Berenson thinks that we are far too sanguine about this link. He wonders how large the risk is, and what might be behind it. In one of the most fascinating sections of “Tell Your Children,” he sits down with Erik Messamore, a psychiatrist who specializes in neuropharmacology and in the treatment of schizophrenia. Messamore reports that, following the recent rise in marijuana use in the U.S. (it has almost doubled in the past two decades, not necessarily as the result of legal reforms), he has begun to see a new kind of patient: older, and not from the marginalized communities that his patients usually come from. These are otherwise stable middle-class professionals. Berenson writes, “A surprising number of them seemed to have used only cannabis and no other drugs before their breaks. The disease they’d developed looked like schizophrenia, but it had developed later—and their prognosis seemed to be worse. Their delusions and paranoia hardly responded to antipsychotics.”
Truth be told, one of the biggest draws to using CBD oil for pain has been the fact that it has little distinguishable side-effects or contraindications with other medications. In fact, in a massive report that was published by the World Health Organization during last year’s 2017 Expert Committee on Drug Dependence, it was (finally) declared to the world that CBD is a “safe, well tolerated [compound, which] is not associated with any significant adverse public health effects.”
Recreational cannabis use centers around one chemical: the psychoactive cannabinoid tetrahydrocannabinol (THC). Consuming this chemical induces euphoric and stimulating sensations commonly referred to as a “high.” For most marijuana users, these sensations are pleasurable and enjoyable. For some, however, THC can induce feelings of anxiety and paranoia, especially in large doses.
The 2014 Farm Bill legalized the sale of "non-viable hemp material" grown within states participating in the Hemp Pilot Program. This legislation defined hemp as cannabis containing less than 0.3% of THC delta-9, grown within the regulatory framework of the Hemp Pilot Program. The 2018 Farm Bill allowed for interstate commerce of hemp derived products, though these products still fall under the purview of the FDA.
"Hemp was widely grown in the United States from the colonial period into the mid-1800s. Fine and coarse fabrics, twine, and paper from hemp were in common use. By the 1890s, labor-saving machinery for harvesting cotton made the latter more competitive as a source of fabric for clothing, and the demand for coarse natural fibers was met increasingly by imports. Industrial hemp was handled in the same way as any other farm commodity in that USDA compiled statistics and published crop reports33 and provided assistance to farmers promoting production and distribution.34 In the early 1900s, hemp continued to be grown, and USDA researchers continued to publish information related to hemp production and also reported on hemp’s potential for use in textiles and in paper manufacturing.35 Several hemp advocacy groups, including HIA and Vote Hemp, Inc., have compiled other historical information and have copies of original source documents.36
By the 1930s, marijuana was banned in 24 states. The newly minted Federal Bureau of Narcotics launched a campaign against the drug, and newspapers fueled hysteria with headlines like the 1933 Los Angeles Examiner's "Murder Weed Found Up and Down the Coast — Deadly Marihuana Dope Plant Ready for Harvest That Means Enslavement of California Children." By 1937, Congress passed the Marihuana Tax Act, which effectively banned marijuana except for a few medicinal purposes, according to "Smoke Signals: A Social History of Marijuana – Medical, Recreational and Legal" (Scribner, 2012).
Thapa, D., Toguri, J. T., Szczesniak, A. M., & Kelly, A. E. M. (2017, April 1). The non-psychoactive phytocannabinoid, cannabidiol (CBD), and the synthetic derivatives, HU308 and CBD-DMH, reduces hyperalgesia and inflammation in a mouse model of corneal injury [Abstract]. FASEB Journal. Retrieved from https://www.fasebj.org/doi/abs/10.1096/fasebj.31.1_supplement.811.7
Hemp plants are almost always cultivated outdoors, as opposed to marijuana plants, which are mostly planted in greenhouse or indoor settings. Because hemp is susceptible to the same predators diseases and insects that attack marijuana, the hemp industry employs a technique called crop rotation, in which alternating crops are planted in the same place, to avoid any buildup of these organisms and allow nutrients to return to the soil. The specific order of crop rotation and types of crops being rotated with hemp will depend on the location of the farm. Hemp is also used as a rotational crop at farms where it is not the primary agricultural product.
In Canada, the methodology used for analyses and sample collection for THC analysis of hemp plantings is standardized (at the Health Canada/Therapeutics Program/Hemp web site at www.hc-sc.gc.ca/hpb-dgps/therapeut/htmleng/hemp.html, see “Industrial Hemp Technical Manual” for procedures on sampling plant materials and chemical procedures for determining THC levels). The regulations require that one of the dozen independent laboratories licensed for the purpose conduct the analyses and report the results to Health Canada. Sample collection is also normally carried out by an independent authorized firm. The Canadian system of monitoring THC content has rigidly limited hemp cultivation to cultivars that consistently develop THC levels below 0.3%.
Acute effects may include anxiety and panic, impaired attention and memory, an increased risk of psychotic symptoms, [b] the inability to think clearly, and an increased risk of accidents. Cannabis impaired a person's driving ability, and THC was the illicit drug most frequently found in the blood of drivers who have been involved in vehicle crashes. Those with THC in their system were from three to seven times more likely to be the cause of the accident than those who had not used either cannabis or alcohol, although its role is not necessarily causal because THC stays in the bloodstream for days to weeks after intoxication.[c]
Phytocannabinoids are lipid soluble with slow and erratic oral absorption. While cannabis users claim that the smoking of cannabis allows easy dose titration as a function of rapid onset, high serum levels in a short interval inevitably result. This quick onset is desirable for recreational purposes, wherein intoxication is the ultimate goal, but aside from paroxysmal disorders (eg, episodic trigeminal neuralgia or cluster headache attack), such rapid onset of activity is not usually necessary for therapeutic purposes in chronic pain states. As more thoroughly reviewed elsewhere (Russo 2006b), cannabis smoking produces peak levels of serum THC above 140 ng/mL (Grotenhermen 2003; Huestis et al 1992), while comparable amounts of THC in Sativex administered oromucosally remained below 2 ng/mL (Guy and Robson 2003).
In addition to acting on the brain, CBD influences many body processes. That’s due to the endocannabinoid system (ECS), which was discovered in the 1990s, after scientists started investigating why pot produces a high. Although much less well-known than the cardiovascular, reproductive, and respiratory systems, the ECS is critical. “The ECS helps us eat, sleep, relax, forget what we don’t need to remember, and protect our bodies from harm,” Marcu says. There are more ECS receptors in the brain than there are for opioids or serotonin, plus others in the intestines, liver, pancreas, ovaries, bone cells, and elsewhere.
Lisa Hamilton, a jeweler and doula in Brooklyn, NY, knows about the side effects. She recently tried CBD for the shoulder pain that plagued her five years after an accident. Her doctor certified that she was in chronic pain, which under New York State law allowed her to buy from a state dispensary. One Friday, she swallowed two 10-mg capsules, the amount recommended at the dispensary, then took another two on Saturday. “By Sunday, it felt like I’d gotten hit by a truck. Every muscle and joint ached,” Hamilton says. She cut back to one pill a day the following week, but still felt hungover. She stopped after that.
The market is rife with misinformation even when CBD is sold as a relatively simple oil or supplement. When it’s squirted into a latte or baked into a cookie, CBD’s uses and effects get even more opaque. The chemical’s loudest advocates make health claims far beyond the current scientific evidence, and its harshest critics often dismiss the compound entirely as just another snake oil in America’s long tradition of health scams. Journalists are starting to get a handle on what CBD actually does and what is actually known about it, but along with researchers and regulators, we’re still playing catch-up when it comes to the people who have pushed the compound into what feels like mainstream overnight success: entrepreneurs.
The Medical Marijuana Industry here has glommed on to the “Alternative” Medicine Industry models. I half expected the Dispensary employee to explain that because the Hemp Oil was in contact with CBD, it was the same thing. The Industry even has high quality magazines where they advertise and give advice, most contain a lot of pseudo science. The refer to Pharma Industry Studies as proof that CBD works.
Early this month, the FDA just approved a new drug for depression called esketamine. Esketamine, marketed under the brand name Spravato, is a ketamine-based drug designed for patients who aren’t responding to conventional antidepressant medications. It comes in a nasal spray form, and is touted to be the world’s first quick-relief depression medication in the market.
Cannabidiol (CBD) and tetrahydrocannabinol (THC) are two compounds found within the cannabis plant that are showing promise as pain relievers. And as the legalization of cannabis continues to spread, and as researchers continue to study the plant’s therapeutic potential, the stigma will continue to disappear. The number of people using CBD for pain relief is on the rise, showing that cannabis, and the cannabinoids it produces, can do so much more than produce an intoxicating high, it can actually help heal.
Because C. sativa has been a neglected crop for so long in North America, there are only negligible genetic resources available on this continent. Most germplasm stocks of hemp are in Europe, and the largest and most important collection is the Vavilov Institute gene bank in Leningrad. Figure 11 shows THC concentrations in the Vavilov collection, as well as in our own collection, largely of European germplasm. A disturbingly high percentage of the collections have THC levels higher than 0.3%, making it difficult to incorporate these into breeding programs.