^ Blest-Hopley G, Giampietro V, Bhattacharyya S (May 2018). "Residual effects of cannabis use in adolescent and adult brains - A meta-analysis of fMRI studies". Neuroscience and Biobehavioral Reviews. 88: 26–41. doi:10.1016/j.neubiorev.2018.03.008. PMID 29535069. This may reflect the multitude of cognitive tasks employed by the various studies included in these meta-analyses, all of which involved performing a task thereby requiring the participant to reorient their attention and attempt to solve the problem at hand and suggest that greater engagement of this region indicates less efficient cognitive performance in cannabis users in general, irrespective of their age.
In the United States, the legality of medical marijuana varies in substantial ways from state to state. There are currently 29 US states with legal medical cannabis laws, as well as the District of Columbia. That leaves 21 states where medical marijuana is entirely prohibited. Marijuana cultivation, possession, and use in any form is illegal at the federal level.
^ Parliament of the Czech Republic (1998), Explanatory Report to Act No. 112/1998 Coll., which amends the Act No. 140/1961 Coll., the Criminal Code, and the Act No. 200/1990 Coll., on misdemeanors (in Czech), Prague "Podle čl. 36 Jednotné úmluvy o omamných látkách ze dne 31. března 1961 (č. 47/1965 Sb.) se signatáři zavazují k trestnímu postihu tam uvedených forem nakládání s drogami včetně jejich držby. Návrh upouští od dosavadní beztrestnosti držby omamných a psychotropních látek a jedů pro svoji potřebu. Dosavadní beztrestnost totiž eliminuje v řadě případů možnost postihu dealerů a distributorů drog."
Some jurisdictions use free voluntary treatment programs and/or mandatory treatment programs for frequent known users. Simple possession can carry long prison terms in some countries, particularly in East Asia, where the sale of cannabis may lead to a sentence of life in prison or even execution. Political parties, non-profit organizations, and causes based on the legalization of medical cannabis and/or legalizing the plant entirely (with some restrictions) have emerged in such countries as China and Thailand.
In a Phase II double-blind, randomized, placebo-controlled, 5-week study of 56 rheumatoid arthritis patients with Sativex (Blake et al 2006), employed nocturnal treatment only to a maximum of 6 sprays per evening (16.2 mg THC + 15 mg CBD). In the final treatment week, morning pain on movement, morning pain at rest, DAS-28 measure of disease activity, and SF-MPQ pain at present all favored Sativex over placebo (Table 1).
In this report, researchers reviewed 16 previously published studies testing the use of various cannabis-based medicines in the treatment of chronic neuropathic pain and found some evidence that cannabis-based medicines may help with pain relief and reduce pain intensity, sleep difficulties, and psychological distress. Side effects included sleepiness, dizziness, mental confusion. The authors concluded that the potential harm of such medicines may outweigh their possible benefit, however, it should be noted that the studies used a variety of cannabis-based medicines (e.g. inhaled cannabis and sprays and oral tablets containing THC and/or CBD from plant sources or made synthetically), some of which are more likely to result in these side effects than products without THC.
The high absorbency of hemp hurds has led to their occasional use as an absorbent for oil and waste spill cleanup. Hemp as an industrial absorbent has generated some interest in Alberta, for use in land reclamation in the oil and gas industry. Because hemp hurds are a costly product, it is likely that animal bedding will remain the most important application.
But he wasn’t finished. In February of 1980, Dr. Mechoulam teamed up with South American researchers to publish a study regarding cannabis and epilepsy. This study is seen as one of the earliest double-blind studies of CBD on clinical subjects. The study Dr. Mechoulam and his team conducted included 16 people, many of whom were children, who all suffered from severe epilepsy. The results were startling: Every subject who received CBD experienced improvement in their condition with little to no side effects. This anticonvulsant study has since proven to be an integral milestone in the world of clinical marijuana research, but largely went unnoticed at the time.
Not until the end of the 20th century was the specific mechanism of action of THC at the neuronal level studied. Researchers have subsequently confirmed that THC exerts its most prominent effects via its actions on two types of cannabinoid receptors, the CB1 receptor and the CB2 receptor, both of which are G protein-coupled receptors. The CB1 receptor is found primarily in the brain as well as in some peripheral tissues, and the CB2 receptor is found primarily in peripheral tissues, but is also expressed in neuroglial cells. THC appears to alter mood and cognition through its agonist actions on the CB1 receptors, which inhibit a secondary messenger system (adenylate cyclase) in a dose-dependent manner. These actions can be blocked by the selective CB1 receptor antagonist rimonabant (SR141716), which has been shown in clinical trials to be an effective treatment for smoking cessation, weight loss, and as a means of controlling or reducing metabolic syndrome risk factors. However, due to the dysphoric effect of CB1 receptor antagonists, this drug is often discontinued due to these side effects.
Yet Germany’s health insurance companies, doctors, and pharmacies weren’t prepared for the rush. Prior to legalization, cannabis represented a small niche in the country with just a thousands patients with access to the drug because of a special permit. But legalization spawned a rapid growth; in 2018 alone, there were 142,000 prescriptions issued.
Nabilone (Cesamet) (Figure 1), is a synthetic dimethylheptyl analogue of THC (British Medical Association 1997) that displays greater potency and prolonged half-life. Serum levels peak in 1–4 hours (Lemberger et al 1982). It was also primarily developed as an anti-emetic in chemotherapy, and was recently re-approved for this indication in the USA. Prior case reports have noted analgesic effects in case reports in neuropathic pain (Notcutt et al 1997) and other pain disorders (Berlach et al 2006). Sedation and dysphoria were prominent sequelae. An RCT of nabilone in 41 post-operative subjects actually documented exacerbation of pain scores after thrice daily dosing (Beaulieu 2006) (Table 1). An abstract of a study of 82 cancer patients on nabilone claimed improvement in pain levels after varying periods of follow-up compared to patients treated without this agent (Maida 2007). However, 17 subjects dropped out, and the study was neither randomized nor controlled, and therefore is not included in Table 1.
Hemp is used to make a variety of commercial and industrial products including rope, textiles, clothing, shoes, food, paper, bioplastics, insulation, and biofuel. The bast fibers can be used to make textiles that are 100% hemp, but they are commonly blended with other fibers, such as flax, cotton or silk, as well as virgin and recycled polyester, to make woven fabrics for apparel and furnishings. The inner two fibers of the plant are more woody and typically have industrial applications, such as mulch, animal bedding and litter. When oxidized (often erroneously referred to as "drying"), hemp oil from the seeds becomes solid and can be used in the manufacture of oil-based paints, in creams as a moisturizing agent, for cooking, and in plastics. Hemp seeds have been used in bird feed mix as well. A survey in 2003 showed that more than 95% of hemp seed sold in the European Union was used in animal and bird feed.
Infusions: Research and opportunity have driven chefs and chemists to infuse CBD into all sorts of readily usable products, such as edibles to elixirs, sublingual sprays, capsules and even topicals. Much like concentrates, each infusion sports specific combinations or isolations of CBD, THC, and other cannabinoids, allowing users to pick and choose products that suit their exact needs. CBD topicals, for example, are incredibly effective when applied to surface-level problems like bruises, joint aches, and headaches, and have been scientifically proven to successfully combat skin-based issues including pruritus with far broader implications.
But experimental anxiety, which is when stressors are applied to make a volunteer feel anxious for a test, is different than clinical anxiety, and long-term, rigorous clinical trials are necessary to find CBD’s real-life effects on patients. Several are under way right now, including one Blessing is conducting at NYU, but the process of completing those, finding appropriate dosages, and creating a consistent drug that can meet Food and Drug Administration approval standards takes time. “Getting into the full pipeline of FDA approval is probably eight to 10 years away,” Blessing says.