Medical Schools Aren’t Teaching Their Students About Cannabis, Survey Finds

Medical Schools Aren’t Teaching Their Students About Cannabis, Survey Finds

Original Post: Merry Jane: Medical Schools Aren't Teaching Their Students About Cannabis, Survey Finds

[Canniseur: We know cannabis is medicine. Why don’t medical schools teach the little bit we do know about cannabis as medicine? These schools are not giving medical students the information and training they need. Newly minted doctors from our medical schools will see many patients who use cannabis and won’t tell them about their cannabis use, even in legal states. We know there is medical value in cannabis. Medical schools need to normalize cannabis as medicine.]

Students at a leading US medical school said that they are not receiving formal training about medical cannabis, according to a new study published in Complementary Theories in Medicine.

Researchers administered an online survey to students attending George Washington University (GWU) in Washington, DC. The survey asked a number of questions regarding whether or not medical students had received any education on the benefits or risks of cannabis, and if they felt prepared to use this knowledge in their medical practice. A total of 105 students responded to the survey, 37 percent of whom were first-year students. Students in their second through fourth years accounted for about 20 percent of respondents each.

Roughly 60 percent of respondents said that they had received absolutely no formal cannabis education. Only two participants said that the school had covered “a sufficient amount” of marijuana knowledge. The majority of students (55.2 percent) said that they had already encountered a patient who had asked them about medical marijuana. But due to their lack of cannabis education, 57.1 percent of future doctors said they were “not at all prepared” to discuss the benefits of medical marijuana, and 54.1 percent felt unprepared to discuss potential risks.

The survey also asked medical students whether they thought their school should offer more formal cannabis education. Over 77 percent of all respondents said that they either agreed or strongly agreed with this proposition. The study authors note that the lack of formal medical cannabis education at GWU is “striking,” given the fact that medical marijuana has been legal in DC since 2010 and private adult-use became legal in 2015.

“The perceived knowledge gap demonstrated by this survey indicates that US medical students could very well benefit from increased undergraduate medical cannabis education,” the authors wrote. “These participants overwhelmingly reported that they are not comfortable with their level of cannabis knowledge and would like to learn more while in medical school.”

The survey has a number of serious limitations, as only one specific medical school was surveyed, and only about 12 percent of the school’s students responded to the survey. However, other research indicates that these results are likely accurate. A nationwide study conducted in 2017 found that nearly 90 percent of medical school graduates felt unprepared to recommend medical marijuana to patients.

A more recent study found that although 73 percent of oncologists believed cannabis could help fight cancer, 53 percent said they felt uncomfortable recommending cannabis due to lack of education.

Medical marijuana is now legal in 33 states, but most medical schools still fail to offer education about the benefits of this increasingly popular medicine. A number of colleges, including Northern Michigan University and Colorado State University, now offer courses on cannabis biology and chemistry, but medical marijuana programs for doctors are few and far between. So far, the University of Maryland School of Pharmacy is the only US institution to offer a medical marijuana master’s program.

Original Post: Merry Jane: Medical Schools Aren't Teaching Their Students About Cannabis, Survey Finds

Pregnant Women with Anxiety or Depression More Likely to Smoke Weed, Study Finds

Pregnant Women with Anxiety or Depression More Likely to Smoke Weed, Study Finds

Original Post: Merry Jane: Pregnant Women with Anxiety or Depression More Likely to Smoke Weed, Study Finds

[Canniseur: Not surprising again. The only thing we don’t know is if cannabis affects the forming fetus. There have been no studies on this and they’d have to be longitudinal in order to have value. This study only discusses the numbers of women who smoke while pregnant, not if cannabis affected their babies. We need a study about babies and mothers who smoked while pregnant or while breastfeeding for that matter.]

Women who are suffering from trauma, depression, or anxiety are more likely to use cannabis while they are pregnant, according to a new study recently published in JAMA Network Open.

Last summer, another JAMA study reported that the rate of cannabis use among pregnant women nearly doubled between 2002 and 2017. Other studies have suggested that these expecting mothers are using cannabis to relieve stress, nausea, or pain, but a team of researchers from one of California’s largest healthcare companies set out to investigate whether mental health also played a role in prenatal cannabis use.

Kelly C. Young-Wolff, PhD, MPH, a research scientist from the Kaiser Permanente Northern California (KPNC) Division of Research, launched a new study to determine if pregnant women suffering from trauma or mental health issues were more likely to use pot. To investigate the issue, Young-Wolff and her fellow researchers turned to KNPC’s integrated healthcare system, which has collected data on hundreds of thousands of pregnancies.

Pregnant women who receive prenatal care at KPNC facilities are asked to self-report any mental health or substance use issues on a questionnaire. Doctors also conduct a urine drug test during prenatal screenings, and women who test positive undergo a second test for confirmation. Although some women did not complete the questionnaire or drug test, researchers were still able to acquire data on 196,022 pregnant women who visited these facilities between 2012 and 2017.

 

Out of these nearly 200,000 women, only 6 percent (11,681) were using cannabis while pregnant. Researchers then used electronic health records and the self-report questionnaires to determine if any of these women were suffering from depressive, anxiety, or trauma disorders during their pregnancy. Among all the subjects, the incidence of these issues ranged from 1.9 percent (domestic violence) to 11 percent (depression symptoms of at least moderate severity).

The study reports that women suffering from mental health issues were in fact more likely to use cannabis while pregnant. Researchers calculated that prenatal cannabis users were more likely to have an anxiety disorder (8.3 percent of cannabis users vs. 4.7 percent of non-users), a depressive disorder (10.6 percent vs. 4.3 percent), or both at once (8.4 percent vs. 3.1 percent). Prenatal cannabis users were also more likely to have been diagnosed with trauma (8.3 percent vs. 2.0 percent) or to have self-reported intimate partner violence (4.4 percent vs. 1.8 percent).

“These results support previous qualitative findings that pregnant women self-report using cannabis to manage mood and stress and suggest a dose-response association, with higher odds of cannabis use associated with co-occurring depressive and anxiety disorders and greater depression severity,” the authors concluded.

The study does have a number of limitations, though. All of the subjects were sourced from one health care system in Northern California, and as the researchers note, “the findings may not generalize to all pregnant women.” The evaluations were only taken around the 8th week of pregnancy, and do not account for cannabis use occurring before or after that date. Also, the study relies on self-reports of mental health, which may not always be entirely honest.

The study asserts that “no amount of cannabis use during pregnancy has been shown to be safe,” but the hard truth of the matter is that the scientific community is not entirely certain about what risks cannabis might pose to the developing child. Another JAMA study from last year suggested that cannabis use is linked to premature birth or other poor birth outcomes, and another recent study found that weed could increase the risk of miscarriage.

Other studies have come to the opposite conclusion, however. A Jamaican study found that children who had been exposed to cannabis actually showed better physiological stability at the age of one month than children who had not been exposed to weed.

Still, health authorities are erring on the side of caution and advising all expecting mothers to steer clear of pot. The US Food and Drug Administration issued a memo last fall urging all mothers to stay away from all CBD and THC products, even when breastfeeding. California has also officially declared cannabis a pregnancy risk, and Michigan is about to require all legal weed products to contain warnings against prenatal consumption.

Original Post: Merry Jane: Pregnant Women with Anxiety or Depression More Likely to Smoke Weed, Study Finds

Medical Marijuana Can Treat Vomiting and Pain Linked to GI Disorders, Study Says

Medical Marijuana Can Treat Vomiting and Pain Linked to GI Disorders, Study Says

Original Post: Merry Jane: Medical Marijuana Can Treat Vomiting and Pain Linked to GI Disorders, Study Says

[Canniseur: Another study showing the effect cannabis can have on yet another human malady. The ‘correct’ political answer today seems to be; “Before I can get behind legalization, there need to be more studies.” It’s a crock. There are getting to be many studies like this about many topics surrounding cannabis consumption. It’s about time politicians got off their collective butts and legalize. Some have, but obviously not enough.]

A new clinical research study has found that medical cannabis can help patients suffering from gastroparesis, a stomach condition that causes abdominal pain, vomiting, and other symptoms.

Gastroparesis is a disease caused by damage to the vagus nerve, which is responsible for tightening the stomach muscles to push food through the digestive system. When this nerve is damaged, the stomach is unable to empty itself properly, which can cause undigested food to ferment. This can cause symptoms of heartburn, nausea, weight loss, dehydration, and poor blood sugar control. In extreme cases, food can harden into solid masses that can block the intestines.

Traditional medicine has struggled to treat this condition effectively, and over 10 percent of patients suffering from gastroparesis report being disabled by their condition and unable to work. Hospitalizations for this disease have increased by more than 300 percent between 1997 and 2013, and gastroparetics are often hospitalized longer than patients suffering from other gastrointestinal conditions.

A team of gastroenterologists from across the US decided to investigate whether cannabinoids could treat this condition more effectively than traditional medications. The new study, published in the Cureus journal, notes that “gastroparesis is a neuromuscular disorder and neuropathy plays a large role in its pathogenesis.” Noting that prior research has found cannabinoids to effectively treat both neuropathy and gastrointestinal conditions, the researchers hypothesized that cannabinoids could help treat this challenging disease.

Researchers recruited 24 patients with gastroparesis from one gastroenterology practice and asked them to fill out a standard questionnaire evaluating their symptoms and pain levels. Patients were then asked to use medical marijuana for 60 days, after which they filled out the form again. Some patients were asked to use medical cannabis purchased from licensed New York dispensaries, which was either vaped or taken as sublingual drops. Other patients used 2mg to 10mg of dronabinol, a synthetic cannabinoid, two to four times daily.

Researchers found that “cannabinoids dramatically improve refractory gastroparesis symptoms, including abdominal pain.” Before the treatment, patients self-reported an abdominal pain score of 3.97 on a scale of one to five. After taking medical cannabis, the average score dropped to 2.34, a significant improvement. When comparing natural cannabis with its synthetic counterpart, researchers found that “marijuana was superior to dronabinol in improving all symptoms, with statistical significance seen in the abdominal pain score and the total symptom composite score.”

“Cannabinoids represent a new treatment in this difficult-to-treat, burdensome condition with minimal data-supported treatment options,” the researchers concluded. “We demonstrated that cannabinoids dramatically, and significantly, improve all symptoms of gastroparesis. Furthermore, abdominal pain was significantly improved with cannabinoids. This role in pain management represents a breakthrough for gastroparesis-associated abdominal pain treatment, for which there are currently no validated therapies.”

This study has a number of limitations, particularly the small subject size and the fact that all subjects were treated at one specific institution. The researchers also note that the subjects who used medical cannabis acquired different products at different dispensaries, which made it impossible to control the ratio of CBD to THC that each subject was consuming.

To overcome these limitations, the researchers recommend that “further studies should be conducted to confirm the efficacy of cannabinoids in refractory gastroparesis, and focus should be applied to optimal THC:CBD dosing, long-term efficacy, and sustainability of symptom improvement, as well as the side-effects of chronic cannabinoid use.”

Original Post: Merry Jane: Medical Marijuana Can Treat Vomiting and Pain Linked to GI Disorders, Study Says

Michigan Recalls 9,300 Legal THC Vapes Over Vitamin E Additives

Michigan Recalls 9,300 Legal THC Vapes Over Vitamin E Additives

Original Post: Merry Jane: Michigan Recalls 9,300 Legal THC Vapes Over Vitamin E Additives

[Canniseur: Here’s another reason I don’t like to vape anything other than whole flower. Imagine; Vitamin E oil in legal cartridges. How and why did it get there? Does anyone know what is actually in those cartridges? I don’t. I don’t know what’s in that oil or who made them either. Not knowing is detrimental to the experience. Knowledge is power.]

Michigan cannabis regulators have recalled over 9,000 vaping products that tested positive for vitamin E acetate, a vape oil cutting agent that health authorities believe is responsible for the recent outbreak of vaping-related lung injuries.

On Wednesday, the state Marijuana Regulatory Agency (MRA) recalled several different flavors of Savage brand vaping concentrate sold by Plan B Wellness, a licensed dispensary in Detroit. The state pulled 8,020 prepackaged vape carts off the store’s shelves and inventories, but the recall also includes 1,360 vape carts that had already been sold to customers, MLive reported. Each of these products was found to contain vitamin E acetate.

“Patients or caregivers who have these affected medical marijuana products in their possession should return them to Plan B Wellness for proper disposal,” the MRA stated in a press release. “Plan B Wellness must notify patients or caregivers that purchased these medical marijuana products of the recall.”

The list of contaminated products include Savage Stick vape carts sold in October and November, and carts of Blackberry Kush, GG#4, and Runtz that were sold on January 16. Customers who find themselves suffering from lung problems after using these products are advised to seek immediate medical attention and to notify the MRA by email or phone.

Back in November, the MRA halted the sale of every single vaping product on the market in order to test these products for vitamin E additives. Many products passed the tests and were returned to the market, but on December 17, the state recalled nearly 65,000 vape carts for failing these tests. Several Savage brand products were included among this recall as well.

These contaminated products were able to make their way onto the market thanks to Michigan’s rush to launch early sales of adult-use weed. In August, the MRA began allowing newly-licensed dispensaries to transfer existing, untested weed products into the state’s cannabis sales system. These untested products were made legal for sale, so long as customers signed waivers acknowledging that they understood the risks of using untested products.

However, these sales began before the news of vaping-related lung illness (EVALI or VAPI) began to spread, so customers were unaware that the risks of vaping untested products could be life-threatening. The US Centers for Disease Control (CDC) have now linked 2,668 cases of EVALI and 60 deaths to vaping products, although the number of new cases is now on the decline. In a recent report, the CDC reported that 82 percent of these cases involved the use of THC vapes.

The CDC suspects that vitamin E acetate may be one of the main factors responsible for this illness. The cutting agent is sometimes used to thicken lower-quality vaping oils, in order to pass them off as higher-quality products. At first, authorities believed that only black market vapes included this additive, but Michigan regulators are now finding that many legal products have vitamin E acetate in them, too.

A Colorado testing lab suggested that vitamin E acetate can actually occur naturally within cannabis products, at levels that may not present a risk to users, which could explain the results of Michigan’s testing. It is currently unknown whether the producers of the recalled carts intentionally added vitamin E acetate or not.

Original Post: Merry Jane: Michigan Recalls 9,300 Legal THC Vapes Over Vitamin E Additives

Medical Cannabis Helps Chronic Pain Patients Get Quality Sleep, Study Finds

Medical Cannabis Helps Chronic Pain Patients Get Quality Sleep, Study Finds

Original Post: Merry Jane: Medical Cannabis Helps Chronic Pain Patients Get Quality Sleep, Study Finds

[Canniseur: Yet another study not done in the U.S. would seem to debunk a recent story on CNN that stated exactly the opposite. This Israeli study shows that patients with chronic pain get to sleep and stay asleep. I can only comment from my story about acute surgical pain and the relief that cannabis gave me that allowed me to sleep for the week after my procedure. One note: The story specifically states that it was medical cannabis. There is no difference between medical cannabis and regular cannabis.]

Dozens of clinical research studies have found that medical cannabis can help treat symptoms of chronic pain. There’s also a wealth of anecdotal evidence showing that pot can help insomnia. But can weed help chronic pain patients get better sleep?

A team of Israeli researchers set out to find the answer to that question. In short, the answer is yes — but there are some caveats. The research team recruited 128 chronic pain patients from the Rambam Institute for Chronic Pain in Haifa, Israel. Out of these participants, 66 were using medical cannabis, while 62 were not. For the medical marijuana group, the researchers only accepted subjects who used cannabis for at least one year prior to the start of the study.

All of the subjects were age 50 or older, but researchers discovered that patients who chose not to use cannabis tended to be slightly older on average than those who used pot. Researchers also noted that 58 percent of the non-cannabis group were male, versus only 40 percent of the medical marijuana group. The two groups had similar pain levels, education levels, medication use, and patterns of alcohol and cigarette use.

During the study, the participants were asked to rate their responses to three insomnia-related questions on a 7-point Likert scale. These questions asked patients how often they woke up during the night, how often they woke up early and were unable to fall back asleep, and how often they had problems trying to fall asleep. The researchers then made adjustments for age, sex, pain level, and use of traditional sleep medications.

Overall, 27.2 percent of the study group reported always waking up at night, 24.1 percent said they always woke up early and couldn’t fall back asleep, and 20.2 percent said they always had trouble falling asleep. But when comparing the two groups, researchers found that medical marijuana users were less likely to wake up in the middle of the night. For the other two categories, there was no difference between the groups.

However, the study also reports that medical cannabis users who reported frequent use actually had more problems falling asleep or woke up more during the night than non-users. The researchers theorize that this increased insomnia could be due to patients developing tolerance to the sleep-aid characteristics of cannabis.

The study also investigated how frequently patients consumed medical cannabis, and how much they used. Overall consumption varied, but the medical marijuana group used pot for around four years, and consumed 31 grams a month on average. Researchers also analyzed the medical marijuana users’ preferred products, and found an average THC-level of 15.6 percent and an average CBD level of 2.84 percent.

“This study is among the first to test the link between whole plant MC [medical cannabis] use and sleep quality,” the researchers conclude. “In our sample of older (50+ years) chronic pain patients we found that MC may be related to fewer awakenings at night. Yet, patients may also develop a tolerance to the sleep-aid characteristics of MC. These findings may have large public health impacts considering the aging of the population, the relatively high prevalence of sleep problems in this population along with increasing use of MC.”

The researchers also note the limitations of their study, including the limited size and diversity of the subjects and the fact that they had no control over the timing, dosage, or strain of medical cannabis that the subjects used. The study recommends that further research be conducted using randomized control trials on human or animal subjects to more fully explore the efficacy of cannabis on insomnia.

Original Post: Merry Jane: Medical Cannabis Helps Chronic Pain Patients Get Quality Sleep, Study Finds

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