Category: Notes to the SCC

Medical Cannabis and Pain Management

Bonni Goldstein, MD, forwards this “very interesting” editorial from the January 2018 Journal of Applied Laboratory Medicine, “Medical Cannabis and Pain Management: How Might the Role of Cannabis Be Defined in Pain Medicine?” The authors, Amor Deshpande and Angela Mailis, are pain specialists based in Toronto. Very interesting, indeed. Excerpts follow with boldface showing our strong agreement. With every passing day, the din surrounding the inappropriateness of cannabinoids in pain medicine grows quieter. While it would be remarkable to attribute this acquiescence to a growing body of robust supporting evidence, the reality is that the number and quality of clinical cannabinoid trials in...

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MBC to Weigh New MJ Guidelines October 27

The Medical Board of California has posted its agenda for the upcoming quarterly meeting in San Diego. “Review, Discussion, and Possible Action on Guidelines for Recommendation of Cannabis for Medical Purposes” is agenda item 18 on Friday, Oct. 27. LA ophthalmologist Howard Krauss, MD, and Walnut Creek attorney Kristina Lawson comprised the task force that drafted the revised guidelines. The most onerous provisions being pushed by the Federation of State Medical Boards —decried by the Society of Cannabis Clinicians at a previous board meeting and in correspondence— have been deleted by the task force. But the new guidelines include...

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Notes From Practitioners

From Joe D. Goldstrich, MD, on Cannabinoid Hyperemesis Syndrome, My current thinking is that CHS is most likely caused by Azadirachtin from Neem oil. Despite treating hundreds of patients with very high doses of THC, I have yet to see a case. It’s as good a working hypothesis as any, methinks. https://www.google.com/search?q=cannabis+hyperemesis+syndrome+Azadirachtin&source=lnt&tbs=qdr:y&sa=X&ved=0ahUKEwiPze320-bWAhUm9IMKHb43D64QpwUIHw&biw=1526&bih=666 From Nancy Sajben, MD: I thought results showed they were down, not up. (With a link to a newspaper story headed: “Legal cannabis linked to 66% rise in traffic deaths in Colorado: Study reveals surge in fatal motor accidents since the state went green in 2013.” http://www.dailymail.co.uk/health/article-4971644/Cannabis-linked-66-rise-traffic-deaths-Colorado.html...

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Cannabinoid Hyperemesis Syndrome Diagnoses More Common

Forwarded by Dale Gieringer, who notes “This article dates the increase in cannabis hyperemesis sydrome from 2009, which it says marks the rising availability of cannabis recreationally and medically.  The first recreational laws weren’t until 2012.  A better explanation may be the rise of high-potency concentrates and  ‘dabbing,’ which deliver unusally high dosages of THC.” The incidence of cannabinoid hyperemesis syndrome has increased with the loosening of marijuana laws in the United States, according to a new study presented at the 2017 Digestive Disease Week (abstract Tu1688). Cannabinoid hyperemesis syndrome and cyclic vomiting syndrome are barely known to physicians...

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A Use for Rimonabant? (Sanofi Isn’t Interested)

Cannabinoid-receptor inverse-agonist drugs can be used as antidotes to rescue people overdosing on synthetic cannabinoids (widely marketed as “Spice,” “K2,” etc.).  So suggests a paper in the British Journal of Pharmacology by Gareth Pryce and David Baker, researchers from Queen Mary University of London. It has long been established that CB1-receptor inverse-agonist drugs, administered in advance of cannabinoid use, can block intoxication. Pryce and Baker were investigating whether the “effects of a synethic cannabinoid could be reversed after they are manifest.” Working with mice, they administered 5mg/kg of the antagonist drug AM-251 20 minutes after intoxication was induced by an...

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