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A ‘Significant’ Number Of Patients Stopped Taking Benzodiazepines After Starting Medical Marijuana

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Nearly half of patients using marijuana to help with their respective medical conditions stopped taking prescribed benzodiazepines, a new study reports.

“Within a cohort of 146 patients initiated on medical cannabis therapy, 45.2% patients successfully discontinued their pre-existing benzodiazepine therapy,” the study’s authors write. “This observation merits further investigation into the risks and benefits of the therapeutic use of medical cannabis and its role relating to benzodiazepine use.”

While much research has been dedicated to understanding how medical cannabis could potentially replace opioids for patients who deal with chronic pain and other ailments, the new study suggests patients who take Valium, Xanax and other popular tranquilizers for neurological conditions (such as anxiety, insomnia and seizures) may find relief through marijuana. The findings were published last month in the journal Cannabis and Cannabinoid Research.

Researchers in Canada conducted a retrospective analysis of data collected from a group of patients who had been referred to the Canabo Medical Clinic for medical cannabis to treat a variety of medical conditions. They identified 146 patients who reported taking benzodiazepines regularly at the start of their cannabis therapy.

According to their findings, 44 patients (30 percent) had discontinued their benzodiazepines by their first follow-up visit. Another 21 had stopped the benzodiazepine treatment by their second follow-up visit, and one more person reported doing so at the third visit. All in all, 66 patients, or 45 percent of the sample, stopped taking benzodiazepines after starting a medical marijuana regimen.

“Patients initiated on medical cannabis therapy showed significant benzodiazepine discontinuation rates after their first follow-up visit to their medical cannabis prescriber, and continued to show significant discontinuation rates thereafter,” the study states. “Discontinuation was not associated with any measured demographic characteristic. Patients also reported decreased daily distress due to their medical condition(s) following prescription cannabinoids.”

The amount of CBD and THC content did not appear to play a role in who continued to discontinued taking the tranquilizers.

The design of the study, however, limited the authors’ ability to speculate about the mechanisms underscoring their results. Additionally, because they didn’t have access to information on what marijuana strains patients used or how they consumed it, the authors caution that their results can’t be generalized to what’s available in legal commercial markets today.

“The study results are encouraging, and this work is concurrent with growing public interest in a rapidly developing Canadian cannabis market,” said lead author Chad Purcell in a statement. “We are advising the public to observe caution. The results do not suggest that cannabis should be used an alternative to conventional therapies. Our purpose is inspiring others to advance current cannabis understanding as we collect stronger efficacy and safety data that will lead to responsible policy and recommended practices for use.”

The study also serves as an opportunity to draw more attention to the potential risks associated with benzodiazepines, Purcell told PsyPost. “I was interested in this project because it presented an opportunity to address benzodiazepines and cannabis use, both of which are becoming increasingly socially relevant. Benzodiazepines can be effective in treating many medical conditions but unlike opioids, there seems to be little public awareness of the risks associated with these commonly used prescription medications.”

According to the Centers for Disease Control and Prevention, overdose deaths related to benzodiazepines rose 830 percent between 1999 and 2017.

Patients Are Substituting Marijuana For Addictive Pharmaceutical Drugs, Two New Studies Show

Photo courtesy of Ndispensable

Marijuana Moment is made possible with support from readers. If you rely on our cannabis advocacy journalism to stay informed, please consider a monthly Patreon pledge.

Kimberly Lawson is a former altweekly newspaper editor turned freelance writer based in Georgia. Her writing has been featured in the New York Times, O magazine, Broadly, Rewire.News, The Week and more.

Science & Health

CBD Is A ‘Promising’ Therapy In Treating Cocaine Misuse, Meta-Study Finds

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A key component of marijuana shows promise in the treatment of cocaine misuse, according to a new meta-study.

Scientists analyzed 14 studies from the past five years on the administration of CBD in animal subjects consuming cocaine, and determined that the non-intoxicating ingredient appears to have a multitude of effects that mitigate addictive behaviors.

“CBD promotes reduction on cocaine self-administration. Also, it interferes in cocaine induce brain reward stimulation and dopamine release,” the study, published this month in the journal Pharmacology Biochemistry and Behavior, states. “CBD promotes alteration in contextual memory associated with cocaine and in the neuroadaptations, hepatotoxicity and seizures induced by cocaine.”

“CBD is a promising adjunct therapy for the treatment of cocaine dependence.”

While not all of the studies under review were consistent with one another, and the researchers emphasized the need for human trials, they said that animal research has generally indicated CBD can reduce self-administration of cocaine and many symptoms of addiction.

For example, a 2018 study found that a 20 mg/kg daily dose of cannabidiol led to a “significant difference in the consumption of [cocaine] on the 10th day of the study and lower consumption throughout the entire procedure compared to the control group” of mice.

In 2019, researchers similarly reported that “the systemic administration of CBD (20 mg/kg)” 30 minutes before testing “significantly reduced the self-administration of low doses of cocaine.” The effect did not occur with lower concentrations of CBD, however.

Another study that was analyzed showed that 10 and 20mg/kg CBD doses “significantly increased the threshold for self-stimulation, suggesting a reduction in the brain-stimulation reward,” which is a major component of addiction.

Rat subjects with a history of cocaine use that were treated with the cannabis compound also exhibited less anxiety, according to another study. That was “evidenced by the greater time spent in the open arms of the elevated plus maze.”

“The evidence described in the present systematic review indicates that CBD is a promising adjunct therapy for the treatment of cocaine dependence due to its effect on cocaine consumption, brain reward, anxiety, related contextual memories, neuroadaptations and hepatic protection as well as its anticonvulsant effect and safety,” the study authors concluded.

“The clinical administration of CBD leads to a reduction in the self-administration of cocaine and, consequently, the amount of the drug consumed. Moreover, the reward induced by cocaine is blunted by CBD treatment.”

“Among the other findings of the present literature review, neuroadaptations promoted by cocaine were attenuated; contextual memory associated with cocaine was reduced; anxiety related to cocaine consumption was reduced; and hepatotoxicity and seizures associated with cocaine use were reduced when animals were treated with CBD. Considering the low toxicity, the absence of severe side effects and the reduction of cocaine-related behavior, CBD is a promising adjuvant in treatment processes for individuals with problems related to cocaine use.”

There has been widespread interest in the potential risks and therapeutic benefits of CBD since hemp and its derivatives were federally legalized under the 2018 Farm Bill. Most recently, a White House office completed a review of pending Food and Drug Administration (FDA) guidance on marijuana and CBD research.

FDA also submitted a report to Congress this month that showed significant inconsistencies between cannabinoid concentrations listed on product labels and what they actually contain.

A recent industry-funded study on CBD concluded that the compound represents a potentially promising tool for dental hygiene, preventing health conditions such as plaque and gingivitis.

‘Lazy Stoner’ Stereotype Smashed By Study Finding Marijuana Consumers Exercise More

Photo courtesy of Mike Latimer.

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Psychedelic Therapists Petition Government For Permission To Dose Themselves In Order To Better Treat Patients

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As a group of terminally ill patients in Canada awaits word from the minister of health on whether they can legally access psychedelic mushrooms for end-of-life care, their team of clinicians has tacked on an additional request: The therapists want to be able to dose themselves, too.

The group behind the request, Victoria, B.C.–based TheraPsil, a nonprofit that aims to expand access to psilocybin-based psychotherapy in Canada, says the additional step of providing safe access for therapists will ensure they gain firsthand experience into the psilocybin’s effects and its applications to psychotherapy.

“The fundamental reason to expose therapists to their own experiences with psychedelics is that, unless you have visited these realms, you are unlikely to understand their importance.”

“Part of ensuring a very high-quality psychedelic treatment for patients is to ensure high-quality training for therapists,” Spencer Hawkswell, TheraPsil’s executive director, told Marijuana Moment in an interview. “It’s greatly beneficial if therapists have had psychedelic therapy themselves.”

Few people, he offered by analogy, “would advise going to a sex therapist who’s never had sex before.”

TheraPsil, founded by clinical psychologist and psychotherapist Bruce Tobin, has been fighting for expanded access to psilocybin end-of-life care for years. In 2017, the group first filed a petition to exempt patients with certain terminal conditions from Canada’s ban on psilocybin. It was reportedly the first time a therapist had asked the Canadian government for such an exemption.

It wasn’t until this past January that TheraPsil finally heard back, Hawkswell said. “After three years of back-and-forth, they got back to us and said, ‘We’re going to be rejecting this application.’” The agency said there was no obvious medical necessity for the psychedelics.

TheraPsil was undaunted. “They say there’s no necessity,” Hawkswell said. “Maybe it’s because they haven’t met that person yet.”

In April, the group helped four more people with terminal illnesses file petitions with Health Canada and Health Minister Patty Hajdu seeking exemptions that will allow them to access psilocybin. In an interview with Marijuana Moment, Hawkswell said patients had gone months so far without a word from Hajdu, who with a stroke of a pen could allow the patients to access the drug.

“What we are working on right now is ramping up our messaging,” Hawkswell said. “We are going to try everything we can to get to the minister to make sure she sees these patients and responds to them.”

Efforts to allow TheraPsil’s clinicians to use psilocybin themselves are more recent. Dr. Sean O’Sullivan, an emergency room physician and psychotherapist who serves on TheraPsil’s board of directors, said the exemptions are necessary so that therapists can be better trained and more familiar with how psychedelics work in a therapeutic setting.

“The fundamental reason to expose therapists to their own experiences with psychedelics is that, unless you have visited these realms, you are unlikely to understand their importance,” O’Sullivan told Marijuana Moment. “The point is to allow therapists to understand the field they’re plowing in.”

Therapists need to be alert and able to recognize how psychedelic experiences manifest themselves in therapy, O’Sullivan said. Patients might bring up material having to do with their own birth, a traumatic experience or interactions with otherworldly beings. “If you’re not attuned to this possibility, not aware of this possibility, then it’s just going to slide by you,” he said. 

“It’s a bit like describing Beethoven’s Fifth,” O’Sullivan added. “You can describe it all you like, but at some point you have to play the music.”

As psychedelic therapy is more widely sought by patients, O’Sullivan said, demand for qualified therapists is likely to go up. “We are expecting that as we get more permission for patients to access psilocybin at the end of life,” he said, “that there will be an increase in demand for therapists that have had that psychedelic experience.”

Public opinion in Canada generally supports allowing access to psilocybin therapy for the terminally ill, TheraPsil says. A poll released by the group last month found that 59 percent of Canadians support legal access. Including respondents who said they were “ambivalent,” TheraPsil said, acceptance increased to 78 percent.

“What’s unreasonable is the political decision” to deny patients access to psilocybin, Hawkswell argued. “It’s not a scientific one, it’s not a democratic one. It’s political.”

Patients facing their imminent death often experience feelings and fears that psychedelics can help to ease, he said. Among them are demoralization, anxiety and depression. Existing treatment includes pharmaceuticals, talk therapy and occasionally inpatient treatment.

Psychedelics play a role in treatment by inducing what Hawkswell and others refer to as a “mystical experience”—a collection of psychoactive and sometimes spiritual events that accompany a psychedelic journey. The experience can reorient a person’s way of thinking, dissolving barriers between an individual and the world around them. For end-of-life patients, he explained, it can help them embrace that death “is natural—just as natural as being born.”

Practitioners note that psychedelic therapy doesn’t work the same way as many other pharmaceutical drugs, such as antidepressants or even medical marijuana. Patients usually take those substances under their own supervision and allow them to work in the background. With therapeutic use of psilocybin and other psychedelics, patients typically take the drug and undergo guided psychotherapy. Psychedelics’ unusual, sometimes disorienting effects are believed to allow patients to better approach and engage obstacles, then emerge with a fresh perspective.

Another psychedelic therapy group, Field Trip, which uses ketamine in therapy, describes the treatment on their website as a way “to press reset on your mental health.”

The emerging promise of psychedelics in recent years have caught the attention of academics, public policy reformers and even the U.S. government. Last month, the University of North Carolina (UNC) announced a $27 million project funded by the department of defense to research and develop psychedelics-inspired drugs.

That project’s researchers seem to believe they can separate psychedelics from what they describe as “disorienting” side effects, despite what Hawkswell and others say about the importance of a “mystical experience.”

“Although drugs like ketamine and potentially psilocybin have rapid antidepressant actions, their hallucinogenic, addictive, and disorienting side effects make their clinical use limited,” said Bryan L. Roth, a professor of pharmacology at UNC School of Medicine and the research team’s leader. The government partnership, UNC said, “aims to create new medications to effectively and rapidly treat depression, anxiety, and substance abuse without major side effects.”

In September of last year, Johns Hopkins University announced the launch of the nation’s first-ever psychedelic research center, a $17-million project to study the use of psychedelics to treat conditions such as opioid use disorder, Alzheimer’s disease, depression, anxiety and post-traumatic stress disorder.

Meanwhile, activists in the United States have advocated for state- and local-level reforms to research, decriminalize and in some cases even legalize psychedelics themselves.

At the municipal level, Denver became the first U.S. city to enact such a reform, with voters in May 2019 approving a measure to effectively decriminalize possession of psilocybin mushrooms. Soon after, officials in Oakland, California, decriminalized possession of all plant- and fungi-based psychedelics. In January of this year, Oakland activists unveiled plans to allow go further and legalize the commercial sale of natural entheogenic substances. That same month in nearby Santa Cruz, the City Council effectively decriminalized psychedelics by voting to make the enforcement of laws against them among the city’s lowest enforcement priorities.

Reformers are now pushing for similar changes in other jurisdictions. In Washington, D.C. this month, Decriminalize Nature D.C. submitted signatures to qualify a measure for November’s ballot that would decriminalize all natural psychedelic drugs, including psilocybin, ayahuasca and ibogaine.

Other reform efforts are ongoing in Oregon, where voters later this year will decide whether to legalize psilocybin therapy—the very therapy TheraPsil’s patients are pushing Canadian Health Minister Hajdu to allow. Oregon voters will also see a separate measure to decriminalize the possession of all drugs and expand access to treatment for problem use on their November ballot.

Lawmakers in Hawaii earlier this year approved a plan to study psilocybin mushrooms’ medical applications with the goal of eventually legalizing access.

In Canada, for now, psilocybin remains illegal. Hawkswell of TheraPsil, however, believes a constellation of other national policies—including medical marijuana, safe injection sites, and physician-assisted dying—support extending psilocybin access to patients in palliative care. And Canada already permits certain religious groups to use ayahuasca as religious sacrament, Hawkswell noted.

“At this point psilocybin is a reasonable medical choice for these individuals,” he told Marijuana Moment. “This is about the minister being compassionate and using her ministerial abilities to help give patients access to something that’s going to help them.”

Patients waiting to hear back from Hajdu’s office, he said, don’t have time to wait for lengthy, bureaucratic processes. “We’re not just going to keep waiting,” he told Marijuana Moment. “We do have a legal team prepared, but that’s all I’ll say.”

Psychedelics Decrim Activists Mark First Anniversary Of Denver’s Historic Psilocybin Mushroom Vote

Photo courtesy of Wikimedia/Workman

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CBD-Infused Mouthwash Works Better Than Regular Products, Industry Study Shows

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Is marijuana the future of mouthwash? Companies racing to develop cannabis-based health products say cannabidiol (CBD) and other cannabis-derived compounds are emerging as promising new tools to prevent oral health issues such as plaque and gingivitis.

In a recent study out of Belgium, researchers reported that cannabinoid-infused mouthwash was just as effective at killing certain plaque-related oral bacteria as chlorhexidine, an active ingredient in many prescription mouthwashes. The cannabinoid mouthwash was also more effective at killing bacteria than two popular over-the-counter products.

Authors said the efficacy of the mouthwashes, which separately contained CBD and cannabigerol (CBG), “demonstrate the potential of cannabinoids in developing efficient and safer mouthwash products and next generation oral care products.”

“Most of the reported studies show chlorhexidine containing mouthwash as the most effective mouthwash, however tooth staining is an unacceptable side effect of chlorhexidine,” the study says. “Mouthwash products with cannabinoids infusion offer a safer and effective alternative without any fluorides or alcohol.”

The study, published late last month in the peer-reviewed Journal of Cannabis Research, evaluated mouthwashes made by CannIBite, a Belgium-based company that develops cannabinoid-based dental products. The company designed and funded by the study, and Veronica Stahl, a dental practitioner and the founder of CannIBite, was one of the two co-authors.

“To our knowledge this is the first report on such efficient mouthwash product with natural key ingredients including cannabinoids and without any kind of fluoride or alcohol.”

The products tested do not include THC, the main intoxicating ingredient in marijuana.

Traditional mouthwashes serve a variety of purposes. Most freshen breath, and simple swishing (even with water alone) can remove food and other particles stuck between teeth.

A major reason for using mouthwash is to reduce harmful oral bacteria that can build up and cause problems such as plaque and gingivitis. As the study notes, chlorhexidine is considered the industry-standard microbial rinse, and people with periodontal diseases are frequently prescribed mouthwashes containing the drug, though some evidence suggests it can also pose health threats by disrupting beneficial bacteria.

In any case, mouthwash today is a multibillion-dollar industry, and companies that make cannabis-derived health products now want a piece of it.

In the study, oral bacteria from plaque samples of 72 adults were grown in a lab and then treated with fives different mouthwashes: a solution of 0.2 percent chlorhexidine, a solution with CBD and spearmint oil, a solution with CBG and spearmint oil, and two common over-the-counter products—one with essential oils and alcohol as well as an alcohol-free mouthwash with fluoride. After periods of either 24 or 36 hours, the samples were measured to see how the mouthwashes affected bacterial growth.

Results of the experiment indicated that the two cannabinoid-infused mouthwashes significantly inhibited the growth of bacteria—on par with the chlorhexidine. The two over-the-counter mouthwashes, meanwhile, had little to no detectable effect.

“Cannabinoids (CBD / CBG) infused mouthwashes together with other natural key ingredients shows promising bactericidal activity in vitro against total-culturable aerobic bacterial content in dental plaque,” the study says, “with efficiency equivalent to or better than that of the gold standard (0.2% chlorhexidine).”

“Cannabinoid infused mouthwash products perform equal or better than that of chlorhexidine 0.2%”

Photos of agar plates published along with the study underscore the findings. Areas treated with cannabinoid mouthwashes or the chlorhexidine solution appear as circles free of visible bacteria. Samples treated with over-the-counter mouthwashes are covered in a filmy, speckled haze.

Given that chlorhexidine has side effects including tooth discoloration, the study says, cannabinoid-based mouthwashes could offer appealing alternatives that are more effective at killing germs than over-the-counter products.

“Based on our in vitro study, the cannabinoids infused CannIBite mouthwash products offer a much safer, efficient and natural alternative to alcohol and/or fluoride containing mouthwashes,” the authors wrote. “It will be interesting to study the in vivo performance of CannIBite mouthwash products in future to examine for other properties such as tooth discoloration and to examine the oral health benefits.”

CannIBite, which also makes toothpaste and a “protective oral spray,” has patents pending for the application of cannabinoids in dental care. But the company is hardly alone in trying to capitalize on cannabis in oral hygiene. Other companies, such as Impression Healthcare in Australia and San Diego-based Axim Biotechnologies, which also make cannabis-based oral-care products, are testing CBD toothpaste and mouthwash formulas of their own.

John W. Huemoeller II, CEO of Axim, told Forbes last month that “CBD is a powerful antibiotic and anti-inflammatory, so we have found it has great benefits in relation to oral care after year of offering our patented CBD-based chewing gum.”

With companies scrambling to roll out new products to curious customers, it could be only a matter of time before more cannabinoid-based dental products make their way to store shelves.

“As CBD comes to light as a health supplement with a range of potential treatments,” Huemoeller said, “the FDA is already feeling the pressure from the CBD industry and its consumers to allow the non-psychoactive compound to be added into foods and beverages.”

FDA Notifies Public About Recall Of CBD Product That Tested High For Lead

Photo courtesy of Chris Wallis // Side Pocket Images

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