Cannabis and Mental Health: Schizophrenia

Cannabis and Mental Health: Schizophrenia

[Canniseur: Here’s an interesting debate. Does cannabis help or hurt people who are diagnosed with schizophrenia? There are two sides to this. More research will help us understand how cannabis affects schizophrenia. Good or bad? I’m guessing that for different people, cannabis can have opposite effects. The more we learn, we’re beginning to see that cannabis consumption, by whatever means, is hugely complex.]

About 1.1 percent of the worldwide population is diagnosed with schizophrenia. According to the Schizophrenia and Related Disorders Alliance of America, schizophrenia is one of the leading causes of disability in the United States, affecting 3.5 million people.

The mental health condition can erase people’s memories of their days, past and even their reality. The SRDAA states that person must have at least two of the following symptoms to be diagnosed with schizophrenia, with one of the first three listed being one a person is suffering form:

  1. Delusions
  2. Hallucinations
  3. Disorganized speech
  4. Disorganized or catatonic behavior
  5. Negative symptoms

Cannabis consumption tends to be a debated topic surrounding most mental health conditions today. This is particularly true with schizophrenia. Some believe that cannabis can lead to increased psychosis, a common symptom in schizophrenia. Meanwhile, others believe that may not be the case just yet.

Dr. Alex Dimitriu is a double board-certified in Psychiatry and Sleep Medicine and founder of Menlo Park Psychiatry & Sleep Medicine. In response to this article, Dr. Dimitriu explained what the effects of psychosis are like on a person. “Psychosis is defined as having false beliefs (often called delusions) and seeing or hearing things that are not real (hallucinations). In a psychotic state, people may appear disorganized, confused, paranoid, almost as if they were tripping on something (like LSD, or magic mushrooms).”

He also expanded on how THC is a mild hallucinogen that can lead to short-term schizophrenia but should not be long-lasting. “Believe it or not, to some degree or other many users of cannabis have experienced the “psychotic” like effects of the drug. Fortunately, this is short-lived, usually lasting hours. Most commonly, this is seen as the paranoia – thoughts like “are people watching me?” “am I going to get in trouble with the authorities?” or, “I think I’m having a panic attack and should maybe go to the ER?”

Dr. Amy Baxter, CEO of Pain Care Labs, felt differently about cannabis use and its potential to affect people. She wrote that while cannabis can be useful in a myriad of conditions from cancer to PTSD, the dopamine pain receptors targeted can lead to mania and psychosis when overstimulated. Dr. Baxter elaborated, “In fact, 10-15% of people get paranoia and hallucinations (psychosis symptoms). With certain genetic backgrounds, even a single use of cannabis can lead to a 10x greater risk of lifelong schizophrenia.”

She also recommended a 2017 review of cannabis through the centuries, noting its recommendation for more research.

Dr. Jordan Tishler is a Harvard graduate and doctor with his own practice and research and works with CannabisMD. He noted that cannabis use is used at higher rates by people with schizophrenia and other psychotic disorders. Dr. Tishler added, “This has lead to the association of cannabis use with development or worsening of these illnesses. It’s entirely unclear whether cannabis is causing these problems or the problems lead to cannabis use. Obviously these are very different situations. Studies that try to solve this riddle are very mixed, some appear to show causation, others do not.”

Unlike other articles in this series, no patients came forward to share their experience with High Times. That said, many testimonies online detail individual experiences. From the medical professional perspective, while often short-lived, Dr. Dimitriu noted that come symptoms can worsen when using cannabis. He recalled a patient in their 20s who experienced paranoid thoughts, didn’t go to school and slept on the floor to avoid electromagnetic waves. He also noted a 50-something-year-old patient who started hearing voices after smoking a potent strain.

Dr. Tishler also offered up an example they encountered. In this case, a 65-year-old patient suffered from severe and constant physical pain and unresponsive to traditional medicine. The patient also had suffered from 40 years of mental health issues, dating back to her 20s. He explained how they came to a suitable treatment plan using cannabis.

“Ideally, we’d avoid cannabis for her, but her pain is debilitating, unresponsive to prior treatment, and her acute psychosis was long ago. In this case, I was able to devise a care plan with her vast mental health team to monitor her daily (as they were already doing) such that if cannabis made her worse, we’d know rapidly.”

He said that he “did lose sleep over her case,” but the issue worked out in this case. He also offered a counterexample. “I’ve had cases where, despite careful consideration, they did poorly and were thankfully noticed quickly.”

With such varying outcomes and the severity of the condition, Dr. Tishler recognized that cannabis could be the cause of psychosis, or increase the illness. Therefore, it is wise to avoid using cannabis if there are any signs of any such symptoms. He also addressed the problem with this solution. “The problem, of course, is that it is hard to foresee these illnesses until they strike. Since these illnesses tend to occur in late teens and early young adults, this is part of the reason for suggesting that these people avoid cannabis.”

The other responding physicians agreed with this approach. Dr. Baxter called using cannabis with this mental health condition “extremely risky.” Meanwhile, Dr. Dimitriu expanded on other substances people with schizophrenia and other conditions may want to consider avoiding.

“Certainly true with uppers – whether it is amphetamines like Adderall, or methylphenidate – Ritalin, even caffeine and energy drinks – these meds can increase levels of dopamine which can worsen agitation, and the symptoms of psychosis. Classic psychedelics should be definitely avoided – like LSD, psilocybin (magic mushrooms), DMT, and so on.”

While THC appears to be a cannabinoid medical professionals would not recommend in most schizophrenia patients, some are discussing the positive benefits of CBD.

Dr. Bill Code is a cannabis expert concerning mental conditions, including schizophrenia. His book, Solving the Brain Puzzle, addresses cannabis use. He explained how CBD led to “considerable benefit” with psychosis and schizophrenia. He came to a decision after reading a French study of high potency CBD and its equivalence to modern antipsychotics “without the rough side effects.”

Dr. Dimitriu expanded on why CBD may prove to be an effective anti-psychotic. “CBD has been shown to have numerous medicinal benefits – as a pain reducer, an anti-convulsant (anti-seizure), a sleep inducer, and has been shown to lower anxiety levels,” he said while adding that additional studies are required. He mentioned a 2012 investigation of the effects of CBD as an antipsychotic for further reading.

In the end, just with any condition, the choice falls on the patient as long as they are of a sound mind to do so. “This is not always an easy decision…careful planning and monitoring is essential to being able to avoid problems or [react] quickly if they do arise,” said Dr. Tishler.

Cannabis and Mental Health: Schizophrenia was posted on High Times.

Do We Talk About LGBTQ Cannabis Inclusion Enough?

Do We Talk About LGBTQ Cannabis Inclusion Enough?

[Canniseur: News Flash: The LGBTQ community includes both people of color & women. Really, you don’t have to choose between groups to add diversity in your organization. An entity can can choose to just not discriminate. Select people to work with that don’t look like you and your world becomes diverse.]

Be honest, be educated and be ready to do the work.

The cannabis industry could serve as the ideal for other industries regarding inclusion and diversity. Much of the discussion has centered on communities primarily affected by the drug war, often being people of color, and women in general. The market does seem to be performing slightly better than most others, but there is room for improvement as the industry matures.

The discussion around such equitable measures will sometimes, but not always, include the LGBTQ community as well. While most in the space agree that people of color and women need to be prioritized, does the same need to apply for LGBTQ people? The responses we received from those we spoke to for this article seem to indicate that the feeling is mixed. 

“While there’s little available data on LGBTQ representation within the cannabis industry, there is some tension around representation – and it’s existed for some time,” said Michael Klein, CEO of cannabisMD. Klein mentioned other prominent outlets covering the topic in recent years. He discussed the need for the industry to acknowledge the impact the community had in growing the market, while also understanding the market’s good intentions. “But there’s a difference between wanting to do the right thing and actually doing it. It’s important that the industry look back and celebrate those that have contributed to bringing it into mainstream consciousness.”

Acknowledging the shared history of cannabis rights and the LGBTQ movement is something that John Entwistle is very familiar with. As director of the Dennis Peron Legacy Advisory Board, he understands how linked the two are, especially in the Bay Area. “Two great advances for human rights everywhere came from San Francisco where gay people and cannabis users combined forces first to elect Harvey Milk and later, during the AIDS epidemic, legalized marijuana for all medical use,” he explained. 

He elaborated on their significant efforts. “Two marginalized groups of people who were entirely underground working together to push back against the dark forces of discrimination and fear. This is a huge story, and it deserves more attention.”

Chris Schroeder owns Somatik, a Bay Area-based cannabis business. He spoke further about the connection between the early cannabis movement and the LGBTQ community. “Historically, the legacy cannabis community has always been very inclusive, but hadn’t necessarily reflected equal representation of all communities. However the LGBTQ impact on cannabis is undeniable.” 

Schroeder added, “As a diverse brand in a changing industry, it’s essential that we take an active role in creating a diverse company by creating space on our board, in our community and within our four walls for representation of each of those communities.”

As such, he does not feel like there is equal representation in the current market. Schroeder explained that businesses need to make conscious choices around equal representation. This includes seeking candidates outside of a person’s usual social and business networks. “Equal representation isn’t just a cannabis goal, it’s a goal for our society as a whole. This is an opportunity for the cannabis industry to set the standard by showing that a diverse team of people running our businesses fosters innovation, better products, and a healthier economy.”

Others feel that while LGBTQ representation and equality is paramount, women and people of color receive more attention because of the implications of the current system. Sara Gluck, Chief Operating Officer of the America Israel Cannabis Association (AICA), delved into why the attention should be focused on people of color, namely African Americans. “Studies have shown that those that identify as LGBTQ+ are twice as likely to use illicit substances, including cannabis. However, to my knowledge, sexuality doesn’t equate to being twice as likely to being imprisoned for cannabis, race does,” Gluck pointed out. 

Schroeder also agreed that diverse representation includes all three of the core groups in the discussion. He also expanded on the differences each group faces in cannabis and beyond. “I would be reluctant to compare it to the other groups because the LGBTQ community has not been targeted by the war on drugs, and the cannabis industry is a good example of how the fight for female inclusion applies to every industry and is a global goal.”

Tess Taylor, founder of the brand TAYLOR + tess said her interactions with women of various ethnicities and gender preferences revealed barriers around licensing, funding, pay and other key areas of the business. “However, this creates a thread of commonality that bands these groups together, which is empowering for everyone.” Taylor added, “I do believe that this is an inclusive industry and a paradigm shift is happening in this industry and beyond.”

That paradigm shift seems to include brand inclusion. Today, Pride events are filled with sponsors promoting openness to the LGBTQ community. This extends past cannabis and into major names like banks, clothing and scores of other brands getting involved. Entwistle mentioned vaporizer brand PAX and its efforts to celebrate LGBTQ history and its participation in Pride week celebrations. 

Others get involved outside of Pride. Dan Karkoska, aka DJ Dank, puts on PUFF, a queer, cannabis, drag party in San Francisco. PUFF has been nominated for best in city awards and has had support from major cannabis brands. Sponsors have included Somatik, Papa and Barkley and other leading names in the cannabis space to give out samples and educate the crowd. “By mixing a party, music and drag with weed education, we created a whole new hybrid show,” Karkoska noted. 

That said, some are dubious to the influx of cannabis brands embracing the LGBTQ. Paul Rathert is the co-founder of Higher Level and considers himself a straight ally. He noted how consumers are becoming wiser to companies pandering support instead of actually embracing it. “Right now It’s easy to throw a rainbow sticker on your packaging and post it on IG with a bunch of community-friendly hashtags. It’s something else entirely to consistently see an LP actually doing good within a community.” 

Rathert expanded on his inside perspective to the situation. “There’s a lot of talk about supporting minorities, but not many LPs actively supporting them or protecting them from being exploited. There’s a lot of talk and marketing behind supporting the LGBTQ community, but not many LPs are focusing time on it or telling the story of the relationship between illegal cannabis cultivation, especially in the famed Emerald Triangle and the AIDS epidemic in the Bay Area in the early 80s.”

With the need for representation and equality a must in the space, cannabis can serve as the fair entry point for LGBTQ people, as well as people of color and women. While the general consensus is that people of color and women deserve a bit more priority, many believe cannabis could be the unifier of all our differences. 

This is something Karkoska hopes to achieve through PUFF – and with the plant in general. “Let’s educate ourselves on the amazing benefits of the cannabis plant, and create a community of all sizes, shapes and colors. Cannabis is a great uniter!”

Top Photo by Gracie Malley for Cannabis Now

Original Post: Marijuana Times: Do We Talk About LGBTQ Cannabis Inclusion Enough?

What Experts Have to Say about the Endocannabinoid System

What Experts Have to Say about the Endocannabinoid System

[Canniseur: We’re learning more and more about the ECS, how it works, and how cannabis effects us. We’re learning not only how individualized it is, but how we might soon be able to correct many auto-immune issues like Crohn’s disease, MS, and more.]

Let’s talk about ECS, baby. Let’s talk about you and weed.

“For decades, scientists and mental health physicians tried to figure out how THC worked on the brain and body,” explained Dr. Paul Song, Chief Medical Officer of Calyx Peak Companies via email. A significant breakthrough came with the discovery of the endocannabinoid system (ECS) in the late ‘80s and early ‘90s.

Additional research has since identified endocannabinoids as the cannabinoids produced within our own bodies. The endocannabinoid system regulates and interprets a series of processes in the body, including memory, pain, reproduction, appetite, immune function and many others. The two major endocannabinoids to be identified today are Anandamide and 2-AG, or Arachidonoylglycerol.

In an email to High Times, Katie Stem, CEO of Peak Extracts, gave a brief overview of the endocannabinoid system. “The system consists of two main receptor types: CB1 and CB2. The endocannabinoids are lipid-based neurotransmitters that elicit effects on the entire nervous system, from your brain to your fingertips.”

Stem added, “Although we have much still to learn, it appears that in some situations, the ECS acts as a volume control for a variety of processes and factors, modulating the way our body interprets signals, whether they be pain, hunger, excitement, etc.”

Dr. Song added another significant benefit of the ECS. “Having this biologic basis of the therapeutic effects of cannabinoids has provided more credibility and justification for the medicinal use of cannabis.”

How THC and CBD Interact with the ECS

This may be the part where people understand the endocannabinoid system more than they might have imagined. The reason why a person feels the effects of a high when consuming THC is because it binds to both CB1 and CB2 receptors, giving an effect throughout the body and head. On the other hand, CBD does not have the same effect on the receptors but does have an effect by activating other receptors in the body.

Stem elaborated on CBD, which she considers the most fascinating of the phytocannabinoids that have an affinity for the ECS, which also includes THC, CBN, 11-Hydroxy THC, THC-V. “[CBD] acts on serotonin receptors and members of the G-Protein coupled receptor family, which are entirely separate from the ECS. There is evidence that it acts as a modulator for the way other cannabinoids act on the ECS, for instance blocking THC activity, or modulating the effects of other ECS stimulants.”

Cannabis is far from the only influencer on the endocannabinoid system. Other drugs interact with it, as well as an array of daily actions and lifestyle choices ranging from sleep and diet, to exercise, sex, and acupuncture therapy. However, it is far from a one size fits all sort of assessment.

Stem explained how each person’s endocannabinoid system is unique. She wrote, “Cannabinoids, or other things that affect the ECS, will have different effects on different people based on their individual physiologies. Thus, there’s no “magic bullet,” and people will experience varied benefits of using cannabis depending on their ECS system.”

Ian Jenkins, CEO of Frelii, a provider of DNA sequencing and genome analysis, wrote how nourishing the ECS can extend well past the two most popular cannabinoids. “Although most of the research is around THC and CBD, just about every cannabinoid can be thought of as nourishing.”

He expanded on his point: “They are ligands that bind to a receptor that create nourishing physiological reactions, even though they themselves don’t necessarily “nourish” the system. It all comes down to homeostasis and health and not necessarily nutrition or nourishment in the classical sense.”

Multiple Misconceptions Remain

Information surrounding the endocannabinoid system continues to develop and expand. As such, misconceptions often arise. Dr. Song mentioned several, including that the ECS did not evolve due to cannabis use. Jenkins agreed with this opinion. “Although there may have been co-evolution, the ECS is an essential part of the human body, and both cannabinoids and terpenes are found in more plants than just cannabis….It is however likely that we have had a long term relationship with all plants that have cannabinoids due to the benefit they have on the body.”

Dr. Song also pointed out that cannabinoids can be found in plants other than cannabis. He also acknowledged the misconceptions about how CBD and THC bind to the body’s receptors. Jenkins discussed a similar point concerning the location of the critical receptors. “Although the highest concentrations of CB1 are in the brain and CB2 are in the peripheral nervous system, both CB1 and CB2 receptors are found throughout the body.”

Latest Developments

Dr. Song noted the changing sentiment around cannabis as a prime driver to better understand how the system works in the prevention, development, and treatment of various diseases. He added, “Great work is also being done to develop highly specific synthetic cannabinoids for pharmaceutical purposes, and highly customized cannabis strains are being developed to provide even greater therapeutic response.”

Stem discussed the increase in discussions around ECS deficiency syndrome. She said the syndrome “could be the etiology of a variety of serious illnesses such as multiple sclerosis and inflammatory bowel disease.” The belief is that a lack of endogenous cannabinoids can lead to the immune system spiraling out of control. As a 20-plus year sufferer of Crohn’s disease, the developments hit close to home for her.

In addition to the developments, Stem is on a research team that aims to study different methods of consumption and how they are absorbed and metabolized. In time, they hope to begin exploring the different terpene profiles of various strains and how they affect the ECS in concert with the phytocannabinoids.

Jenkins acknowledged improvements in AI, a space his company works closely with. Discussing the broader scope of the ECS space, he said: “Regardless of whether or not you believe the co-evolution theory, there is an incredible interaction between humans and cannabis.” He added, “we have only just begun to unlock the benefits.”

What Experts Have to Say about the Endocannabinoid System was posted on High Times.

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