Marijuana. Cannabinoid Reception in the Brain. Levi van Tol 2/16/2015 Cellular Neuroscience

Similar documents
A look at Marijuana in 2014

Medical Cannabis MATT WEBSTER DO, MS

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

History Of Medical Cannabis

ADVANCED CLINICAL CANNABINOID PROVIDER EXAM ACCP

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

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

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

Research on Cannabis and PD: Is there any evidence?

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

CANNABIS LEGALIZATION: SUPPORT MATERIAL FOR MANITOBA PHYSICIANS

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

Cannabidiol, or CBD, Benefits for Pain, Mental Illness & Anxiety

Medical Marijuana: The Move to Schedule II

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

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

CANADIAN CANNABIS CRAZE (AND CONUNDRUM) Dr. Melissa Snider-Adler Chief Medical Review Officer DriverCheck Inc. Addiction Medicine Physician

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

July 15 TH, ANDREW MEDVEDOVSKY, M.D. Board Certified Neurologist & Pain Medicine Specialist Director New Jersey Alternative Medicine

Federal Law: Marijuana

(THC) Delta9-tetrahydrocannabinol:

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

Investigational Pharmacy Cannabidiol treatment in Epilepsy

AGENDA. 9:00 Sign-in and introductions 9:15 Marijuana 10:30 Break 10:45 Opioid Prevention 11:30 Discussion & Wrap-Up

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

Introduction to Medical Cannabis

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

Medical Marijuana Consent Form

The Return of Medicinal Cannabis

Medicinal cannabis use among PLWH in the era of legalization

CBD and Your Health.

Imagine having a son who would punch

The Shifting Federal Regulation of Cannabis Products

The Scientific Side of Medical Marijuana

Cannabis derived terpenes for sale

Recent trends in medical cannabis use in Canada

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

MARIJUANA & THE EFFECTS ON THE BRAIN

Use of Medical Marijuana in Cancer Treatment & Care

POLICY NUMBER: POL 153

Medical Marijuana. Navigating Medical Marijuana in Workers Compensation

Psychoactive drugs Drugs which affect mental processes. Legal but restricted (by prescription only)

WHO Expert Committee on Drug Dependence Pre-Review: Cannabis plant and resin. Expert Peer Review 2

THE COMPLETE CBD GUIDE

Cannabis in the Workplace: Lessons Learned. Sponsored by:

Is the most common illicit drug used in the United States. After a period of decline in the last decade, its use has been increasing among young

Learning Objectives 1/8/2019. Therapeutic Potential of the Marijuana-Derived Cannabinoids THC and CBD. Disclosures. Outline. Take home messages

Weeding Through the Science of Cannabis. Ryan Vandrey, PhD

History of Medical Cannabis in Nursing

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

CBD & Hemp Oil: Cannabis, Cannabinoids And The Benefits Of Medical Marijuana By Aaron Hammond READ ONLINE

The Verde Mountain Fund offers a unique opportunity to gain early entry into one of the fastest growing industries in a generation.

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

INTRODUCTION WHAT IS MARIJUANA 2/28/2018

Lecture: Medical Marijuana Long term effects and interac ons with common medicines Neuropharamacology of the brain with cannabis

CANNABIS AND CANADA S CHILDREN AND YOUTH CPS Podcast

The CBD Truth 5 Surprising Ways CBD Can Change Your Life!

Medical Marijuana A Primer for Pharmacists

The Benefits and Uses of CBD Oil

a very bad combination

Medical Cannabis: A Patient Primer

Marijuana What Physicians Need to Know

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

MOTION FOR A RESOLUTION

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

Medical Cannabis Program. Dr. Maureen Small Co Medical Director Andrea Sundberg Program Coordinator

Outline. Part I: Nick Jikomes The cannabis plant Cannabinoids & psychoactivity. Part II: John Hatch Marijuana and human health

PREVENTING MARIJUANA USE AMONG YOUTH & YOUNG ADULTS

Marijuana Education in a Post-Legalization Society Presented on October 31, 2017

Cannabis in the treatment of Autism:

420 ADVISORY MANAGEMENT

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

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

OXZGEN FAQ s What is the Endocannabinoid System? What are cannabinoids? What is CBD oil?

Medical Cannabis. Christine Yoshioka, NP

The ATTC Network LEARNING OBJECTIVES. Clinical Skills in the Era of Legal Cannabis. Clinical Skills in the Era of Legal Cannabis 6/30/2015

Activity 1: Connections

MEDICAL MARIJUANA: WHAT S THE EVIDENCE?

These documents were created to support the work of the Coalition of Colorado Campus Alcohol and Drug Educators. We welcome prevention teams at

Cannabis: Therapeutic properties of the plant

The products being taken by children with epilepsy are not the equivalent of the marijuana widely used for recreational purposes.

Medical vs Recreational Use of Cannabis. 11 th December 2017

MARIJUANA in MEDICAL CARE READY or RISKY. HINDI MERMELSTEIN, MD FAPM Beth Israel Medical Center, NYC Dec

MEDICAL CANNABIS IN MINNESOTA

The Highs and Lows of Medical Marijuana

Research paper: Legal treatment of the use of cannabis for medical purposes in the member states of the European Union

Use of Cannabinoids in Medical Practice

Marijuana and the Chronic Non-Cancer Pain Patient

Cannabis for Medical Use: Body and Mind

Cannabis and the Endocannabinoid System

Trichomes: Crystalline structures that coat parts of the cannabis plant that hold the majority of the cannabinoid content.

Beginner s Guide to CBD OIL

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

I would like to begin by acknowledging that we are on the ancestral grounds of the Beothuk people

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

Anti-inflammatory Cannabinoids without psycho-active side-effects

Slide 1 Is Marijuana Medicine?

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

Marijuana as Medicine

Transcription:

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 in today s society. From hazy smoke to brownies, the plant is in high demand. Since 2007, marijuana use has been on the rise (Nationwide Trends, 2010). It is estimated that 18.9 million people were current marijuana users in 2012, which is just under the equivalent of the entire state of Florida. Of the 9.2% of the United States population over the age of 12 that used illicit drugs within the past month, 7.3% were marijuana users (Nationwide Trends, 2010). With the legality of marijuana in great debate all over the country, Colorado, Washington, Alaska and Oregon have all passed laws that make marijuana use recreationally and medically legal. If so many people currently use marijuana then why does it face continued opposition? A wide range of research is being done on marijuana s effects on the brain, but the basic mechanisms are known. The Working Brain The human brain is a complex machine, made up of around 100 billion neurons. Neurons are the cells of the nervous system. Neurons use gradients much like a car battery to send signals to other neurons (Lodish et al., 2000). Signaling occurs at the end of a neuron where extremely tiny particles called neurotransmitters are released from the neuron onto the neuron it is signaling. Neurotransmitters attach to receptors on the second neuron to cause a variety of responses based on their makeup (Lodish et al., 2000). There are many ways in which the effects that a neurotransmitter provides can be increased or decreased. Drugs, whether they are prescribed or illicit, often work to alter some aspect of neuron function or transmitter release. Some drugs make neurons pump out more neurotransmitters which enhance the effects those neurotransmitters usually have. Others can stop neurons from releasing neurotransmitters, decreasing effects. Marijuana works in this way.

van Tol 2 Early Marijuana Research Marijuana comes in many different forms and stems from the plant Cannabis sativa. It is most often smoked but can be ingested through foods or even brewed (Chudler, 2010). Marijuana gets into the blood no matter how it is taken in. Once in the bloodstream is makes its way to the brain. The composition of the Cannabis sativa plant is what provides the effects of marijuana use. The main ingredients that alter brain activity are the psychoactive chemical, delta-9-tetrahydrocannabinol or THC and about 60 other cannabinoids. Psychoactive refers to an effect where brain function is altered resulting in short-term differences in mood, behavior, and perception (Greydanus, D. E., Hawver, Greydanus, M. M., and Merrick, 2013). Cannabinoids are the neurotransmitter-like particles in marijuana that can alter our normal neuron function. Before discussing how these cannabinoids interact with the brain, it is necessary to fully understand the complexity of their makeup. Besides THC, the most widely known cannabinoids include cannabidiol (CBD), cannabigerol (CBG), and cannabinol (CBN) (Greydanus, D. E., Hawver, Greydanus, M. M., and Merrick, 2013). While THC is psychoactive, the other components of marijuana are not. THC and other cannabinoids can cause an increase in appetite, decrease in nausea, and also pain suppression (Cellular Biology: How Cannabis Works in the Body, 2013). Specifically, CBD can have anti-inflammatory, antiemetic, and anti-psychotic effects (Greydanus, D. E., Hawver, Greydanus, M. M., and Merrick, 2013). All of these effects are what create the high that is referred to by marijuana users. But how do cannabinoids actually interact with the brain? Marijuana in the Brain: Mechanisms Reviewed In the mid to late 20 th century, research on the components of marijuana was in full swing and is a continued area of study. The human body has its own endocannabinoid system, which is

van Tol 3 an internal system that produces the effects we associate with marijuana. We have the ability to create our own high if the right signals are sent without even coming into contact with marijuana. This system is made up of cannabinoid receptors which are a type of receptor that is found on a neuron or other cells. The internal particles that we make on our own are called 2- arachidonoyl glycerol (2-AG) and anandamide, also known as arachidonoyl ethanolamide (AEA) (Greydanus, D. E., Hawver, Greydanus, M. M., and Merrick, 2013). These homemade particles function just like the components we find in marijuana. The two main receptors that are found in our own bodies that respond to the homemade marijuana like particles are called CB-1 and CB-2. They are found widely throughout the body including the limbic system and other tissues like the heart and gastrointestinal tract (Greydanus, D. E., Hawver, Greydanus, M. M., and Merrick, 2013). Like marijuana components, 2-AG and AEA relate to the reward system in the brain and their levels are often altered during the use of drugs that are frequently abused. When we smoke or ingest marijuana, we add particles to our system that act like or enhance the effects of naturally occurring internal molecules like 2-AG and AEA to induce similar effects. Current Areas of Research: Medical Applications With the wide array of CB-1 and CB-2 receptors in the body and the equally wide array of potential effects that endocannabinoids can create, manipulation of this system for medical applications is in great debate. Figure 1 lists the plethora of possible benefits that medical marijuana could help. A study done on the effects of marijuana components on breast cancer found that they can freeze cancer growth to put it simply (Caffarel et al., 2012). The study also found that mice with cancer had their tumor growth slowed with the use of cannabinoids. Another study found that CBD from flax could reduce inflammation through the activation of a peripheral CB-2 receptor at the sight of inflammation (Styrczewska et al., 2012). The studies

van Tol 4 listed above show promise to improve the issue of cancer which effects many people worldwide every day and is problem that needs further treatment options. In addition, the anti-inflammatory effects marijuana has could help in recovery time for surgeries or to bring down swelling in injuries. Some pharmaceutical companies have begun to produce prescription cannabis-containing products. Two of these, Marinol and Cesamet, both contain THC and are used to treat anorexia. The drugs act to reduce nausea through cannabinoids (Fernandez-Ruiz, 2012). Neurological problems like epilepsy and multiple sclerosis also see improvements with the use of cannabinoids. Epilepsy - reoccurring seizures was Figure 1(Greydanus, et. al., 2013). recreated in lab during one study. It was found that, by manipulating the internal cannabinoid system, epilepsy could be treated (Hofmann and Frazier, 2011). Exactly how changing the internal system with the use of marijuana helps epilepsy patients isn t fully understood, many researchers believe the answer lies in the way the neurons create a charge and signal. Spasticity, a usual symptom of multiple sclerosis, is the condition of constant contraction of specific muscles. Research has found that marijuana use reduces spasticity in multiple sclerosis patients (Corey-Bloom et. al., 2012). All of these benefits seem to be promising, but like other prescription drugs marijuana has potential adverse properties. Current Areas of Research: Adverse Properties

van Tol 5 Marijuana use can lead to a long list of potential side effects. With the increase in appetite from cannabinoid receptor stimulation, long term marijuana use can lead to weight gain. The relaxing effects can also lead to a reduction in physical activity to add to the weight gain (Greydanus, D. E., Hawver, Greydanus, M. M., and Merrick, 2013). Studies have shown that marijuana can also reduce rapid eye movement as well as decrease EEG activity (DSM-IV-TR, 2000). Side effects like bronchitis and chronic cough can occur because of the irritation to lung tissues during the smoking of marijuana (Mallaret, Dal Bo-Rohrer, Demattéis, 2005). These can lead to the development of asthma (Davis and Gunderson, 2012). Dental diseases can form from marijuana use because of the carcinogens found in the plant (Cho, Hirsch, and Johnstone, 2005). With the CB-1 and CB-2 receptors also found in the heart tissue, marijuana increases blood pressure and heart rate (Malinowska, Baranowska-Kuczko, and Schlicker, 2012). Like many other drugs, tolerance can occur in marijuana users (Budney, 2011). Tolerance happens when receptors are repeatedly over stimulated and the defense mechanism is to reduce the number of receptors on the cell. Future Research in Marijuana: Whether it be in the next feature film watched or a lyric from one of the many new songs on the radio, marijuana is a huge topic of everyday life. All the in s and out s of its uses and effects are still widely speculated and researched. Some of the areas for future research in marijuana are as follows. How marijuana effects neurons associated with epilepsy is still unknown. Another area for research is the exact functions of CB-1 and CB-2 receptors Also for further study, marijuana may be able to aid in the blockage of fear memory by CBD (Stern et. al., 2012). One underlying feature of most current research in this field is the need for human trials. Most research is currently being done with animal models or has been tested little in humans.

van Tol 6 Overall, marijuana is a complex drug that needs further scrutiny and research to determine how to utilize its potential. Marijuana definitely should be reconsidered for its uses to help in medical situations but must be monitored closely to prevent abuse.

van Tol 7 References: American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, DSM- IV-TR. (2000). 4th ed Washington, DC: American Psychiatric Association Budney AJ. (2011). Should cannabis withdrawal disorder be included in DSM-5? Psychiatric Times, 2, 28. 48 50. Caffarel MM, Andradas C, Pérez-Gómez E, Guzmán M, Sánchez C. (2012).Cannabinoids: a new hope for breast cancer therapy? Cancer Treatment Reviews, 7, 38. 911-18. (2013) Cellular Biology: How Cannabis Works in the Body. Compassionate Sciences Alternative Treatment Center. Retrieved from http://www.csatc.org/cellularbiology.html Cho CM, Hirsch R, Johnstone S. (2005) General and oral health implications of cannabis use. Australian Dental Journal, 2, 50. 70 4. Chudler, E. (2010). Marijuana. Neuroscience for Kids. Retrieved from https://faculty.washington.edu/chudler/mari.html Corey-Bloom J, Wolfson T, Gamst A, Jin S, Marcotte TD, Bentley H, et al. (2012). Smoked cannabis for spasticity in multiple sclerosis: a randomized, placebo-controlled study. Canadian Medical Association Journal, 10, 184. 1143 50. Davis GP, Gunderson EW. (2012). Evaluation of chronic cough should consider cannabis use. American Family Physician, 7, 85. 680 2. Fernandez-Ruiz J. (2012). Cannabinoid drugs for neurological diseases: what is behind? Revista de Neurologia, 10, 54. 613 28. Greydanus, D. E., Hawver, E. K., Greydanus, M. M., & Merrick, J. (2013). Marijuana: Current Concepts. Frontiers in Public Health, 1, 42. Hofmann ME, Frazier CJ. (2011). Marijuana, endocannabinoids, and epilepsy: potential and challenges for improved therapeutic intervention. Experimental Neurology, 233. 112 25.

van Tol 8 Lodish H, Berk A, Zipursky SL, et al. Molecular Cell Biology. 4th edition. New York: W. H. Freeman; 2000. Section 21.1, Overview of Neuron Structure and Function. Malinowska B, Baranowska-Kuczko M, Schlicker E. (2012). Triphasic blood pressure responses to cannabinoids: do we understand the mechanism? British Journal of Pharmacology, 7, 165. 2073 88. Mallaret M, Dal Bo-Rohrer D, Demattéis M. (2005). Adverse effects of marijuana. La Revue du Praticien,1, 55. 41-9. (2014) National Institute on Drug Abuse. Nationwide Trends Retrieved from http://www.drugabuse.gov/publications/drugfacts/nationwide-trends Nestler, E. J. (2005). The Neurobiology of Cocaine Addiction. Science & Practice Perspectives, 3(1), 4 10. Stern CA, Gazarini L, Takahashi RN, Guimarães FS, Bertolglio LJ. (2012). On disruption of fear memory by reconsolidation blockage: evidence from cannabidiol treatment. Neuropsychopharmacology. Styrczewska M, Kulma A, Ratajczak K, Amarowicz R, Szope J. (2012). Cannabinoid-like antiinflammatory compounds from flax fiber. Cellular and Molecular Biology Letters, 3, 17. 479-99.