Cannabidiol (CBD)

Treatment of Dental Pain & Disease

CBD is known to have anti-inflammatory, anti-anxiety, analgesic, anti-microbial and anti-cancer effects that may have therapeutic potential for oral and dental conditions.

 

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.

 

Key to Links:

  • Grey text – handout
  • Red text – another page on this website
  • Blue text – Journal publication

 

Cannabidiol (CBD) – Clinical Use

While the clinical benefits obtained from marijuana (cannabis) are derived from the many constituents found in the plant, the two cannabinoids, THC (delta-9 tetrahydrocannabinol) and CBD (cannabidiol), together are responsible for the majority of the medical benefits. CBD has the advantage over THC in that it is associated with fewer side effects; notably it lacks the euphoric effect or high that impairs thought processing.

For more information regarding CBD products, See:

 

CBD and Dental Disease

Cannabis sativa has been utilized in traditional Asian medicine for tooth-pain management, prevention of dental caries and reduction in gum inflammation. There are many cannabinoid (CB) receptors in the mouth underscoring that the endocannabinoid system may allow for the treatment of oral and dental diseases and interest has most recently been focused on the use of cannabidiol (CBD). CBD is known to have anti-inflammatory, anti-anxiety, analgesic, anti-microbial and anti-cancer effects that may have therapeutic potential for conditions such burning mouth syndrome, dental anxiety, gingivitis (gum disease), and possibly oral cancer. Other constituents found in cannabis such as terpenes and flavonoids also share anti-inflammatory, analgesic, anxiolytic and anti-microbial properties that may also have dental and oral applications.

 

The cannabinoid receptors CB1 and CB2 in addition to a related receptors, the transient receptor potential vanilloid channel type 1 (TRPV1), are located in the mouth and salivary glands and provide therapeutic targets for treatment of certain oral diseases. Cannabinoid receptors located in salivary glands (particularly submandibular acinar cells) help regulate salivation and be useful in the treatment of xerostomia (“dry-mouth”). The following oral and dental conditions have research support for therapeutic benefit.

 

Toothache

Although studies are limited and mechanisms of action not yet established, ∆9-THC, CBD and Cannabigerol (CBG) may help pain associated with toothaches, tooth extractions and post-operative dental pain management.

 

CBD for Acute Dental Pain

A 2024 study, the first randomized clinical trial testing CBD for managing emergency dental pain, evaluated 40 patients with acute dental pain with a single dose of either 10mg/kg or 20mg/kg dose of CBD.  (This is equivalent to 4.5 mg/lb 0r 9 mg/lb). It was demonstrated that both doses provided the same, significant pain relief within 3 hours. The higher dose providing a more rapid onset of relief than the lower dose (15 min vs 30 min) and a more rapid onset of 50% relief ( (60 min vs 120 min). The lower dose was associated with calmness, relaxation, or sleepiness) wheras the higher dose was also more likely to experience diarrhea and abdominal pain which resolved in the same day.

When comparing CBD with other commonly used analgesics for acute dental pain including ibuprofen, ibuprofen with acetaminophen, and oxycodone-10mg with acetaminophen, CBD provided similar benefits. Using the comparator of NNTs, namely the number of patients needing treatment before 1 patient experiences a minimum of 50% pain relief, the NNT for CBD-10 was 3.1 and CBD-20 was 2.4 compared to ibuprofent 400-600mg (2.5-2.7) ibuprofen 200mg/acetaminophen 650mg (1.6) and oxycodone-10/acetaminophen 650mg (2.3).

This study showed for the first time that CBD only can provide more than 70% analgesia to patients with emergency dental pain while maintaining a safe drug profile with minimal side effects.

 

 

Tooth Decay

Dental caries (“cavities” or “tooth decay”), is the result of several factors including plaque- and biofilm-forming bacteria, frequent intake of sugary foods that cause acid build-up, lack of adequate teeth cleaning and subsequent demineralization/erosion of the enamel.

CBD, with its antibacterial properties, assists in the treatment of dental caries. Other major cannabinoids such as cannabichromene, cannabigerol, ∆9-THC, and cannabinol have also demonstrated potent antibacterial activity against bacteria implicated in oral and dental diseases. Cannabinoid-infused mouthwashes also inhibit bacterial activity in dental plaque as effectively as chlorhexidine a common disinfectant and antiseptic agent. CBD-supplemented tooth polishing powder has also been shown to inhibit dental plaque bacteria.

 

Periodontal Disease

Periodontal disease is an inflammatory gum disease caused by bacterial plaque build- up, inflammation and bleeding of the gums.  Periodontal diseases include gingivitis (early-stage gum disease) and periodontitis (severe, advanced-stage gum disease), both characterized by irritation and inflammation of the gum. If left untreated, the disease leads to progressive bone loss and eventually, tooth loss.

 The endocannabinoid system (ECS) offers promise for the treatment of periodontal disease as it plays a role in the modulation/suppression of inflammatory responses by periodontal cells. The endocannabinoid anandamide (AEA) plays a modulatory role in periodontal inflammation. Palmitoylethanolamide (PEA) enhances the benefits of AEA as does the cannabinoid CBG, both providing potent anti-inflammatory and analgesic effects.

Of particular interest is the potential for synergy between PEA, CBD and CBG which when combined, can produce optimal anti-bacterial, anti-inflammatory, antioxidant and analgesic effects.  Studies of CBD and CBG on neuroinflammation show that, when combined, their benefits are enhanced. More research needs to be conducted to confirm if these synergies exist for dental application.

 

Dental Anxiety

Dental anxiety is a frequent and legitimate fear with subsequent avoidance of dental care, a global phenomenon that generally begins in childhood due to conditioning from fearful parents. Multiple studies show a positive correlation between dental anxiety and the development of dental disease.

Strategies to manage dental anxiety include non-pharmacological and pharmacological approaches but recently the therapeutic potential of CBD is gaining interest based on its benefits described above and its anxiolytic properties. It is suggested that sublingual 15–30 milligrams of CBD before a dental appointment may be efffective against dental anxiety and dental pain while providing antibacterial properties.

 

Synergy with PEA (Palmitoylethanolamide)

PEA is an endogenous fatty acid amide that controls tissue reactivity and reduces inflammation. It has been shown to help with neuropathic pain, including dental pain, and based on its mechanisms of action reviewed below it would be expected to do so. A 2011 study found that patients experienced significantly less pain when they were treated with PEA in their postoperative course after impacted lower third molar extraction.

 

PEA is known to mimic several endocannabinoid-driven activities, although it does not bind the classical CB receptors. It enhances the physiological activity of cannabinoids by potentiating their affinity for cannabinoid receptors and the orphan G protein-coupled receptor (GPR)-55 receptors.  PEA suppresses their metabolic degradation by inhibiting FAAH. PEA may also indirectly enhance the effects of both plant cannabinoids and endocannabinoid as agonists of the transient receptor potential vanilloid type 1 (TRPV1), peroxisome proliferator- activated receptor-α (PPAR-α), and the cannabinoid receptors. PEA also down-regulates mast cells, lessening inflammation.

 

Conclusions

Despite the vast anecdotal evidence of the use of cannabinoids and PEA to treat oral and dental disorders, there is limited rigorous scientific evidence for their use in dentistry. There is generally strong evidence to support the properties of cannabinoids, including their analgesic, antioxidant, anti-inflammatory, anti-microbial, anti-pruritic and anti-cancer properties.

 

Cannabinoids may have a significant role in dentistry for the treatment of:

    1. Toothaches
    2. Bacterial infections causing periodontitis, gingivitis, periodontal disease, dental caries, salivary gland infections and abscesses
    3. Inflammation-based oral diseases
    4. Oral and salivary gland cancers
    5. Burning Mouth Syndrome,
    6. Dental anxiety, and
    7. General maintenance of oral hygiene.

Cannabinoids may also be a safer alternative to treat oral and dental diseases and for commercial oral and dental products in general. Further rigorous scientific studies are required to confirm their safety, tolerability, toxicity, efficacy, optimal dosages and optimal delivery systems.

 

 

Dosing of CBD

Specific dosing of CBD needs to be guided individually, taking into account desired therapeutic benefits related to specific symptoms and disease processes as well as the potential for drug-drug interactions with other prescribed medications. Dosing should be guided by a physician knowledgeable about cannabis and cannabis-based products. CBD suppresses the “high” caused by THC when provided at an 8:1 CBD:THC ratio.

 

Incidentally, due to lack of government regulation and oversight, CBD products sold online are often mislabeled regarding constituents, qualitatively and quantitatively. Caution is necessary when purchasing CBD products, including confirmation of product quality by obtaining 3rd party chemical analyses that evaluate product contents. Without this information, predicting accurate dosing from a product becomes very unreliable. Legitimate manufacturers provide these chemical analyses on demand and will often have them available on their websites.

 

CBD can be effective at a very wide range of dosages. It has been found that very low doses can have a very profound impact, from as little as 2.5 mg of CBD daily depending on method of delivery. Doses up to hundreds of milligrams have also been used safely and effectively. In a study that evaluated daily oral doses of 700mg, CBD was found to be nontoxic and other studies have reported CBD doses up to 1500mg/day to be safe. It has also been reported that cannabinoids may have a biphasic or triphasic effect, in that a low dose may provide a certain effect, but higher doses may provide different or opposite effects.

 

A very high dose may also not provide additional benefit over a low dose, so it’s best to start with a low dose: 2.5-5 mg of CBD initially (maybe 10 mg at the most), depending on the product and method of use. A typical starting CBD dose for most people would be a total of 10-12 mg of CBD a day, divided into 3 daily doses. If the desired effect is not achieved at a low dose, then higher doses can gradually be introduced until the therapeutic goal is achieved or side effects or expense deter further increased dosing.

 

The use of tinctures sublingually will be expected to provide a more rapid onset of effect but may not last as long as an oral dose. Orally administered (swallowed) CBD oil can last for four hours or more, but the onset of effects is much slower (30-90 minutes) than a tincture administered sublingually (under the tongue). Tincture dosing is generally performed with a 1 ml dropper which provides about 20 drops/ml.

 

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

 

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 – Dental Pain & Disease

  1. The Current and Potential Application of Medicinal Cannabis Products in Dentistry – 2021
  2. Cannabidiol as an Alternative Analgesic for Acute Dental Pain – 2024

 

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 – PEA (Palmitoylethanolamide)

  1. The Endocannabinoid System and PPARs – Focus on Their Signalling Crosstalk, Action and Transcriptional Regulation – 2021
  2. The Current and Potential Application of Medicinal Cannabis Products in Dentistry – 2021
  3. The Therapeutic Potential of Cannabis in Counteracting Oxidative Stress and Inflammation – 2021
  4. Cannabis and Canabidinoids on the Inflammatory Bowel Diseases – Going Beyond Misuse – 2020
  5. Endocannabinoid System and Its Regulation by Polyunsaturated Fatty Acids and Full Spectrum Hemp Oils – 2021
  6. CB2 Receptor in Microglia – The Guardian of Self-Control – 2021
  7. Therapeutic Potential of Cannabidiol (CBD) for Skin Health and Disorders – 2020
  8. Mast cell–glia axis in neuroinflammation and therapeutic potential of the anandamide congener palmitoylethanolamide – 2012
  9. The Role of the Brain’s Endocannabinoid System in Pain and Its Modulation by Stress – 2015
  10. Cannabinoid‐based therapy as a future for joint degeneration. Focus on the role of CB2 receptor in the arthritis progression and pain – an updated review – 2021
  11. Manipulation of the endocannabinoid system in colitis – A comprehensive review – 2017
  12. Fibromyalgia – Recent Advances in Diagnosis, Classification, Pharmacotherapy and Alternative Remedies – 2020
  13. Cannabinoid Receptor-2 Ameliorates Inflammation in Murine Model of Crohn’s Disease – 2017
  14. Cannabinoids for treating inflammatory bowel diseases – where are we and where do we go? – 2017
  15. Relevance of Peroxisome Proliferator Activated Receptors in Multitarget Paradigm Associated with theEndocannabinoid System – 2021
  16. Palmitoylethanolamide and Cannabidiol Prevent Inflammation- induced Hyperpermeability of the Human Gut In Vitro and In Vivo—A Randomized, Placebo-controlled, Double-blind Controlled Trial. – 2018
  17. Synergistic attenuation of chronic pain using mu opioid and cannabinoid receptor 2 agonists – 2016
  18. Short-term efficacy of a fixed association of Palmitoylethanolamide and other phytochemicals as add-on therapy in the management of chronic pain in elderly patients – 2018
  19. Efficacy of a Combination of N-Palmitoylethanolamide, Beta-Caryophyllene, Carnosic Acid, and Myrrh Extract on Chronic Neuropathic Pain – A Preclinical Study – 2019
  20. Cannabimimetic phytochemicals in the diet – an evolutionary link to food selection and metabolic stress adaptation? – 2016
  21. Fatty Acid Amide Hydrolase – an overview | ScienceDirect Topics – 2009
  22. The Endogenous Cannabinoid System – A Budding Source of Targets for Treating Inflammatory and Neuropathic Pain- 2018
  23. Cannabis sativa L. as a Natural Drug Meeting the Criteria of a Multitarget Approach to Treatment – 2021
  24. The ‘Entourage Effect’- How THC can team up with PEA to treat symptoms of Tourette syndrome – 2017
  25. A novel composite formulation of palmitoylethanolamide and quercetin decreases inflammation and relieves pain in inflammatory and osteoarthritic pain models – 2013
  26. Effect of Ultra-Micronized-Palmitoylethanolamide and Acetyl-l-Carnitine on Experimental Model of Inflammatory Pain – 2021
  27. Palmitoylethanolamide and hemp oil extract exert synergistic anti-nociceptive effects in mouse models of acute and chronic pain – PubMed 2021

 

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.

 

For medical-legal reasons, access to these links is limited to patients enrolled in an Accurate Clinic medical program.

 

Should you wish more information regarding any of the subjects listed – or not listed –  here, please contact Dr. Ehlenberger. He has literally thousands of published articles to share on hundreds of topics associated with pain management, weight loss, nutrition, addiction recovery and emergency medicine. It would take years for you to read them, as it did him.

 

For more information, please contact Accurate Clinic.

 

Supplements recommended by Dr. Ehlenberger may be purchased commercially online or at Accurate Clinic.

Please read about our statement regarding the sale of products recommended by Dr. Ehlenberger.

Accurate Supplement Prices

 

 

.