Cannabis and politics are at an intriguing crossroads as we creep ever
closer to the next election year. Politicians must decide how to position
themselves on the hot-button issue of cannabis legalization. Many potential
legalization bills have been proposed in the House of Representatives but very
few have ever made it out of committee. National legalization bills have a
history of facing intense scrutiny in the houses of Congress. There are a
number of reasons for this but the vast differences in political opinions of
members of Congress makes compromise on any bill, let alone one about a hot
button issue like cannabis legalization, very difficult.
However, on Wednesday, November 20th, a new bill that would decriminalize cannabis nationally, allow states to make their own laws on full-scale legalization, and create the potential for expunging criminal records related to cannabis arrests passed in the House Judiciary Committee.
Chances of the Bill Passing
Though it is tough to envision a cannabis bill actually seeing the light of
day, there is hope for this most recent iteration. The bill already has 50
co-sponsors, bipartisan support from notable pro-cannabis legalization
Republicans like Matt
Gaetz of Florida, and passed the House Judiciary Committee with a vote of
24-10. It is always encouraging when Republicans and Democrats can agree on
legislation, especially when it comes to a potential cannabis legalization
bill. Recently, the House of Representatives passed the SAFE
Banking Act with bipartisan support. The bill allows for cannabis
businesses to bank safely and discreetly. Its passage shows the willingness of
Congressional Republicans and Democrats to work together to pass a cannabis
bill.
The House cannabis bill is undoubtedly an exciting moment for those in the legalization movement. As promising as the bill seems, it is unlikely that it will be passed without major changes. It may pass the Democrat-controlled House of Representatives, but will face an intense battle in the Republican-controlled Senate. As unlikely as the bill’s passage is, those investing in the cannabis industry seem to believe the bill has a chance to become a part of American law soon.
Impact On The Cannabis Industry
As news of the forwarding of the house cannabis bill was announced, cannabis
company stocks soared. The three biggest cannabis stocks, Canopy Growth, Tilray
Inc., and Aurora Cannabis all saw prices rise between 8% and 15% on Wednesday,
according to Reuters. Investor excitement is palpable, but some experts
warn about the long term future for the House cannabis bill. Alan Brochstein,
managing partner at New Cannabis Ventures, cautioned that the bill is, “such an
early step in a long process that there are no near-term implications for
cannabis stocks.”
The merits of the House cannabis bill will likely debated for the next few
months. Changes will be made and votes will be cast before anything is set in
stone. Whether or not this iteration of a legalization bill becomes law is
unknown, but the fact that some politicians continue to fight for cannabis
legalization is tremendously promising.
The state of Minnesota is making headlines this December, not for its freezing temperatures or a new record snowfall, but for increasing medical cannabis access. Clinical cannabis got its start in the state when former governor Mark Dayton signed the first Minnesota medical cannabis bill into law in 2014. Many criticized the bill for being far too restrictive as it listed only 9 qualifying conditions and stipulates a lengthy patient registration process. However, as of December 3rd, 2019, the state added macular degeneration and the much more generally outlined chronic pain to the list of qualifying conditions. Minnesota can now expect to see more registered medical cannabis patients thanks to the expanded list of qualifying conditions.
Making Medical Marijuana More Accessible
Though many American states have taken steps to legalize clinical cannabis, a number of potential patients still do not have access. In most cases, state regulations prevent people with certain conditions from using medical cannabis. If the state regulatory body does not list a medical condition as qualifying, then people suffering from that condition may not use cannabis for medicinal reasons, even if a medical professional recommends it as a potential treatment. The stringent nature of qualifying condition lists make Minnesota’s addition of chronic pain as a qualifying condition a massive win for medical cannabis advocates.
Chronic pain is a very generally defined medical condition. Any number of ailments can cause it and is usually up to the patient to define. For these reasons, acquiring a recommendation for medical cannabis can be far easier than it is for other conditions. There is little doubt that Minnesota’s clinical cannabis patient registry will expand greatly in the coming months thanks to the addition of chronic pain and macular degeneration. According to the Boston Globe, “As of October, nearly 18,000 patients were certified for the state’s medical marijuana program.” That number is bound to increase as more conditions make the list.
The Future of Medical Cannabis in Minnesota
Many consider Minnesota as having one of the more severely restrictive medical cannabis programs. Though Minnesota’s list of qualifying conditions is still small, it is encouraging that the state continues to implement updates. Lawmakers must work with patients and advocates to continue to pursue the creation of a fair and easily accessible medical cannabis program. If the state continues to update its list of qualifying conditions, it can at least begin to change the narrative.
In recent years, the United States and Canada have become the leaders of the cannabis legalization movement. While these countries have taken charge, England and the rest of the United Kingdom have lagged far behind. This week, the National Health Service (NHS) approved two cannabis-derived medicines for the first time. The news comes as a welcome surprise to some in the English legalization movement.
Cannabis Policy Overseas
There are a number of factors that contribute to the excruciatingly slow pace at which legalization efforts have moved in England. One key reason for this stand still is the division of public opinion. While 66% of Americans support cannabis legalization, only 48% of English citizens favor making the growth, sale, and use of cannabis legal. The U.K. government will be far less likely to push forward any legalization movement that less than a majority of its population supports. Until public opinion shifts, NHS policy will not budge.
While legislative policy in England remains stagnant, the NHS continues to research potential cannabis based medicines. Medical cannabis is not legal in the U.K., but the NHS has the ability to approve medicines derived from the plant if it believes they can improve the lives of people suffering from illnesses.
Though cannabis legalization may seem far away in England, the NHS recently approved two cannabis based medications for use. The two medications, Epidiolex and Sativex, are used to treat epilepsy and multiple sclerosis respectively.
Approving Medicines That Can Change Lives
Epidiolex may be familiar to Americans and Canadians as it was the first cannabis based medication to be approved by the FDA in both countries. Now, the NHS has approved it for use in the UK. This medication is CBD based and treats a specific form of epilepsy called Dravet syndrome.
Despite the fact that Epidiolex features no THC and causes no high, some regulators and medical practitioners have felt uneasy about its approval simply because it is cannabis-derived. Despite its detractors, the safety and efficacy of Epidiolex is something that families of loved ones with Dravet epilepsy appreciate.
Sativex, the second medication that is now NHS-approved for UK patients, has not received prescription approval in the US, but is approved for patients in Canada. This treatment comes in an oral spray form and consists of delta-9 THC and CBD. Practitioners use Sativex to treat spasticity associated with MS. One of the more devastating conditions associated with MS, symptoms include muscle stiffness and severe spasticity. Sativex treats this by alleviating inflammation and aiding in neurotransmission to the affected muscles.
The British public clearly lacks the same enthusiasm about cannabis legalization as the United States and Canada. However, the NHS approval of two cannabis based medicines has a chance to become a tipping point that convinces people that cannabis is a viable medication.
According to the Anxiety and Depression Association of America, anxiety disorders are the most common mental complications in the United States affecting more than 40 million adults in the U.S. or at least 18% of the population every year. Although anxiety disorders are highly treatable, only about 36% of anxiety patients receive treatment.
Several factors can lead to anxiety. Some of
these factors include brain chemistry, genetics, personality, and drastic life
changes. We are all, therefore, prone to anxiety.
Anxiety affects us differently. Some people
might feel unprepared, unsure, or nervous when trying something new or before
giving a speech. These feelings may manifest in physical symptoms such as
headaches, shortness of breath, or clammy hands.
Anxiety is actually an adaptive response that
can help us cope with challenges or day to day threats. These responses can
help identify and avert potential threats, encourage us to work harder, etc.
However, when we don’t respond well to these triggers, they can become
maladaptive leading to clinical anxiety disorders.
There exist many medications to deal with this
condition. Some of the common drugs include tranquilizers like Valium and Xanax
and selective serotonin reuptake inhibitors like Zoloft and Prozac. While some
of these drugs may work, some people may not respond well. There have been
cases where patients fail to see any changes or are unable to tolerate the side
effects. Also, drugs such as Xanax and Valium can be highly addictive.
For this reason, more and more people are
looking for natural alternatives that can help them cope with anxiety
disorders. This is where CBD comes in. But the question is, can it work?
FIRST THINGS FIRST:
WHAT IS CBD?
CBD (Cannabidiol) comes from the cannabis
plant. It is one of the 120+ chemical compounds (cannabinoids) that are
naturally produced by the plant. Unlike THC (tetrahydrocannabinol), another
popular compound in the cannabis plant, CBD is not psychoactive. This means
that you won’t get the ‘high’ that is usually associated with cannabis
consumption.
CAN CBD HELP WITH
ANXIETY?
Cannabidiol has been touted for its many health benefits, including remedying chronic pain, depression, cancer symptoms, and now anxiety.
HOW DOES CBD WORK?
Before we delve deeper into this subject, it
is worth noting that most studies describing how CBD works for anxiety are
preclinical and based on animal models. This means that more research is still
needed to ascertain the effectiveness of CBD as a natural remedy for anxiety.
That said, Cannabidiol exerts several actions
on the brain that may help explain why it may be an effective treatment for
anxiety disorders.
5-HT1A AGONIST
5-HT1A is a subtype of the serotonin receptor.
According to experts, anxiety can be treated using medications or drugs that
target the serotonin system.
Findings indicate that CBD could represent a novel fast antidepressant drug.
Selective serotonin reuptake inhibitors (SSRI)
such as Zoloft and Prozac treat anxiety by inhibiting the re-absorption of
serotonin in the brain. This ensures that serotonin is available in the
synaptic space, which helps the brain cells to transmit more serotonin signals.
It is believed that this can help boost moods and reduce anxiety. (Of course,
the actual biological process is more complicated than this)
Just like selective serotonin reuptake
inhibitors, Cannabidiol may boost serotonin transmission.
According to a study conducted by Spanish researchers,
CBD can enhance 5-HT1A transmission and can actually affect serotonin faster
than standard selective serotonin reuptake inhibitors.
HIPPOCAMPAL
NEUROGENESIS
The hippocampal is a vital brain area
responsible for critical roles such as cognition and brain formation. Scans on
patients suffering from anxiety or depression have often shown a smaller
hippocampus. Depression and anxiety medications, therefore, aim at triggering
neurogenesis (birth of new neurons)
In a study involving mice, it was discovered
that repeated application of Cannabidiol may help boost neurogenesis. A
growing body of research suggests a link between CBD, SSRIs,
neurogenesis and anxiety and depression.
Based on these findings, researchers are
bringing forward data suggesting that CBD may help improve the common
anxiety-disorders in humans.
HUMAN STUDIES
SUGGESTING CBD MAY HELP TREAT ANXIETY
A study carried out in 2010 found out that CBD
could help remedy symptoms in social anxiety disorder (SAD)
patients. Follow up brain scans on the group revealed altered blood flow to the
brain parts concerned with anxiety and mood regulation. In this study, CBD was
not only found to be effective in making people feel better but also altered
the way their brains responded to stress and anxiety.
In 2011, another study was conducted to find out
whether CBD could remedy social anxiety disorder. In a public speaking test
that followed, people who received 600mg CBD experienced less anxiety, had less
cognitive impairment, were more relaxed and comfortable than their counterparts
who received a placebo.
CBD inhibits the fear of speaking in public, a symptom of social anxiety disorder.
A 2015 analysis of existing studies concluded
that Cannabidiol has great potential as a natural remedy for different forms of
anxiety including panic disorder, social anxiety disorder, post-traumatic stress disorder, generalized
anxiety disorder, and obsessive-compulsive disorder.
In 2017, researchers from Sao Paulo University
in Brazil found out that CBD helped reduce anxiety in patients with social phobia.
WRAPPING UP
It is clear that more studies on human are
still needed to ascertain the link between anxiety and CBD. However,
preliminary findings validating CBD’s efficacy as a natural remedy for anxiety
are promising.
It is important that all stakeholders in the
health sector come together and see if there is a way to improve this natural
compound to produce even better results. This should be treated as a matter of
urgency, given the huge economic and social cost that anxiety impacts not only
in the US but across the globe.
The use of medical cannabis is becoming more widespread now that it’s legalized in 33 states and the District of Columbia. If you’re a nurse or doctor who can legally prescribe medical cannabis, teaching your patients about this treatment and how it works can bring them one step closer toward achieving better health and improving their medical conditions.
The following tips can help you advocate for patients who
may be seeking medical cannabis.
Explain How Medical Cannabis Works
The cannabis (marijuana) plant contains more than 100
cannabinoids—each of which produces different effects depending on which
receptors they bind to in the body and brain. THC and CBD are the most
well-known cannabinoids when it comes to cannabis. THC offers therapeutic
effects of reducing pain, nausea, and inflammation. CBD offers similar health benefits and
more without producing a psychoactive high like THC.
When explaining to your patients how medical cannabis works,
discuss the differences between different cannabinoid ratios and how that will affect their symptoms. If your
patients are concerned about a psychoactive high, assure them that you can
prescribe medical cannabis that can effectively improve their condition or
symptoms without producing a psychoactive high. Recommend
your patient discuss this concern with a licensed medical cannabis pharmacist
for best results.
Talk About How Medical Cannabis Can Be Used
Medical cannabis can be smoked, vaporized, ingested, applied topically, or taken as a liquid extract. Each consumption method has a different onset time and depends on your patient’s tolerance level. Smoking or vaporizing medical cannabis produces near-immediate effects, while medical cannabis edibles can take up to 2 hours to start producing medical effects. Smoking cannabis is not medically recommended since this method burns off the majority of the therapeutic medical cannabinoids.
Talk to your patients about their options for using medical cannabis and about which method may be most ideal for them based on their personal preferences and medical condition.
Discuss Possible Drug Interactions
Medical cannabis is highly therapeutic when used on its own, but may cause unexpected adverse reactions when used with certain types of medications. When discussing medical cannabis with your patients, ask about the medications they’re currently using and help them stay safe by educating about possible drug interactions. Medications that may cause adverse reactions when used with medical cannabis include warfarin, pentobarbital, oxymorphone, and disulfiram.
In recent years Cannabidiol (CBD) has been
proven to help treat the symptoms of anxiety, epilepsy and pain. Now, new
research is emerging that CBD may be part of the next wave of antibiotics used
to treat bacterial infections.
Drug resistant diseases are on the rise and
reaching a critical level affecting all countries. In April 2019, the World
Health Organization released a groundbreaking report “demanding
immediate, coordinated and ambitious action to avert a potentially disastrous
drug-resistance crisis.” If no action is taken, it is estimated that diseases
that do not respond to drug treatment could cause 10 million deaths a year by
2050. This epidemic will result in a global economic crisis similar to the 2008
financial crisis.
h Drug-resistant infections are the cause at least 700,000 deaths globally each year
This week new evidence came out that CBD could be one of the next new treatments to help fight the threat of drug resistant bacteria. Mark Blaskovich, PhD, presented research at the American Society for Microbiology annual meeting. Blaskovich is a senior research officer at the Centre for Superbug Solutions at the Institute for Molecular Bioscience at the University of Queensland in Australia.
The results Blaskovich shared at ASM Microbe
showed that CBD has a surprisingly powerful antibiotic effect against
Gram-positive bacteria that was comparable to existing antibiotics, including
vancomycin and daptomycin. The in vitro study led by
Blaskovich found that CBD is active against Gram-positive bacteria such
as Staphylococcus aureus (Staph) and Streptococcus
pneumoniae (Strep).
Mark Blaskovich, PhD, senior research officer at the Centre for Superbug Solutions at the Institute for Molecular Bioscience at the University of Queensland in Australia
Even in low concentrations, CBD had positive
effects in treating methicillin-resistant S. aureus (MRSA). This bacterium is
widely known for being the common cause of hospital-acquired infections and is
resistant to some forms of antibiotics. The CDC reported that MRSA resulted in 20,000
deaths in 2017 and is considered a significant cause of mortality in the United
States.
Blaskovich tweeted this week that “Cannabidiol shows
promise against superbug infections.” He also stated that they reviewed CBD’s
ability to kill bacteria. “In every case, CBD had a very similar potency to
that of common antibiotics.”
Though this research is unpublished it may be the next breakthrough to combat the growing problem of antibiotic resistant strains of bacterial infections. Blaskovich has received a grant from Global Antibiotic Research & Development Partnership (GARDP) to assist in the research to find ‘5 By 25’. The ambitious project’s goal is to develop and deliver five new treatments by 2025 in response to the growing burden of antibiotic resistant infections. According to GARDP “Alarming levels of resistance are now reported in countries of all income levels”. This is resulting in thousands of newborn deaths and patients that have infections that do not respond to any available antibiotics. “Drug-resistant infections already cause at least 700,000 deaths globally each year.”
As more countries legalize cannabis, and
research restriction are lifted, clinical trials involving CBD and THC will be
able to proceed similar to other drug trials. We are optimistic that similar to
the FDA approval of cannabidiol to treat
epilepsy, more research will emerge involving the medicinal properties of the
various cannabinoids found in cannabis.
