1 Cannabis and Cannabinoids: Review of Existing and Potential Therapeutic Applications in Oncology
2 2 Pamela C. Cartright, MAE, RT (R)(T) Assistant Professor and Program Director Radiation Therapy Program Armstrong State University Savannah GA
3 3 Objectives: Upon completion of this presentation, the audience will be able to: Trace the historical use of marijuana both commercially and recreationally Describe what is meant by cannabinoid receptors and cannabinoids List the pharmaceutical and non-pharmaceutical forms of cannabinoids Explain the legal and regulatory policies faced by healthcare professionals and by patients regarding the therapeutic use of both pharmaceutical and non-pharmaceutical cannabinoid and cannabis products. Review the evidence for medical uses of marijuana and cannabinoids Review the data that points to the potential for harm vs. general benefits to the body through the use of marijuana. Relate the medical use of marijuana and cannabinoids to effective therapeutic applications in cancer patients
4 4 10,000-year History of Marijuana Use Hemp has been used for centuries (beginning as early as BC) as rope, in the making of textiles in China and Turkestan, and paper Psychotropic properties mentioned in BC
5 5 10,000-year History of Marijuana Use
6 6 10,000-year History of Marijuana Use
7 7 10,000-year History of Marijuana Use
8 8 10,000-year History of Marijuana Use
9 9 10,000-year History of Marijuana Use Canada even has a commercial
10 10 10,000-year History of Marijuana Use 2009: President Obama made steps toward ending the very unsuccessful 20-year "war on drugs" initiated during the Regan administration by stating that individual drug use is really a public health issue, and should be treated as such. The U.S. Justice Department announced that federal prosecutors will no longer pursue medical marijuana users and distributors who comply with state laws.
11 11 10,000-year History of Marijuana Use Oct 2010 Nov 2010 Nov 2012 July 7, 2014 Nov 2014 July 24, 2015
12 12 What is the difference in cannabis and a cannabinoid? Cannabis is can be tall or short The female plant is short, branchier and has a more abundant source of the psychoactive substance tetrahydrocannabinol (THC) Has over 500 natural compounds and cannabinoids make up about 85 of those. Some are psychoactive and some are not
13 13 There is Sativa and There is Indica
14 14 Genetic Production Plants that produce high levels of THC express genes that code for the enzyme THCA synthase. This enzyme converts CBG into THCA, which becomes THC when heated. These plants are typically considered indica. Some plants express genes that code for the enzyme CBDA synthase. This enzyme converts CBG into CBDA, the precursor of CBD, instead. These plants are typically considered sativa.
15 15 What is the difference in cannabis and a cannabinoid? Out of the 85 cannabinoids, two stand out: tetrahydrocannabinol (THC) and cannabidiol (CBD). THC, known for its psychoactive properties, is the reason you feel buzzed after ingesting marijuana. Too much THC can trigger anxiety and paranoia
16 16 What is the difference in cannabis and a cannabinoid? CBD is a non-psychoactive cannabinoid and actually works to calm the high. CBD has numerous medicinal benefits, such as antiinflammatory properties and the ability to protect the neurons from injury or degeneration.
17 17 A little terminology THC: best known cannabinoid; the primary psychoactive compound. CBN: non-psychoactive and is generally attributed with a sedative effect. THCV: commonly believed to be an appetite suppressant.
18 18 A little terminology CBC: Least understood, believed to stimulate bone growth CBVD: May offer an option for the treatment of epilepsy CBD: Most of the medical benefits come from this compound; not psychoactive THCA: Most prominent compound in fresh undried cannabis CBG: Non-psychoactive cannabinoid CBDA: Non-psychoactive cannabinoid believed to have anti-inflammatory properties
19 19 Cannabinoid Receptors Endocannabinoid System (ECS) Cannabinoid receptors are active sites that are found within different parts of the body, each with a unique function that contributes to the balance of an internal environment. Scientific research has indicated there are two types of receptors in this system, the CB1 and the CB2 receptors.
20 20 The Endocannabinoid System
21 21 Pharmaceutical and Non-pharmaceutical forms of cannabinoids
22 22 A little terminology: Drug Classifications An updated and complete list of the schedules is published annually in Title 21 Code of Federal Regulations (C.F.R.) through Schedule 1 drug Schedule 2 drug Schedule 3 drug Schedule 4 drug Schedule 5 drug
23 23 Pharmaceutical Cannabinoids The first two cannabinoid pharmaceuticals are legal in the US Dronabinal (Marinol) Nabilone (Cesamet) Nabiximols (Sativex)
24 24 Dronabinal or delta-9-thc 1985: The FDA approves dronabinol, a synthetic THC, for cancer patients. Used to treat nausea and vomiting caused by chemotherapy in people who have already taken other medications to treat this type of nausea and vomiting without good results. May be habit forming
25 25 Nabilone (Cesamet) Schedule I drug available through RX in the form of a capsule Chemical structure similar to THC Approved for marketing by the FDA in1985 Used for treatment of nausea and vomiting associated with chemotherapy
26 26 Nabiximols (Sativex) Sativex (nabiximols) is a cannabis-based oral spray. It is the first drug made with ingredients extracted from the cannabis plant. Sativex contains an equal 1:1 ratio of THC and CBD. The active ingredients are absorbed through the inner linings of the mouth. As a result, it enters the bloodstream quicker than other oral cannabinoid preparations.
27 27 Non-pharmaceutical Cannabis
28 28 Legalities Both Federal and State Federal law prohibits the possession, selling, or harvesting of marijuana
29 29 Many Supporters of Legalization Cite Health Benefits The most frequently cited reasons for supporting the legalization of marijuana are its medicinal benefits (41%) and the belief that marijuana is no worse than other drugs (36%) with many explicitly mentioning that they think it is no more dangerous than alcohol or cigarettes.
30 30 Recreational Usage Should be Illegal, Medicinal Use OK About one-in-five opponents of legalization (19%) say marijuana is illegal and needs to be policed 11% say it is a gateway to harder drugs and 8% say it is especially harmful to young people. A small share of opponents (7%) say that while the recreational use of marijuana should be illegal, they do not object to legalizing medical marijuana.
31 31 Marijuana Laws on 50 States 4 states- Colorado, Washington, Oregon - and the District of Columbia have passed measures to legalize marijuana use 14 states have decriminalized certain amounts of marijuana 23 states plus the District of Columbia, allow medical marijuana According to this map, Mississippi has decriminalization laws, still prohibited in Alabama and Louisiana
32 32 Insurance In the United States, health insurance companies may not pay for a medical marijuana prescription All expenses incurred fulfilling a medical marijuana prescription will possibly be incurred as out-of-pocket. However, the New Mexico Court of Appeals has ruled that workers' compensation insurance must pay for marijuana prescribed as part of the state's Medical Cannabis Program.
33 33 Where federal and state law clash, federal law always trumps.
34 34 The American Medical Association, the Institute of Medicine, and the American College of Physicians contend that the patchwork of state laws do little to establish clinical standards for marijuana use Have called for reclassification of cannabis as a Schedule II controlled substance
35 35 Comparing the potential for harm vs. general benefits to the body through the use of marijuana Medical use Typically, adverse effects of medical cannabis use are not serious. The amount of cannabis normally used for medicinal purposes is not believed to cause any permanent cognitive impairment in adults Long-term treatment in adolescents should be weighed carefully as they are more susceptible
36 36 Harm vs. Benefit Recreational use Acute effects: Anxiety and panic Impaired attention and memory (while intoxicated) Increased risk of psychotic symptoms Possible increased risk of accidents if driving while intoxicated
37 37 Harm vs. Benefit Recreational use Chronic Decline in IQ Lung Cancer Addiction Psychosis
38 38 The term medical marijuana is ambiguous in that it can refer to 2 of the 3 forms in which cannabinoids occur. These include: Endocannabinoids: (naturally synthesized in the body) Phytocannabinoids (Botanical cannabis) Synthetic cannabinoids (Pharmaceutical)
39 39 Review the evidence for medical uses of Cannabis sativa (botanical cannabis) and cannabinoids: beginning with the 19 th century and Dr. O Shaughnessy
40 40 Traditional Eastern medicine met Western medicine when W. B. O Shaughnessy, an Irish physician working in Calcutta in the 1830s, wrote a paper extolling Indian hemp. Dr. O Shaughnessy s report included an analysis of the known history of medicinal cannabis uses by physicians in India and the Middle East.
41 41 The Institute of Medicine issued a report based on a summary of the peer-reviewed literature addressing the efficacy of therapeutic marijuana use. The 1999 study found at least some benefit for smoked marijuana in : stimulating appetite particularly in AIDS-related wasting syndrome combating chemotherapy-induced nausea and vomiting, severe pain, and some forms of spasticity
42 : Update of Cannabis and Its Medical Use, World Health Organization Neuropathic Pain Nausea and Vomiting Appetite Multiple Sclerosis Glaucoma Post-traumatic stress disorder (PTSD) Epilepsy
43 43 AIDS Wasting, Cachexia and Appetite Enhancement Studies have shown that smoked or ingested cannabis, either as a botanical or a synthetic THC (dronabinol), improves appetite, increases weight, and improves quality of life in HIV/AIDS patients. Seven Randomized Clinical Trials with smoked cannabis or individual cannabinoids of short duration (21-84 days) were identified for the treatment of AIDS in a small number of patients
44 44 Multiple Sclerosis Multiple sclerosis (MS) is an inflammatory, autoimmune, degenerative disease of the central nervous system. It is among the most common causes of non-traumatic neurological disability in young adults of northern European descent. Three Randomized Clinical Trials were identified which used inhaled or vaporized cannabis to treat MS symptoms.
45 45 Multiple Sclerosis A double-blind randomized placebo-controlled study of inhaled cannabis smoke on postural responses was performed in 10 adult patients (five female, five male) with spastic MS and 10 normal volunteers matched for age, sex, and weight. Tracking errors were higher for patients than controls and response speed of the patients was lower, with eyes closed. The conclusion of the study investigators was that cannabis smoking worsens posture and balance in MS patients
46 46 Multiple Sclerosis Placebo-controlled, crossover trial of 37 adults, with 30 completing the trial Authors concluded that smoked cannabis was superior to placebo in spasticity and pain reduction in participants.
47 47 Glaucoma Cannabis lowers blood pressure and may also reduce aqueous humor production via cannabinoid receptor activation, pharmacological actions that temporarily reduce IOP In 2009, the American Glaucoma Society recommended against the use of cannabis because of "its side effects and short duration of action, coupled with a lack of evidence that its use alters the course of glaucoma"
48 48 Post-traumatic stress disorder (PTSD) There are no large scale Randomized Clinical Trials with cannabis to alleviate PTSD symptoms.
49 49 Epilepsy As of 2012, there have been few studies of the anticonvulsive properties of CBD and epileptic disorders. In , Epidiolex, a cannabis-based product developed for experimental treatment of epilepsy, underwent stage 2 trials in the US in 2014.
50 50 Cannabis and the Cancer Patient The U.S. Food and Drug Administration has not approved Cannabis as a treatment for cancer or any other medical condition.
51 51 Relevance of Use for Cancer Patients Neuropathic Pain Nausea and Vomiting Anxiety and Depression Possible Induction of Apoptosis in Tumor Cells
52 52 Possible Induction of Apoptosis in Tumor Cells At present, data show contradictory results. The promise of cannabinoids as anti-tumor agent stems from preclinical research, using either cultured cells derived from human or rodent tumors, or mouse tumor models.
53 53 National Cancer Institute/CAM The National Cancer Institute (NC) under the umbrella of the National Institute of Health, has a section called the Complementary and Alternative Medicine (CAM) Under this section cannabis and cannabinoids are listed.
54 54 National Cancer Institute/CAM Laboratory/Animal/Preclinical studies Neuropathic Pain Nausea and Vomiting Anxiety and Depression Possible Induction of Apoptosis in Tumor Cells
55 55 National Cancer Institute/CAM Laboratory/Animal/Preclinical studies Antitumor Effects In 1996, the National Toxicology Program did a study in mice and rats suggested that cannabinoids may have a protective effect against the development of certain types of tumors. In 2006, another study, delta-9-thc, delta-8-thc, and cannabinol were found to inhibit the growth of Lewis lung adenocarcinoma cells in vitro and in vivo
56 56 National Cancer Institute/CAM Laboratory/Animal/Preclinical studies Antitumor Effects Investigations from 2011 have confirmed that CB1 and CB2 receptors may be potential targets in non-small cell lung carcinoma and breast cancer. Both plant-derived and endogenous cannabinoids have been studied for anti-inflammatory effects.
57 57 National Cancer Institute/CAM Laboratory/Animal/Preclinical studies Antitumor Effects In 2010 and 2011, studies have been done that show the antitumor effect of cannabinoids (i.e., CBD and THC) in preclinical models of breast cancer. A 2012 investigation into the antitumor effects of CBD examined the role of intercellular adhesion molecule-1 (ICAM-1). In 2013: A combined preclinical therapy of cannabinoids and temozolomide against glioma.
58 58 National Cancer Institute/CAM Human/Clinical Studies Cancer Treatment Antiemetic Effect Appetite Stimulation Analgesia Anxiety and Sleep
59 59 National Cancer Institute/CAM Human/Clinical Studies Cannabinoids Cannabis
60 60 National Cancer Institute/CAM Human/Clinical Studies Appetite Stimulation Anorexia, early satiety, weight loss, and cachexia are problems experienced by cancer patients. Such patients are faced not only with the disfigurement associated with wasting but also with an inability to engage in the social interaction of meals.
61 61 National Cancer Institute/CAM Human/Clinical Studies Pain Cancer pain results from inflammation, invasion of bone or other pain-sensitive structures, or nerve injury. When cancer pain is severe and persistent, it is often resistant to treatment with opioids.
62 62 National Cancer Institute/CAM Human/Clinical Studies Anxiety and Sleep No studies specifically addressing these issues
63 63 Where is the Current Research? Reviewing the list of NCI-supported cancer clinical trials for cancer CAM clinical trials, the finding were: Dronabinol: no results Marijuana: no results Nabiximols: no results Nabilone: no results Cannabidiol: no results
64 64 If Cannabis Were Reclassified as a Schedule 2 Drug The Schedule II classification of these pharmaceuticals countenances not only a healthy respect for their addictive potential but also a robust appreciation for their medicinal value
65 65 The Habitual User vs. the Naive User Medical and recreational users differ in how they use the drug. The amount used and goals of ingestion diverge. The fundamental motivation (symptom relief) of the former does not match the goal (getting high) of the latter
66 66 Smoked Cannabis vs. Oral Cannabinoids Some patients prefer smoked cannabis over oral cannabinoids, with rationales that include: Ability to self-titrate smoked cannabis The swallowing of pills is difficult while experiencing emesis Onset of relief is faster with smoking The whole plant ( entourage ) is more effective
67 67 Smoked Cannabis vs. Oral Cannabinoids A significant proportion of older cancer patients with no previous cannabis experience have refused to continue its use because they found the psychoactive effects too unpleasant.
68 68 Summary
69 69 Thank you Pamela C. Cartright, MAE, RT (R)(T) Assistant Professor and Program Director Radiation Therapy Program Armstrong State University Savannah GA
70 70 References Advanced Holistic Health CannLabs MedlinePlus Study: Patients find cannabis more effective than cannabis pharmaceuticals Thomas AA, Wallner LP, Quinn VP, et al.: Association between cannabis use and the risk of bladder cancer: results from the California Men's Health Study. Urology 85 (2): , 2015.
71 71 References THERAPEUTICS AND POLITICS OF MEDICAL MARIJUANA Watson SJ, Benson JA Jr, Joy JE. Marijuana and medicine: assessing the science base: a summary of the 1999 Institute of Medicine report. Arch Gen Psychiatry. 2000;57(6): Update on cannabis and its medical use Marks MA, Chaturvedi AK, Kelsey K, et al.: Association of marijuana smoking with oropharyngeal and oral tongue cancers: pooled analysis from the INHANCE consortium. Cancer Epidemiol Biomarkers Prev 23 (1): , 2014.
72 72 References Volkow ND, Baler RD, Compton WM, Weiss SR (2014). "Adverse health effects of marijuana use". N. Engl. J. Med. 370 (23): doi: /NEJMra PMID Agurell S, Halldin M, Lindgren JE, et al.: Pharmacokinetics and metabolism of delta 1-tetrahydrocannabinol and other cannabinoids with emphasis on man. Pharmacol Rev 38 (1): 21-43, Mehra R, Moore BA, Crothers K, et al.: The association between marijuana smoking and lung cancer: a systematic review. Arch Intern Med 166 (13): , 2006.
73 73 References Sutton IR, Daeninck P: Cannabinoids in the management of intractable chemotherapy-induced nausea and vomiting and cancer-related pain. J Support Oncol 4 (10): 531-5, 2006 Nov-Dec. Duran M, Pérez E, Abanades S, et al.: Preliminary efficacy and safety of an oromucosal standardized cannabis extract in chemotherapy-induced nausea and vomiting. Br J Clin Pharmacol 70 (5): , Johnson JR, Burnell-Nugent M, Lossignol D, et al.: Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain. J Pain Symptom Manage 39 (2): , Lynch ME, Cesar-Rittenberg P, Hohmann AG: A double-blind, placebo-controlled, crossover pilot trial with extension using an oral mucosal cannabinoid extract for treatment of chemotherapy-induced neuropathic pain. J Pain Symptom Manage 47 (1): , 2014.
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
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
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
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
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
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
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
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
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
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:
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
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.
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
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
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
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
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
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
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
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
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
Medical Marijuana Gina C. Guzman, MD, DBIM, FALU, FLMI Vice President & Chief Medical Director ACSW/SEAC Annual Meeting Munich Re US (Life) 17 Nov 2016 Learning Objectives 1. Provide an introduction to
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
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.
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
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
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
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
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
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
The Facts Cannabis, commonly known as marijuana and by numerous other names, is a preparation of the cannabis plant intended for use as a psychoactive drug and now as medicine. Marijuana also refers to
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
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
History of Medical Cannabis in Nursing Kristen Luttenberger RN, MSN, CCRN, APNc http://marijuanapolitics.com/wp-content/uploads/2016/07/caduceus-lg.jpg https://images-na.ssl-imagesamazon.com/images/i/41gtt5pb4el._sx314_bo1,204,203,200_.jpg
Cannabis in the treatment of Autism: Are we ready? Deb Karhson, PhD and Lawrence Fung, MD, PhD Cannabis Anecdotal Data: Comparing Epilepsy and Autism+ Science of Cannabinoids: Endocannabinoid System Receptor
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
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
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
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
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
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
CBD Oil: Anxiety Aid & Much More This often misunderstood hemp extract may be a health miracle for many. LISA TURNER NOV 1, 2017 betternutrition.com You ve probably heard of and wondered about CBD (cannabidiol),
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
The Cannabis model in Canada and the USA Dr Mark A Ware MD MRCP MSc McGill University Montreal, Quebec, Canada Outline Canada Cannabinoid medicines Existing regulatory framework Proposed new regulations
(THC) Delta9-tetrahydrocannabinol: Most prominent compound found in the cannabis plant found in the 1960 s. THC binds to the CB1 and CB2 receptors causing a change in the function of the cell it is binding.
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
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
THE COMPLETE CBD GUIDE WHAT IS CBD (CANNABIDIOL)? 2 WHERE DOES CBD COME FROM? 3 HOW DOES CBD WORK IN THE BODY? 4 HOW MUCH CBD DO I TAKE? 5-6 CBD OIL VS. HEMP OIL 7 CBD NOT THC 8 THE BENEFITS OF CBD 9 PETS
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)
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
Weeding out the myths on Medical Cannabis Presented by A/Prof David Allsop Lambert Initiative for Cannabinoid Therapeutics University of Sydney For Walk on the Wild Side 2016: Superstition or Evidence?
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
The Scientific Side of Medical Marijuana Ken Mackie, MD Indiana University Bloomington, IN December 3, 2009 firstname.lastname@example.org Financial disclosures NIH (NIDA) - research grants Alzheimer s Association
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
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
USING ALTERNATIVE MEDICATION: MEDICAL CANNABIS (MARIJUANA)--BENEFITS AND HARMFUL EFFECTS JENNIFER KAPUR, PHARM.D. MARCH 1, 2016 OBJECTIVES Compare and contrast federal law and state laws regarding marijuana
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.
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
OXZGEN FAQ s What is the Endocannabinoid System? Discovered only a few decades ago, the endocannabinoid system (ECS) is one of the most important physiological systems in our body. It consists of a group
Budding Therapies: Medical Cannabis and its Uses MARIAH CADAVOS, PHARMD & VIVIAN NGUYEN, PHARMD PGY1 PHARMACY PRACTICE RESIDENTS FEBRUARY 10, 2019 1 Disclosures & Disclaimer Both presenters have nothing
VIRTUAL LECTURES THE ROLL OF MEDICAL CANNABIS: IS IT TIME TO BURN ONE DOWN? MFMER Virtual Lectures Planning Committee Disclosure Summary As a provider accredited by ACCME, College of Medicine, Mayo Clinic
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 email@example.com DrKevinHill.com,
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
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
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
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
CBD USER GUIDE CUREDNUTRITION.COM CBD INFUSED PRODUCTS MADE FROM COLORADO-GROWN ORGANIC HEMP table of contents All about CBD What are Cannabinoids What is CBD? How is CBD different from THC? The Endocannabinoid
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
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
Marijuana Cannabinoid Reception in the Brain Levi van Tol 2/16/2015 Cellular Neuroscience van Tol 1 Books, movies, songs, politics, schools, and just about every corner we turn to, marijuana is a hot topic
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
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
Cannabis 101 Safe, Versatile & Effective Medicine Cannabis is a treasure trove of healing. Dr. Raphael Mechoulam, the father of cannabis science is an organic chemist and professor of Medical Chemistry,
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).
Does Legality equal Legitimacy? The challenges of fostering safe practice with state legalization of marijuana Carla Lomuscio, LCSW, Betsy Long, MSW and Amy Carver, PharmD Disclosures We have no financial
ASAM ISAM AND CANNABIS LEGALIZATION Marijuana and Cannabinoids Science Myth Legalization Decriminalization Possession Sale Medical Marijuana Recreational Marijuana Clinical Issues Policy and Regulatory
Slide 1 Is Marijuana Medicine? Perspectives, Potentials, & Problems Allan Barger, MSW PRI Research Analyst www.primeforlife.org Slide 2 Presentation Goals Define terms Identify and explain the human endocannabinoid