THC found more important for therapeutic effects in cannabis than originally thought
Researchers measure product characteristics and associated effects with mobile app
February 26, 2019
Science Daily/University of New Mexico
Researchers recently solved a major gap in scientific literature by using mobile software technology to measure the real-time effects of actual cannabis-based products used by millions of people every day.
Contrary to popular media-reports and scientific dogma, the psychoactive chemical, tetrahydrocannabinol or "THC," showed the strongest correlation with therapeutic relief and far less evidence for the benefits of relying on the more socially acceptable chemical, cannabidiol or "CBD."
In a new study titled, "The Association between Cannabis Product Characteristics and Symptom Relief," published in the journal Scientific Reports, UNM researchers Sarah See Stith, assistant professor in the Department of Economics, and Jacob Miguel Vigil, associate professor in the Department of Psychology, found that THC and CBD contents were the most important factor for optimizing symptom relief for a wide variety of health conditions.
The findings were based on the largest database of real-time measurements of the effects of cannabis in the United States, collected with the ReleafApp, developed by co-authors Franco Brockelman, Keenan Keeling and Branden Hall.
Since its release in 2016, the commercially developed ReleafApp has been the only publicly available, incentive-free app for educating patients on how their type of product (e.g., flower or concentrate), combustion method, cannabis subspecies (indica, sativa, and hybrid), and major cannabinoid contents (THC and CBD) affect their symptom severity levels, essentially providing invaluable user feedback on their health status, medication choices, and the clinical outcomes of those choices as measured by symptom relief and side effects.
The study aimed to address the practical questions of knowing how fundamental characteristics of currently available and frequently used cannabis products, characteristics that often influence consumer choices, affect health symptom intensity levels. The average patient, across the roughly 20,000 measured user sessions and 27 measured symptom categories ranging from depression to seizure activity, showed an immediate symptom improvement of 3.5 points on a 0-10 scale. Dried flower was the most commonly used product and generally associated with greater symptom improvement than other types of products.
Cannabis is rapidly gaining popularity as a mid-level analgesic and promising substitute for prescription opioids and other classes of medications, which often carry undesirable side effects, dangerous drug interactions and risk of death. Presently, federal barriers restrict researchers from conducting cannabis administration studies in the U.S.
"We were able to fill the most significant absence in the previous medical literature, understanding the 'efficacy, dose, routes of administration, or side effects of commonly used and commercially available cannabis products in the United States,'" said Vigil, quoting from the recently released report from the National Academies of Sciences, Engineering, and Medicine, Committee on the Health Effects of Marijuana.
By studying products containing both THC and CBD, the authors were able to analyze the relative importance of these cannabinoids for symptom relief and side effect prevalence, advancing previous research examining either chemical in the absence of the other. One of the most striking patterns in the current results was that THC was generally associated with a more intense user experience, as measured by symptom relief and the prevalence of both positive and negative side effects.
"Despite the conventional wisdom, both in the popular press and much of the scientific community that only CBD has medical benefits while THC merely makes one high, our results suggest that THC may be more important than CBD in generating therapeutic benefits. In our study, CBD appears to have little effect at all, while THC generates measurable improvements in symptom relief. These findings justify the immediate de-scheduling of all types of cannabis, in addition to hemp, so that cannabis with THC can be more widely accessible for pharmaceutical use by the general public," said Vigil.
"More broadly understanding the relationship between product characteristics and patient outcomes is particularly important given the lack of medical guidance received by medical cannabis patients," said Stith. "Most receive only a referral for cannabis treatment from their healthcare provider with all other treatment advice coming from prior recreational experience, the internet, social interactions, and/or often minimally trained personnel working in dispensaries.
"This is very different from how patients receive treatment using conventional pharmaceuticals that come with clear dosing instructions and a standardized, uniform product," she added.
The authors caution that cannabis use does carry the risks of addiction and short-term impairments in cognitive and behavioral functioning, and may not be effective for everyone.
"However, I have seen many people use it as a primary medication for a full spectrum of health conditions as part of their broader desire to gain more control over their healthcare treatment," says Vigil, a perspective that seems to gaining momentum as cannabis appears to be re-emerging as one of the most widely used medications in the U.S.
This investigation was supported in part by public donations to the University of New Mexico Medical Cannabis Research.
https://www.sciencedaily.com/releases/2019/02/190226112353.htm
Nearly 70 percent of cannabidiol extracts sold online are mislabeled
Mislabeling may lead to adverse effects for patients, including children with epilepsy
November 7, 2017
Science Daily/University of Pennsylvania School of Medicine
In recent years, there has been an increased interest in the medicinal use of Cannabidiol (CBD), a chemical that naturally occurs the in cannabis plant (aka "marijuana"). There is interest in CBD as a medicine because there is some evidence that it has medical benefits, but it does not make people feel "high" and there is no indication that CBD, by itself, is abused. Recent research has shown potential therapeutic effects of CBD for young children with rare seizure disorders, and patients in states where cannabis or CBD have been legalized report using it for a variety of health conditions. Business experts estimate that the market for CBD products will grow to more than $2 billion in consumer sales within the next three years. While interest in this area continues to grow, little has been done to ensure regulation and oversight of the sale of products containing CBD. The primary reason for this is that CBD is currently classified as a Schedule I controlled dangerous substance by the DEA, despite having been legalized for medicinal use in many states. Thus, many people do not have access to stores that sell CBD products and instead rely on online retailers to purchase CBD products.
A new study by a Penn Medicine researcher, published this week in JAMA, found that nearly 70 percent of all cannabidiol products sold online are either over or under labeled, causing potential serious harm to its consumers. Marcel Bonn-Miller, PhD, an adjunct assistant professor of Psychology in Psychiatry and the lead author on the study, believes the mislabeling of cannabidiol products is a direct result of inadequate regulation and oversight.
"The big problem, with this being something that is not federally legal, is that the needed quality assurance oversight from the Food and Drug Administration is not available. There are currently no standards for producing, testing, or labeling these oils," Bonn-Miller said. "So, right now, if you buy a Hershey bar, you know it has been checked over; you know how many calories are in it, you know it has chocolate as an ingredient, you know how much chocolate is in there. Selling these oils without oversight, there is no way to know what is actually in the bottle. It's crazy to have less oversight and information about a product being widely used for medicinal purposes, especially in very ill children, than a Hershey bar."
For a month, Bonn-Miller and his team of researchers conducted internet searches to identify and purchase CBD products available for online retail purchase that included CBD content on the packaging. The team purchased and analyzed 84 products from 31 different companies and found that more than 42 percent of products were under-labeled, meaning that the product contained a higher concentration of CBD than indicated. Another 26 percent of products purchased were over-labeled, meaning the product contained a lower concentration of CBD than indicated. Only 30 percent of CBD products purchased contained an actual CBD content that was within 10% of the amount listed on the product label. While studies have not shown that too much CBD can be harmful, products containing either too little or too much CBD than labeled could negate potential clinical benefit to patients. Further, the variability across products may make it troublesome for patients to get a reliable effect.
"People are using this as medicine for many conditions (anxiety, inflammation, pain, epilepsy)," Bonn-Miller explained. "The biggest implication is that many of these patients may not be getting the proper dosage; they're either not getting enough for it to be effective or they're getting too much."
According to Bonn-Miller, a number of products also contained a significant amount of THC -- the chemical compound in cannabis responsible for making a person feel "high" -- which has been shown cause cognitive impairment and other adverse health effects. "This is a medication that is often used for children with epilepsy, so parents could be giving their child THC without even knowing it," he said.
In a previous study, Bonn-Miller and colleagues analyzed cannabinoid dose and label accuracy in edible medical cannabis products and found similar discrepancies. He hopes this and future studies will call attention to the impact of inconsistent cannabis product labelling.
"Future research should be focused on making sure people are paying attention to this issue and encouraging regulation in this rapidly expanding industry."
https://www.sciencedaily.com/releases/2017/11/171107112244.htm