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For the estimated five million Americans suffering from Fibromyalgia (FM), a chronic pain condition of unknown etiology, pain, fatigue, and depression are often a way of life. Though the US Food and Drug Administration has approved a small number of drugs to treat symptoms of FM, many patients report that these prescription pills provide little relief. By contrast, more and more patients with FM are finding effective relief from medical cannabis.

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9 Reasons Why Sanjay Gupta Changed His Mind About Marijuana

Dr. Sanjay Gupta, CNN's chief medical correspondent, says he was wrong to ignore marijuana's medical potential when he wrote an opinion piece in 2009 called "Why I would Vote No on Pot."

Gupta filmed a documentary that aired on CNN on Sunday, August 11, and earlier this week wrote an editorial on CNN.com in which he admitted that the research for the movie changed his mind about the drug and its medicinal effects.

After traveling the world, meeting with medical experts and medical marijuana patients, Gupta concludes "we have been terribly and systematically misled for nearly 70 years in the United States, and I apologize for my own role in that."

Here are Gupta's reasons for his change of stance:

  1. Marijuana laws are not based on science. Gupta wrote: "Not because of sound science, but because of its absence, marijuana was classified as a schedule 1 substance" at the urging of Assistant Secretary of Health, Roger Egeberg in 1970.
  2. Gupta notes that marijuana doesn't have a "high potential for abuse" and it doesn't lead people to use other drugs. "We now know that while estimates vary, marijuana leads to dependence in around 9 to 10% of its adult users." Cocaine, classified as a (less addictive) schedule 2 substance, hooks 20% of those who use it. Around 25% of heroin users and 30% of tobacco users become addicted.
  3. In some medical cases, marijuana is "the only thing that works." Gupta met with one woman in Colorado who used marijuana to cut the number of seizures she had from 300-per-week to two or three per month.
  4. It's safer than a lot of prescription drugs: Someone dies from a prescription drug overdose every 19 minutes in the United States, but Gupta could not find a single person who died from a marijuana overdose.
  5. Other doctors believe in it: Seventy-six percent of physicians surveyed would prescribe marijuana to ease the pain of women suffering from breast cancer.
  6. While quitting marijuana can produce some withdrawal symptoms, like insomnia, anxiety and nausea, it is still nowhere near as bad at drugs like heroin or cocaine, or even booze. "I have seen the withdrawal from alcohol, and it can be life threatening," Gupta said. Not so with marijuana.
  7. Medicinal plants (including marijuana specifically) aren't a new idea: The medical and scientific communities have been studying medical marijuana since the 19th Century, and marijuana was actually used to treat neuropathic pain until 1943.
  8. Only 6% of research on marijuana published in the last year analyzed benefits. The other 93% are designed primarily to investigate harm. "That imbalance paints a highly distorted picture," Gupta said.
  9. The system is biased against research into medical marijuana's benefits. First, you have to get the marijuana for your study from one government-approved farm, and you have to get approval from the National Institute on Drug Abuse, which is tasked with studying and preventing drug abuse, not the medical benefits of drugs.

In general, Gupta says he listened a bit too closely to medical marijuana opponents and skeptics, and he "didn't look hard enough, until now. I didn't look far enough. I didn't review papers from smaller labs in other countries doing some remarkable resea

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Half of the United States Has Now Passed Some Form of Medical Cannabis Legalization

March 29, 2014
In 2014 numerous states have joined the movement to legalize at least some form of medical cannabis.
In Utah, the governor recently signed a measure legalizing low-THC cannabis oil. In Kentuckymerry, the state’s legislature has voted unanimously to legalize cannabidiol (a compound found in cannabis); the measure is expected to be signed by the governor.
In Mississippi, the state’s House and Senate has voted to also legalize cannabis oil that’s low in THC for medical purposes. The measure awaits response from the governor.
In Maryland, the state’s full legislature has voted to legalize medical cannabis, including dispensaries and cultivation centers.
Alabama’s Legislature has approved a measure which establishes a million dollar study on medical cannabis oil, allowing the University of Alabama to produce and distribute it to those with seizure disorders.
Although these measures don’t go far enough – the whole cannabis plant should be legalized for example, and not just cannabis oil – they’re clearly a step in the right direction. The approval of these proposals is also numerous states admitting that cannabis has medical value, demonstrating that it doesn’t fit the legal description of a Schedule 1 controlled substance.
With these states recently passing medical cannabis proposals, it makes 25 states in the U.S. – half of the entire country – that has voted to legalize some form of medical cannabis (with the others being Alaska, Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Massachusetts, Michigan, Montana, Nevada, New Hampshire, New Jersey, New Mexico, Oregon, Rhode Island, Vermont and Washington). This is a huge achievement given the first medical cannabis law was passed less than 20 years ago.
Other state legislatures, such as Florida‘s, are also currently advancing medical cannabis proposals, and numerous other states have legislation being discussed. It’s only a matter of time before medical cannabis will be legalized nation, and worldwide.
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Colorado and Washington state made headlines when they legalized marijuana for recreational use, but those pioneering states are unlikely to be the last battles in the pot wars. The battle for marijuana legalization is just getting started, and a number of other states are expected to follow the path set by Washington and Colorado.

While battles for both medical and recreational pot are underway in a number of states across the nation, these are the six states experts feel could be the next ones to legalize the drug during the 2014 election cycle.

#1 - Oregon
Oregon is well known for its liberal politics, so it should come as no surprise that the state would be spearheading the effort for legalized marijuana. Indeed, many political observers both inside and outside the state expect Oregon to be the next to legalize pot for recreational use.

#2 - Florida
Advocates of marijuana legalization just passed a major milestone when they gathered enough signatures to get the measure on the fall ballot. While those opposed to the legalization of marijuana are vowing to fight the legitimacy of the signatures on those petitions, experts widely expect that the measure will indeed appear when voters go to the polls in 2014.

Recent polls have shown that a majority of Floridians support the legalization of marijuana. That means there is reason to believe that the Sunshine State will indeed take this step when the 2014 election season rolls around.
  
#3 - Alaska
Many outside observers would not expect Alaska to legalize marijuana. After all, the state is known as the home of conservative darling Sarah Palin, and its preference for republican policies is well known.

Alaska may indeed be a conservative place, but it is also the home of many libertarians and free thinkers. Many of those freedom-loving individuals feel the state has no business telling them what they can and cannot enjoy in their own homes, and that has led to an effort to legalize marijuana for recreational use.

#4 - California
California already has a booming business in medical marijuana, but there is a strong movement to legalize the drug for recreational use. No fewer than four ballot measures could be on the ballot in 2014. Each one of those ballot initiatives would legalize the use of marijuana for users over 21 years of age.

The most radical of those measures would allow individuals to possess up to 12 pounds of cannabis. While that measure is not expected to pass, experts give good odds to the other ballot initiatives that would legalize the recreational use of marijuana by adults.

#5 - Arizona
Advocates of legalized marijuana in Arizona have been busy gathering signatures for a petition that would place the measure on the fall 2014 ballot. Those advocates will need to gather 300,000 valid signatures by July 3, and they appear to be making good progress.
  
If the petition drive succeeds, Arizona voters will get a chance to weigh in on the legalization of the drug. Experts are divided about its chances, but the drive for the ballot initiative is a good indication of the success of the pro-cannabis movement.

#6 - Washington, D.C.
There is a strong drive for legalization of marijuana in the nation's capital, and advocates expect to begin gathering the signatures they will need in February or March of 2014. There are still some legal hurdles to be overcome, but if those barriers are cleared the measure to decriminalize marijuana could end up on the fall ballot.

Recent polls have shown strong support for the legalization of marijuana in Washington D.C. If those polls prove correct, the capital could become the next battleground in the fight over legalized pot.

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The legalization of medical marijuana has sparked debate across the nation for decades. Some have argued that medical marijuana's legalization will lead to higher crime rates. But according to a new study at UT Dallas, legalization of medical cannabis is not an indicator of increased crime.

It actually may be related to reductions in certain types of crime, said Dr. Robert Morris, associate professor of criminology and lead author of the study published in the journal PLOS ONE.

"We're cautious about saying, 'Medical marijuana laws definitely reduce homicide.' That's not what we're saying," Morris said. "The main finding is that we found no increase in crime rates resulting from medical marijuana legalization. In fact, we found some evidence of decreasing rates of some types of violent crime, namely homicide and assault."

The UT Dallas team began its work in summer 2012 after repeatedly hearing claims that medical marijuana legalization posed a danger to public health in terms of exposure to violent crime and property crime.

The study tracked crime rates across all 50 states between 1990 and 2006, when 11 states legalized marijuana for medical use: Alaska, California, Colorado, Hawaii, Maine, Montana, Nevada, Oregon, Rhode Island, Vermont and Washington. Since the time period the study covered, 20 states and Washington, D.C., have legalized marijuana for medical use.

Using crime data from the FBI's Uniform Crime Report, the researchers studied rates for homicide, rape, robbery, assault, burglary, larceny and auto theft, teasing out an effect for the passing of medical marijuana laws.

None of the seven crime types increased with the legalization of medical marijuana.

Robbery and burglary rates were unaffected by medical marijuana legalization, according to the study. These findings run counter to the claim that marijuana dispensaries and grow houses lead to an increase in victimization because of the opportunities for crime linked to the amount of drugs and cash that are present.

Morris said the models accounted for an exhaustive list of sociodemographic and econometric variables that are well-established links to changes in crime rates, including statistics on poverty, unemployment, college education, prison inmates and even the amount of beer consumed per person per year. Data came from the U.S. Census Bureau, the Bureau of Economic Analysis and the Bureau of Labor Statistics.

"The results are remarkable," Morris said. "It's pretty telling. It will be interesting to see what future studies hold."

Once data are available, the researchers plan to investigate the relationship between recreational marijuana legalization and crime in Washington and Colorado, where the legalized marijuana marketplace is taking shape.

While it's too soon to say if there are definitive drawbacks to legalizing marijuana for medical purposes, Morris said, the study shows that legalization does not pose a serious crime problem, at least at the state level.

"This new information, along with continued education of the public on the realities of the negative aspects of smoking marijuana -- which there are considerable negative attributes -- will make the dialogue between those opposed and in favor of legalization on more of an even playing field," Morris said. "It takes away the subjective comments about the link between marijuana laws and crime so the dialogue can be more in tune with reality."

UT Dallas doctoral student Michael TenEyck, assistant professor Dr. J.C. Barnes and associate professor Dr. Tomislav V. Kovandzic, all from the criminology program, also contributed to the study as co-authors.

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A new guideline from the American Academy of Neurology suggests that there is little evidence that most complementary or alternative medicine therapies (CAM) treat the symptoms of multiple sclerosis (MS). However, the guideline states the CAM therapies oral cannabis, or medical marijuana pills, and oral medical marijuana spray may ease patients' reported symptoms of spasticity, pain related to spasticity and frequent urination in multiple sclerosis (MS). The guideline, which is published in the March 25, 2014, print issue of Neurology®, the medical journal of the American Academy of Neurology, states that there is not enough evidence to show whether smoking marijuana is helpful in treating MS symptoms.

The guideline looked at CAM therapies, which are nonconventional therapies used in addition to or instead of doctor-recommended therapies. Examples include oral cannabis, or medical marijuana pills and oral medical marijuana spray, ginkgo biloba, magnetic therapy, bee sting therapy, omega-3 fatty acids and reflexology.

"Using different CAM therapies is common in 33 to 80 percent of people with MS, particularly those who are female, have higher education levels and report poorer health," said guideline lead author Vijayshree Yadav, MD, MCR, with Oregon Health & Science University in Portland and a member of the American Academy of Neurology. "People with MS should let their doctors know what types of these therapies they are taking, or thinking about taking."

For most CAM therapies, safety is unknown. There is not enough information to show if CAM therapies interact with prescription MS drugs. Most CAM therapies are not regulated by the Food and Drug Administration (FDA). Dronabinol and nabilone are synthetic forms of key ingredients in marijuana. The FDA approved both drugs as treatments for nausea and vomiting associated with cancer chemotherapy that do not respond to standard treatments. Dronabinol also is approved for loss of appetite associated with weight loss in patients with AIDS.

The guideline found that certain forms of medical marijuana, in pill or oral spray form only, may help reduce patients' reported spasticity symptoms, pain due to spasticity, and frequent urination but not loss of bladder control. The therapy may not help reduce tremor. Long-term safety of medical marijuana use in pill or oral spray is not known. Most of the studies are short, lasting six to 15 weeks. Medical marijuana in pill or oral spray form may cause side effects, some of which can be serious. Examples are seizures, dizziness, thinking and memory problems as well as psychological problems such as depression. This can be a concern given that some people with MS are at an increased risk for depression or suicide. Both doctors and patients must weigh the possible side effects that medical marijuana in pill or oral spray form can cause.

Among other CAM therapies studied for MS, ginkgo biloba might possibly help reduce tiredness but not thinking and memory problems. Magnetic therapy may also help reduce tiredness but not depression.

Reflexology might possibly help ease symptoms such tingling, numbness and other unusual skin sensations. Bee sting therapy, a low-fat diet with fish oil, and a therapy called the Cari Loder regimen all do not appear to help MS symptoms such as disability, depression and tiredness. Bee stings can cause a life-threatening allergic reaction and dangerous infections.

Moderate evidence shows that omega-3 fatty acids such as fish oil likely do not reduce relapses, disability, tiredness or MRI brain scan lesions, nor do they improve quality of life in people with MS.

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The above story is based on materials provided by American Academy of Neurology (AAN). Note: Materials may be edited for content and length.

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New research from The Netherlands shows that people who smoke high-potency cannabis end up getting higher doses of the active ingredient (THC). Although they reduce the amount they puff and inhale to compensate for the higher strength, they still take in more THC than smokers of lower potency cannabis.

For the past decade or more, the common sense idea that high strength cannabis leads to higher doses of THC and therefore poses a greater risk of unwanted effects such as dependency has been challenged and labelled the 'potent pot myth'. It has been argued that smokers of strong cannabis adjust their drug intake to compensate for the potency, usually by inhaling less smoke or rolling weaker joints. It is even argued that 'super pot' is healthier for cannabis users because they get their desired high while inhaling less lung-harming smoke.

The Dutch researchers in this study observed 98 experienced cannabis smokers as they rolled and smoked joints using their own cannabis samples, which were of varying concentrations. Those who made strong joints inhaled smaller volumes of smoke, presumably in an attempt to titrate the amount of THC taken into the body. But these titration efforts were only partially successful, compensating for roughly half of the THC strength.

So although smokers of strong cannabis alter their smoking behavior to compensate for the higher potency, they don't alter it enough. There is some truth to the 'potent pot myth'.

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The above story is based on materials provided by Wiley. Note: Materials may be edited for content and length.

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The use of cocaine dropped sharply across the United States from 2006 to 2010, while the amount of marijuana consumed increased significantly during the same period, according to a new report.

Studying illegal drug use nationally from 2000 to 2010, researchers found the amount of marijuana consumed by Americans increased by more than 30 percent from 2006 to 2010, while cocaine consumption fell by about half. Meanwhile, heroin use was fairly stable throughout the decade.

Methamphetamine consumption dramatically increased during the first half of the decade and then declined, but researchers did not have enough information to make a credible estimate of the drug's use from 2008 to 2010.

The findings come from a report compiled for the White House Office of National Drug Control Policy by researchers affiliated with the RAND Drug Policy Research Center.

"Having credible estimates of the number of heavy drug users and how much they spend is critical for evaluating policies, making decisions about treatment funding and understanding the drug revenues going to criminal organizations," said Beau Kilmer, the study's lead author and co-director of the RAND Drug Policy Research Center. "This work synthesizes information from many sources to present the best estimates to date for illicit drug consumption and spending in the United States."

Because the project only generated estimates through 2010, researchers say the report does not address the recent reported spike in heroin use or the consequences of marijuana legalization in Colorado and Washington. The report also does not try to explain the causes behind changes in drug use or evaluate the effectiveness of drug control strategies.

The study, published on the website of the Office of National Drug Control Policy, provides estimates of the amount of cocaine, heroin, marijuana and methamphetamine used each year from 2000 to 2010. The study includes estimates of retail spending on illicit drugs and the number of chronic users, who account for a majority of drug consumption.

Researchers say that drug users in the United States spent on the order of $100 billion annually on cocaine, heroin, marijuana and methamphetamine throughout the decade. While the amount remained stable from 2000 to 2010, the spending shifted. While much more was spent on cocaine than on marijuana in 2000, the opposite was true by 2010.

"Our analysis shows that Americans likely spent more than one trillion dollars on cocaine, heroin, marijuana and methamphetamine between 2000 and 2010," Kilmer said.

The surge in marijuana use appears to be related to an increase in the number of people who reported using the drug on a daily or near-daily basis.

The estimates for marijuana are rooted in the National Survey on Drug Use and Health, which surveys nearly 70,000 individuals each year. Estimates for cocaine, heroin and methamphetamine are largely based on information from the Arrestee Drug Abuse Monitoring Program, or ADAM. The final estimates also incorporated information from other data sources

However, since the federal government recently halted funding for ADAM, researchers say it will be considerably harder to track the abuse of cocaine, heroin, and methamphetamine in the future.

"The ADAM program provided unique insights about those who abused hard drugs and how much they spent on these substances," said Jonathan Caulkins, a study co-author and the Stever Professor of Operations Research and Public Policy at Carnegie Mellon University. "It's a tragedy that 2013 was the last year for ADAM. It is such an important data system for understanding drug problems."

To improve future estimates, the report recommends investments in programs like ADAM that collect detailed data from heavy users. It also recommends that federal agencies revise some of the questions on existing self-report surveys.

The study, "What America's Users Spend on Illegal Drugs, 2000-2010," can be found at http://www.whitehouse.gov/ondcp. Other authors of the report are Susan Everingham, Greg Midgette, Rosalie Pacula, Rachel Burns, Bing Han and Russell Lundberg, all of RAND, and Peter Reuter of the University of Maryland.

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The above story is based on materials provided by RAND Corporation. Note: Materials may be edited for content and length.

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An international group led by Vanderbilt University researchers has found cannabinoid receptors, through which marijuana exerts its effects, in a key emotional hub in the brain involved in regulating anxiety and the flight-or-fight response.

This is the first time cannabinoid receptors have been identified in the central nucleus of the amygdala in a mouse model, they report in the current issue of the journal Neuron.

The discovery may help explain why marijuana users say they take the drug mainly to reduce anxiety, said Sachin Patel, M.D., Ph.D., the paper's senior author and professor of Psychiatry and of Molecular Physiology and Biophysics.

Led by first author Teniel Ramikie, a graduate student in Patel's lab, the researchers also showed for the first time how nerve cells in this part of the brain make and release their own natural "endocannabinoids."

The study "could be highly important for understanding how cannabis exerts its behavioral effects," Patel said. As the legalization of marijuana spreads across the country, more people -- and especially young people whose brains are still developing -- are being exposed to the drug.

Previous studies at Vanderbilt and elsewhere, Patel said, have suggested the following:

The natural endocannabinoid system regulates anxiety and the response to stress by dampening excitatory signals that involve the neurotransmitter glutamate. Chronic stress or acute, severe emotional trauma can cause a reduction in both the production of endocannabinoids and the responsiveness of the receptors. Without their "buffering" effect, anxiety goes up. While marijuana's "exogenous" cannabinoids also can reduce anxiety, chronic use of the drug down-regulates the receptors, paradoxically increasing anxiety. This can trigger "a vicious cycle" of increasing marijuana use that in some cases leads to addiction.

In the current study, the researchers used high-affinity antibodies to "label" the cannabinoid receptors so they could be seen using various microscopy techniques, including electron microscopy, which allowed very detailed visualization at individual synapses, or gaps between nerve cells.

"We know where the receptors are, we know their function, we know how these neurons make their own cannabinoids," Patel said. "Now can we see how that system is affected by … stress and chronic (marijuana) use? It might fundamentally change our understanding of cellular communication in the amygdala."

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The above story is based on materials provided by Vanderbilt University Medical Center. The original article was written by Bill Snyder. Note: Materials may be edited for content and length.

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Since 1990, the street price of illegal drugs has fallen in real terms while the purity/potency of what's on offer has generally increased, both of which are indicators of availability.

The United Nations recently estimated that the illicit drug trade is worth at least US $350 billion every year. And needle sharing is one of the key drivers of blood borne infections, including HIV. The drug trade is also linked to high rates of violence.

Over the past several decades most national drug control strategies have focused on law enforcement to curb supply, despite calls to explore approaches, such as decriminalization and strict legal regulation.

The researchers analysed data from seven international government-funded drug surveillance systems, which had at least 10 years of information on the price and purity of cannabis, cocaine and opiates, including heroin.

They also reviewed the number of seizures of illegal drugs in drug production regions and rates of consumption in markets where demand for illegal drugs is high.

Three of the seven surveillance systems reported on international data; three reported on US data; and one reported on data from Australia. In some cases the data went back as far as 1975, with the most recent data going back to 2001.

Three major trends emerged from the data analysis: the purity/potency of illegal drugs either generally remained stable or increased between 1990 and 2010; with few exceptions, the street price generally fell; and seizures of drugs increased in both the countries of major supply and demand.

In the US, after adjusting for inflation and purity, the average street price of heroin, cocaine and cannabis fell by 81%, 80%, and 86%, respectively, whereas the purity and/or potency of these drugs increased by 60%, 11%, and 161%, respectively.

Similar trends were observed in Europe where, during the same period, the average price of opiates and cocaine, adjusted for inflation and purity, decreased by 74% and 51%, respectively, and in Australia, where the price of cocaine fell by 14% and the price of heroin and cannabis dropped by 49%.

In the US seizures of cocaine roughly halved between 1990 and 2010, but those of cannabis and heroin rose by 465% and 29%, respectively; in Europe seizures of cocaine and cannabis fluctuated, but seizures of heroin had risen 380% by 2009.

On the basis of the data, the authors conclude, as previous studies have, "that the global supply of illicit drugs has likely not been reduced in the previous two decades."

They add: "In particular, the data presented in this study suggest that the supply of opiates and cannabis have increased, given the increasing potency and decreasing prices of these illegal commodities."

And they conclude: "These findings suggest that expanding efforts at controlling the global illegal drug market through law enforcement are failing."

"It is hoped that this study highlights the need to re-examine the effectiveness of national and international drug strategies that place a disproportionate emphasis on supply reduction at the expense of evidence based prevention and treatment of problematic illegal drug use," they add.

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The above story is based on materials provided by BMJ-British Medical Journal. Note: Materials may be edited for content and length.

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hough marijuana is a well-known recreational drug, extensive scientific research has been conducted on the therapeutic properties of marijuana in the last decade. Medical cannabis is often used by sufferers of chronic ailments, including cancer and post-traumatic stress disorder, to combat pain, insomnia, lack of appetite, and other symptoms.

Now Prof. Yosef Sarne of Tel Aviv University's Adelson Center for the Biology of Addictive Diseases at the Sackler Faculty of Medicine says that the drug has neuroprotective qualities as well. He has found that extremely low doses of THC -- the psychoactive component of marijuana -- protects the brain from long-term cognitive damage in the wake of injury from hypoxia (lack of oxygen), seizures, or toxic drugs. Brain damage can have consequences ranging from mild cognitive deficits to severe neurological damage.

Previous studies focused on injecting high doses of THC within a very short time frame -- approximately 30 minutes -- before or after injury. Prof. Sarne's current research, published in the journals Behavioural Brain Research and Experimental Brain Research, demonstrates that even extremely low doses of THC -- around 1,000 to 10,000 times less than that in a conventional marijuana cigarette -- administered over a wide window of 1 to 7 days before or 1 to 3 days after injury can jumpstart biochemical processes which protect brain cells and preserve cognitive function over time.

This treatment, especially in light of the long time frame for administration and the low dosage, could be applicable to many cases of brain injury and be safer over time, Prof. Sarne says.

Conditioning the brain

While performing experiments on the biology of cannabis, Prof. Sarne and his fellow researchers discovered that low doses of the drug had a big impact on cell signalling, preventing cell death and promoting growth factors. This finding led to a series of experiments designed to test the neuroprotective ability of THC in response to various brain injuries.

In the lab, the researchers injected mice with a single low dose of THC either before or after exposing them to brain trauma. A control group of mice sustained brain injury but did not receive the THC treatment. When the mice were examined 3 to 7 weeks after initial injury, recipients of the THC treatment performed better in behavioral tests measuring learning and memory. Additionally, biochemical studies showed heightened amounts of neuroprotective chemicals in the treatment group compared to the control group.

The use of THC can prevent long-term cognitive damage that results from brain injury, the researchers conclude. One explanation for this effect is pre- and post-conditioning, whereby the drug causes minute damage to the brain to build resistance and trigger protective measures in the face of much more severe injury, explains Prof. Sarne. The low dosage of THC is crucial to initiating this process without causing too much initial damage.

Preventative and long-term use

According to Prof. Sarne, there are several practical benefits to this treatment plan. Due to the long therapeutic time window, this treatment can be used not only to treat injury after the fact, but also to prevent injury that might occur in the future. For example, cardiopulmonary heart-lung machines used in open heart surgery carry the risk of interrupting the blood supply to the brain, and the drug can be delivered beforehand as a preventive measure. In addition, the low dosage makes it safe for regular use in patients at constant risk of brain injury, such as epileptics or people at a high risk of heart attack.

Prof. Sarne is now working in collaboration with Prof. Edith Hochhauser of the Rabin Medical Center to test the ability of low doses of THC to prevent damage to the heart. Preliminary results indicate that they will find the same protective phenomenon in relation to cardiac ischemia, in which the heart muscle receives insufficient blood flow.

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The above story is based on materials provided by American Friends of Tel Aviv University. Note: Materials may be edited for content and length.

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Though controversial, medical cannabis has been gaining ground as a valid therapy, offering relief to suffers of diseases such as cancer, Post-Traumatic Stress Disorder, ALS and more. The substance is known to soothe severe pain, increase the appetite, and ease insomnia where other common medications fail.

In 2009, Zach Klein, a graduate of Tel Aviv University's Department of Film and Television Studies, directed the documentary Prescribed Grass. Through the process, he developed an interest in the scientific research behind medical marijuana, and now, as a specialist in policy-making surrounding medical cannabis and an MA student at TAU's Porter School of Environmental Studies, he is conducting his own research into the benefits of medical cannabis.

Using marijuana from a farm called Tikkun Olam -- a reference to the Jewish concept of healing the world -- Klein and his fellow researchers tested the impact of the treatment on 19 residents of the Hadarim nursing home in Israel. The results, Klein says, have been outstanding. Not only did participants experience dramatic physical results, including healthy weight gain and the reduction of pain and tremors, but Hadarim staff saw an immediate improvement in the participants' moods and communication skills. The use of chronic medications was also significantly reduced, he reports.

Klein's research team includes Dr. Dror Avisar of TAU's Hydrochemistry Laboratory at the Department of Geography and Human Environment; Prof. Naama Friedmann and Rakefet Keider of TAU's Jaime and Joan Constantiner School of Education; Dr. Yehuda Baruch of TAU's Sackler Faculty of Medicine and director of the Abarbanel Mental Health Center; and Dr. Moshe Geitzen and Inbal Sikorin of Hadarim.

Cutting down on chronic medications

Israel is a world leader in medical cannabis research, Klein says. The active ingredient in marijuana, THC, was first discovered there by Profs. Raphael Mechoulam and Yechiel Gaoni. Prof. Mechoulam is also credited for having defined the endocannabinoid system, which mimics the effects of cannabis and plays a role in appetite, pain sensation, mood and memory.

In the Hadarim nursing home, 19 patients between the ages of 69 and 101 were treated with medical cannabis in the form of powder, oil, vapor, or smoke three times daily over the course of a year for conditions such as pain, lack of appetite, and muscle spasms and tremors. Researchers and nursing home staff monitored participants for signs of improvement, as well as improvement in overall life quality, such as mood and ease in completing daily living activities.

During the study, 17 patients achieved a healthy weight, gaining or losing pounds as needed. Muscle spasms, stiffness, tremors and pain reduced significantly. Almost all patients reported an increase in sleeping hours and a decrease in nightmares and PTSD-related flashbacks.

There was a notable decline in the amount of prescribed medications taken by patients, such as antipsychotics, Parkinson's treatment, mood stabilizers, and pain relievers, Klein found, noting that these drugs have severe side effects. By the end of the study, 72 percent of participants were able to reduce their drug intake by an average of 1.7 medications a day.

Connecting cannabis and swallowing

This year, Klein is beginning a new study at Israel's Reuth Medical Center with Drs. Jean-Jacques Vatine and Aviah Gvion, in which he hopes to establish a connection between medical cannabis and improved swallowing. One of the biggest concerns with chronically ill patients is food intake, says Klein. Dysphagia, or difficulty in swallowing, can lead to a decline in nutrition and even death. He believes that cannabis, which has been found to stimulate regions of the brain associated with swallowing reflexes, will have a positive impact.

Overall, Klein believes that the healing powers of cannabis are close to miraculous, and has long supported an overhaul in governmental policy surrounding the drug. Since his film was released in 2009, the number of permits for medical cannabis in Israel has increased from 400 to 11,000. His research is about improving the quality of life, he concludes, especially for those who have no other hope.

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The pain relief offered by cannabis varies greatly between individuals, a brain imaging study carried out at the University of Oxford suggests.

The researchers found that an oral tablet of THC, the psychoactive ingredient in cannabis, tended to make the experience of pain more bearable, rather than actually reduce the intensity of the pain.

MRI brain imaging showed reduced activity in key areas of the brain that substantiated the pain relief the study participants experienced.

'We have revealed new information about the neural basis of cannabis-induced pain relief,' says Dr Michael Lee of Oxford University's Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB).

He adds: 'Our small-scale study, in a controlled setting, involved 12 healthy men and only one of many compounds that can be derived from cannabis. That's quite different from doing a study with patients. My view is the findings are of interest scientifically but it remains to see how they impact the debate about use of cannabis-based medicines. Understanding cannabis' effects on clinical outcomes, or the quality of life of those suffering chronic pain, would need research in patients over long time periods.'

The researchers report their findings in the journal Pain. The study was funded by the UK Medical Research Council and the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre.

Long-term pain, often without clear cause, is a complex healthcare problem. Different approaches are often needed to help patient manage pain, and can include medications, physiotherapy and other forms of physical therapy, and psychological support. For a few patients, cannabis or cannabis-based medications remain effective when other drugs have failed to control pain, while others report very little effect of the drug on their pain but experience side-effects.

'We know little about cannabis and what aspects of pain it affects, or which people might see benefits over the side-effects or potential harms in the long term. We carried out this study to try and get at what is happening when someone experiences pain relief using cannabis,' says Dr Lee.

The Oxford research team carried out a series of MRI scans with each of the 12 volunteers at the FMRIB centre in Oxford.

Before a scan, participants were given either a 15mg tablet of THC or a placebo. THC, or delta-9-tetrahydrocannabinol, is the active psychotropic compound in cannabis -- the ingredient that's responsible for the high that drives recreational use of the drug.

To induce a certain level of pain, the volunteers also had a cream rubbed into the skin of one leg. This was either a dummy cream or a cream that contained 1% capsaicin, the ingredient of chillis that causes a hot, burning and painful sensation.

Each participant had four MRI tests to cover each combination of THC or placebo, and chilli pain-inducing cream or dummy cream.

'The participants were asked to report the intensity and unpleasantness of the pain: how much it burned and how much it bothered them,' says Dr Lee. 'We found that with THC, on average people didn't report any change in the burn, but the pain bothered them less.'

While this average effect was statistically significant, there was great variability among the participants in THC's effect on the pain they experienced. Only six out of the 12 reported a clear change in how much the pain bothered them, for example.

The brain imaging results substantiate the reports of the participants. The change in unpleasantness of pain was matched with a suppression of activity in the part of the brain called the anterior mid-cingulate cortex. This structure sits in a deep part of the brain and is involved in many functions, and has previously been implicated in the emotional aspects of pain.

There were also changes in activity of the right amygdala that correlated with the lessening in the unpleasantness of the pain with THC. It is already known that the right side of the amygdala can be 'primed' by pain.

Of most interest to the researchers, however, was the strength of the connection in individuals between their right amydala and a part of the cortex called the primary sensorimotor area. The strength of this connection in individual participants correlated well with THC's different effects on the pain that that volunteer experienced.

This is suggestive that there might be a way of predicting who would see benefits from taking cannabis for pain relief.

'We may in future be able to predict who will respond to cannabis, but we would need to do studies in patients with chronic pain over longer time periods,' says Dr Lee.

He adds: 'Cannabis does not seem to act like a conventional pain medicine. Some people respond really well, others not at all, or even poorly. Brain imaging shows little reduction in the brain regions that code for the sensation of pain, which is what we tend to see with drugs like opiates. Instead cannabis appears to mainly affect the emotional reaction to pain in a highly variable way.'

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Cannabis seems to ease the painful muscle stiffness typical of multiple sclerosis (MS), indicate phase III trial results, published in the Journal of Neurology Neurosurgery and Psychiatry.

Up to 90 per cent of MS patients endure painful muscle stiffness at some point during the course of their disease, which reduces their mobility and interferes with daily routine activities and sleep quality. But current treatments often fail to resolve symptoms fully, and can be harmful, as a result of which many MS patients have experimented with alternative therapies, including cannabis.

Adult MS patients with stable disease, from 22 different specialist centres across the UK, were either randomly assigned to cannabis extract (tetrahydrocannabinol) daily (144) or a dummy pill (placebo) (135) for a period of 12 weeks.

The treatments were given in gradually increasing doses from 2.5 mg up to a maximum of 25 mg for two weeks, followed by maintenance doses for the remaining 10 weeks. The aim was to see if cannabis extract alleviated or improved muscle stiffness, associated pain, muscle spasms, and sleep quality, using a validated 11 point rating scale.

After the first two weeks of treatment, 87 per cent of those taking the placebo were on the maximum daily dose compared with just under half of those (47%) taking the cannabis extract.

After 12 weeks, one in four patients treated with cannabis extract was taking the maximum daily dose compared with over two thirds (69.4%) of those taking the placebo.

At the end of the study period, the rate of relief from muscle stiffness was twice as high among those given the cannabis extract as those given the placebo. Muscle stiffness was alleviated in just under 30 per cent of those given cannabis compared with just under 16 per cent of those treated with the placebo.

This difference was evident after 4 and 8 weeks, and also extended to pain, muscle spasms and sleep quality, at all time points, the results showed.

The differences were most noticeable among patients not already using antispasmodic treatment, among whom almost 40 per cent of those taking the cannabis extract gained relief compared with just over 16 per cent of those taking placebo.

The rate of side effects was higher among those taking the cannabis extract and highest during the first two weeks of treatment. Nervous system disorders and gut problems were the most commonly reported side effects, but none was severe.

The authors conclude that the results of their trial indicate that cannabis extract could be a useful treatment for the muscle problems typical of MS, and could provide effective pain relief, particularly for those in considerable pain.

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The above story is based on materials provided by BMJ-British Medical Journal. Note: Materials may be edited for content and length.

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American and European scientists have found that increasing natural marijuana-like chemicals in the brain can help correct behavioral issues related to fragile X syndrome, the most common known genetic cause of autism.

The work indicates potential treatments for anxiety and cognitive defects in people with this condition. Results appear online in Nature Communications.

Daniele Piomelli of UC Irvine and Olivier Manzoni of INSERM, the French national research agency, led the study, which identified compounds that inhibit enzymes blocking endocannabinoid transmitters called 2-AG in the striatum and cortex regions of the brain.

These transmitters allow for the efficient transport of electrical signals at synapses, structures through which information passes between neurons. In fragile X syndrome, regional synapse communication is severely limited, giving rise to certain cognitive and behavioral problems.

Fragile X syndrome is caused by a mutation of the FMR1 gene on the X chromosome. People born with it are mentally disabled; generally experience crawling, walking and language delays; tend to avoid eye contact; may be hyperactive or impulsive; and have such notable physical characteristics as an elongated face, flat feet and large ears.

The researchers stress that their findings, while promising, do not point to a cure for the condition.

"What we hope is to one day increase the ability of people with fragile X syndrome to socialize and engage in normal cognitive functions," said Piomelli, a UCI professor of anatomy & neurobiology and the Louise Turner Arnold Chair in the Neurosciences.

The study involved mice genetically altered with FMR1 mutations that exhibited symptoms of fragile X syndrome. Treated with novel compounds that correct 2-AG protein signaling in brain cells, these mice showed dramatic behavioral improvements in maze tests measuring anxiety and open-space acceptance.

While other work has focused on pharmacological treatments for behavioral issues associated with fragile X syndrome, Piomelli noted that this is the first to identify the role endocannabinoids play in the neurobiology of the condition.

About endocannabinoids

Endocannabinoid compounds are created naturally in the body and share a similar chemical structure with THC, the primary psychoactive component of the marijuana plant, Cannabis. Endocannabinoids are distinctive because they link with protein molecule receptors -- called cannabinoid receptors -- on the surface of cells. For instance, when a person smokes marijuana, the cannabinoid THC activates these receptors. Because the body's natural cannabinoids control a variety of factors -- such as pain, mood and appetite -- they're attractive targets for drug discovery and development. Piomelli is one of the world's leading endocannabinoid researchers. His groundbreaking work is showing that this system can be exploited by new treatments to combat anxiety, pain, depression and obesity.

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The above story is based on materials provided by University of California - Irvine. Note: Materials may be edited for content and length.

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