process of the US Food and Drug Administration. Notwithstanding this opposition to use, the AAP recognizes that marijuana may currently be an option for cannabinoid administration for children with life-limiting or severely debilitating conditions and for whom current therapies are inadequate. 27 Evidence for Recommendation #2 AAP-The current system of medical marijuana does not routinely include standardization of purity, dose, effects, side effects, or indications. It is outside the FDA. California Society Addiction Medicine-2010-Violates core principals of medicine 1) administering any medication via drawing hot smoke into the lungs is inherently unhealthy 2) although use of vaporizers, sprays, and tinctures solves problems inherent in smoking, treatment of illness without standardized dose or content of the medication remain a safety issue 3) if the public wants to legalize marijuana, there is no reason to force physicians to be gatekeepers in a manner that enables liberal access to marijuana but generally fails to uphold accepted standards of practice for recommending a potentially addicting medication/drug. 28 Bottom Line Definitions: Cannabinoids Cannabinoids are biologically active molecules that have a number of regulatory functions in the human body. Humans produce endocannabinoids Anandamide (N-arachidonoylethanolamine) 2-AG (2-arachidonoylglycerol) Humans have endocannabinoid receptors known as CB1 and CB2. CB1 is found in the brain and nervous system CB2 is found in certain immune system cells

6 Endocannabinoid Actions Endocannabinoid Actions The neuron s volume control dials down neuron activity when too strong Endocannabinoids travel from postsynaptic to pre-synaptic CB receptors to decrease presynaptic release of neurotransmitters across the synapse Cannabinoids: Biology Definitions: Marijuana Currently cannabinoid biology is incompletely understood. Research has identified areas of therapeutic potential for these molecules, including analgesia in chronic neuropathic pain appetite stimulation in debilitating disease spasticity in multiple sclerosis cachexia The cannabis plant, which contains a large number of biologically active cannabinoids. There are numerous species and subspecies of cannabis; Cannabis sativa and indica are the most commonly utilized Cannabis sativa typically causes an alert and energetic high, Cannabis indica causes a relaxed and lethargic high. Both species have been hybridized repeatedly. A typical medical marijuana plant will have varying amounts of both sativa and indica Definitions: THC Medical Marijuana THC: Tetrahydrocannabinol, also know as delta-9- tetrahydrocannibinol, the primary psychoactive cannabinoid in the marijuana plant. The amount of THC in a given plant varies widely THC has 2-4x the binding affinity to CB receptors as compared to endocannabinoids 35 Regardless of the species, the main active ingredients currently utilized for the desired medicinal effects are delta-9 tetra-hydro-cannabinol (THC), a psychoactive cannabinoid cannabidiol (CBD), a non-psychoactive cannabinoid. Buds and leaves of the plant are smoked, vaporized, and/or cooked (and drunk or eaten) for their effects. Percentage of THC or CBD can be assessed and manipulated. 36 6

7 Pharmaceutical Cannabinoids Two marijuana-based medications are available in the United States and approved by the Food and Drug Administration. Dronabinol (marinol) Schedule III oral medication approved for the treatment of AIDS-related wasting, and chemotherapy-induced nausea and vomiting. capsule taken whole orally Onset of symptom relief longer than smoked marijuana. Nabilone (cesamet) oral capsule with properties similar to dronabinol Schedule II medication due to a possible higher abuse potential Pharmaceutical Cannabinoids THC Receptors Nabiximols (Sativex) cannabinoid-based oral-mucosal spray. approved in Canada, United Kingdom, Spain, New Zealand for relief of neuropathic pain / spasticity in multiple sclerosis. approved in Canada as an adjunctive analgesic treatment in patients with cancer pain. undergoing late stage clinical testing in the United States similar indications. contains equal amounts of THC and CBD. rapidly absorbed and easy to titrate, which may make it a more effective and easy-to-use medication that dronabinol. Onset of desired effects typically occurs within minutes Recommendation #3 The AAP opposes legalization of marijuana because of the potential harms to children and adolescents. The AAP supports studying the effects of recent laws legalizing the use of marijuana to better understand the impact and define best policies to reduce adolescent marijuana use. Evidence for Recommendation #3 Based on the past history and current behavior of the tobacco industry, with profit motive being primary, the likelihood of adolescents being targeted by the developing marijuana industry is likely, unless truly strict and enforceable rules and regulations are in place

8 Status of Adolescents and Marijuana Based on current prevalence of marijuana use among adolescents, the added market pressures and access issues that are likely to occur with further legalization may be problematic Adolescent Substance Use 8th 10th 12th 10% 22% 35% 12% 25% 35% 8th 10th 12th 8th 10th 12th * * ** ** 10% 4% 1%.5% 14% 6% 3%.8% 16% 11% 4%.6% *Used in the last 30 days **Used in the last year Monitoring the Future Survey Percent of US 12th Graders Reporting Using Substances in Lifetime, Percent Who Use Daily Monitoring the Future Survey 2015 Monitoring the Future Survey Legalization Status US Enthusiasm for Marijuana US

9 Perceived Risk of Harm and Marijuana Use - US 12th Graders: Use and Perceived Risk Monitoring the Future Survey Marijuana acceptance has outpaced scientific support Summary Increasing acceptance among adults of the potential medical benefits of marijuana, despite limited evidence and known harms The majority of Americans live in a state where marijuana is legal for adults Adolescent marijuana use is increasing Pediatricians are likely to be asked questions about indications for medical marijuana for adolescents Pediatricians may be asked to prescribe (recommend) marijuana by their adolescent patients, or by parents for their children who are not responding to usual medications for a variety of chronic conditions. 51 1) Adolescents are uniquely vulnerable to the neurotoxic effects of marijuana 2) Marijuana is legal for medical or recreational purposes in MOST of the United States with an associated presumption of low risk of harm 3) Adolescents should NOT use marijuana 52 Practice Change Resources As a result of attending this session, I encourage you to incorporate these changes: Recognize adolescence as uniquely vulnerable to the neurotoxic effects of marijuana Clearly and unequivocally recommend to your pediatric and adolescent patients to NEVER use marijuana, or to stop current use 53 American Academy of Pediatrics: Substance Abuse and Mental Health Services Administration: National Institute on Drug Abuse: Office of National Drug Control Policy: Smart Approaches to Marijuana: Marijuana Policy Project: Drug Policy Alliance:

9/28/2015. Support. R01CA A1 Intervening with smoking parents of inpatients to reduce

9/28/2015. Support. R01CA A1 Intervening with smoking parents of inpatients to reduce Medical marijuana and the impact of marijuana policy on children Karen M. Wilson, MD, MPH, FAAP Associate Professor of Pediatrics Section Head, Pediatric Hospital Medicine University of Colorado School

More information

MARIJUANA & THE EFFECTS ON THE BRAIN

MARIJUANA & THE EFFECTS ON THE BRAIN MARIJUANA & THE EFFECTS ON THE BRAIN Sheryl Ryan, MD Professor of Pediatrics Chief, Division of Adolescent Medicine, Penn State Health Hershey Medical Center DISCLOSURES I have no relevant financial relationships

More information

Medical Cannabis. Danial Schecter, MD, CCFP. Vocational Rehabilitation Association November 7th, Executive Director Cannabinoid Medical Clinic

Medical 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 information

Research on Cannabis and PD: Is there any evidence?

Research 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 information

ADVANCED CLINICAL CANNABINOID PROVIDER EXAM ACCP

ADVANCED 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 information

Medicinal cannabis. What is medicinal cannabis? What are cannabinoids? The endocannabinoid system

Medicinal 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 information

Medical Cannabis MATT WEBSTER DO, MS

Medical 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 information

Medical Marijuana. 1. is a plant species, variety known as hemp. 3. Tetrahydrocannabinol is an aromatic with low water solubility.

Medical 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 information

Cannabis. Member of the Cannabaceae family of flowering plants (along with hops) Cannabis sativa (v. sativa, indica, afghanica, ruderalis)

Cannabis. 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 information

POLICY NUMBER: POL 153

POLICY NUMBER: POL 153 Chapter: CLAIMS Subject: MEDICAL CANNABIS Effective Date: October 25, 2018 Last Update: October 25, 2018 PURPOSE STATEMENT The purpose of this policy is to explain how the Workers Compensation Board determines

More information

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. 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 information

Medical Marijuana: The Move to Schedule II

Medical Marijuana: The Move to Schedule II Medical Marijuana: The Move to Schedule II David Deitz, MD, PhD David Deitz & Associates Today s discussion Does medical marijuana actually treat anything? What are the workplace issues? What are the interactions

More information

50 Shades of Developing Gray Matter: Adolescents and Marijuana

50 Shades of Developing Gray Matter: Adolescents and Marijuana 50 Shades of Developing Gray Matter: Adolescents and Marijuana Ken Winters, Ph.D. Department of Psychiatry University of Minnesota winte001@umn.edu MNCAMH Webinar October 10, 2014 www.psychiatry.umn.edu/research/casar/home.html

More information

Use of Cannabinoids in Medical Practice

Use 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 information

Changing the Drug Enforcement Administration (DEA) Schedule of Tetrahydrocannabinol (THC), Cannabidiol and Combinations to Promote Research

Changing the Drug Enforcement Administration (DEA) Schedule of Tetrahydrocannabinol (THC), Cannabidiol and Combinations to Promote Research 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 TITLE: Changing the Drug Enforcement Administration (DEA) Schedule of Tetrahydrocannabinol

More information

A look at Marijuana in 2014

A 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 information

Marijuana. Module 4 ALLIED TRADES ASSISTANCE PROGRAM PREVENTATIVE EDUCATION: SUBSTANCE USE DISORDER

Marijuana. Module 4 ALLIED TRADES ASSISTANCE PROGRAM PREVENTATIVE EDUCATION: SUBSTANCE USE DISORDER Marijuana Module 4 ALLIED TRADES ASSISTANCE PROGRAM PREVENTATIVE EDUCATION: SUBSTANCE USE DISORDER Marijuana Pot Grass Weed Reefer Herb Mary Jane MJ Whatever you call it, marijuana is the nations most

More information

Medicinal Marijuana: The Canadian Journey

Medicinal 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 information

Research: Medical Cannabis

Research: Medical Cannabis Research: Medical Cannabis Background The hemp plant Cannabis sativa (cannabis) is commonly known as marijuana and can be used as a therapy to alleviate symptoms such as pain and fatigue caused by chronic

More information

9/13/2017. Marijuana and the Brain Matthew Wong, MD Assistant Professor, Department of Neurology, Epilepsy Section. Disclosures.

9/13/2017. 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 information

Cannabis Use: Scope of the Issue

Cannabis Use: Scope of the Issue Three Areas of Focus How Changing Cannabis Policy Will Affect Your Practice Kevin P. Hill, MD, MHS Director, McLean Hospital Division of Alcohol and Drug Abuse Belmont, MA Assistant Professor of Psychiatry,

More information

Dr. Meldon Kahan. Women s College Hospital. with PIA LAW

Dr. Meldon Kahan. Women s College Hospital. with PIA LAW with PIA LAW and Toronto ABI Network Dr. Meldon Kahan Women s College Hospital Dr. Meldon Kahan is an Associate Professor in the Department of Family Medicine at University of Toronto, and Medical Director

More information

4/15/2019. US States with Marijuana Laws in Have ACOG and SMFM taken notice? THE EFFECTS OF MARIJUANA USE ON PREGNANCY AND LACTATION

4/15/2019. US States with Marijuana Laws in Have ACOG and SMFM taken notice? THE EFFECTS OF MARIJUANA USE ON PREGNANCY AND LACTATION THE EFFECTS OF MARIJUANA USE ON PREGNANCY AND LACTATION Susan R Davidson, MD Maternal Fetal Medicine Department of Ob/Gyn St. Mary s Hospital Madison, WI SSM Health I HAVE NO FINANCIAL DISCLOSURES TO REPORT

More information

Marijuana and the Chronic Non-Cancer Pain Patient

Marijuana and the Chronic Non-Cancer Pain Patient Marijuana and the Chronic Non-Cancer Pain Patient Kevin P. Hill, M.D., M.H.S. Pain 101: Provider Workshop 9/23/16 McLean Hospital Division of Alcohol and Drug Abuse khill@mclean.harvard.edu DrKevinHill.com,

More information

Global Legal Cannabis Market: Size, Trends & Forecasts ( ) September 2018

Global Legal Cannabis Market: Size, Trends & Forecasts ( ) September 2018 Global Legal Cannabis Market: Size, Trends & Forecasts (2018-2022) September 2018 Global Legal Cannabis Market: Coverage Executive Summary and Scope Introduction/Market Overview Global Market Analysis

More information

INTRODUCTION WHAT IS MARIJUANA 2/28/2018

INTRODUCTION WHAT IS MARIJUANA 2/28/2018 INTRODUCTION AT THE END OF THE SESSION, YOU WILL ASSESS THE USE AND IMPACT (SIDE EFFECTS) OF MARIJUANA ON PATIENTS EXPLORE CANNABIS THERAPY LEGALITY AND PRACTICALITY POSSESS STRATEGIES TO PROVIDE PSYCHO-EDUCATIONAL

More information

Medical Marijuana. Speaker Disclosure Requirements. Share with a Partner 4/10/2015

Medical 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 information

Medical Marijuana. Navigating Medical Marijuana in Workers Compensation

Medical 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 information

The 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 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 information

MEDICAL MARIJUANA: WHAT S THE EVIDENCE?

MEDICAL 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 information

Act 16 and Medical Cannabis in Pennsylvania

Act 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 information

Federal Law: Marijuana

Federal 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 information

CDHA 2016 Fall Symposium. Speaker Handout Files. For registered attendees only

CDHA 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 information

Medical vs Recreational Use of Cannabis. 11 th December 2017

Medical 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 information

Cannabidiol as a potential treatment for anxiety disorders. Esther Blessing, MD PhD

Cannabidiol as a potential treatment for anxiety disorders. Esther Blessing, MD PhD Cannabidiol as a potential treatment for anxiety disorders Esther Blessing, MD PhD Overview History and of cannabidiol (CBD) and cannabis Safety and tolerability of CBD CBD pharmacology Clinical need for

More information

Marijuana as Medicine

Marijuana as Medicine Marijuana as Medicine What is medical marijuana? The term medical marijuana refers to using the whole, unprocessed marijuana plant or its basic extracts to treat symptoms of illness and other conditions.

More information

CANNABIS LEGALIZATION: SUPPORT MATERIAL FOR MANITOBA PHYSICIANS

CANNABIS LEGALIZATION: SUPPORT MATERIAL FOR MANITOBA PHYSICIANS CANNABIS LEGALIZATION: SUPPORT MATERIAL FOR MANITOBA PHYSICIANS 1. GENERAL INFORMATION Cannabis 101 What is cannabis? Cannabis is a product derived from the Cannabis sativa plant. Cannabis contains hundreds

More information

The Shifting Federal Regulation of Cannabis Products

The 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 information

Medical Marijuana Myths and Realities

Medical Marijuana Myths and Realities Medical Marijuana Myths and Realities Herbert D. Kleber, M.D. Professor of Psychiatry Director, Division on Substance Abuse Columbia University/NYSPI October 8, 2013 THS 2013 Biarritz Introduction Marijuana

More information

Effects of Marijuana On Brain, Body & Behavior. Nora D. Volkow, MD Director

Effects of Marijuana On Brain, Body & Behavior. Nora D. Volkow, MD Director Effects of Marijuana On Brain, Body & Behavior Nora D. Volkow, MD Director Marijuana is the Most Commonly Used Illicit Drug In the U.S. Over 111 million Americans have tried it at least once An estimated

More information

Durban 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 information

PREVENTING MARIJUANA USE AMONG YOUTH & YOUNG ADULTS

PREVENTING MARIJUANA USE AMONG YOUTH & YOUNG ADULTS PREVENTING MARIJUANA USE AMONG YOUTH & YOUNG ADULTS PREVENTING MARIJUANA USE AMONG YOUTH & YOUNG ADULTS 2 The Drug Enforcement Administration s (DEA) primary mission and responsibility is to enforce the

More information

The Return of Medicinal Cannabis

The 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 information

James 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 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 information

Opioid Review and MAT Clinic Marijuana

Opioid Review and MAT Clinic Marijuana 1 Opioid Review and MAT Clinic Marijuana April 18, 2018 Learning Objectives Describe the societal impact of marijuana Explain the long-term ramifications of early initiation of marijuana use 2 Disclosure

More information

Weeding Through the Science of Cannabis. Ryan Vandrey, PhD

Weeding 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 information

CBD and Your Health.

CBD 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 information

Talking Points (2018) Talal Khan MD Mariah DeYoung LMSW CAADC

Talking Points (2018) Talal Khan MD Mariah DeYoung LMSW CAADC Talking Points (2018) Talal Khan MD Mariah DeYoung LMSW CAADC Cannabis - Key Chemicals Marijuana comes from the plant Cannabis sativa. It has more than 500 chemicals. Many Psychoactive (mind-altering).

More information

Hot Topics in Healthcare Osher Lifelong Learning Institute University of California at San Diego. October 17, 2017

Hot Topics in Healthcare Osher Lifelong Learning Institute University of California at San Diego. October 17, 2017 Hot Topics in Healthcare Osher Lifelong Learning Institute University of California at San Diego October 17, 2017 Format Notes Speakers present pro and con perspectives Goal is to inform..not have one

More information

Cannabinoids (CB): Outline. CB: Epidemiology. CB: Categorization. CB: Pharmacodynamics. Part #1: Cannabinoid (CB) Primer.

Cannabinoids (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 information

Cannabis and Cannabinoids: Review of Existing and Potential Therapeutic Applications in Oncology

Cannabis and Cannabinoids: Review of Existing and Potential Therapeutic Applications in Oncology Cannabis and Cannabinoids: Review of Existing and Potential Therapeutic Applications in Oncology 2 Pamela C. Cartright, MAE, RT (R)(T) Assistant Professor and Program Director Radiation Therapy Program

More information

Steven G. Kinsey, PhD Associate Professor, Department of Psychology West Virginia University

Steven 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 information

Cannabis and the Endocannabinoid System

Cannabis 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 information

The Scientific Side of Medical Marijuana

The 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 information

Final parade Handover

Final parade Handover 2019 Leaders Final parade Handover Our final parade for the year saw the 2018 student executive hand over to the 2019 student leaders. It was also an opportunity for our Year 12 students to say farewell

More information

Medical Marijuana A Primer for Pharmacists

Medical 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 information

Cannabinoids: access and symptom management in cancer

Cannabinoids: 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 information

Coalition for Medical Marijuana Research & Education

Coalition for Medical Marijuana Research & Education Coalition for Medical Marijuana Research & Education Nagi Kumar, Ph.D., R.D., FADA Professor, Oncologic Sciences Director, Cancer Chemoprevention Executive Director, Coalition for Medical Marijuana Research

More information

WELCOME TO THEORY WELLNESS PATIENTS. Committed to wellbeing through cannabis.

WELCOME TO THEORY WELLNESS PATIENTS. Committed to wellbeing through cannabis. WELCOME TO THEORY WELLNESS PATIENTS Committed to wellbeing through cannabis. Focused on small batches and unique genetics, we strive to develop a premium range of strains and products for consumers in

More information

WELCOME TO THEORY WELLNESS CUSTOMERS. Committed to wellbeing through cannabis.

WELCOME TO THEORY WELLNESS CUSTOMERS. Committed to wellbeing through cannabis. WELCOME TO THEORY WELLNESS CUSTOMERS Committed to wellbeing through cannabis. Focused on small batches and unique genetics, we strive to develop a premium range of strains and products for consumers in

More information

Medical Marijuana. Medicalization of Marijuana. Objectives. Disclosure. Objectives. US FDA Drug Approval Process

Medical Marijuana. Medicalization of Marijuana. Objectives. Disclosure. Objectives. US FDA Drug Approval Process Objectives Medicalization of Marijuana Joe Spillane Pharm.D., DABAT This is not about recreational marijuana. This is not about the Florida Governor election. This is not about politics at all.. This is

More information

Investigational Pharmacy Cannabidiol treatment in Epilepsy

Investigational Pharmacy Cannabidiol treatment in Epilepsy Jon Beck BS Pharm D Coordinator Investigational Pharmacy Disclosure I have no relevant financial relationships with a Commercial Provider Nebraska Medicine Omaha, NE Investigational Pharmacy Cannabidiol

More information

Effects of Marijuana On Brain, Body & Behavior. Nora D. Volkow, M.D. Director

Effects of Marijuana On Brain, Body & Behavior. Nora D. Volkow, M.D. Director Effects of Marijuana On Brain, Body & Behavior Nora D. Volkow, M.D. Director Marijuana is the Most Commonly Used Illicit Drug In the U.S. Over 111 million Americans have tried it at least once An estimated

More information

Medical 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 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 information

History Of Medical Cannabis

History 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 information

CANNABIS FOR THE RHEUMATOLOGIST

CANNABIS 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 information

Use of Medical Marijuana in Cancer Treatment & Care

Use 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 information

Cannabinoids and Mental Health

Cannabinoids and Mental Health Cannabinoids and Mental Health https://upload.wikimedia.org/wikipedia/commons Karen M. Lounsbury, PhD Professor of Pharmacology 802-656-3231, Karen.lounsbury@uvm.edu Objectives Describe the underlying

More information

Pennsylvania House of Representatives. Joint Health and Judiciary Committee Hearing. Medical Cannabis - Health Care Forum

Pennsylvania House of Representatives. Joint Health and Judiciary Committee Hearing. Medical Cannabis - Health Care Forum Pennsylvania House of Representatives Joint Health and Judiciary Committee Hearing Medical Cannabis - Health Care Forum Tuesday, March 24, 2015 Philadelphia, Pennsylvania Testimony offered by: David J.

More information

Acknowledgements: What it is What it s not. Cannabis Evidence Series. Evidence-informed decision-making

Acknowledgements: 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 information

Medical Marihuana for Patients in the Lymphoma Setting. Speakers: Ruth Turner, RN, Con Rob Laister, PhD

Medical Marihuana for Patients in the Lymphoma Setting. Speakers: Ruth Turner, RN, Con Rob Laister, PhD Medical Marihuana for Patients in the Lymphoma Setting Speakers: Ruth Turner, RN, Con Rob Laister, PhD Medical Marihuana for Patients in the Lymhoma Setting Disclosure: No endorsement or promotion of marihuana

More information

Medical Marijuana Consent Form

Medical 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 information

Outcome. Educating Ohio Providers On The Basics Related To Recommending Medical Marijuana. Connie J. Cerilli, APRN, FNP-C

Outcome. 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 information

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 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 information

Medical Marijuana Update Chris Belletieri, DO

Medical 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 information

Medicinal 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 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 information

MARIJUANA 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 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 information

CANNABIS AND CANNABINOIDS: 2017 REPORT, U.S. NATIONAL ACADEMIES OF SCIENCES, ENGINEERING AND MEDICINE

CANNABIS AND CANNABINOIDS: 2017 REPORT, U.S. NATIONAL ACADEMIES OF SCIENCES, ENGINEERING AND MEDICINE 1 CANNABIS AND CANNABINOIDS: 2017 REPORT, U.S. NATIONAL ACADEMIES OF SCIENCES, ENGINEERING AND MEDICINE The Health Effects of Cannabis and Cannabinoids. The Current State of Evidence and Recommendations

More information

SECTION V: EMPLOYEES POLICY 5375 MEDICAL MARIJUANA, HEMP & CANNABIDIOL (CBD)

SECTION V: EMPLOYEES POLICY 5375 MEDICAL MARIJUANA, HEMP & CANNABIDIOL (CBD) Regardless of a student, employee, parent or any individual s status as a medical marijuana license holder, marijuana is not allowed on the premises of the district or in any school vehicle or in any personal

More information

Clinical Policy Title: Botanical marijuana for medical use

Clinical Policy Title: Botanical marijuana for medical use Clinical Policy Title: Botanical marijuana for medical use Clinical Policy Number: CCP.1132 Effective Date: January 1, 2015 Initial Review Date: August 20, 2014 Most Recent Review Date: October 2, 2018

More information

Doc, will you sign my medical. Fellow in Hematology/Medical Oncology General Internal Medicine Grand Rounds

Doc, will you sign my medical. Fellow in Hematology/Medical Oncology General Internal Medicine Grand Rounds Doc, will you sign my medical marijuana card? Daniel W. Bowles, MD Fellow in Hematology/Medical Oncology General Internal Medicine i Grand Rounds September 21, 2010 Disclosures Skeptical about marijuana

More information

I 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 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 information

Disclosure. Medical Marijuana Updates. Nothing to disclose

Disclosure. Medical Marijuana Updates. Nothing to disclose Medical Marijuana Updates Darren Quarrie, PharmD, CPh Clinical Pharmacist Specialist, Transplant Service Orlando VA Medical Center Disclosure Nothing to disclose 1 Objectives Describe the biology of medical

More information

Cannabis and What we Know. Bonnie Schnittker RN PHN Public Health Nurse October 20, 2017

Cannabis and What we Know. Bonnie Schnittker RN PHN Public Health Nurse October 20, 2017 Cannabis and What we Know Bonnie Schnittker RN PHN Public Health Nurse October 20, 2017 We All Have a Role to Play! Objectives What is Cannabis? What do we know about the health effects? Legalization:

More information

Medical Cannabis and OMT

Medical Cannabis and OMT Medical Cannabis and OMT David R. Beatty, DO Professor of Osteopathic Principles and Practice, WVSOM November 4, 2017 Objectives At the completion of this presentation the attendee should be able to: 1.

More information

MEDICAL CANNABIS IN MINNESOTA

MEDICAL 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 information

Marijuana. DATE: February 21, 2017 PRESENTED BY: Melissa Weimer, DO, Assistant Professor of Medicine

Marijuana. DATE: February 21, 2017 PRESENTED BY: Melissa Weimer, DO, Assistant Professor of Medicine Marijuana DATE: February 21, 2017 PRESENTED BY: Melissa Weimer, DO, Assistant Professor of Medicine Objectives Describe marijuana laws in the state of Oregon and the nation List evidence available for

More information

marijuana and the teen brain MARY ET BOYLE, PH. D. DEPARTMENT OF COGNITIVE SCIENCE UCSD

marijuana and the teen brain MARY ET BOYLE, PH. D. DEPARTMENT OF COGNITIVE SCIENCE UCSD marijuana and the teen brain MARY ET BOYLE, PH. D. DEPARTMENT OF COGNITIVE SCIENCE UCSD in this talk what is marijuana? the brain on marijuana is the teen brain special? current research what is marijuana?

More information

Life s brighter under the sun MEDICAL CANNABIS AND GROUP BENEFITS PLAN COVERAGE

Life s brighter under the sun MEDICAL CANNABIS AND GROUP BENEFITS PLAN COVERAGE Life s brighter under the sun MEDICAL CANNABIS AND GROUP BENEFITS PLAN COVERAGE With the legalization of recreational cannabis upon us in Canada, our conversation about cannabis use is changing. It s not

More information

420 ADVISORY MANAGEMENT

420 ADVISORY MANAGEMENT THE CANNABIS ACT: WHAT DOES IT MEAN FOR CANADIANS? 420 CLINIC, LTD. OBJECTIVES At the end of the session, you will be able to: 1) Understand the ramifications of recreational cannabis legalization 2) Understand

More information

Objectives. 1. Review controversy 2. Pathophysiology 3. Indications for Use 4. Adverse Effects 5. How Patients Access

Objectives. 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 information

Medical Cannabinoids for the Management of Chronic Noncancer Pain

Medical 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 information

Cannabis use carries significant health risks, especially for people who use it frequently and or/begin to use it at an early age.

Cannabis use carries significant health risks, especially for people who use it frequently and or/begin to use it at an early age. Background: The Centre for Addiction and Mental Health (CAMH) released recommendations for the Legalization of Marijuana (with restrictions and regulations) on October 8, 2014. Addiction Services of Thames

More information

marijuana and the teen brain MARY ET BOYLE, PH. D. DEPARTMENT OF COGNITIVE SCIENCE UCSD

marijuana and the teen brain MARY ET BOYLE, PH. D. DEPARTMENT OF COGNITIVE SCIENCE UCSD marijuana and the teen brain MARY ET BOYLE, PH. D. DEPARTMENT OF COGNITIVE SCIENCE UCSD in this talk what is marijuana? the brain on marijuana is the teen brain special? current research what is marijuana?

More information

Minnesota, Marijuana and Myths

Minnesota, Marijuana and Myths 3M: Minnesota, Marijuana and Myths Ken Winters, Ph.D. Senior Scientist Oregon Research Institute & Adjunct Faculty, Dept. of Psychology University of Minnesota winte001@umn.edu April 26, 2018 Curious How

More information

Marijuana and Health

Marijuana and Health Marijuana and Health MNCAMH June Webinar June 9, 2017 Ken Winters, Ph.D. Adjunct Faculty, Dept. of Psychology University of Minnesota & Senior Scientist, Oregon Research Institute winte001@umn.edu Web-Based

More information

Clinical Policy Title: Botanical marijuana for medical use

Clinical Policy Title: Botanical marijuana for medical use Clinical Policy Title: Botanical marijuana for medical use Clinical Policy Number: 00.02.10 Effective Date: January 1, 2015 Initial Review Date: August 20, 2014 Most Recent Review Date: October 19, 2017

More information

MONITORING THE FUTURE 2013 TEEN DRUG USE

MONITORING THE FUTURE 2013 TEEN DRUG USE COCAINE PRESCRIPTIONS POT BOOZE VICODIN CRACK ALCOHOL INHALANTS CIGARETTES RITALIN STEROIDS hookahs K2/Spice BATHSALTS CigaretteS MONITORING THE FUTURE 2013 TEEN DRUG USE OxyContin cigarettes SEDATIVES

More information

Cell body, axon, dendrite, synapse

Cell body, axon, dendrite, synapse SOME BASIC NEUROSCIENCE Neurons have specialised extensions 1: Label the parts of a neuron by selecting the correct term from the box below. Cell body, axon, dendrite, synapse 1 dendrite synapse cell body

More information