Cannabidiol (CBD)

Treatment of Addiction

Drug addiction, currently defined as substance use disorders (SUD), are chronic relapsing disorders characterized by a compulsive desire to seek and use drugs or continue behaviors. Additionally, there is impaired control over the substance use or behavior resulting in the persistence of use despite negative consequences.

CBD has potential for treating SUD by improving impaired impulse control and reducing relapse risk by suppressing:

  • Craving induced by drug contexts
  • Susceptibility to stress
  • Anxiety

 

 

Links to other Pertinent Educational Pages:

Links to ALL Marijuana Educational Pages

 

 

Cannabidiol (CBD)

 

 

The medical information on this site is provided as a resource for information only, and is not to be used or relied upon for any diagnostic or treatment purposes and is not intended to create any patient-physician relationship.  Readers are advised to seek professional guidance regarding the diagnosis and treatment of their medical concerns.

 

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Cannabidiol (CBD) –  Treatment of Addiction

Cannabidiol (CBD) appears to have low reinforcing properties with limited abuse potential and also appears to inhibit drug-seeking behavior. Additionally, CBD’s anxiolytic properties and minimal adverse side effects also support its potential viability as a treatment option for a variety of symptoms associated with drug addiction.

 

CBD is a cannabinoid that acts on several neurotransmission systems involved in addiction. Animal studies have shown possible benefits of CBD on opioid and psychostimulant addiction, while human studies offer some preliminary evidence of a beneficial impact of CBD on cannabis and tobacco dependence. CBD has  therapeutic properties of its own that may indirectly be useful in the treatment of addiction disorders, such as its protective effect on stress vulnerability and neurotoxicity. Overall, emerging data remain very limited and are far from being conclusive.

 

The glutamatergic and dopaminergic systems have been found to play an important role in the reinforcing effects of drugs and prolonged risk of relapse. The endocannabinoid system (ECS) has been shown to influence the acquisition and maintenance of drug-seeking behaviors, through its role in reward and brain plasticity. Cannabinoid receptors, particularly cannabinoid type 1 (CB1) receptors, have been implicated in addiction-related processes. Other cannabinoid-related receptors are also linked to neurophysiological functions in the ECS, including transient receptor vanilloid potential 1 (TRVP1), which binds the endogenous cannabinoid anandamide (AEA).

 

One possible therapeutic application for CBD is the treatment of drug addiction. Drug addiction is a chronic, relapsing brain disease and drug addicts remain at risk for relapse for multiple reasons. Prominent among these risks are susceptibility to stress, craving induced by drug contexts, heightened anxiety, and impaired impulse control. 

 

CBD may be effective for reducing these risks. CBD has been reported to have therapeutic benefit for the compulsive nature of drug seeking in addicted individuals., along with anxiolytic and stress-reducing effects and possible antidepressant benefits. CBD exerts many of its neurobiological effects within the brain circuitry that mediates drug craving and seeking and stress (See: Reward Deficiency Syndrome). Also, CBD has neuroprotective actions that include reduction of alcohol-induced neurodegeneration which likely contributes to impulse control deficits in alcoholics. Considering these profiles, CBD has therapeutic potential relevant for multiple conditions that underlie relapse risk, including craving induced by drug-related environmental contexts, susceptibility to stress, heightened anxiety and, possibly, impaired impulse control.

 

CBD seems to influence specific phases of addiction for only certain substances of abuse. A recent systematic review of a limited number of preclinical studies concluded that CBD may have therapeutic properties for opioid, cocaine, and psychostimulant addiction, and also that it may be beneficial in cannabis and tobacco addiction. However, considerably more research is required to evaluate CBD as a potential treatment.

 

CBD – Opioid Addiction

Cannabis (marijuana) is commonly used in combination with heroin and oral opiates, in addition to other substances such as cocaine and benzodiazepines. In several studies of non-opiate illicit drug use in opiate-dependent individuals, cannabis use remains high during treatment for opiate dependence. Several groups have investigated the impact of cannabis use on various measures of treatment outcome and success, such as retention in treatment or compliance. 

 

Multiple studies have reported synergy between cannabinoids and opiates when administered concurrently. No risk or harm to treatment outcome is associated with cannabis use in patients on methadone maintenance therapy (MMT) or buprenorphine (Suboxone). Intermittent cannabis users were found to have improved retention and outcomes in antagonist treatment for opiate dependence. 

 

Nabiximols (Sativex), a THC plus CBD oral spray, in combination with psychosocial interventions is a safe and effective method for reducing cannabis use among individuals with cannabis dependence who are seeking treatment.However, in a 2017 study of 644 patients, 328 of which were considered baseline cannabis users and 256 considered heavy users, patients with baseline cannabis use and heavy cannabis use were at increased risk of dropout (38.9% and 48.1%, respectively). By gender, only female baseline users and male heavy users were found to be at increased risk of premature dropout.

 

CBD by itself appears to have an impact on the intoxication phase of opioid addiction in animals, by reducing the reward-facilitating effect of morphine. So far, research on CBD’s impact on the withdrawal phase of opioid dependence tends to show no or little benefits when administered alone, but CBD may act in synergy with THC on opioid withdrawal. In a study on the effectiveness of non-opioid drugs for opiate withdrawal, cannabis was reported by patients to be less effective in reduction of symptoms than benzodiazepines, but more effective than cocaine, alcohol and nicotine.

 

Perhaps most importantly, CBD affects the relapse phase of opioid addiction by decreasing cue-induced, drug-seeking behaviors.

 

CBD – Cannabis Addiction

See: Cannabis Use Disorder

 

CBD – Tobacco Addiction

One study looked at the impact of CBD on tobacco addiction, a randomized, double-blind, placebo-controlled study of 24 smokers who wished to stop smoking. Two groups received either a CBD inhaler (400 μg/inhalation) or a placebo inhaler. They were instructed to use the inhaler whenever they felt the urge to smoke, to assess daily cigarette and inhaler use, and to monitor their craving. The results showed a significant reduction in the number of cigarettes smoked (≈40%) in the CBD inhaler group during the week of treatment, with a trend indicating a reduction after follow-up. Both groups also showed a reduction in cravings between day 1 and day 7.

 

CBD – Alcohol and Cocaine Addiction

Substance use disorders are chronically relapsing conditions and relapse risk persists for multiple reasons including craving induced by drug contexts, susceptibility to stress, elevated anxiety, and impaired impulse control. The “anti-relapse” potential of a transdermal CBD preparation was evaluated in rat models of drug seeking, anxiety and impulsivity. Rats with alcohol or cocaine self-administration histories received transdermal CBD at 24 hour intervals for 7 days.  CBD reduced context-induced and stress-induced drug seeking without tolerance, sedative effects, or interference with normal motivated behavior. Following treatment these benefits persisted up to 5 months although plasma and brain CBD levels remained detectable only for 3 days. CBD also reduced experimental anxiety and prevented the development of high impulsivity in rats with an alcohol dependence history. These results support the potential of CBD in relapse prevention regarding vulnerability states with long-lasting effects with only brief treatment.

 

In a human study of the impact of CBD on the intoxication phase of alcohol addiction,  the effects of CBD on acute consumption of alcohol in 10 healthy volunteers was performed in a randomized, double-blind, crossover study. Testing subjects were administered alcohol (1 g/kg) and CBD (200 mg) alone or in combination. No difference was found in feelings of being “drunk” or  “drugged” between alcohol- alone and alcohol plus CBD groups.

 

 

Mechanism of Action of CBD with Addiction

The endocannabinoid system (ECS) has targets for treating craving and addiction, including the endogenous cannabinoid receptors and ligands that constitute the ECS. The ECS interacts with other neurotransmission systems that are important in the neural adaptations induced by drug use. For example, type 1 cannabinoid (CB1) receptors  are co-localized with μ opioid receptors in the brain reward center (striatal output projection neurons of the nucleus accumbens and dorsal striatum) that modulate reward, goal-directed behavior, and habit formation important to addiction. Type 2 cannabinoid (CB2) receptors  have very low presence in the brain generally, but recently have been shown to be present in other brain reward areas, the dopamine neurons of the midbrain ventral tegmental area. This area influences the dopamine neurons central to addiction-related behaviors such as drug reinforcement. Stimulation of CB2 receptors in animals suppresses cocaine and alcohol self- administration and related conditioned place preference, as well as nicotine place preference behavior.

 

There are  several pharmacological actions that may contribute to CBD’s benefits for addiction. Contrary to previous beliefs that CBD does not bind directly to cannabinoid receptors, recent research indicates that CBD acts as an inverse agonist at CB1 and CB2. CBD functions as a weak CB1 agonist and it reduces the breakdown of the endocannabinoid anandamide (AEA ) by inhibiting fatty acid amine hydrolase (FAAH) which increases the availability of  AEA. AEA may reduce drug seeking as well as behavioral responses to anxiety and stress.

 

CBD also interacts with neural signaling regulating motivation and reinforcement outside the endocannabinoid system by allosteric modulation of μ-opioid and ∂-opioid receptors. CBD stimulates the transient receptor potential vanilloid 1/2 proteins (TRPV1), which serve as ionotropic cannabinoid receptors. Additionally, CBD modulates glutamatergic transmission in the brain which may ba another possible mechanism for CBD’s “anti-relapse” effects. CBD has serotonin (5-HT1A) receptor agonist actions and it has been shown that 5-HT1A antagonists block the anxiolytic and anti-stress effects of CBD, thus supporting 5-HT1A receptors as a target through which CBD consistently decreases stress vulnerability with produces anti-anxiety activity

 

Recent findings suggest neurogenesis plays a role in the inhibition of drug seeking and relapse. The proneurogenic activity of CBD may represent a mechanism that explains the long-lasting reduction of drug seeking after only brief CBD treatment. Proneurogenic effects have also been implicated in the anti-anxiety effects of CBD.

Terpenes and Addiction

It is theorized that terpenes might provide adjunctive support including myrcene via sedation, pinene via increased alertness, and especially caryophyllene via CB2 agonism due to a newly discovered possible mechanism of action in addiction treatment. CB2 is expressed in dopaminergic neurons in the ventral tegmental area and nucleus accumbens, areas mediating addictive phenomena. Activation of CB2 in rats has been shown to inhibit dopamine release and cocaine self-administration. Caryophyllene, as a high-potency selective CB2 agonist would likely produce similar effects.

 

Resources:

National Academy of Sciences

The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research

 

These lay-person websites appear to be good resources for exploring medical marijuana:

  1. www.GreenCamp.com
  2. www.Healer.com
  3. www.MedicalJane.com
  4. www.ProjectCBD.org

 

 

References:

Epidiolex (cannabidiol)

  1. FDA approves CBD drug – Epidiolex – The Washington Post

Marinol (dronabinol)

  1. Marinol – dronabinol

 

 

Cannabidiol (CBD)- Overviews

  1. CANNABIDIOL (CBD) Pre-Review Report WHO 2017
  2. Cannabidiol – State of the art and new challenges for therapeutic applications. – 2017 PubMed – NCBI
  3. Molecular Targets of Cannabidiol in Neurological Disorders – 2015
  4. A systematic review of cannabidiol dosing in clinical populations – 2019
  5. Applications of Cannabis Sativa L. in Food and Its Therapeutic Potential – From a Prohibited Drug to a Nutritional Supplement – 2021

 

 

CBD – Addiction

  1. Cannabidiol as an Intervention for Addictive Behaviors – A Systematic Review of the Evidence -2015
  2. Unique treatment potential of cannabidiol for the prevention of relapse to drug use – preclinical proof of principle – 2018
  3. Early Phase in the Development of Cannabidiol as a Treatment for Addiction – Opioid Relapse Takes Initial Center Stage – 2015
  4. Impact of Cannabis Use During Stabilization on Methadone Maintenance Treatment – 2013
  5. Nabiximols for the Treatment of Cannabis Dependence: A Randomized Clinical Trial – PubMed – 2019
  6. The impact of cannabis use on patients enrolled in opioid agonist therapy in Ontario, Canada – 2017
  7. Effect of Pharmacological Modulation of the Endocannabinoid System on Opiate Withdrawal: A Review of the Preclinical Animal Literature – 2016

 

CBD – Anxiety

  1. Overlapping Mechanisms of Stress-Induced Relapse to Opioid Use Disorder and Chronic Pain – Clinical Implications – 2016
  2. Cannabidiol Modulates Fear Memory Formation Through Interactions with Serotonergic Transmission in the Mesolimbic System – 2016
  3. Cannabidiol regulation of emotion and emotional memory processing: relevance for treating anxiety-related and substance abuse disorders. – PubMed – NCBI
  4. Review of the neurological benefits of phytocannabinoids – 2018
  5. Plastic and Neuroprotective Mechanisms Involved in the Therapeutic Effects of Cannabidiol in Psychiatric Disorders – 2017
  6. Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. – PubMed – NCBI
  7. Evidences for the Anti-panic Actions of Cannabidiol – 2017
  8. Cannabidiol, a Cannabis sativa constituent, as an anxiolytic drug – 2012
  9. Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients – 2011
  10. The non-psychoactive cannabis constituent cannabidiol is an orally effective therapeutic agent in rat chronic inflammatory and neuropathic pain. – PubMed – NCBI 2007
  11. Beyond the CB1 Receptor – Is Cannabidiol the Answer for Disorders of Motivation? – 2016
  12. Cannabis Therapeutics and the Future of Neurology – 2018
  13. Cannabidiol in Anxiety and Sleep – A Large Case Series – 2019
  14. Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain – 2019
  15. A systematic review of cannabidiol dosing in clinical populations – 2019
  16. Medicinal cannabis for psychiatric disorders – a clinically-focused systematic review – 2020

 

CBD – Interaction with THC

  1. Cannabidiol: a promising drug for neurodegenerative disorders? – PubMed – NCBI
  2. Oral Cannabidiol does not Alter the Subjective, Reinforcing or Cardiovascular Effects of Smoked Cannabis – 2015
  3. Taming THC – potential cannabis synergy and phytocannabinoid-terpenoid entourage effects – 2011
  4. A tale of two cannabinoids: the therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. – PubMed – NCBI
  5. Impact of cannabidiol on the acute memory and psychotomimetic effects of smoked cannabis – 2010

 

 

CBD – Metabolites

  1. Human Metabolites of Cannabidiol – A Review on Their Formation, Biological Activity, and Relevance in Therapy – 2016

 

CBD – Drug-Metabolic Interactions

  1. Cannabidiol, a Major Phytocannabinoid, As a Potent Atypical Inhibitor for CYP2D6 – 2011
  2. The Effect of CYP2D6 Drug-Drug Interactions on Hydrocodone Effectiveness – 2014 
  3. Characterization of P-glycoprotein Inhibition by Major Cannabinoids from Marijuana – 2006

CBD – Pain

  1. The non-psychoactive cannabis constituent cannabidiol is an orally effective therapeutic agent in rat chronic inflammatory and neuropathic pain. – PubMed – NCBI 2007
  2. Molecular Targets of Cannabidiol in Neurological Disorders – 2015
  3. Cannabidiol Modulates Fear Memory Formation Through Interactions with Serotonergic Transmission in the Mesolimbic System – 2016
  4. Cannabidiol enhances morphine antinociception, diminishes NMDA-mediated seizures and reduces stroke damage via the sigma 1 receptor – 2018
  5. Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain. – PubMed – NCBI – 2018
  6. Synergistic attenuation of chronic pain using mu opioid and cannabinoid receptor 2 agonists – 2017
  7. Effects of Cannabidiol and a Novel Cannabidiol Analog against Tactile Allodynia in a Murine Model of Cisplatin-Induced Neuropathy – Enhanced Effects of Sub-Analgesic Doses of Morphine – 2018
  8. Plant-Based Cannabinoids for the Treatment of Chronic Neuropathic Pain – 2018

 

CBD – Topical

  1. Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis – 2015
  2. Myorelaxant Effect of Transdermal Cannabidiol Application in Patients with TMD – A Randomized, Double-Blind Trial – 2019
  3. The Cannabinoids Δ8THC, CBD, and HU-308 Act via Distinct Receptors to Reduce Corneal Pain and Inflammation – 2018
  4. Therapeutic Potential of Cannabidiol (CBD) for Skin Health and Disorders – 2020

  

 

CBD – Pharmacokinetics

  1. Human Cannabinoid Pharmacokinetics – 2007
  2. A tale of two cannabinoids: the therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. – PubMed – NCBI
  3. Human Metabolites of Cannabidiol – A Review on Their Formation, Biological Activity, and Relevance in Therapy 2016
  4.  A Comprehensive Review on Pharmacotherapeutics of Herbal Bioenhancers – 2012
  5. The effects of black pepper on the intestinal absorption and hepatic metabolism of drugs. – PubMed – NCBI – 2011
  6. Piperine-pro-nanolipospheres as a novel oral delivery system of cannabinoids: Pharmacokinetic evaluation in healthy volunteers in comparison to buc… – PubMed – NCBI – 2017
  7. A Systematic Review on the Pharmacokinetics of Cannabidiol in Humans

CBD – Inflammatory Bowel Disease

  1. Cannabidiol Reduces Intestinal Inflammation through the Control of Neuroimmune Axis – 2011
  2. Cannabidiol and Other Non-Psychoactive Cannabinoids for Prevention and Treatment of Gastrointestinal Disorders – Useful Nutraceuticals? – 2020
  3. Manipulation of the endocannabinoid system in colitis – A comprehensive review – 2017
  4. Cannabinoids and Inflammations of the Gut-Lung-Skin Barrier – 2021

  

CBD – Neurologic Disorders: Overviews

  1. Molecular Targets of Cannabidiol in Neurological Disorders – 2015

CBD – Neurodegenerative Disorders: Traumatic Brain Injury and CTE

  1. Molecular Targets of Cannabidiol in Neurological Disorders – 2015
  2. Endocannabinoids and traumatic brain injury – 2011
  3. Endocannabinoids – A Promising Impact for Traumatic Brain Injury. – 2017
  4. Natural cannabinoids improve dopamine neurotransmission and tau and amyloid pathology in a mouse model of tauopathy. – PubMed – NCBI
  5. Preventive Effects of Resveratrol on Endocannabinoid System and Synaptic Protein Modifications in Rat Cerebral Cortex Challenged by Bilateral Common Carotid Artery Occlusion and Reperfusion – 2018
  6. Cannabidiol Reduces Aβ-Induced Neuroinflammation and Promotes Hippocampal Neurogenesis through PPARγ Involvement – 2011
  7. Critical role of mast cells and peroxisome proliferator-activated receptor gamma (PPARγ) in the induction of myeloid-derived suppressor cells by marijuana cannabidiol in vivo – 2015
  8. Endocannabinoid Degradation Inhibition Improves Neurobehavioral Function, Blood–Brain Barrier Integrity, and Neuroinflammation following Mild Traumatic Brain Injury – 2015
  9. Palmitoylethanolamide Reduces Neuropsychiatric Behaviors by Restoring Cortical Electrophysiological Activity in a Mouse Model of Mild Traumatic Brain Injury – 2017
  10. Cannabidiol for neurodegenerative disorders – important new clinical applications for this phytocannabinoid? – 2013
  11. Modulation of Astrocyte Activity by Cannabidiol, a Nonpsychoactive Cannabinoid – 2017

 

Medical Marijuana – Prescribing Guidelines

  1. Simplified guideline for prescribing medical cannabinoids in primary care – Canadian Family Physician – 2018
  2. Physician Recommendation of Medical Cannabis Guidelines Calif Medical Assoc – 2011
  3. Prescribing smoked cannabis for chronic noncancer pain. Preliminary recommendations – Canadian Family Physician – 2014

 

Medical Marijuana – Opioids

  1. Use-of-Prescription-Pain-Medications-Among-Medical-Cannabis-Patients
  2. It is premature to expand access to medicinal cannabis in hopes of solving the US opioid crisis – 2018
  3. Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort – 2018
  4. Patterns and correlates of medical cannabis use for pain among patients prescribed long-term opioid therapy. – PubMed – NCBI
  5. Associations between medical cannabis and prescription opioid use in chronic pain patients – A preliminary cohort study – 2017
  6. The prevalence and significance of cannabis use in patients prescribed chronic opioid therapy: a review of the extant literature. – PubMed – NCBI
  7. The use of cannabis in response to the opioid crisis: A review of the literature. – PubMed – NCBI
  8. Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999–2010 – 2014
  9. Rationale for cannabis-based interventions in the opioid overdose crisis – 2017
  10. Cannabis and the Opioid Crisis – 2018
  11. Impact of co-administration of oxycodone and smoked cannabis on analgesia and abuse liability. – PubMed – NCBI
  12. Cannabinoid–Opioid Interaction in Chronic Pain
  13. Synergistic interactions between cannabinoid and opioid analgesics. – PubMed – NCBI
  14. FDA approves CBD drug – Epidiolex – The Washington Post
  15. Opioid transport by ATP-binding cassette transporters at the blood-brain barrier: implications for neuropsychopharmacology. – PubMed – NCBI – 2011
  16. Opioids and the Blood-Brain Barrier – A Dynamic Interaction with Consequences on Drug Disposition in Brain – 2017
  17. The pharmacokinetics and the pharmacodynamics of cannabinoids. – PubMed – NCBI – 2018
  18. Cannabinoids and Cytochrome P450 Interactions. – PubMed – NCBI – 2016
  19. Pharmacogenetics of Cannabinoids – 2017 Enhanced Brain Disposition and Effects of Δ9-Tetrahydrocannabinol in P-Glycoprotein and Breast Cancer Resistance Protein Knockout Mice. 2012
  20. Pharmacogenomics of methadone maintenance treatment. – PubMed – NCBI
  21. Relationship between ABCB1 polymorphisms and serum methadone concentration in patients undergoing methadone maintenance therapy (MMT). – PubMed – NCBI- 2016
  22. Impact of ABCB1 and CYP2B6 Genetic Polymorphisms on Methadone Metabolism, Dose and Treatment Response in Patients with Opioid Addiction – A Systematic Review and Meta-Analysis – 2014
  23. ABCB1 haplotype and OPRM1 118A > G genotype interaction in methadone maintenance treatment pharmacogenetics – 2012
  24. The opioid epidemic – a central role for the blood brain barrier in opioid analgesia and abuse – 2017
  25. Morphine and the blood-brain barrier – diffusion, uptake, or efflux? – 2017
  26. Cyclosporine-inhibitable Blood-Brain Barrier Drug Transport Influences Clinical Morphine Pharmacodynamics – 2013
  27. Methadone Treatment for Pain States – 2005
  28. Cyclosporine-inhibitable Cerebral Drug Transport Does not Influence Clinical Methadone Pharmacodynamics – 2014
  29. Targeting blood–brain barrier changes during inflammatory pain – an opportunity for optimizing CNS drug delivery – 2011
  30. Targeting Transporters – Promoting Blood-Brain Barrier Repair in Response to Oxidative Stress Injury – 2015
  31. Cannabidiol enhances morphine antinociception, diminishes NMDA-mediated seizures and reduces stroke damage via the sigma 1 receptor – 2018

Medical Marijuana –Misc

  1. A tale of two cannabinoids: the therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. – PubMed – NCBI
  2. Cannabis and cannabis extracts – greater than the sum of their parts? – 2001
  3. Medical cannabis and mental health: A guided systematic review. 2016 – PubMed – NCBI
  4. Epidemiological characteristics, safety and efficacy of medical cannabis in the elderly. – PubMed – NCBI
  5. Cannabis-conclusions – 2017 National Academy of Sciences
  6. Cannabis-chapter-highlights – 2017 National Academy of Sciences
  7. Cannabis-report-highlights – 2017 National Academy of Sciences
  8. Clinical Endocannabinoid Deficiency (CECD): Can this Concept Explain Therapeutic Bene ts of Cannabis in Migraine, Fibromyalgia, Irritable Bowel Syndrome and other Treatment-Resistant Conditions?-2004
  9. Marijuana use and the risk of lung and upper aerodigestive tract cancers: results of a population-based case-control study. – PubMed – NCBI
  10. Cannabis use and cognitive function: 8-year trajectory in a young adult cohort. – PubMed – NCBI
  11. Cannabinoids for Medical Use: A Systematic Review and Meta-analysis. – PubMed – NCBI
  12. Cannabinoids and Cytochrome P450 Interactions. – PubMed – NCBI Pharmacogenetics of Cannabinoids – 2018
  13. Systematic review of systematic reviews for medical cannabinoids – 2018
  14. Adverse effects of medical cannabinoids – a systematic review – 2008
  15. Cannabimimetic effects modulated by cholinergic compounds. – PubMed – NCBI
  16. Antagonism of marihuana effects by indomethacin in humans. – PubMed – NCBI
  17. Pharmacokinetics and pharmacodynamics of cannabinoids. – PubMed – NCBI
  18. Clinical Pharmacodynamics of Cannabinoids – 2004
  19. Affinity and Efficacy Studies of Tetrahydrocannabinolic Acid A at Cannabinoid Receptor Types One and Two. – 2017
  20. Quality Control of Traditional Cannabis Tinctures – Pattern, Markers, and Stability – 2016
  21. Exogenous cannabinoids as substrates, inhibitors, and inducers of human drug metabolizing enzymes: a systematic review. – PubMed – NCBI
  22. Pharmacology of Cannabinoids
  23. Current-status-and-future-of-cannabis-research-Clin-Researcher-2015
  24. Medical Marijuana for Treatment of Chronic Pain and Other Medical and Psychiatric Problems – A Clinical Review – 2015
  25. Cannabis sativa L. as a Natural Drug Meeting the Criteria of a Multitarget Approach to Treatment – 2021

 

Medical Marijuana – Product Evaluation

  1. The Cannabinoid Content of Legal Cannabis in Washington State Varies Systematically Across Testing Facilities and Popular Consumer Products – 2018
  2. Quality Control of Traditional Cannabis Tinctures – Pattern, Markers, and Stability – 2016

Emphasis on Education

 

Accurate Clinic promotes patient education as the foundation of it’s medical care. In Dr. Ehlenberger’s integrative approach to patient care, including conventional and complementary and alternative medical (CAM) treatments, he may encourage or provide advice about the use of supplements. However, the specifics of choice of supplement, dosing and duration of treatment should be individualized through discussion with Dr. Ehlenberger. The following information and reference articles are presented to provide the reader with some of the latest research to facilitate evidence-based, informed decisions regarding the use of conventional as well as CAM treatments.

 

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