Science/Medical

Does Cannabis Really Increase Your Creativity?
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by Dr. Nicola Davies

For decades, artists and entertainers (among others) have extolled the creative benefits of cannabis. Bob Marley believed that “music and herb go together.” Lady Gaga has said she uses cannabis when she writes her songs. Steve Jobs claimed that cannabis made him feel creative. The astronomer Carl Sagan even wrote an essay in 1969 for a book by Dr. Lester Grinspoon titled “Marihuana Reconsidered,” in which he wrote that cannabis increased his appreciation of art, music and food.

To test the hypothesis that cannabis increases creativity, researchers from various fields are conducting studies to establish a reliable link . However, what has emerged is that the link to creativity is more complex than previously thought and hinges on many factors, including the dose of cannabis, its quality and the user’s personality. Researchers who have collated their evidence from properly controlled studies do not necessarily agree with the well-publicized perceptions of many famous users.  So, who is right?

 

In pursuit of the definition of creativity

While creativity is commonly defined as the ability to interpret traditional thinking in new and innovative ways, it is not necessarily confined to artists and performers; a person may be able to use their creativity to make more friends or to find fifty uses for a paperclip. In other words, the definition of creativity can refer either to a person’s output or their personality type.

 

Divergent and convergent thinking

During tests designed to understand how cannabis can affect creativity, scientists measured two types of thinking involved in creativity. There is divergent thinking, where a person arrives at a number of solutions to a problem through brainstorming many different ideas — the more alternate and innovative ideas, the more creative they are. Guildford’s Alternative Uses Task is used to measure this ability.

In convergent thinking, scientists measure a person’s ability to find the most appropriate solution to a defined problem using the Remote Associates Task. In a 2015 Dutch study, the researchers found that if they gave their participants high doses of delta-9-tetrahydrocannabinol (THC) (22mg) versus a low dose (5.5mg) in vaporized cannabis, those on the high dose experienced a drop in creativity, when compared to participants in the  low dose and placebo groups.1 Specifically, high THC doses impaired divergent thinking. On a lower dose, participants scored better on verbal fluency tests, an important aspect of divergent thinking. The study found that the THC content in cannabis, the regularity of how much the person smokes, and the personality type influenced the results. It cited a study in which scores on the Torrance Test of Creative Thinking (TTCT) went down after smoking a joint for those who smoked cannabis regularly; but, for first time users, the TTCT scores increased.2

When less potent cannabis was smoked, users reported feeling that their artistic inhibitions were relaxed. But the question still remained: Did it really allow for better creativity? Scientists looked to neurotransmitters in the brain for answers.

 

It all comes down to dopamine

Dopamine is a neurotransmitter that can increase communication between the neurons and is commonly responsible for activating hormones to produce a “feel good” effect. In a University College of London study, researchers found that low doses of THC allowed neurons in the brain to fire with less inhibition.3 This meant that everyday thoughts were more united rather than random, allowing for deeper concentration. Many studies have documented that cannabis can increase the cerebral blood flow, allowing frontal lobe activation and increased neuron activity, thereby allowing artists to live in the moment and, as Carl Sagan mentioned, increase their appreciation of whatever is in that moment.

At the Karolinska Institute in Sweden, researchers looked at the dopamine receptors of people termed ‘highly creative.’4 They found that a low density of these dopamine receptors in the thalamus allowed many thoughts to get through without the dopamine performing its usual filtering task. This process could be responsible for the divergent thinking of highly creative people, as well as individuals with schizophrenia. But, what effect does cannabis have on individuals at risk of schizophrenia?

 

Psychotic symptoms

According to Rebecca Kuepper of the Department of Psychiatry and Psychology at Maastricht University in the Netherlands, those who take large doses of cannabis to enhance creativity run the risk of psychotic symptoms that could persist long-term.5 Although the researchers involved in Kuepper’s study were cautious, they did say that the natural endocannabinoid system has an important role to play, which could explain why THC affected neurotransmission in people whose dopamine levels were not well regulated, such as those with a psychotic disorder. It would seem from various studies that healthy individuals can cope with low doses of THC, even helping them to focus on their creative output. On the other hand, those at risk of schizophrenia can internalize this creativity in the form of paranoia and delusions.

 

Cannabis might help those low on creativity

In research conducted by Gráinne Schafer and her team from the Clinical Psychopharmacology Unit at University College London, two groups were identified — one with high-trait creativity and one with low-trait creativity.3 Researchers measured scores of various functions on a day when there was no cannabis use and again on a day when cannabis was administered. They found that verbal fluency scores for the group with low-trait creativity increased on the days they had cannabis. In fact, the scores matched the levels of those in the creative group, which they believed might be due to the increased dopamine release reducing inhibitions. They also found that THC seemed to have a disruptive effect on convergent thinking when searching for and converging on a single solution to a problem.

 

Non-users versus regular users

People who smoke cannabis regularly were found to have a fairly low level of dopamine functioning, and with the increase in dopamine activity they would perform better on a divergent thinking task, as long as the THC dose was not too strong. In contrast, for healthy people who have never smoked cannabis and who have no dopamine imbalances, a low dose of THC could stimulate dopamine production to such an extent that they could not perform at optimum levels, therefore reducing their creative ability.

Among highly creative individuals, whether or not they used cannabis regularly, a low dose of THC did not have a negative impact on their creative thinking. It would seem that very creative people have built-in protective systems prevent their brains from being overloaded with neuron activity and an excess of dopamine production.

Overall, it has been established that low doses of cannabis allow most people to focus — in other words, they become more productive rather than creative when they are writing, composing, or painting. In their relaxed state, it seems that cannabis users are able to embrace the ideas normally floating around in their heads and spend the time needed to transform them into a product. So, creative people are right in the  sense that moderate cannabis use allows them to concentrate long enough to sit down and come up with the product that proves their innate creative ability. However, whether using cannabis actually makes a person more creative is still under investigation. ♦   


1.  Kowal, M. A., Hazekamp, A., Colzato, L. S., van Steenbergen, H., van der Wee, N. J. A., Durieux, J., … Hommel, B. (2015). Cannabis and creativity: highly potent cannabis impairs divergent thinking in regular cannabis users. Psychopharmacology232(6), 1123–1134.

2.  Bourassa M, Vaugeois P (2001) Effects of marijuana use on divergent thinking. Creat Res J 13:411–416.

3.  Schafer, G., Feilding, A., Morgan, C. J. A., Agathangelou, M., Freeman, T. P., & Valerie Curran, H. (2012). Investigating the interaction between schizotypy, divergent thinking and cannabis use. Consciousness and Cognition21(1), 292–298.

4.  de Manzano Ö, Cervenka S, Karabanov A, Farde L, Ullén F (2010) Thinking Outside a Less Intact Box: Thalamic Dopamine D2 Receptor Densities Are Negatively Related to Psychometric Creativity in Healthy Individuals. PLoS ONE 5(5): e10670. 

5.  Kuepper R, Ceccarini J, Lataster J, van Os J, van Kroonenburgh M, van Gerven JMA, et al. (2013) Delta-9-Tetrahydrocannabinol-Induced Dopamine Release as a Function of Psychosis Risk: 18F-Fallypride Positron Emission Tomography Study. PLoS ONE 8(7): e70378.

 

Dr. D's Easy Access to Medical Marijuana
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by Amanda Pampuro, photos courtesy of Dr. Donald Davidson

Dr D's Van advertising online cannabis cards

You usually don’t want to hear “doctor” and “virus” in the same sentence, but Dr. D. is taking medical marijuana viral. Earlier this year, Dr. Donald Davidson launched the first tele-medicine platform for cannabis. Now individuals in California with pre-existing conditions can apply for a medical marijuana card from anywhere with WiFi.

“There’s always this buzzword in medicine, which is access, right? And tele-medicine creates access for people that wouldn’t actually have it, whether it’s too big of an inconvenience or they’re elderly or immobile or whatever,” Davidson said. 

Since Davidson partnered with Ease, a California-based cannabis delivery company, his patients can be approved for a referral card and obtain medicine all from within the comfort of their home.

“The way it works is this is a specialized medicine. People are coming in with chronic conditions that have been going on for years and years … so they fill out an intake form and you ask them questions, so you already know what’s going on,” Davidson said. “Our job is to educate people and to screen out people who are unstable, have mental illnesses, and screen out people with new issues. So we wouldn’t give a recommendation just seeing someone online with a new onset, like knee-pain or redness or swelling over the last few weeks or months.”

Dr. D's fleet of smart cars

Harboring an entrepreneurial spirit, Davidson’s other business ventures have included the milk and cookie delivery service. Campus Cookies, running a fishing and kayaking tour service, and being a dating coach. Describing himself as a “typical smart guy,” Davidson was first exposed to the work of Dr. Sue Sisley — famous for her extended struggle to test the efficacy of cannabis in the treatment of PTSD — during his residency at the University of Arizona where he studied emergency medicine.

“The far majority of these [cannabis] doctors [in LA] were total weirdos,” Davidson said. “They had horrible malpractice and were hiding in the cannabis industry, folks prescribing narcotics, over-prescribing Adderall, and giving out fake doctor’s notes. And once we saw that, we were like, ‘Wow, okay, we have a huge opportunity to create this portal to make it safe and normal.’”

“I always loved the business stuff, promoting it, building the business, running the ad campaign, social media, all that stuff,” Davidson said, adding that he personally vets all of the doctors he works with, ensuring his staff maintains both certification and professional appearance.

While he declined to disclose who is launching it, Davidson said, “The Dr. D product line, named in my honor for all my work in the field, is being launched by a friend of mine who has licensed and legal cultivation and manufacturing operations.” While Davidson said he has no financial interest in the product line, he is giving both his name and knowledge to its development.

Dr. Davidson vape pen

“I think the greatest challenge, but it’s also the most fun, is educating people about cannabis,” Davidson said, adding that cannabis is still off the radar for most medical schools. “So me, with an MD behind my name, anything I say publicly must have science behind it. You know, I’m not a stupid staff writer … or any of that bullshit where they fill up these big articles with a bunch of spammy links that’s all fluff, meant to drive traffic to their website. I’m a doctor. What I specialize in is taking massive amounts of information fed to me fire-hose style and finding the need-to-know take away points that people can actually use in a clinically relevant way.”

In addition to using his website as an educational resource for patients, Davidson is about to take a mobile clinic on a road trip across the Golden State to retirement homes and country clubs.

By “educating people that most of these budtenders are 18-year-olds who know nothing of [the] pharmacology of cannabis,” Dr. D. hopes his consultation services will keep the ethos of medical marijuana strong. ♦

Mysterious Marijuana: Myths and Realities
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by Dr. Nicola Davies

Weed, pot, grass, hashish, cannabis, marijuana — whatever you call it, unarguably no other plant in history has been so controversial. Is marijuana an adverse substance that has corrupted users over time? Or does it hold secrets that could change the way it is perceived? Let’s delve into the myths, realities, and possible benefits of this infamous substance.

 
Myth #1: Marijuana is a  gateway to addiction

For decades, marijuana has been nicknamed the “gateway drug” since it is often the first drug people try. In the U.S. and Canada it is the most commonly used illicit drug. According to a survey conducted by Yahoo and The Marist Institute, 55 million Americans have tried the drug at least once in their lifetime.1 Due to its wide use, it may be a gateway drug for some.2 However, the idea that it tempts users to progress to harder substances is mere speculation. There is little evidence to prove that marijuana drives dependence on other drugs. Dr. Karen van Gundy, researcher at the University of New Hampshire, says, “There seems to be this idea that we can prevent later drug problems by making sure kids never smoke pot. But whether marijuana smokers go on to use other illicit drugs depends more on social factors like being exposed to stress and being unemployed — not so much whether they smoked a joint in the eighth grade.”3

 

Myth #2: Marijuana is more addictive than tobacco and alcohol

Marijuana may lead to substance abuse. Research suggests that people who start using marijuana before they turn 18 are more susceptible to substance abuse than those who start using as adults.4 However, many studies over the years have proven that alcohol and tobacco are more addictive than marijuana. For example, Ruben Baler, health scientist administrator for the National Institute on Drug Abuse, said in an interview for a Live Science article, that the adverse effects of alcohol are far more direct and immediate compared to marijuana use. Gary Murray from the National Institute on Alcohol Abuse and Alcoholism also believes that alcohol is often more dangerous than marijuana as it is more likely to react with other drugs.5

 

Myth #3: Marijuana is an herb, so it cannot be harmful

As marijuana is natural, people think it isn’t harmful. While its effects may not be instant, studies have shown correlations between its use and negative health effects. For example, depending on consumption levels, it can interfere with the brain’s ability to process information, which can impact the ability to drive. In 2016, scientists at The National Institutes of Health cited the widespread use of marijuana by American teenagers, with symptoms including slowed cerebral development, depression, and insomnia. 6 According to the World Health Organization (WHO), cannabis can also result in chronic bronchitis.7 Thus, while data on marijuana’s negative effects are not enough to make a conclusive connection, it is by no means harmless.

 

Myth #4: Marijuana has only short-term physical effects

Marijuana, like any illicit drug or even prescription medicine, can have adverse repercussions. However, it boils down to the question of how much is too much. For some, marijuana serves as a rite of passage in their youth. It is unlikely that such users would suffer any long-term consequences. Short-term symptoms can include altered vision and impaired movement and thinking. In contrast, those who become dependent on marijuana and turn into chronic users are likely to have far greater problems, just like an alcoholic or a chain smoker.8 However, to say that marijuana is a killer is a gross exaggeration.

 

Myth #5: Marijuana leads to crime

Marijuana and crime — this connection is as old as marijuana itself. Negative connotations are typical with anything illicit or socially unacceptable. This is not to say that negative perceptions are entirely baseless. In 2013, a study by the office of National Drug Control Policy suggested a strong connection between drug use and crime.9 In 2016, another study found that the long-term use of cannabis could trigger violent behavior.10 However, it can be argued that conclusions from statistically correlative studies may not consider subjective factors such as socioeconomic circumstances or personality traits.

 

Myth #6: Legalizing marijuana will increase its use

Legalized marijuana is not new. The drug is already fully legal in eight states and Washington D.C., as well as partially legal in countries such as The Netherlands and Germany. According to the writer Austin Smith, legalizing marijuana has its advantages. For instance, it offers social benefits like employment and increased tax revenue.11 A major argument against legalizing marijuana is the risk of encouraging teenagers to use it more. However, a survey of youth behavior in the U.S. indicated that teenage use of marijuana has declined over the past two decades.12 Federal statistics indicate that in Colorado, teenage use of marijuana dropped after legalization.13

 

Myth #7: Marijuana causes mental illness and brain damage

Being an illicit drug, marijuana has been shrouded by speculation driven by prejudice and fear. A study by the National Academies of Sciences showed only moderate evidence of an association between the use of marijuana and cognitive impairment. With respect to mental health, the study did suggest a connection to conditions such as schizophrenia in frequent cannabis users.14 But while heavy doses may potentially trigger mental illness, there is no conclusive data to suggest that marijuana causes brain damage.15

 

Myth #8: Marijuana cannot possibly have medicinal benefits

According to the US National Cancer Institute, the use of marijuana for healing goes back over 3,000 years when it was used to alleviate pain and control seizures.16 It’s not a new trend — prescription drugs such as tetrahydrocannabinol have been legitimately sold in the U.S. for years. Cannabinoids are effective in treating symptoms such as vomiting, pain, and muscular stiffness. In 2012, researchers at the University of Plymouth, UK discovered that marijuana helped ease muscle stiffness in 30 percent of 300 multiple sclerosis patients in their sample group.17 A 2017 National Academies of Sciences report on the health effects of marijuana stated that cannabinoids are effective for treating chronic pain in adults, as well as epileptic seizures.18 Although current research on the medicinal benefits of marijuana remains inadequate, its healing qualities are well known and it has been legalized for medical purposes in many countries.

 

Myth #9: Marijuana works miracles in glaucoma treatment

Glaucoma is an eye condition in which optic nerves are damaged due to high eye pressure, or intraocular pressure (IOP). Glaucoma can be managed by lowering IOP. In this context, studies indicate that smoking marijuana could reduce IOP. However, marijuana can only reduce IOP for a few hours, which is why ophthalmologists do not recommend it as a treatment.19


 Myth #10: Medicinal marijuana reverses cancer

Marijuana can reverse or cure cancer — it’s the buzzword that’s gone viral across social media channels in recent times. However, while it has been proven that medical cannabis provides cancer patients relief from chemotherapy’s side effects and studies in animals have indicated that cannabinoids lower tumor growth, there is not enough research to state definitively that marijuana can cure cancer. 20

 

Marijuana Mysteries: The Journey Continues

The world is in the midst of medical innovation, including heightened speculation on marijuana. In this context, it remains to be seen whether marijuana is exalted to the higher echelons of healthcare or if it simply continues its colorful journey through time. But one thing is certain: The myths and misconceptions will also evolve along the way. ♦


References:

1 Yahoo News & Marist College Institute for Public Opinion. (2017). ‘Yahoo News/Marist Poll: Weed & The American Family’. [pdf] USA: Marist College Institute for Public Opinion. Available at: http://maristpoll.marist.edu/wp-content/misc/Yahoo%20News/20170417_Summary%20Yahoo%20News-Marist%20Poll_Weed%20and%20The%20American%20Family.pdf [Accessed 20/06/2017]

2 Secades-Villa R, Garcia-Rodríguez O, Jin CJ, Wang S, Blanco C. (2015) ‘Probability and predictors of the cannabis gateway effect: a national study,’ International Journal of Drug Policy, 26(2):135-142.

3 Gundy, K. (2010). ‘Sep 07, 2010 Researchers Debunk the Gateway Theory … Again’ [blog] 7 September. Available at: https://blog.mpp.org/tag/karen-van-gundy/ [Accessed 20 June 2017]

4 Winters KC, Lee C-YS. (2008). ‘Likelihood of developing an alcohol and cannabis use disorder during youth: Association with recent use and age.’ Drug Alcohol Depend. 92(1-3):239-247.

5 Brownstein, J. (2014). ‘Marijuana vs. Alcohol: Which Is Really Worse for Your Health?’ [blog] 21 January. Available at: www.livescience.com/42738-marijuana-vs-alcohol-health-effects.html/ [Accessed 21 June 2017]

6 Zajicek JP, Hobart JC, Slade A, et al. (2012). ‘Multiple Sclerosis and Extract of Cannabis: results of the MUSEC trial.’ Journal of Neurology, Neurosurgery & Psychiatry. 83:1125-1132.

7 World Health Organization (2017). ‘Management of substance abuse: Cannabis Facts and Figures.’ Available at: www.who.int/substance_abuse/facts/cannabis/en [Accessed 21 June 2017]8

 9 Executive Office of the President of the United States. (2013). ‘National Drug Control Strategy’. [pdf] The White House. Available at: https://obamawhitehouse.archives.gov/sites/default/files/ondcp/policy-and-research/ndcs_2013.pdf [Accessed 21/06/2017]

 10 Schoeler, T et al. (2016) ‘Continuity of cannabis use and violent offending over the life course’ Cambridge Core; Psychological Medicine, 46(8):1663-77.

11 Smith, A. (2016). ‘4 marijuana stats that will blow you away’ [blog] 17 May. Available at: www.usatoday.com/story/sponsor-story/motley-fool/2016/05/17/motley-fool-marijuana-stats/84326712/ [Accessed 21/06/2017]

12 Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Service. (2016). ‘MMWR Series: Youth Risk Behavior Surveillance - United States, 2015. [pdf] USA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Available at: www.cdc.gov/healthyyouth/data/yrbs/pdf/2015/ss6506_updated.pdf [Accessed 22/06/2017]

13 SAMHDA—the Substance Abuse and Mental Health Data Archive (2015). ‘National Survey on Drug Use and Health: Comparison of 2013-2014 and 2014-2015 Population Percentages

(50 States and the District of Columbia).’ [pdf] USA: SAMHDA. Available at: http://samhda.s3-us-gov-west-1.amazonaws.com/s3fs-public/field-uploads/2k15StateFiles/NSDUHsaeShortTermCHG2015.htm [Accessed 22/06/2017]

14 National Academy of Science (2017). ‘The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research’ [pdf] USA: National Academy of Science. Available at: www.drugabuse.gov/publications/marijuana/what-are-marijuanas-long-term-effects-brain [Accessed 22/06/2017]

 15 National Institute on Drug Abuse (NIDA) (2017). ‘Marijuana’ [pdf] USA: NIDA. Available at: http://nationalacademies.org/hmd/~/media/Files/Report%20Files/2017/Cannabis-Health-Effects/Cannabis-report-highlights.pdf [Accessed 22/06/2017]

 16 National Cancer Institute (2017). ‘Cannabis and Cannabinoids (PDQ®)–Patient Version’ [blog] 13 April. Available at: www.cancer.gov/about-cancer/treatment/cam/patient/cannabis-pdq#link/_7 [Accessed 20/06/2017]

17 Zajicek, J.P. et al (MUSEC Research Group) (2012). ‘MUltiple Sclerosis and Extract of Cannabis: results of the MUSEC trial’ [pdf] UK: University of Plymouth. Available at: http://jnnp.bmj.com/content/83/11/1125 [Accessed 21/06/2017]

 18 National Academy of Science (2017). ‘The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research’ [pdf] USA: National Academy of Science. Available at: www.drugabuse.gov/publications/marijuana/what-are-marijuanas-long-term-effects-brain [Accessed 22/06/2017]

19 Turbert, D. (2014). ‘Does Marijuana Help Treat Glaucoma?’, EyeSmart, American Academy of Ophthalmology, 27 June [online]. Available at: www.aao.org/eye-health/tips-prevention/medical-marijuana-glaucoma-treament [Accessed 21/06/2017]

20 Kossen, J. (2016). ‘Can Cannabis Cure Cancer?’ [blog] 27 March. Available at: www.leafly.com/news/health/can-cannabis-cure-cancer [Accessed 21/06/2017]

Cannabis Treatment for Hypertension
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By Dr. Nicola Davies

What Is Hypertension?

Hypertension, also known as high blood pressure, is a serious, chronic medical issue. It occurs when your blood pumps through your veins with too much power. People with hypertension are more likely to suffer from cardiovascular diseases and premature death.  Blood pressure is measured in two parts: systolic pressure and diastolic pressure. The systolic pressure, the top number in blood pressure readouts, expresses how much pressure your blood applies to your artery walls when your heart beats. Since your heart is pumping, the blood pressure is higher and that is the reason the systolic is the top number. The diastolic pressure expresses how much pressure your blood applies to your artery walls between heartbeats. When your heart is not pumping, the pressure is lower and that is why the diastolic pressure is the bottom number. If your systolic pressure is higher than 140 mmHg or your diastolic pressure is over 90 mmHg, then you have hypertension.1 There are many ways to treat high blood pressure, including diet, exercise and maintaining a healthy weight, and studies now show that use of medical marijuana could be a viable treatment for this condition as well.

 

How Can Cannabis Help with Lowering Blood Pressure?

 

Cannabis as Dietary Supplement

A study on hypertensive rats, conducted by researchers at the Department of Human Nutritional Sciences, University of Manitoba, Canada, presents interesting results on the effects of the hemp seed (Cannabis sativa L.)  on systolic blood pressure.2 In a two-month feeding experiment with spontaneous hypertensive rats, the normal systolic pressure was controlled or even decreased when they were fed with hemp seed protein (HPI) or protein hydrolysate (HMH) compared to a casein-only diet. After the third week of the experiment, the rats that had hemp seed protein hydrolysate added to their diet had statistically significant reduction of their systolic pressure compared to the other groups. In the second experiment with adult rats with established hypertension, the diets containing hemp seed peptides or proteins also had an antihypertensive effect compared to the other diet groups. Based on the findings of this research, hemp seed could potentially be used as a nutritional additive for the prevention and treatment of high blood pressure.

Smoking Marijuana

In an early placebo-controlled study amongst patients with glaucoma, marijuana smoking resulted not only in reduced intraocular pressure but also in decreased blood pressure.3 It has also been shown that five to ten minutes after marijuana consumption, subjects can experience tachycardia (a heart rate that exceeds the normal resting rate) and decreased blood pressure.4 A more recent study comprising US adults found that the marijuana smokers had 69 percent probability of not suffering from hypertension compared to non-smokers.5 Nonetheless, the same study demonstrated that the number of years of marijuana use is an important factor and that in the long-term, marijuana smoking can have negative effects on metabolic health. Indeed, research has shown that the sudden discontinuance of cannabis use in heavy users could increase blood pressure.6 Furthermore, the diastolic pressure of the study participants escalated from a mean (SEM) of 74.8 (0.7) mmHg while smoking marijuana to a mean of 81.8 (0.6) mmHg following cessation. Similarly, the mean systolic pressure raised from 129.6 (0.9) mmHg to 139.8 (0.8) mmHg and the mean arterial pressure was also increased.6

 

Cannabinoids in Vivo

The application of cannabis extracts in vivo has also demonstrated positive effects on blood pressure. Rimonabant, a cannabinoid CB1 receptor antagonist, could potentially lower blood pressure, especially in males. In a study where obese or overweight patients were given 20mg rimonabant as a means of controlling their weight, both their diastolic and systolic blood pressure decreased.7 This reduction was even more evident in patients with pre-existing hypertension. Other cannabinoid extracts, such as the main psychoactive ingredient of marijuana, Δ9-tetrahydrocannabinol (THC) and anandamide, caused low blood pressure in unconscious spontaneous hypertensive rats, and the effects of amandine were still evident even when the rats were conscious.

 

Mechanism of Cannabinoids and their Effects

Sándor Bátkai, PhD, and colleagues explored the relationship between the endocannabinoid system and the cardiovascular system, concluding that “endocannabinoids tonically suppress cardiac contractility in hypertension” and that “enhancing the CB1-mediated cardio depressor and vasodilator effects of endogenous anandamide by blocking its hydrolysis can normalize blood pressure.”8 They also argued that focusing on the endocannabinoid system could potentially lead to novel treatments for hypertension. Furthermore, follow-up research found that, “Functional CB1 receptors are present in vascular tissue as well as the myocardium,” and therefore “cannabinoid agonists and endocannabinoids exert major hypotensive and cardio depressor effects in vivo through the stimulation of CB1 receptors.”9 The authors maintain that pharmaceutical research on the endocannabinoid system could prove beneficial for treating high blood pressure and ischemic heart disease.

 

Indirect Ways of Cannabis Effects to Hypertension

Hypertension has many underlying causes, including smoking, obesity, lack of physical activity, a diet high in salt, excessive consumption of alcohol, stress, sleep apnea, genetics, adrenal and thyroid disorders, chronic kidney disease, genetics, and older age.10 Cannabis could be used to treat some of these conditions and, thus, indirectly treat hypertension.

 

Obesity: In a study of 4,657 US adult males and females, it was demonstrated that current marijuana use resulted in lower levels of fasting insulin and smaller waist circumference.11 Based on a study investigating marijuana use and metabolic syndrome among adults in the U.S., current cannabis users were 45 percent less likely to present with metabolic syndrome compared to those who had never used cannabis. For the middle-aged participants, the findings were more interesting, as both current and past users had lower probabilities of developing metabolic syndrome as opposed to those who had never used marijuana.12

 

Stress: In a review study, in which the author examined the effects of medicinal marijuana and post-traumatic stress disorder (PTSD), it was concluded that marijuana use is associated with lower levels of PTSD.13 Neurobiological studies performed on animals and humans confirm these findings, but more research is needed.

 

What does the Future Hold?

Despite the numerous studies examining the effect of cannabis on blood pressure, there are no cannabinoid-based medicines produced which target hypertension. Even though the use of cannabis has been proven highly beneficial with reducing intraocular pressure and marijuana is legally prescribed to patients with glaucoma, there is still room for improvement to prove its benefits for lowering blood pressure. As there is not yet any study that focuses on the effects of marijuana and its extracts on hypertensive patients, the antihypertensive potential of cannabis is left largely unexplored. Ideally, more studies with hypertensive patients should be considered to provide reliable data which physicians can use to prescribe cannabis-based treatment for this condition.

 

 

References:

  1. Eisenberg, J. M. (2012). Measuring Your Blood Pressure at Home. Center for Clinical Decisions and Communications Science. Retrieved February 21, 2017, from https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0041082/#conssmbp.s3
  2. Girgih, A. T., Alashi, A., He, R., Malomo, S., & Aluko, R. E. (2014). Preventive and treatment effects of a hemp seed (Cannabis sativa L.) meal protein hydrolysate against high blood pressure in spontaneously hypertensive rats.European journal of nutrition53(5), 1237-1246.
  3. Merritt, J. C., Crawford, W. J., Alexander, P. C., Anduze, A. L., & Gelbart, S. S. (1980). Effect of marijuana on intraocular and blood pressure in glaucoma.Ophthalmology87(3), 222-228.
  4. Merritt, J. C. (1982). Glaucoma, hypertension, and marijuana.Journal of the National Medical Association74(8), 715.
  5. Yankey, B. N., Strasser, S., & Okosun, I. S. (2016). A cross-sectional analysis of the association between marijuana and cigarette smoking with metabolic syndrome among adults in the United States.Diabetes & Metabolic Syndrome: Clinical Research & Reviews10(2), S89-S95.
  6. Vandrey, R., Umbricht, A., & Strain, E. C. (2011). Increased blood pressure following abrupt cessation of daily cannabis use.Journal of addiction medicine5(1), 16.
  7. Pacher, P., Bátkai, S., & Kunos, G. (2006). The endocannabinoid system as an emerging target of pharmacotherapy.Pharmacological reviews58(3), 389-462.
  8. Bátkai, S., Pacher, P., Osei-Hyiaman, D., Radaeva, S., Liu, J., Harvey-White, J., ... & Kunos, G. (2004). Endocannabinoids acting at cannabinoid-1 receptors regulate cardiovascular function in hypertension.Circulation110(14), 1996-2002.
  9. Pacher, P., Bátkai, S., & Kunos, G. (2005). Blood pressure regulation by endocannabinoids and their receptors.Neuropharmacology48(8), 1130-1138.
  10. Klodas,E. (2015).Causes of high blood pressure. (2015). WebMD. Retrieved February 23, 2017, from, http://www.webmd.com/hypertension-high-blood-pressure/guide/blood-pressure-causes#1
  11. Penner, E. A., Buettner, H., & Mittleman, M. A. (2013). The impact of marijuana use on glucose, insulin, and insulin resistance among US adults.The American journal of medicine126(7), 583-589.
  12. Vidot, D. C., Prado, G., Hlaing, W. M., Florez, H. J., Arheart, K. L., & Messiah, S. E. (2016). Metabolic Syndrome among marijuana users in the United States: an analysis of National Health and Nutrition Examination Survey data.The American journal of medicine129(2), 173-179.
  13. Yarnell, S. (2014). The Use of Medicinal Marijuana for Posttraumatic Stress Disorder: A Review of the Current Literature.The primary care companion for CNS disorders17(3).
Does CBD Convert to THC When Ingested? The findings from one study conclude it is possible.
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by Dr. Nicola Davies

Many people may be aware that cannabidiol (CBD) is a non-psychoactive constituent of the cannabis plant. New research, however, seems to indicate that this isn’t actually correct.

Cannabis strains high in CBD are popularly used as anti-inflammatories, as muscle relaxants and as general analgesics. Cannabis plants with high levels of delta 9–tetrahydrocannabinol (THC), on the other hand, are often smoked or ingested in order to produce feelings of euphoria and concomitant reductions in stress. Though high-CBD strains are often associated with indica varieties and high-THC with sativa varieties, this is not necessarily the case.

Executive Director of Wo/Men’s Alliance for Medical Marijuana (WAMM), Valerie Corral, wrote in a 2007 unpublished study titled “Differential Effects of Medical Marijuana Based on Strain and Route of Administration: A Three-Year Observational Study” that, “Patients did not note major differences between the cannabis sativa and cannabis indica strains.” Corral concluded, “We hope that a reliable and accessible means of analysis will become available in the near future.”1 Corral’s hopes for the future are closer to being realized. New research carried out by Kazuhito Watanabe (PhD) and his associates at Daiichi College of Pharmaceuticals, Japan, resulted in a paper titled, “Conversion of Cannabidiol to Δ9-tetrahydrocannabinol and Related Cannabinoids in Artificial Gastric Juice, and Their Pharmacological Effects in Mice.”2 The research has shown that variations in gastric juices can lead to a different result from that expected when taking CBD. So far, testing has only been carried out on mice and artificial gastric juices have been used, but the results provide food for thought and may pave the way for further studies with human participants.

Essentially, the study by Watanabe and his team has demonstrated that when CBD comes into contact with an artificial gastric juice, the non-psychoactive CBD is converted by those juices to the
psychotropic element delta 9–tetrahydrocannabinol (THC), as well as 9α-hydroxyhexahydrocannabinol (9α-OH-HHC) and 8-hydroxy-isohexahydrocannabinol (8-OH-iso-HHC). These two latter cannabinoids, known together as HHCs (hexahydroxycannabinols), were found to have THC-like effects on the laboratory mice. The researchers do point out, however, that the effects of the HHCs were not as strong as those of actual THC.

The main objective of the research was to show that THC is not the only psychoactive component of cannabis. The results suggest that sufficient attention needs to be paid to HHCs and their effect when they are combined with gastric juices during the digestive process. This could explain the anomalies in results for previous studies when the effects of CBD were tested on humans. As studies have so far only been conducted on mice, further research is required with humans to establish its applicability in the real world.

What causes the change to occur?
When people ingest cannabis in cakes or cookies, these usually contain some kind of sugar. The stomach becomes more acidic due to the sugars in these foods, as well as in any alcoholic drinks consumed when smoking or ingesting CBD. This acidity accelerates the change from CBD into THC, two HHCs and cannabinol (CBN).

What did the scientists measure?
The researchers began from the baseline of what has already been established about the effects of THC on the body: loss of sensation, drop in body temperature, prolonged sleep and reduced pain perception. The four aspects they chose to test were catalepsy (the loss of sensation or consciousness, inducing a rigid body), hypothermia (an abnormal drop in body temperature), pentobarbital induced sleep (deeper sleep when a barbiturate is given) and antinociception (the reduction in sensitivity to painful stimuli).

How did they do it?
Watanabe and associates isolated and purified THC, CBD and CBN from cannabis leaves using previously tried and tested methods. They placed the cannabinoids into an artificial gastric juice to observe the effects. Using a gas chromatograph, a sample solution was injected into the instrument, which then entered a gas stream of either helium or nitrogen used as carrier gas. The sample was then directed into a tube that separated the components. Results showed that CBD broke down into THC, two HHCs and CBN. To test the effects of these CBD components, the researchers administered small quantities to their experimental mice.

...when CBD comes into contact with an artificial gastric juice, the non-psychoactive CBD is converted by those juices to the psychotropic element delta 9–tetrahydrocannabinol (THC)...

How were changes measured and what did they find?
To test catalepsy, 24 mice were separated into three groups of eight and injected with THC, HHCs and CBN. Researchers waited fifteen minutes for the cannabis to take effect, then placed the front paws of the mice on a bar. If the mouse did not move its paws within 30 seconds, it was regarded as having a rigid or cataleptogenic reaction. The injection of THC affected the mice the most, and the HHCs were less effective than THC, but more so than CBN, which had very little effect.

For the hypothermic reactions test, mice were again divided into groups of eight and injected with THC, HHCs and CBN, respectively. Two hours later, their rectal temperature was taken. The results were consistent with the test for catalepsy, with THC causing the highest temperature drop. HHCs had an effect, but not as pronounced as THC, while injections of CBN did not produce any significant drop in temperature. Through its action on the central nervous system, THC prolongs deep sleep, so for this test, the researchers injected the mice first with the cannabinoids, and then gave them sodium pentobarbital fifteen minutes later to see how their sleep was affected. As expected, the mice given the THC slept the longest, those given HHCs slept less and those given the
CBN were least affected.

For the sensitivity to pain test, the mice were again given injections of the various cannabinoids, then twenty minutes later were given a 0.7 percent acetic acid solution and assessed on the amount of writhing produced by measuring abdominal contractions. Again, the results were consistent: THC produced the strongest block to pain with least writhing, the HHCs were somewhat effective, but less than THC and CBN had very little effect on pain blocking compared to the placebo group. 

Further studies needed
Much research has involved the administration of THC and CBD to patients for symptoms such as fibromyalgia, Crohn’s disease and insomnia, but researchers have been circumspect in declaring their results and have called for further testing. Watanabe’s research, though conducted on mice, may hold true for humans – but that must be the subject of future studies. As Georgetown University Medical School’s Dr. Robert du Pont pointed out, there are an estimated 400 components in the cannabis plant, making it difficult to determine exactly which component is providing relief when cannabis is ingested for medical reasons.3 

Could anomalies in results have resulted from the way gastric juices break down CBD within the human body? In a 2016 study published in Cannabis and Cannabinoid Research, by John Merrick and associates, it was noted that, “In recent epilepsy research, pediatric subjects receiving orally administered CBD showed a relatively high incidence of adverse events (≤44%), with somnolence (≤21%) and fatigue (≤17%) among the most common.”4 This led the researchers to more closely investigate the accepted premise that CBD is non-psychoactive. They came to the conclusion that, “Gastric fluid without enzymes converts CBD into the psychoactive components Δ9-THC and Δ8-THC, which suggests that the oral route of administration may increase the potential for  psychomimetic adverse effects from CBD.”

From recent studies, it seems that there is a need to find delivery methods that decrease the risk of psychoactive cannabinoids forming during the digestive process. To this end, Zynerba Pharmaceuticals Inc. has developed an innovative transdermal synthetic cannabinoid treatment that bypasses the gastrointestinal tract, thus avoiding bioconversion to psychoactive THC.5 This may be the way forward in using CBD to assist patients with medical conditions without them inadvertently experiencing unwanted psychoactive effects. 

 

1. Corral, V.L., 2001. Differential effects of medical marijuana based on strain and route of administration: a three-year observational study. Journal of Cannabis Therapeutics, 1(3-4), pp.43-59.

2. Watanabe, K., Itokawa, Y., Yamaori, S., Funahashi, T., Kimura, T., Kaji, T., Usami, N. and Yamamoto, I., 2007. Conversion of cannabidiol to Δ9-tetrahydrocannabinol and related cannabinoids in artificial gastric juice, and their pharmacological effects in mice. Forensic Toxicology, 25(1), pp.16-21.

3. Kleber, H.D. and Dupont, R.L., 2012. Physicians and medical marijuana. American Journal of Psychiatry, 169(6), pp.564-568.

4. Merrick, J., Lane, B., Sebree, T., Yaksh, T., O’Neill, C. and Banks, S.L., 2016. Identification of Psychoactive Degradants of Cannabidiol in Simulated Gastric and Physiological Fluid. Cannabis and Cannabinoid Research, 1(1), pp.102-112.

5. Zynerba Pharmaceuticals, Inc., 2016. First and Only Synthetic CBD Formulated as a Permeation-Enhanced Gel Being Developed for Refractory Epilepsy, Osteoarthritis and Fragile X Syndrome. [ONLINE] Available at: http://zynerba.com/in-development/cbd-gel-zyn002/. [Accessed 21 July 2016].

The Black, White and Gray of Cannabis Regulation
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by David B. Bush

Talk about cannabis, especially in the realm of industrial hemp, invariably leads somebody to offer up the bromide that there are “gray areas” of the law. The law is vague and confusing, so it is said, which creates uncertainty about what is legal and what is illegal. But when I read the black letter of the law, I find little if anything that anyone would ever call gray. Federal drug laws may be a lot of things, including silly, counterproductive, and downright bad, but they are not vague or confusing. I find no shades of gray.

Make no mistake about it, cannabis plants, all cannabis plants, are classified under federal law as marijuana, a Schedule I controlled substance. Not only that, but most parts of the cannabis plants are also considered marijuana; in particular, the leaves and flowers. Nor does the law stop there. “Every compound, manufacture, salt, derivative, mixture, or preparation” of marijuana is also classified as marijuana.

All varieties of cannabis plants contain dozens or hundreds of chemical constituents. These include cannabinoids, nitrogenous compounds, amino acids, proteins, glycoproteins, enzymes, sugars, hydrocarbons, alcohols, aldehydes, ketones, simple acids, fatty acids, esters, lactones, steroids, terpenes, non-cannabinoid phenols, flavonoids, vitamins, and pigments. To the extent that any are derived from the leaves or flowers of cannabis, federal law classifies them as marijuana. One might challenge the wisdom of that definition all day long, I certainly do, but disagreement over what the law says does not make it any less clear.

Colorado is experiencing a boom in the market for cannabinoid products derived from cannabis. Most noteworthy perhaps is Δ-9 tetrahydrocannabinol, the multisyllabic psychoactive goody that we have all come to know and love as THC, popularly consumed throughout the ages for its recreational and medical benefits. But there is a veritable alphabet soup of cannabinoids found in cannabis besides THC, dozens or hundreds of them. They include tetrahydrocannabivarin (THCV), cannabidiol (CBD), cannabinol (CBN), cannabichromene (CBC), cannabigerol (CBG) and a host of others.  Every single cannabinoid meets the federal definition of marijuana, because they are all derived from the leaves and flowers of cannabis. Every single one of them is a Schedule I controlled substance, making their unauthorized manufacture, possession and distribution a federal crime.

There is a flawed popular perception that the key to illegality in the world of cannabis is THC. But THC appears nowhere in the federal definition of marijuana.  Federal law does not care whether a cannabis plant is chock full of THC or has any measurable concentration of the substance at all. It simply does not matter whether the stuff made from cannabis could give one a buzz or not.  It is all equally illegal in the eyes of the law.

Many wish to believe that industrial hemp is different. A number of states, including Colorado, define industrial hemp to mean cannabis with a below-threshold concentration of THC in the plant tissue, generally recognized as no more than 0.3 percent by dry weight. Other than the narrow exception for academic research and development articulated in the 2014 Farm Bill, no similar distinction exists in federal law. But low concentrations of THC in industrial hemp does not help the plant avoid the onus of federal prohibition. Cannabinoid products are all classified as marijuana, regardless of the variety of plant from which they were made and regardless how much or how little THC the plant or the product made from it might contain.

Manufacture of cannabinoid products in Colorado is booming. But they are not being regulated in a consistent manner. Cannabinoid products made from what the state has defined as marijuana are strictly controlled under complex and pervasive regulations promulgated and administered by the Marijuana Enforcement Division in the Department of Revenue. In contrast, the only aspect of state-defined industrial hemp that is subject to regulation is cultivation, by the Department of Agriculture. Processing and sale of cannabinoid products made from industrial hemp is not regulated at all. In fact, Colorado law actually accords statutory immunity to anyone who processes and sells products made from legally registered and cultivated industrial hemp. Section 108(2) of the hemp regulatory statutes provides as follows: “[A] person engaged in processing, selling, transporting, possessing, or otherwise distributing industrial hemp cultivated by a person registered under this article, or selling industrial hemp products produced therefrom, is not subject to any civil or criminal actions under Colorado law for engaging in such activities.”

The stark difference in Colorado between the regulation of marijuana and industrial hemp presents a particular challenge to federal drug enforcement. In a now-famous memorandum authored by Deputy Attorney General James M. Cole on August 29, 2013, the U.S. Department of Justice effectively gave the nod to states such as Colorado to experiment with regulated cannabis markets. Federal law enforcement policy since issuance of the Cole Memorandum generally has been to avoid prosecution in states where cannabis is legal, provided that actors play by state rules and avoid implicating certain federal law enforcement priorities. One of the enumerated law enforcement priorities is to prevent the diversion of marijuana from a state where it is legal to another state where it is not. Therein lies the problem in Colorado. Diversion of cannabinoid products made from industrial hemp is now occurring on a large scale.

Transporting cannabinoid products made from industrial hemp across state lines places them in the stream of interstate commerce, where federal law, not Colorado law, controls. And federal law is clear: any product made from the leaves or flowers of any cannabis plant is marijuana. Interstate sales of cannabinoid products cannot be characterized as anything other than trafficking in a Schedule I controlled substance. Such activities not only break federal law, but they implicate at least one of the law enforcement priorities set forth in the Cole Memorandum, against diverting marijuana out of state.

So far, the federal government has been remarkably tolerant of interstate sales of cannabinoid products, other than for those rich in THC. Relatively few attempts have been made to impede their transport outside of Colorado. But that does not reflect any change in the law, only a relatively lax attitude by the current administration in Washington. That could change dramatically with the next administration, or for that matter, at any time. The current situation cannot continue. It exposes the regulated cannabis market in Colorado to the risk of significant intervention by federal law enforcement.

Recent calls have been made in some circles in Colorado for implementation of regulations that would apply to all cannabinoid products, without regard to the source material from which they were made. Such regulations would include licensing, standards for quality and content, labeling, and prohibitions against export out of state, as long as the products remained federally illegal. Not surprisingly, some in the industrial hemp sector have reacted with vehement indignation to such proposals. The very thought of having their industry lumped in with marijuana offends their self-image of moral superiority and entitlement to special protection. But the reality is otherwise.  There is but one plant, cannabis. There is but one body of federal law against it. Cannabis has but one future. We must all sink or swim from the same boat.

Federal drug laws are bad and need to be changed. Prohibitions against cannabis, all cannabis, both marijuana and industrial hemp, should be abolished. But until that day comes, the State of Colorado must rationalize its current regulatory system to avoid implicating federal law enforcement priorities set forth in the Cole Memorandum.

As an industrial hemp attorney, I support regulation of the processing and sale of cannabinoid products, including those made from industrial hemp. I have little doubt that it is coming. Resistance to regulation might delay the day of reckoning, but cannot forestall the inevitable. The industrial hemp sector can choose to be part of the problem, by denying that there is one. Or it can be part of the solution, by working to create a sound, reasonable and fair system of regulation. I would respectfully counsel the latter.

 

 


 

David B. Bush is the managing member of David B. Bush, L.L.C. dba David’sLaw, a business law practice dedicated to furthering the successful development of industrial hemp in Colorado and throughout the United States. His web page is www.davidlawcolorado.com and he may be reached at [email protected].

Morning Sickness and Marijuana
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by Dr. Nicola Davies

Severe morning sickness can cause dehydration, weight loss, and bleeding. These effects are sometimes so acute that women need to be hospitalized. However, small doses of marijuana have been found to be highly effective in the treatment of morning sickness, even in severe cases. Those who prefer the use of something non-psychoactive can utilize low-THC hemp oil, which also gives relief from morning sickness. Nevertheless, what concerns mothers-to-be is the possible impact of cannabis on the developing fetus. Dr. Nicola Davies investigates the historical, anecdotal, and scientific evidence surrounding this controversial use for medical marijuana.

Cannabis for Morning Sickness: Historical Evidence
Historical evidence suggests that various forms of cannabis have been used for the treatment of morning sickness for thousands of years. The earliest records date back to ancient Egypt, where women chewed hemp seeds as a cure for nausea during early pregnancy.

Records from China and Persia, dating back to the 7th century BC, also refer to the use of cannabis for morning sickness. According to Dr. Ethan Russo, in his work “Cannabis treatments in obstetrics and gynecology: a historical review”, female flowers or seeds were used. Presumably, treatment was administered in much the same way as we use cannabis today, whereby seeds are taken orally and flowers are smoked.

By the 19th Century, cannabis tinctures were being used in Europe and America as a treatment for a variety of conditions, ranging from headaches to morning sickness. However, in the 1930s, the U.S. media campaign against cannabis began, and various unsubstantiated claims regarding “Reefer Madness” became the sensational news of the day. This led to the banning of any form of cannabis, including non-psychoactive hemp, in 1937.

The end result of this ban was to effectively end modern research on the therapeutic effects cannabis; even today, researchers still have great difficulty obtaining approval for studies regarding the use of cannabinoids for therapeutic applications.

Modern Evidence
In 1994, Dr Melanie Dreher’s article on the use of cannabis as treatment for morning sickness among Jamaican women was published in the scientific journal Pediatrics. According to Dreher, Jamaican women smoke cannabisas a folk remedy for morning sickness, despite the fact that it is officially discouraged.

In 2002, Dr. Wei-Lin Curry, who herself suffered from a severe, life-threatening form of morning sickness known as Hyperemesis gravidarum (HG), published an anecdotal paper regarding her personal experience of medical marijuana as a treatment. She notes that conventional medicines are known to be “questionable” for the “long-term safety of the fetus,” as well as being expensive and limited in efficacy. Curry turned to medical marijuana as a last resort and found that two puffs in the evening and one in the morning were sufficient to cure her condition.

A 2006 survey, conducted in Canada and published in the Journal Complementary Therapies in Clinical Practice, found that 68 percent of respondents had tried cannabis as a treatment for morning sickness; 92 percent of these women said that cannabis was effective in treating their condition. Of these, 31 percent chose non-psychoactive hemp taken orally, 8 percent used high-THC tinctures and oils, and the rest smoked or used a vaporizer. The study calls for further research into the subject.

Could You Be Hurting Your Unborn Baby?
Excessive smoking of any kind reduces the oxygen available to unborn children, but recent studies seem to indicate that light medicinal marijuana use won’t adversely affect the fetus or later development of the child. Advocates of medicinal marijuana recommend the use of a vaporizer, rather than an unfiltered smoke, to limit oxygen depletion and the risks associated with ordinary smoking.

Although there have been many studies on the effects of cannabis on fetal health and subsequent childhood development after birth, few control for other factors, such as the use of alcohol and tobacco, and the socio-economic effects of the childhood environment on the subsequent development of children.

In 1997, however, Dr. J.P. Morgan and Dr. Lynn Zimmer reported, “Marijuana has no reliable impact on birth size, length of gestation… or the occurrence of physical abnormalities”; several other studies now seem to support this conclusion. Among these is a study of over 12,000 UK women, which took alcohol use, the mothers’ pre-pregnancy weight, caffeine use, and the use of other illicit drugs and smoking, into account. In 1999, a study of similar magnitude, conducted in the Netherlands, reached a similar conclusion.

But what about susceptibility to cancer? One of the most common forms of cancer to affect pre-adolescent children, acute myeloid leukemia, and its potential connection with maternal cannabis use, has been studied. The results showed no connection between maternal cannabis use and this condition.

Studies in which mothers admitted to combining cannabis with tobacco use and alcohol are less rosy in their results, but it could be argued that tobacco and alcohol are to blame for the problems that arise. There is certainly a large volume of evidence indicating that alcohol and tobacco can and do affect the health of unborn children and their subsequent development. However, heavy use of marijuana may also be found to have adverse effects on later childhood development, particularly verbal ability.

Lastly, the University of Bristol examined the use of alcohol, tobacco and cannabis during pregnancy in order to determine whether there was any correlation with the later development of psychosis in children. The study concluded that, while both alcohol and tobacco may increase the incidence of psychosis, there was no connection between cannabis use by mothers and psychosis in their offspring.

What if You Don’t Want to Get ‘Stoned’?
Although the use of THC as a means of suppressing nausea and vomiting has been widely studied and found to be effective, there are also at least three animal studies that indicate a reduction in nausea in mothers-to-be after using non-psychoactive CBD. This is the cannabinoid that is associated with low-THC hemp.

Henry Vincenty of Endoca, a Netherlands-based firm that specializes in the production of ultra-low THC hemp oil, says that the endocannabinoid system is not yet well understood. “We all produce natural endocannabinoids that are similar to those found in hemp, and pregnant women produce more endocannabinoids than usual, but no one’s quite sure why this happens. There is plenty of anecdotal evidence that low THC hemp oil can relieve morning sickness without psychoactive effects, but there is little scientific evidence at this time.”

Vincenty says that the main reason CBD has enjoyed less attention from the scientific community is that this cannabinoid was identified later than its better-known relative, THC. “We can’t guarantee that it will be effective against morning sickness, but we know that it works in a lot of cases.” Because orally administered treatments work more slowly than inhaled ones, Vincenty recommends using CBD oil as a preventative measure taken twice daily. “You may have to play around to find the right dose, but CBD oil is harmless and has no psychoactive effects. It has so little THC that you won’t even fail a drug test unless you take enormous amounts.”

So What Should We Conclude?
Cannabinoids can cure morning sickness, and scientific studies seem to indicate that they don’t harm the baby. THC has been more widely researched, but it is psychoactive and illegal in many states. Those who would prefer a non-psychoactive, legal option could consider trying low THC-hemp oil as an alternative.

The Specter of Spice
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by Erin Hiatt

At the end of September in New York City, a 33-year-old Bronx woman gave birth to a baby girl in the bathroom of her boyfriend’s apartment. She cruelly and inexplicably threw the baby out of the seventh floor bathroom window. The building superintendent’s wife, cleaning the alleyway below, discovered the child, its umbilical cord still attached. Over the next few days, on the subway platforms, the street corners, and coffee shops, people shook their heads in upset, baffled and muttering, “How could someone do that?” Kenneth Bolton, who witnessed the woman being led in handcuffs to a waiting police car told The Daily Mail that she “was more like she was not human. She was deranged, like she was lost. You know, when someone has a look in their eyes like they don’t know where they are?” A coffee shop barista exclaimed, “They said the devil was in her eyes! I heard she was taking the K2!”

Julie Netherland, Deputy State Director of New York for the Drug Policy Alliance, wrote for The Huffington Post that, “[D]rug scares, according to scholar Craig Reinarman, have been a recurring feature of U.S. society for than 200 years. In his classic article, ‘The Social Construction of Drug Scares,’ he notes that they share a number of features, including media magnification of the problem, linking the drug to a ‘dangerous class,’ and scapegoating a drug for a wide array of public problems. Simply put, drug scares have been used for centuries to vilify particular groups of people to serve political ends.”

K2 is just one of the street names for synthetic marijuana, but it also goes by Spice, Scooby Snax, Diesel, and many more. It’s a chemical creation that has been around a lot longer than the news storm surrounding it, and it’s only marijuana in the sense that both whole-plant marijuana and synthetic, single compound Spice bind to the cannabinoid receptors in our brains. It’s often marketed as “herbal incense” and packaged in what resembles a trippy Kool-Aid packet marked with the words “not for human consumption.”

Because it’s very difficult to track the manufacturers of K2, there is really no way to know exactly what it’s made of, but it’s usually a collection of leaves, tobacco, or potpourri soaked in acetone and sprayed with chemicals called cannabimimetics. As the word connotes, these chemicals can mimic some of the effects of cannabis, and anecdotal reports suggest that it takes some aspects of the marijuana high, from the mellowest mellow to severe anxiety and paranoia, to the extreme. Drugs.com tells us that “some of the synthesized compounds in fake marijuana bind much more strongly to THC receptors than regular marijuana, which can lead to a more powerful, unpredictable, or dangerous effect.” Some of these chemical compounds have been identified as JWH-018, HU-210, CP 47, JWH-073, and JWH-398, to name a few. The DEA has added some synthetic cannabinoids to its list of Schedule I drugs, but of the hundreds of synthetics, only 40 are listed as illegal.

Less than the cost of a joint, synthetic marijuana can be found on the internet and in neighborhood bodegas and gas stations in largely poor, minority neighborhoods with large and visible homeless populations and creeping gentrification. New York City Police Commissioner Bill Bratton told The New York Daily News that, “Synthetic marijuana gives people abnormal strength, makes them dangerous”, and that “weaponized weed triggers nude psychotic rampages.” These claims have been largely debunked. In fact, Bratton’s story of a nude, psychotic rampage was actually drawn from a 12-year-old video of someone high on PCP, but was wielded all the same to kick up a synthetic marijuana fear-frenzy, a very familiar drug war tactic reminiscent of Reefer Madness.

The New York City Council has recently partnered with the DEA to crack down on K2 sellers, but the designer drug is notoriously slippery to criminalize. The moment one of the synthetic cannabinoids is made illegal, the manufacturers stop using it and make a new, legal one. If you are a clever chemist and don’t mind changing your formula, you can sell it legally, at least until law enforcement catches up with your newest creation.

A father in his 30s with two young daughters, Keith is a former addict who spent nine months in prison for possession of methamphetamine. Keith and his wife Sherie have been together for 10 years, and over that time she has seen him high on meth, marijuana, and Spice. Keith, after being drugfree for several years, tried Spice at the recommendation of a friend because it was legal and he didn’t want to go back to jail. Sherie says, “On marijuana, he was just happy. The biggest thing I had to worry about was that we’d run out of food. But on Spice, it was like watching him die before my eyes. It was like he was sedated, I would say ‘I don’t understand what you’re doing, you’re just a zombie.’”

Keith’s wife is not the only person to compare synthetic marijuana users to the walking dead; even The New York Times called the troubled and notoriously rough block between Park and Lexington Avenues on 125th Street in East Harlem “a street of zombies” because of its high number of visible K2 users. Netherland said that, “In New York City, many people use K2 to avoid a positive drug test because it doesn’t show up on a drug panel, and in order to receive social services, they have to have a negative test. It’s a large problem with the homeless and K2 is being used to stigmatize and drive them out.”

The aforementioned synthetic marijuana chemical JWH-018 is named for the man who created it, Clemson professor emeritus of organic chemistry, John W. Huffman. Intrigued by the discovery of the cannabinoid receptor, the system that THC stimulates and binds to, Huffman was funded by the National Institute on Drug Abuse to research how synthetic compounds would react with cannabinoid receptors. He synthesized many such compounds, the first in 1993. “The chemistry to make these things is very simple and very old,” Huffman told The Washington Post. “You only have three starting materials and only two steps. In a few days, you could make 25 grams, which could be enough to make havoc.” The Washington Post further writes that, “Huffman published his formula in series of papers, journals and a book called “The Cannabinoid Receptors.” No one is sure exactly what followed, but in 2008, a German forensic lab identified JWH-018 in what we now know as Spice.

Keith describes himself as an easy-going guy but found that on Spice he was either alarmingly zoned-out or on the verge of becoming completely unglued. “I had a friend who was on steroids, and my anger response was similar and the same as the crack addicts I had dealt with in the past. All the things that make you an adult instead of a child quickly dissolved.” He describes rising in the early morning hours and anxiously waiting for Sherie to get home from her graveyard shift so he could go to the head shop and replenish his supply. When she woke up some hours later, he would be sitting outside and staring blankly, having smoked his entire stash. Sherie says, “The second he told me he was gonna try it I was mad but he took it anyway because it was legal.”

“I had heard it was like weed. The high is instantaneous and it goes straight to your brain, like weed. But it’s not the same high, there’s like a sickness with it,” Keith explains. When the high would wear off about 45 minutes later, he would get nauseous, and smoking more was the only relief. Nausea is only one of the physical effects of synthetic marijuana; The Washington Post lists the others as extremely high blood pressure (stroke range), dilated pupils and red eyes, glazed expression, inability to speak, rapid heart rate (heart attack range), and possible kidney failure. “I did meth for years and years and I never slapped around a girl or got emotionally dependent. And one day I was scraping the pipe for the resin and she took the pipe from my hand and with that, there was no water under the bridge, everything was insurmountable.”

Sherie told Keith that he wasn’t allowed to do drugs inside the house, but he tried to sidestep that rule by using in the basement. “He kept saying, ‘it’s legal.’ He was cleaning his pipe and by that time I’d had it with the whole thing. I went downstairs to tell him he couldn’t do that in the house and he got angry, angry, angry. He was yelling in my face. And he grabbed my wrist and pushed me, so I ran away that night with our baby. I had to leave with my child and then he realized, ‘um, okay.’” By the time Sherie returned he had vowed to quit. And he did, saying that it was harder than stopping meth.

THC Magazine reached out to the NYPD, the District Attorney’s office, the Department of Health and Mental Hygiene, and the Department of Consumer Affairs. All of them said they were unable to honor any requests about K2’s effects on local communities and law enforcement. Only at the request of a constituent did New York City Councilman Ydanis Rodriguez, who represents District 10 in Northern Manhattan honor a press request, and he regurgitated the press releases written by the NYC Health Commissioner’s office. He added one specific, saying that, “We at the city council are giving muscle to the NYPD and the DEA to make sure that we don’t go back to the ‘80s when we had crack cocaine. We are going to push back and any corner in the city is vulnerable.”

Despite the unwillingness of agencies to honor any information requests, what is abundantly clear is that the city’s response to synthetic marijuana has not been effective. The NYC homeless population is at an all time high and increasingly visible, and that has brought enhanced media scrutiny to the homeless, who have been struck hardest by synthetic marijuana. Rather than continuing to criminalize an already vulnerable population, Netherland suggests that elected officials examine the root of the problem and use prevention and regulation instead of the same old war-on-drugs, knee-jerk reaction to a crisis. The Drug Policy Alliance has been working with the New York Department of Health and in response to the surge in K2 emergency room visits (more than 3,000 in 2015 so far), they are launching a campaign to educate the public about synthetic marijuana, which is not only misunderstood but misconstrued. The differences between isolated chemical compounds and wholeplant cannabis are real and profound.

People have died taking synthetic marijuana and there have been dramatic, negative effects on vulnerable populations. Whole-plant marijuana has never killed anyone and hasn’t put entire populations at risk. Sherie concludes, “I personally think that Spice should not be sold to anyone. Spice is scary and it kills people and it almost ruined my life.”

Has the Cannabis Revolution Spread to Washington D.C.?
Read More

by David Bush, esq.

It is said that revolutions begin in the streets, not in ivory towers. Popular acceptance of cannabis did not start with the federal government, but in spite of it. Twenty-three states, along with the District of Columbia, have legalized medical marijuana, while 13 others have legalized limited cannabis extracts for specific therapeutic use. Four states and the District of Columbia have legalized recreational marijuana. Twenty-two states have enacted laws regarding industrial hemp. Over a dozen of them have authorized or intend to authorize commercial hemp production.

We are in the midst of a revolution where state governments are telling their citizens that they may engage in conduct that is still federally illegal. The feds continue to view cannabis, all forms of cannabis, as Schedule I Controlled Substances, the worst of the worst. For all intents and purposes, America is facing one of the greatest continuing acts of mass civil disobedience for the greater good since Paul Revere tattled on the British and ruined their police action to subdue the colonies. It is taking time for the folks in Washington to catch up with the rest of us.

But what is cannabis, anyway? What does it have to do with marijuana and industrial hemp?

Marijuana and industrial hemp are the same plant. Both are cannabis. The Genus cannabis finds expression in three nominal species, or sub-species, respectively called sativa, indica and ruderalis. What we commonly refer to as “marijuana” and “industrial hemp” are merely variants of these sub-species. Marijuana varieties tend to have higher concentrations of delta-9-tetranhydrocannabinol (THC), the stuff that gets people high. Industrial hemp does not. The most well known chemical constituent of cannabis other than THC is cannabidiol, or CBD. Because CBD is non-psychoactive, it is commonly associated with industrial hemp. But CBD can be extracted from any variety of cannabis, regardless of THC content.

Most of the current legislative initiatives at the federal level are directed towards legalizing either industrial hemp, or cannabis used for medical purposes. Medical cannabis products are popularly referred to as either “medical marijuana” or “therapeutic hemp,” generally depending upon whether they are used primarily for the benefits of THC or CBD.

Federal law makes no distinction between varieties of cannabis. Under the current version of the Controlled Substances Act, all varieties of the genus cannabis are considered “marihuana,” without regard to THC content. Certain parts of the cannabis plant that lack significant concentrations of THC and are incapable of propagation are excepted. They include sterilized seeds, oil pressed from seeds, seed residue (“cake”) and mature stalks. But because the cannabis plant itself is still considered a controlled substance, its cultivation is still prohibited, even to make legal products. The current annual value of the hemp industry in America exceeds $500 million and expanding. Almost all of that value derives from raw materials imported from enlightened foreign countries, where hemp cultivation is not only permitted, but encouraged. Congress is facing increasing pressure to allow a home-grown cannabis industry, at least for industrial and medical purposes.

The first crack in the federal legislative armor appeared in 2014, with enactment of section 7606 of the Farm Bill, codified as 7 U.S.C. § 5940, and aptly named “Legitimacy of Industrial Hemp Research.” The Farm Bill authorized state departments of agriculture and institutions of higher education to conduct “agricultural pilot program[s]” and “other agricultural or academic research.” But it permitted research only where the cultivation of hemp was already allowed under state law.

There is a growing movement in Congress to do more. Several proposals have been introduced that will either remove all federal restrictions on industrial hemp, or in the alternative, prevent the federal government from interfering in state-legal industrial hemp activities. Some initiatives extend to marijuana. Four such proposals are discussed below.
Federal Appropriations

The bluntest instrument that Congress can wield in the struggle to reform cannabis laws is simply to prevent them from being enforced. Three initiatives recently approved in the House of Representatives would deny funding to the Department of Justice and the Drug Enforcement Administration to interfere with state-legal cannabis activities. The initiatives came in the form of amendments to H.R. 2578, an appropriations bill for the Departments of Commerce and Justice for the 2015-2016 fiscal year. The first amendment protects state-legal industrial hemp farming. The second guards industrial hemp research and development carried out under the Farm Bill. The third prohibits federal interference with the possession, distribution or use of CBD in states where it is legal. These measures do nothing to change the legal status of cannabis and, if signed into law, would last only as long as the fiscal year. But they are a step in the right direction.

Industrial Hemp Farming Act

The Industrial Hemp Farming Act was introduced in both the House (HR 525) and Senate (S 134). It seeks to create an exception under the Controlled Substances Act for industrial hemp, which is defined as cannabis with a THC concentration of not more than 0.3 percent on a dry weight basis. HR 525 has 56 co-sponsors, including 37 Democrats and 19 Republicans. S 134 has six co-sponsors, two Democrats and four Republicans.

Therapeutic Hemp (Charlotte’s Web) Medical Access Act

Like the Industrial Hemp Farming Act, the Charlotte’s Web Medical Access Act (HR 1635) and the Therapeutic Hemp Medical Access Act (S 1333) aim to carve industrial hemp out of the Controlled Substances Act. But they coined a new term for industrial hemp by calling it a “cannabidiol-rich plant.” Curiously, the term is defined in the same way that industrial hemp is defined in the Industrial Hemp Farming Act, without any reference to CBD concentration. “Cannabidiol” is defined as CBD extracted from a “cannabidiol-rich plant.” Any CBD produced from marijuana varieties continues to be considered a Schedule I Controlled Substance. The bill would effectively grant industrial hemp growers a monopoly in the rapidly growing market for CBD products.

Respect State Marijuana Law Act

The simplest and undeniably the most radical proposal currently before Congress is HR 1940, called the “Respect State Marijuana Laws Act of 2015.” The bill would render the Controlled Substances Act inapplicable to “any person acting in compliance with State laws relating to the production, possession, distribution, dispensation, administration, or delivery of marihuana.” It would effectively force federal recognition and acceptance of any state law legitimizing recreational marijuana, medical marijuana and industrial and therapeutic hemp. HR 1940 has 11 co-sponsors, six Democrats and five Republicans.

None of the legislative measures described above have been scheduled for hearings in the committees to which they are assigned. Prospects for passage of any them in the 114th Congress are low, but the mere fact that they have been introduced with bipartisan support and multiple co-sponsors is cause for optimism and hope. The federal government has not yet caught up with the rest of America in declaring its self-destructive drug wars at an end. Legitimate cannabis industries in this country are still in their infancy. Reform of our oppressive, illogical and anti-business drug laws still has a very long way to go, but change is coming. Stay tuned.

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