Recently, I wrote about the potential for the usage of cannabidiol (CBD) in professional sports. While I'm trying to keep the jargon to a minimum, there’s a lot more information on CBD that can go a long way to helping understand it.
I’ll also cover some relevant pending legislation and add some fuel to the fire by talking about medical cannabis.
To recap, hemp, from which CBD is extracted, comes from fertilized hemp/cannabis plants. Cannabis, in turn, is created by eliminating all the male plants so that the females produce a sticky resin to attract pollination. That resin contains more of the THC that cannabis users are looking for.
There's something to be gained by adding modern science to the older pharmacology of herbology.
I’ve said that many of the health benefits of cannabis lie in the modern extract called CBD. As an example, short term memory problems are common with THC. A 2010 study found that CBD eliminated that problem. It used the high CBD/low THC plants that were available at that time. The researchers attributed this attenuation of memory to CBD's role as a C-1 antagonist.
In plain English, that means that THC fits into the C-1 receptor in the cerebral cortex. CBD fits into the C-2 receptor, but has the effect of minimizing the effects from the C-1 receptor. It provides more medical benefits without the ‘high’ from THC.
CBD has strong antioxidant properties. It has neuroprotective and anti-ischemic* effects. The US government, however, has insisted that cannabis has no medical benefits. At the same time, they took out patent 6,630,507, giving themselves the right to the antioxidant properties of cannabis (which they still claim don’t exist). They didn’t extend that patent to CBD, so it will remain available.
*Ischemia is caused by problems with blood vessels. It brings resultant damage to, or dysfunction of the tissues. It also refers to local anemia in a given part of a body, sometimes resulting from congestion. That would include vasoconstriction, thrombosis or embolism (blood clots).
Prescription Drug Deaths
What if you could reduce opioid-related prescription drug deaths in the US by 15,000 or more? It’s not even difficult, believe it or not.
Here are the relevant facts:
Deaths from drug overdoses (drug poisoning) continue to rise. Deaths from opioid analgesics increased from 4,030 in 1999 to 15,597 in 2009 and 16,651 in 2010. In 2010, 60 percent of all drug overdose deaths (22,134) involved pharmaceutical drugs. Opioid analgesics showed up in about 3 of every 4 pharmaceutical overdose deaths. That confirms the predominant role opioid analgesics play in drug-related mortality (Jones et al. 2013).
CBD gives a similar pain reduction to many opioid prescription drugs. Morphine, hydrocodone, and oxycodone are examples. It’s not as strong as those, but it can bolster the effects while containing less toxicity, to achieve the best effect. If opioids are necessary, both cannabis and CBD can reduce the amount required.
Most opioid-addicted patients started out looking for relief from pain. In a certain, small percentage of patients, that escalates into a mental form of habitation with MMJ. When CBD solves the pain, you don’t have the issue of addiction developing. There is no receptor for it that would produce true addiction.
The experience of withdrawal can reduce to mild discomfort or be eliminated completely. CBD could play a major role in getting athletes off the painkiller express that’s been common in too many locker rooms, and which the DEA has gotten around to investigating. Extra source links on that are listed below.
Cannabis and CBD
Cannabis/hemp is a remarkable plant. Every part of it can help make a wide variety of things, including biofuel and medicine. Anything that can be made of plastic, can be made from hemp oil, which is also good for health. The plant fibers are long and tough, and can be woven into a soft cloth that wears well. Copies of the Declaration of Independence were written on cannabis paper, since it doesn’t yellow with age like other papers do.
During the Revolutionary War, soldiers were paid with both tobacco and cannabis. George Washington and Thomas Jefferson, among others, encouraged farmers to grow more hemp. It was for needed items from rope to paper, as well as clothing and ships’ sails. The Egyptians were using hemp sails on the Nile at least 3,000-4,000 years ago. It could help reboot our economy today.
During WWII, American farmers were asked to grow as much hemp as possible. When it ended, the government went back to outlawing it. They claimed that using it would weaken our youth and make them more susceptible to Communism (I couldn’t make this up). There’s not a lot of rational thought going on there.
The fertilized form of cannabis - hemp - grows in most climates with little water needed. It has a wide variety of uses, but it doesn’t create more than trace amounts of THC. Most of the US is still saddled with laws that are out of date and based on inaccurate research (if any) regarding hemp. Recently, the DEA stopped and impounded a truckload of legal hemp seeds. It was headed for the research department of the University of Kentucky.
The university then launched a suit against the DEA, and the federal government made the DEA return the hemp to the U of K. That’s how weird this has gotten. Colorado has had the same issue with a truckload of legal hemp seeds that was stopped and held by the DEA on its way from Canada.
These incidents involving hemp seeds helped provide a final impetus toward the House and Senate working to formulate a states rights' law on MMJ. The House has passed such a bill, and it awaits a vote in the Senate. If passed, the law would reach President Obama’s desk and strip a lot of power from the DEA.
They wouldn't be able to interfere in states that have cannabis laws in place. There would be no more meddling or attacks on co-ops and dispensaries by the DEA - in theory, at least. There are also pro-CBD laws in process.
Growing hemp would benefit any state that has an agricultural aspect to its economy. We currently pay a premium to import hemp seeds, which is absurd. Biofuel made from hemp seeds is less expensive and more effective than ethanol derived from corn, which requires a lot of water and uses nearly as much energy as it provides at the gas pump. Touting ethanol as an effective way to combat our addiction to oil is mostly balderdash.
Some of CBD's effects do leave a smile on one's face. Many of its effects and mechanisms are listed here; for those interested in pharmacology and chemistry, it's a good starting point. Yet, while a good start, this is not cutting edge work; most news sources are out of date to some degree by publication date. The field is exploding with new discoveries. Even so, this gives some helpful background information. It also mentions more precise receptor and antagonist actions.
Some cannabis extracts can help to cure heroin addiction, alcoholism, and other true addictions. CBD can reduce the symptoms of MS and cerebral palsy, as can MMJ. MS patients who were having violent muscle spasms have been filmed used cannabis (see Part I). They became relaxed and comfortable after doing so. There are times when medical grade cannabis and THC are more effective than CBD.
The neuroprotective capabilities of CBD make it effective against epilepsy and cerebral palsy. It makes surviving chemotherapy more likely and less horrific. Some aspects within cannabis appear to treat or even prevent certain cancers.
CBD can also treat depression, and PTSD treatments employing it are showing undeniable progress. The trials are in their early stages; I look forward to their finished publication.
Nothing is perfect. Yet this step forward isn’t unlike the effects of Louis Pasteur developing penicillin. It will open new doors in medicine. The process of getting the research done will take time. Early research shows that the benefits will be worth it. CBD isn’t expensive to create. A lot of folks who have the interest will be growing plants that yield that same ratio of THC to CBD at home within a few years at most.
A Short History of Cannabis
About 2,700 years ago, in Persia, the spiritual teacher Zoroaster penned a sacred text of about 10,000 plants. He included marijuana at the top of the compendium, due to its vast clinical applications.
Hippocrates, the father of western medicine, also recommended it.
Queen Victoria's physician, Sir Russell Reynolds - who was one of the world's leading doctors of that era - prescribed medical cannabis for the Queen's menstrual cramps and for other symptoms. Today, the Queen could be thrown in jail for using it. It's still effective for those problems today, but the rules have changed. Writing about medical marijuana in the first edition of the British medical journal The Lancet, Reynolds said it’s “one of the most valuable medicines we possess.”
Sir William Osler, widely hailed as one of the best physicians in the world at that time, used it for migraines with excellent results.
The father of French psycho-pharmacology, Dr. Jean-Jacques Moreau de Tours, used the plant in the treatment of depression. The US government has admitted that it is safe and helpful to treat that condition today.
Many of the modern drugs that are used for the same purpose have dreadful side effects and can be dangerous or even fatal. Cannabis has many things to recommend it, including clinical effectiveness, but near the top has to be the fact that in the known history of the world, not one person has ever died from ingesting cannabis. That's a rare thing in pharmacology.
Dr. Donald Tashkin is one of the world’s leading experts in lung function. After 30 years of study, he could find no reason to keep cannabis prohibited.
Law Enforcement Officers Against Prohibition (LEAP) has a long list of former undercover drug police, police chiefs, and others - including Senior US District Court Judge John L. Kane - who find the current claims on cannabis shaky at best.
There is no evidence at all that CBD is addictive. It has no effect on the consciousness, nor is there a receptor in the brain that would produce an outcome.
The question regarding cannabis addiction, while perfectly valid, has a strange history. I will state that for now, we don’t know that cannabis is addictive. Why?
We know it from the late Dr. Tod Mikuriya, former national administrator of the US Government's marijuana research programs, who is outspoken on the subject. Dr. Mikuriya stated that no other single drug or substance has as many therapeutic benefits as cannabis. He never found a link to addiction.
We know it from Dr. James Hudson, PhD, Professor Emeritus, University of British Columbia Department of Pathology and Lab Medicine, and from dozens of other doctors and studies.
Hudson said pharmaceutical companies have a great incentive to recreate the organic compounds in marijuana and sell a drug from it, rather than just release the all-natural version to the public:
The prime motivation behind any drug company is to make money, and as much money as possible. In the case of a synthetic compound, if it's only an ingredient from the cannabis, they can formulate that as a drug and make a lot more money off of it.
There are dozens of other doctors and similar studies, too many to list here. But Francis Young, an administrative DEA judge, once took medical testimony for over two weeks. At the end of it, on September 6, 1988, he said,
Marijuana, in its natural form, is one of the safest therapeutically active substances known to man.
There are no receptors that cannabinoids fit into that would create true addiction.
The Boggs Act of 1951 established mandatory sentences for drug users and claimed that cannabis was addictive. New testimony given by Dr. Harris Isbell, Director of Research at the Public Health Service hospital in Lexington, Kentucky, exploded the traditional rationale. He stated that marijuana was not physically addictive.
His research was buried under the new rationale for harsh penalties against offenders of the marijuana laws - that the drug inevitably is the stepping stone to heroin addiction. That remains unproven. The government's actual approach to funding research is elucidated here. In short, if it might be helpful, no research is permitted.
In over 6,000 years of usage in Oriental Medicine, I found that no cases of addiction were reported. The Emperor Fu Hsi called it a popular remedy in 2,900 BC.
In the early 1900s, as part of the Prohibition movement (which often went far beyond alcohol), cannabis was claimed by some (few of them in the medical profession) to be addictive. The recommended treatment, in most cases, was the use of heroin. That sums up the validity of those claims in my eyes.
A long term study, Ganja in Jamaica: A Medical Anthropological Study of Chronic Marihuana Use, published in the Journal of the American Medical Association in 1975, showed no concerns with addiction, even when patients who had used cannabis for decades stopped. The same was true with the 1980 study Cannabis in Costa Rica: A Study in Chronic Marijuana Use.
Dr. Lester Grinspoon, Professor Emeritus at Harvard Medical School, spent most of his professional life studying cannabis, from the 1960s to the first decade of this century. You can read his text, Marihuana: The Forbidden Medicine. He didn’t find a single case of addiction. He also said,
There are no deaths from cannabis use. Anywhere. You can't find one.
But in the 1990s, there was a sudden movement of patients who were ‘addicted’ to cannabis into treatment facilities. A survey done at that time noted that nearly all of them had come from the courts, when judges gave as their ruling a requirement for entering into treatment for addiction or entering prison. It was a simple choice for many.
Later in that decade, though, the National Institute on Drug Abuse (NIDA) began to fund research that had the goal of ‘proving’ that cannabis is addictive. Rather than find the biochemical pathway by which this was supposedly true - which has never been done - addiction became defined by the presence of some degree of ‘withdrawal’. Since no specific parameters for withdrawal were defined, the studies proved whatever the researchers wanted.
NIDA wanted to claim that cannabis is addictive. They got what they wanted:
The ugly truth is that the U.S. National Institute on Drug Abuse (NIDA), the agency that oversees 85 percent of the world’s research on controlled substances, is on record stating that its institutional policy is to reject any and all medical marijuana research. “As the National Institute on Drug Abuse, our focus is primarily on the negative consequences of marijuana use,” a NIDA spokesperson told The New York Times in 2010. “We generally do not fund research focused on the potential beneficial medical effects of marijuana.”
Let’s be clear: There are people who shouldn’t use any substance that affects consciousness, cannabis included. They may be among those who are classified as ‘addicted’. People with mental health issues should only use it under a physician’s care. There are anecdotal stories of dire levels of withdrawal, but they are rare and difficult to prove.
When I obtained some of the actual studies, the level of slanting and sloppy research was usually obvious. I will cheerfully change my opinion when and if the biochemical chain that causes withdrawal is proven, and when appropriate research is done. Until then, I remain unconvinced.
Why, after all these millennia, is cannabis suddenly addictive? The higher THC content cannabis that is used for MMJ patients is now available to the public in some states and countries. That could in theory be a factor, but the sudden move to claim addictiveness predated its availability. As a physician, I can’t accept this claim without a reasonable standard of proof. If you run a detox program and insist that a patient is addicted, they will often both believe that and act out of it. I saw that often when working in the detox field. A better standard of proof is required.
Or, patients can try CBD first, and use cannabis if CBD fails.
We’re nearing the end of the pointless government Prohibition model for cannabis. Even many of the conservatives in the House and Senate are jumping on the bandwagon to provide specific legal status for CBD and many, both Republicans and Democrats, for medical marijuana.
In all, over 200 diseases have responded to one or more of the substances, including CBD, that hemp or cannabis contains. I used Lester Grinspoon’s approximate number of the diseases (above) that MMJ treats. I don’t know of anyone with better credentials in the field.
The CBD category is currently the most important substance for the medical cannabis community. I’m one such patient. We’re not interested, as a group, in getting high. CBD won’t do that. We do want to get out of pain. Landslides of recent peer-reviewed studies have shown how well CBD achieves this. There are hundreds of such studies now.
In my case, I’m able to handle longer sessions of work, and my average pain level has diminished. Physically, I’m visibly and noticeably stronger. Continued use of the CBD (combined with other procedures and techniques) allowed me, this week, to lift an 80-pound air conditioner out of the car and place it on a furniture dolly - without pain. I couldn’t lift 20 pounds last year. The wheelchair is now gathering dust in a corner of the garage. That's anecdotal, but for me it's wonderful.
Combining CBD and medical cannabis use with various spinal procedures has been effective in many cases. Anecdotal evidence is how most research starts. A doctor finds benefits in a particular molecule, substance, or procedure, and word gets around. Soon, someone obtains a grant, and research studies are set. The process for better medicine continues.
There’s A Better Way
One option is to legalize cannabis. Questions of its use in athletics, though, may drag on forever. Instead, take a quick look here. Blow up the CannLab paper until you can read it. See the various CBD formulas? Each has benefits that should be researched.
CBD itself treats pain, MS, inflammation, epilepsy, muscle spasms, and dozens of other disorders, including PTSD. To repeat the central issue, CBD is a C-1 receptor antagonist - it reduces or eliminates the high from THC. C-1 is the receptor into which THC fits, which provides the ‘high’.
CBD fits into the C-2 receptor in the cerebral cortex, sparking many health benefits. It changes the neurotransmitter balance for the better. It affects the endocrine and lymphatic systems. There are other receptors for other substances in the plant. All have health benefits, most of which were not explored due to government interference.
The hybridized hemp plant is available, inexpensive, and has shown beneficial effects on many disorders. So has cannabis. Legally, we often can’t research them for lack of funding. Some universities have decided to break that law. Most of our valid research has come in the last five years.
I’m hopeful that more and more parts of the plant will be explored. There is some evidence that certain aspects of cannabis can fight or even prevent certain forms of cancer. That’s just one of the hundreds of possible effects.
Those who use THC need to recognize that the two extracts tend to counter each other. That can be helpful. The CBD is stronger in that encounter, and it will reduce the THC effects of smoking cannabis such as lack of focus and/or short term memory issues. When we look at the side effects of cannabis that have been shown in double-blind, peer reviewed studies, it’s best to recognize that most of them can be eliminated by using common sense and CBD.
To the best of my knowledge, in the vast majority of cases of using CBD, there are no side effects at all. Having the lowest THC level possible will even improve CBD effects. A few patients will probably have some nausea or other mild reactions. I recommend that anyone who considers the product check on them before using it. My experience is that everything ‘new’ will have some unintended consequences.
Although this extract is harmless so far, it may later show some restrictions - everyone’s unique. At this point, what we know is that we can reduce opioid use, their side effects, and the death rate from them.
Let’s use the better option.
I want to thank Doc Ponderosa for his help. His clarity of vision for the patient is laudable. He teaches his students “to cure sometimes, to heal often, and to comfort always”. More doctors should take that advice. His work on developing that approach within the medical system has been a huge help to me personally, as well as to his other patients. Denny, you’re the best.
With the DEA investigation of the NFL’s use of painkillers in its early stages, these may prove informative:
Here are some other studies on cannabis that might prove helpful:
The Wooton Report, England
The Le Dain Report, Canada 1970
The LaGuardia Committee Report, USA 1944 (Mayor of NY LaGuardia presiding)
The Shafer Report, 1972, (Given to Richard Nixon, who ignored it and launched the War on Drugs. The report was initially suppressed for several years.)
CANNABIS: Our Position for a Canadian Public Policy, Canadian Senate, 2002