The cultivation of medical cannabis ( Cannabis sativa L.) is expanding in controlled environments, driven by evolving governmental regulations for healthcare supply. Increasing inflorescence weight ...and plant specialized metabolite (PSM) concentrations is critical, alongside maintaining product consistency. Medical cannabis is grown under different spectra and photosynthetic photon flux densities (PPFD), the interaction between spectrum and PPFD on inflorescence weight and PSM attracts attention by both industrialists and scientists. Plants were grown in climate-controlled rooms without solar light, where four spectra were applied: two low-white spectra (7B-20G-73R/Narrow and 6B-19G-75R/2Peaks), and two high-white (15B-42G-43R/Narrow and 17B-40G-43R/Broad) spectra. The low-white spectra differed in red wavelength peaks (100% 660 nm, versus 50:50% of 640:660 nm), the high-white spectra differed in spectrum broadness. All four spectra were applied at 600 and 1200 μmol m -2 s -1 . Irrespective of PPFD, white light with a dual red peak of 640 and 660 nm (6B-19G-75R/2Peaks) increased inflorescence weight, compared to white light with a single red peak of 660 nm (7B-20G-73R/Narrow) (tested at P = 0.1); this was associated with higher total plant dry matter production and a more open plant architecture, which likely enhanced light capture. At high PPFD, increasing white fraction and spectrum broadness (17B-40G-43R/Broad) produced similar inflorescence weights compared to white light with a dual red peak of 640 and 660 nm (6B-19G-75R/2Peaks). This was caused by an increase of both plant dry matter production and dry matter partitioning to the inflorescences. No spectrum or PPFD effects on cannabinoid concentrations were observed, although at high PPFD white light with a dual red peak of 640 and 660 nm (6B-19G-75R/2Peaks) increased terpenoid concentrations compared to the other spectra. At low PPFD, the combination of white light with 640 and 660 nm increased photosynthetic efficiency compared with white light with a single red peak of 660nm, indicating potential benefits in light use efficiency and promoting plant dry matter production. These results indicate that the interaction between spectrum and PPFD influences plant dry matter production. Dividing the light energy in the red waveband over both 640 and 660 nm equally shows potential in enhancing photosynthesis and plant dry matter production.
•Medical and recreational cannabis use is becoming more frequent among older adults.•The detrimental effects of early-life cannabis use may not translate to use in older ages.•Cannabis use in older ...ages may be associated with improved brain health.•Current evidence of long-term effects of cannabis exposure on cognition in old age is only suggestive.
While medical and recreational cannabis use is becoming more frequent among older adults, the neurocognitive consequences of cannabis use in this age group are unclear. The aim of this literature review was to synthesize and evaluate the current knowledge on the association of cannabis use during older-adulthood with cognitive function and brain aging. We reviewed the literature from old animal models and human studies, focusing on the link between use of cannabis in middle- and old-age and cognition. The report highlights the gap in knowledge on cannabis use in late-life and cognitive health, and discusses the limited findings in the context of substantial changes in attitudes and policies. Furthermore, we outline possible theoretical mechanisms and propose recommendations for future research.
The limited evidence on this important topic suggests that use in older ages may not be linked with poorer cognitive performance, thus detrimental effects of early-life cannabis use may not translate to use in older ages. Rather, use in old ages may be associated with improved brain health, in accordance with the known neuroprotective properties of several cannabinoids. Yet, firm conclusions cannot be drawn from the current evidence-base due to lack of research with strong methodological designs.
Medicinal cannabis (MC) has been used extensively throughout history. However, its criminalization in the United States in 1937 spurred the international community to follow suit, including Norway. ...Despite being reintroduced as a medical treatment in many countries in recent years, the use of MC in Norway is confined to a select few patient groups, and medical specialists must formally apply for authorization from the Norwegian authorities to prescribe the drug.
To assess Norwegian physicians' perceived knowledge of, experience with, and attitudes towards MC.
A cross-sectional survey consisting of 31 closed-ended items captured physicians' perceived knowledge of, experience with, and attitudes towards this treatment.
A total of 102 physicians participated in this study. Physicians generally agreed that MC is a legitimate treatment option (n = 45, 44.1%), that it represents a therapeutic agent for treating cancer and chemotherapy-induced side effects (n = 88, 86%), and that it has the potential to reduce unnecessary opioid use in patients with chronic pain (n = 40, 39.2%). Statistically significant differences were found between subgroups in the sample in terms of years of practice, specialty, age, country the medical diploma was obtained from, and practice type.
This study found acceptance of cannabis as a therapeutic agent as well as acceptance towards MC being introduced by prescription in Norway. Further large-scale in-depth studies on provider perspectives towards MC are warranted.
•Anxiety and PTSD are qualifying conditions for medical marijuana (MM) in PA.•The study sample included individuals with these qualifying psychiatric conditions.•Participants displayed reduced ...anxiety at month 3 post-MM treatment initiation.•They also reported reductions in medication use, particularly for benzodiazepines.•Results support the use of medical marijuana as a treatment for anxiety and PTSD.
Anxiety and post-traumatic stress disorder (PTSD) are qualifying psychiatric conditions for medical marijuana (MM) treatment in Pennsylvania. This study examined baseline prevalence and changes in prescription anxiety medication use three months following MM treatment initiation among individuals with these qualifying conditions.
The study sample was comprised of 108 adults with anxiety or PTSD as a referring condition; they were enrolled in a longitudinal study evaluating biopsychosocial outcomes in new MM patients. Consenting participants completed an assessment battery at baseline and Month 3 (n = 94, 87 % follow-up rate) that included a measure of anxiety severity and questions about current anxiety medication prescription and desired (baseline) and actual (Month 3) reductions in medication use.
Findings indicated that 59 % of participants reported prescription medications for anxiety, with 70 % reporting at least a moderate desire to reduce medication use. Overall and within the medication sub-sample, participants displayed significant reductions in anxiety severity from baseline to Month 3 (p’s <0.0001). Furthermore, 32 % reported actual reductions in medication use at Month 3, and reductions were more likely among patients prescribed benzodiazepines than other drug classes.
Results suggest that a significant number of MM patients with anxiety and/or PTSD diagnoses are currently being prescribed antianxiety medications and that MM may help to reduce their use of these medications.
Limitations include the observational study design and the lack of a PTSD-specific measure. More controlled longitudinal studies are necessary to better understand the role of MM in the treatment of anxiety and PTSD.
The use of cannabis for opioid use disorder is considered irresponsible as there are no clinical trials or research on its use. The article discusses the risks of cannabis use which include cognitive ...impairment, psychotic changes, and structural brain changes. Therefore, use of prescribed medications like methadone, and buprenorphine are advised instead of cannabis treatment which is not proven.
Abstract Objectives Cannabis has been legalized for medical use in almost half of the states in the U.S. Although laws in these states make the distinction between medical and recreational use of ...cannabis, the prevalence of people using medical cannabis and how distinct this group is from individuals using cannabis recreationally is unknown at a national level. Methods Data came from the 2013 National Survey on Drug Use and Health (NSDUH). All adults endorsing past year cannabis use who reported living in a state that had legalized medical cannabis were divided into recreational cannabis use only and medical cannabis use. Demographic and clinical characteristics were compared across these two groups. Results 17% of adults who used cannabis in the past year used cannabis medically. There were no significant differences between those who used medically versus recreationally in race, education, past year depression and prevalence of cannabis use disorders. In adjusted analyses, those with medical cannabis use were more likely to have poorer health and lower levels of alcohol use disorders and non-cannabis drug use. A third of those who reported medical cannabis use endorsed daily cannabis use compared to 11% in those who reported recreational use exclusively. Conclusions Adults who use medical and recreational cannabis shared some characteristics, but those who used medical cannabis had higher prevalence of poor health and daily cannabis use. As more states legalize cannabis for medical use, it is important to better understand similarities and differences between people who use cannabis medically and recreationally.
Recently, several countries approved the use of cannabis flowering tops with standardized amount of ∆9-tetrahydrocannabinol (THC), cannabidiol (CBD) to treat several diseases. Therapeutic monitoring ...of medical cannabis products administered to patients for the established pathologies is rarely carried out. Previous few investigations have been developed in conventional matrices like blood and urine. This is the first study involving hair analysis of THC, CBD and their metabolites in patients treated with medical cannabis. An ultra-high-performance liquid chromatography-tandem mass spectrometry method to quantify THC, CBD, and metabolites, i.e., 11-nor-9-carboxy-THC (THC-COOH), 11-hydroxy-THC (11-OH-THC) cannabidiol-7-oic acid (7-COOH-CBD), 7-hydroxycannabidiol (7-OH-CBD), 6-α-hydroxycannabidiol (6-α-OH-CBD) and 6-β-hydroxycannabidiol (6-β-OH-CBD) in hair samples was developed and fully validated. The validation results indicated that the method was accurate (average inter/intra-day error, <10%), precise (inter/intra-day imprecision, <10%), and fast (10 min run time). Average hair concentrations in four patients treated with different formulations of medical cannabis were 2.75 ng/mg THC, 2.87 ng/mg 11-OH-THC, and 0.32 ng/mg THC-COOH (n = 3); 1.65 ng/mg CBD, 2.73 ng/mg 7-OH-CBD, 1.29 ng/mg 7-COOH-CBD, 0.35 ng/mg 6-α-OH-CBD, and 0.03 ng/mg 6-β-OH-CBD. The proposed method proved suitable for a fast and sensitive determination of all target compounds allowing high throughput testing in individuals monitored for medical cannabis treatments.
•We report the most comprehensive method to quantify THC, CBD and metabolites in hair.•The method is simple and fast, allowing high-throughput analyses.•Suitable for quantifying cannabinoids in hair from patients under medical cannabis treatment.
Following the legalization of cannabis in Canada in 2018, people aged 65 + years reported a significant increase in cannabis consumption. Despite limited research with older adults regarding the ...therapeutic benefits of cannabis, there is increasing interest and use among this population, particularly for those who have chronic illnesses or are at end of life. Long-term Care (LTC) facilities are required to reflect on their care and policies related to the use of cannabis, and how to address residents' cannabis use within what they consider to be their home.
Using an exploratory case study design, this study aimed to understand how one LTC facility in western Canada addressed the major policy shift related to medical and non-medical cannabis. The case study, conducted November 2021 to August 2022, included an environmental scan of existing policies and procedures related to cannabis use at the LTC facility, a quantitative survey of Healthcare Providers' (HCP) knowledge, attitudes, and practices related to cannabis, and qualitative interviews with HCPs and administrators. Quantitative survey data were analyzed using descriptive statistics and content analysis was used to analyze the qualitative data.
A total of 71 HCPs completed the survey and 12 HCPs, including those who functioned as administrators, participated in the interview. The largest knowledge gaps were related to dosing and creating effective treatment plans for residents using cannabis. About half of HCPs reported providing care in the past month to a resident who was taking medical cannabis (54.9%) and a quarter (25.4%) to a resident that was taking non-medical cannabis. The majority of respondents (81.7%) reported that lack of knowledge, education or information about medical cannabis were barriers to medical cannabis use in LTC. From the qualitative data, we identified four key findings regarding HCPs' attitudes, cannabis access and use, barriers to cannabis use, and non-medical cannabis use.
With the legalization of medical and non-medical cannabis in jurisdictions around the world, LTC facilities will be obligated to develop policies, procedures and healthcare services that are able to accommodate residents' use of cannabis in a respectful and evidence-informed manner.
To describe the experience of five Israeli pediatric epilepsy clinics treating children and adolescents diagnosed as having intractable epilepsy with a regimen of medical cannabis oil.
A ...retrospective study describing the effect of cannabidiol (CBD)-enriched medical cannabis on children with epilepsy. The cohort included 74 patients (age range 1-18 years) with intractable epilepsy resistant to >7 antiepileptic drugs. Forty-nine (66%) also failed a ketogenic diet, vagal nerve stimulator implantation, or both. They all started medical cannabis oil treatment between 2-11/2014 and were treated for at least 3 months (average 6 months). The selected formula contained CBD and tetrahydrocannabinol at a ratio of 20:1 dissolved in olive oil. The CBD dose ranged from 1 to 20mg/kg/d. Seizure frequency was assessed by parental report during clinical visits.
CBD treatment yielded a significant positive effect on seizure load. Most of the children (66/74, 89%) reported reduction in seizure frequency: 13 (18%) reported 75-100% reduction, 25 (34%) reported 50-75% reduction, 9 (12%) reported 25-50% reduction, and 19 (26%) reported <25% reduction. Five (7%) patients reported aggravation of seizures which led to CBD withdrawal. In addition, we observed improvement in behavior and alertness, language, communication, motor skills and sleep. Adverse reactions included somnolence, fatigue, gastrointestinal disturbances and irritability leading to withdrawal of cannabis use in 5 patients.
The results of this multicenter study on CBD treatment for intractable epilepsy in a population of children and adolescents are highly promising. Further prospective, well-designed clinical trials using enriched CBD medical cannabis are warranted.
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