Genetics Modify Response to Cannabis: A Look at the COMT Gene

Last week we talked about the need for genetic testing of both the cannabis plant itself and of patients. Speaking in broad terms, we noted that slight alterations in human DNA can lead to noticeable differences in reactions to cannabis. This is something medical cannabis patients can attest to when comparing strains with other medical users. A strain that makes one person feel tired may have little impact on the energy level of another. Today we can introduce one specific mechanism that seems to influence genetic variation in response to cannabis. Interestingly enough, researchers at Warneford Hospital in the UK actually approached this discovery while searching for causes of psychosis (when thought and emotions are so impaired, patients suffer a disconnect from reality). One of the most debated questions in the scientific community is whether cannabis contributes to the development of psychosis. Believers cite that while many people consume cannabis with no lingering health issue, some develop psychotic symptoms immediately after first exposure. Critics do not necessarily disagree with this observation but believe that many different substances and environmental factors can trigger psychotic illness. Regardless, the data would suggest that if only some patients develop symptoms, the cause might be genetic. What gene is causing this? Researchers have identified catechol-o-methyltransferase (COMT) as a gene that regulates dopamine in the cortex of the brain. Studies show that cognitive function is improved in animals “with reduced COMT activity”. This pattern implies that the gene is some sort of limiter, perhaps designed to…

A Practical Look at Cannabis Extract and Sleep

Estimating the number of individuals suffering from sleep disorder is difficult if only because of the variety of sources. While sleep can be interrupted by chronic pain, as is often the case for arthritis patients, other sources such as gastrointestinal activity, breathing difficulties, epilepsy, Alzheimer’s, etc. can also prevent restful sleep. To date, while multiple over-the-counter sleep medications exist, all have large flaws. Benadryl and other anti-histamines, usually diphenhydramine, are known to have the side effect of sleepiness and are often taken as sleeping pills. However, diphenhydramine can be habit-forming. Melatonin, on the other hand, can help re-enforce natural sleep cycle/rhythm, but can’t overcome serious sleeping barriers. Finally, prescription sleeping medications, such as Ambien, which are much stronger and more resilient, often have semi-psychotic side effects and can produce uncomfortable and sometimes dangerous experiences. While cannabis and cannabinoids may not provide a complete answer, they represent another potential avenue for eliciting sleep, and as a result, the relationship between sleep and the endocannabinoid system should be a priority of researchers. Unfortunately, despite the fact that we all need sleep, we actually understand little about it. We’ve managed to determine that sleep plays an important role in restoring and healing both the body and mind, with the brain passing through several stages of sleep characterized by the pattern of brain waves in each stage. Truly restful sleep seems to be characterized by attainment of the last stage in the sleep cycle, REM. However, much of the specific brain chemistry remains unclear,…

A Lot To “Digest”: Cannabinoids in the Gastrointestinal System

As a society, we are indebted to researchers who’ve dedicated entire lives to investigating less popular subjects. Early on, medical researchers heightened interest in cannabis miffed a lot of the scientific community as a whole, who thought of cannabis as a recreational drug unworthy of study. However, the study of cannabis and its active ingredients lead directly to the discovery of the mammalian endocannabinoid system. While we initially saw this system as an unessential group of cannabinoid receptors, cannabinoids, and enzymes involved in regulating that system, we now understand just how vital it is to the body. Likewise, while we initially thought cannabinoid receptors only played a direct role in bowel inflammation, we now understand that the entire endocannabinoid system plays a major role in the digestive process. Recently, researchers at UC Riverside released an aggregate review of studies involving the endocannabinoid system in relation to the gastrointestinal system. We found this review especially helpful and have summarized important highlights for readers. The full article is free to the public at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940133/   Gut Motility To function, the intestine must absorb nutrients but also send food onward. The ability to move food onward is called “motility” and is driven by timed contraction of the intestinal muscle. The gut interacts with the brain to determine the pace of contraction and therefore, food motility. Unfortunately, sometimes the timing of contractions can go haywire. Cannabinoids, whether naturally occurring endocannabinoids or externally administered cannabinoids, have been shown to reduce motility in a dose-dependent matter.…

Is Inhaling Cannabis Bad for You?

As it stands, cannabis has proven beneficial to one's health in too many ways to list. The cannabinoids contained in cannabis exert their myriad of health effects in particularly gentle ways, and unlike most other pharmaceuticals, cannabis appears to have no toxic limit in healthy adults. Even so, frequent consumers of cannabis may wonder: is inhaling the smoke of anything, even cannabis, good for my lungs? Am I causing long-term damage similar to smoking cigarettes? The short answer: yes, you should avoid inhaling smoke or any burning material as much as possible. The lungs were not made to filter smoke continuously or really at all. For this reason, previous articles on the blog have discussed vaporizers and the importance of using non-combustive methods of consumption (edibles anyone?). Vaporizers not only improve taste of cannabis, but also virtually eliminate damage caused by smoking. Furthermore, vaporizers are generally able to glean a greater medicinal effect from a smaller amount of cannabis. Frequent users should find the financial investment a no-brainer. However, clever readers may also wonder: aside from the physical reality of inhaling burning material, what effects do cannabinoids actually have on the lungs? As it happens, cannabinoid research points to an overwhelmingly positive relationship between cannabinoids and lung health. In fact, while we are generally cautious of making strong statements, this is one area where we can be reasonably certain that the long-term effect of cannabis consumption is positive, at least from the properties inherent in cannabinoids themselves. A September article…

Opioid Withdrawal Treatment: Finding New Roads

Opioids/opiates have provided significant and sometimes life-saving relief to countless patients. They remain some of the strongest painkillers available and can be especially helpful in rendering comfort in otherwise extremely painful terminal illnesses. Opioids work by activating opioid receptors located in the brain, which are densely located in emotion-controlling areas that process pain. Unfortunately, prolonged or extreme use of opioids can lead to dependence, or the body adjusting by limiting natural opioid production and therefore resulting in the body physiologically needing increasing amounts of external opioids to function properly. However, aside from practical issues, high doses of opioids can lead to respiratory failure, death, and other serious health consequences, which means that for all but terminally ill users, opioid withdrawal will eventually occur. Withdrawal is not only unpleasant physically and psychologically (depression, lack of appetite, diarrhea), but potentially life-threatening. In fact, withdrawal is so severe that it can sometimes prevent patients from ending opiate use, causing a downward spiral. As a result, modern doctors are cautious to prescribe opioids and usually seek to wean patients off opioids through slowly decreasing prescriptions. Perhaps more concerning though, aside from medical patients, roughly 4.3 million people in the US alone are currently non-medical users of narcotic pain relievers. Drugs like heroin, hydrocodone, oxycodone, etc. are all opiate-based drugs that are frequently abused for the recreational high. Meanwhile, even drugs intended to wean opiate use, such as buprenorphine, are commonly sold and traded. To date, only compounds that directly activate opioid receptors have been…

Is Cannabis Addictive?

One of the early concerns that dominated the medical cannabis discussion was over both the addictive potential and long-term effects of cannabis. For decades, it has generally been understood by the medical community that cannabis is not physically addictive but can be psychologically addictive. To differentiate, individuals addicted to alcohol cannot suddenly end consumption without risk of death or serious health consequences, because their bodies have learned to literally need alcohol. In contrast, even a frequent cannabis consumer can end consumption immediately without serious health risk. However, this transition might be severely uncomfortable due to the psychological dependence of cannabis use. Some anti-cannabis advocates and researchers alike have pushed for the notion that this dependence is life-long. Researchers from Geneva, Switzerland recently pressed one step forward to directly answer this question by observing changes in brain chemistry during and after chronic cannabis use. To back up, what is addiction and what causes addiction? As researchers note, “the addictive effects of virtually all drugs…are thought to be mediated through activation of mesolimbic dopamine projections to the nucleus accumbens.” Essentially, a neurotransmitter, dopamine, is activated to a greater degree than normal, causing an increased interaction with the part of the brain that deals with decision making, risk, and reward. Dopamine is responsible for a multitude of signaling tasks, but perhaps the most known and most important job is signaling reward. When a user consumes a drug, dopamine is released in the brain, essentially rewarding the user for consuming the drug and teaching…

Schizophrenia, Cannabis, and the AKT1 Gene

We’ve written several articles on the Cornerstone blog about cannabis and schizophrenia. The association between the two is one of the most fascinating puzzles of cannabis science. What we know is that people suffering from schizophrenia are more likely to use cannabis than non-users, and daily cannabis users have a small but doubled risk of developing a psychiatric disorder. Like all psychoactive substances, medical or recreational, cannabis is not for everyone. What makes someone more susceptible to an adverse reaction to cannabis? Or any substance for that matter? What increases someone’s likelihood of being a daily user? At the turn of the century, the idea that anyone could be predisposed to a particular psychoactive reaction was largely disregarded. In fact, many physicians did not accept alcoholism as a valid illness when it was originally added to the Diagnostic and Statistical Manual of Mental Disorders. However, genetic research has changed so much of our understanding of psychiatric health. Rather than imagining everyone to have the same psychological operating system, we know that genes dictate large differences from person to person. Even within an individual, genes can be activated and deactivated throughout a person’s lifetime due to environmental factors and stress. Readers may be able to identify with having a friend who cannot or does not smoke cannabis due to repeatedly unpleasant experiences. “It just doesn’t sit well with me.” Such people are unknowingly referring to their genetic make up and general neurological condition. Of course, knowing that there is a genetic…

Soothing Migraine Headaches with Cannabis

Nearly everyone who’s used medical cannabis can relate to its ability to soothe headaches. From easing stress and tight forehead muscles to reducing body pain, cannabis naturally lends itself to being a headache cure. Yet, surprisingly, no clinical tests are being performed at this time to treat migraine patients with medical cannabis. In other words, while some doctors are already prescribing cannabis for recurring headaches, no large clinical studies on actual humans are being conducted. As readers may guess, this may have something to do with the difficulty of getting approval for human studies involving cannabis. In any case, the situation is now remarkably unusual; medical cannabis dispensaries sometimes have more access to medical information than physicians. Specifically, as a general physician, you may have the opportunity to prescribe cannabis to a number of patients, with only a handful of those seeking treatment for headaches. On top of that, after the prescription for medical cannabis, you can’t track what cannabis was used, how potent it was, where it came from, etc. A large part of the treatment data is inherently unknown by the physician, and getting patients to carefully record and report that data is difficult, further reducing the number of people who could realistically be involved in a study. In fact, busy, time-strapped patients may not even return after successfully treating their problems. Contrast this situation with that of a dispensary. At a medical cannabis dispensary, providers can keep a file on each patient, using purchases to record average…

Cannabis and Motor Coordination

As cannabis rounds the bend in many states toward legalization, one of the biggest questions on society’s mind is how to ensure that it is safe and does not impair potential life threatening activities. Since the founding of MADD in 1980, we’ve grown more aware of the danger of drunk driving, which kills close to 28 people a day in America and is a heart-breaking drain on society. Since cannabis can also have mind-altering effects, as a society, we’re equally wary about the danger of driving under the influence of cannabis or any psychoactive substance for that matter. In fact, this fear is constantly cited as reason for not passing medical cannabis legislation. This concern has led states that have already approved medical cannabis to pass regulations specifying levels acceptable for operating vehicles. At first glance, this all seems acceptable. In the same way that patients with allergies should not take Benadryl before operating machinery, medical cannabis patients must be careful about actions that can jeopardize their safety or the safety of others. However, some of these legal driving limits are unbelievably low. In Washington State, for example, the legal limit is 5 nanograms THC-COOH per milliliter of blood in a blood test. To put that in perspective, this amount could actually exist in a medical cannabis patient 24 hours after consuming cannabis. But is a patient realistically an inhibited driver 24 hours after medication? Of course not. Anyone with a proper medical cannabis experience knows that. However, that’s just…

CBD Salve May Have More Uses than Originally Thought

Topical cannabis preparations have been around since the dawn of civilization and have experienced a resurgence in popularity along with medical cannabis. Usually these salves and creams, which are rubbed into the skin directly, are intended to treat conditions directly below the skin. For instance, cannabis-derived salves are popular among those suffering from arthritis, who apply the cream directly to affected areas to reduce swelling. This method of administration is believed to be more effective for arthritis than oral administration and also avoids many of the otherwise psychoactive effects of cannabis. Of course, manufacturers of cannabis creams and salves are often liberal with claims of conditions the cream can help. For instance, some websites discuss the use of cannabis-derived cream to completely eradicate cancerous tumors or genetic diseases. At this stage of cannabis and cannabinoid research, many unknowns remain, so technically it is possible these claims are true. However, knowing what we know at this point in time, this is probably utter nonsense. To be fair, these manufacturers may have witnessed healing that happened in tandem to salve application and may honestly believe their claims. However, there is a stark difference between several personal observations about using a salve and the extensive laboratory testing needed to scientifically support those claims. Regardless, the question remains: what can cannabinoid salves and creams be used for? As it turns out, there may be an accidental shred of truth to over-zealous claims that the salve can solve more than topical issues. Recently, the DARU…