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Medical Marijuana Could Help Patients Reduce Pain With Opiates

27
Jan
posted by                filed under Marijuana

A UCSF study suggests patients with chronic pain may experience greater relief if their doctors add cannabinoids — the main ingredient in cannabis or medical marijuana — to an opiates-only treatment. The findings, from a small-scale study, also suggest that a combined therapy could result in reduced opiate dosages.

More than 76 million Americans suffer from chronic pain — more people than diabetes, heart disease and cancer combined, according to the National Centers for Health Statistics.

“Pain is a big problem in America and chronic pain is a reason many people utilize the health care system,” said the paper’s lead author, Donald Abrams, MD, professor of clinical medicine at UCSF and chief of the Hematology-Oncology Division at San Francisco General Hospital and Trauma Center (SFGH). “And chronic pain is, unfortunately, one of the problems we’re least capable of managing effectively.”

In a paper published this month in Clinical Pharmacology & Therapeutics, researchers examined the interaction between cannabinoids and opiates in the first human study of its kind. They found the combination of the two components reduced pain more than using opiates alone, similar to results previously found in animal studies.

Researchers studied chronic pain patients who were being treated with long-acting morphine or long-acting oxycodone. Their treatment was supplemented with controlled amounts of cannabinoids, inhaled through a vaporizer. The original focus was on whether the opiates’ effectiveness increased, not on whether the cannabinoids helped reduce pain.

“The goal of the study really was to determine if inhalation of cannabis changed the level of the opiates in the bloodstream,” Abrams said. “The way drugs interact, adding cannabis to the chronic dose of opiates could be expected either to increase the plasma level of the opiates or to decrease the plasma level of the opiates or to have no effect. And while we were doing that, we also asked the patients what happened to their pain.”

Abrams and his colleagues studied 21 chronic pain patients in the inpatient Clinical and Transitional Science Institute’s Clinical Research Center at SFGH: 10 on sustained-release morphine and 11 on oxycodone. After obtaining opiate levels from patients at the start of the study, researchers exposed them to vaporized cannabis for four consecutive days. On the fifth day, they looked again at the level of opiate in the bloodstream. Because the level of morphine was slightly lower in the patients, and the level of oxycodone was virtually unchanged, “one would expect they would have less relief of pain and what we found that was interesting was that instead of having less pain relief, patients had more pain relief,” Abrams said. “So that was a little surprising.”

The morphine group came in with a pain score of about 35, and on the fifth day, it decreased to 24 — a 33 percent reduction. The oxycodone group came in with an average pain score of about 44, and it reduced to 34 — a drop of 20 percent. Overall, patients showed a significant decrease in their pain.

“This preliminary study seems to imply that people may be able to get away perhaps taking lower doses of the opiates for longer periods of time if taken in conjunction with cannabis,” Abrams said.

Opiates are very strong powerful pain medicines that can be highly addictive. They also can be deadly since opiates sometimes suppress the respiratory system.

As a cancer doctor, Abrams was motivated to find safe and effective treatments for chronic pain. Patients in the cannabis-opiates study experienced no major side effects such as nausea, vomiting or loss of appetite.

“What we need to do now is look at pain as the primary endpoint of a larger trial,” he said. “Particularly I would be interested in looking at the effect of different strains of cannabis.”

For instance, Delta 9 THC is the main psychoactive component of cannabis but cannabis contains about 70 other similar compounds with different effects. One of those is cannabidiol, or CBD. It appears to be very effective against pain and inflammation without creating the “high” created by THC.

“I think it would be interesting to do a larger study comparing high THC versus high CBD cannabis strains in association with opiates in patients with chronic pain and perhaps even having a placebo as a control,” Abrams said. “That would be the next step.”

Abrams is the lead author of the paper; co-authors are Paul Couey, BA, and Mary Ellen Kelly, MPH, of the UCSF Division of Hematology-Oncology at SFGH; Starley Shade, PhD, of the UCSF Center for AIDS Prevention Studies; and Neal Benowitz, MD, of the UCSF Division of Clinical Pharmacology and Experimental Therapeutics.

The study was supported by funds from the National Institutes on Drug Abuse (NIDA), a subsidiary of the National Institutes of Health (NIH).

Major Components of Cannabis

  • Delta-9 Tetrahydrocannabinol (Delta-9 THC) – It is the main psychoactive component of cannabis with mild to moderate painkilling effects. It also helps treat nausea associate with cancer chemotherapy and to stimulate appetite. It induces feelings of euphoria. Potential side effects include accelerated heartbeat, panic, confusion, anxiety and possible paranoia.
  • Cannabidiol (CBD) - It is a major, non-psychoactive component of cannabis that helps shrink inflammation and reduce pain without inducing the euphoria effects of THC. It has been used to treat rheumatoid arthritis, inflammatory bowel diseases, psychotic disorders and epilepsy. Larger amounts of CBD can relax the mind and body without causing negative side effects associated with THC.
  • Cannabinol (CBN) – It is a secondary psychoactive component of cannabis. It is not associated with painkilling effects of THC or CBD. CBN is formed as THC ages. Unlike the euphoria effects of THC, CBN can induce headaches and a sense of lethargy.
  • Tetrahydrocannabivarin (THCV) – It is found primarily in strains of African and Asian cannabis. THCV heightens the intensity of THC effects and the speed in which the component is delivered, but also causes the sense of euphoria to end sooner.
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Turn off, tune in, drop out

26
Jan
posted by                filed under Psilocybin (Mushrooms), Psychedelic Research
Magic mushrooms reduce blood flow to parts of brain

When Timothy Leary advised his generation to “turn on” by taking psychedelic drugs, he got it all wrong. Turning off parts of the brain may be the real secret to expanding your mind, a new study of hallucinogenic mushrooms finds.

The study is the most detailed look yet at where and how psychedelics work in the human brain, says psychiatrist and neuropsychopharmacologist David Nutt of Imperial College London, whose team reports the findings online January 23 in the Proceedings of the National Academy of Sciences.

Nutt and colleagues recruited 15 people with previous experience taking hallucinogens. Each was injected with a small amount of psilocybin, the ingredient responsible for magic mushrooms’ mind-bending properties. The effect was immediate, peaking in just minutes and lasting for about an hour.

Before and after the volunteers tripped out — one described the experience as “dissolving,” another as “kneeling at the foot of God” — their brains were scanned. These measurements revealed decreases in the amount of blood flowing through parts of the volunteers’ brains. Surprised by the result, the researchers repeated the experiment with another group, using a different scanning technique. The same pattern of reduced activity emerged, most pronounced in the hubs that connect different parts of the brain — including the thalamus and parts of the cingulate cortex.

“The findings are astounding and are going to completely change how we understand the action of hallucinogens,” says psychiatrist and pharmacologist Bryan Roth of the University of North Carolina at Chapel Hill, who was not involved in the study. “They’re the complete opposite of what has been predicted.”

Previous studies suggested that hallucinogens stimulate certain kinds of neurons in mice. Nutt expected to see an uptick of activity in the visual regions of the brain, which would explain the kaleidoscopic hallucinations often experienced by magic mushroom users.

But suppressing core regions that help to coordinate and control the brain could have deeper, more philosophical consequences. It fits with how Aldous Huxley described the effects of mescaline — a hallucinogen that, in his words, flung wide the “doors of perception.”

“Decreasing the activity in certain hubs in the network may allow for a more unconstrained conscious experience,” says Matthew Johnson, an experimental psychologist at Johns Hopkins University School of Medicine in Baltimore who studies psilocybin and other hallucinogens. “These drugs may lift the filters that are at play in terms of limiting our perception of reality.”

Further work by Nutt’s team showed that the brain hubs responded together, linked by a neural circuit called the default mode network. Some scientists believe this highly interconnected brain superhighway is essential for maintaining a person’s sense of self.

Putting the brakes on this network could help to treat certain psychological conditions by opening the brain to new ways of thinking, researchers hope. Several studies have shown that psilocybin can change people’s attitudes for the better and may be useful for treating depression, a condition linked to too much activity in the default mode network.

“Chemically switching off might have very profound beneficial effects,” says Nutt, who suspects that psilocybin could also be useful for treating obsessive-compulsive disorder. “It may help people completely locked into a mindset that drives their lives.”

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Cheer up! Eat your mushrooms…

26
Jan
posted by                filed under Psilocybin (Mushrooms), Psychedelic Research

AH, LUCY in the Sky with Diamonds…Suddenly Cassandra is transported back to those gloriously psychedelic days of the ‘60s thanks to the discovery by British researchers that psilocybin—the mind-altering ingredient in “magic mushrooms”—helps combat depression. Actually, it surely does far more than that, as Aldous Huxley wrote half a century ago in “The Doors of Perception” (a title that was warmly embraced by Jim Morrison, hence his group “The Doors”).

 

The implication of the research into the mysteries of the human brain is that psychedelic drugs such as LSD could have a therapeutic value—but the obvious snag is that they are illegal. In which case, perhaps drugs should be legalised? Why not treat narcotics as an issue of public health—rather like smoking—than a matter of criminality? This has long been the policy of The Economist, and I am pleased to see that Sir Richard Branson is taking up the cause, both in a newspaper column and today before MPs in Britain’s House of Commons. As “the bearded one” points out:

Just as prohibition of alcohol failed in the United States in the 1920s, the war on drugs has failed globally. Over the past 50 years, more than $1 trillion has been spent fighting this battle, and all we have to show for it is increased drug use, overflowing jails, billions of pounds and dollars of taxpayers’ money wasted, and thriving crime syndicates. It is time for a new approach.

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Marijuana Genome Sequenced For Health, Not Highs

22
Aug
posted by                filed under Marijuana, Psychedelic Research, Psychedelic Society

Stoners and scientists alike may be stoked to learn that a startup biotech company has completed the DNA sequence of Cannabis sativa, or marijuana. But here’s something that could ruin a high: The company hopes the data will help scientists breed pot plantswithout much THC, the mind-altering chemical in the plant. The goal is instead to maximize other compounds that may have therapeutic benefits.

Kevin McKernan, founder and chief executive officer of the company, called Medicinal Genomics, says Cannabis sativa has 84 other compounds that could fight pain or possibly even shrink tumors. But anti-marijuana laws make it difficult for scientists to breed and study the plant in most countries. That’s one reason he decided to publish his data for free on Amazon’s EC2, a public data cloud.

McKernan, who has an office in Massachusetts and a lab in the Netherlands, where he can legally gather DNA from marijuana plants, has spent most of his career studying tumors in humans. But he tells Shots he had several friends with cancer who asked him about medical marijuana and whether it might do them some good. That got him interested in the emerging medical research on pot’s healing properties.

Then he heard about a drug called Sativex, a Cannabis-derived drug developed by a German pharmaceutical company to treat muscle stiffness from multiple sclerosis. Sativex contains THC and another cannabanoid called CBD, which the company says keeps the psychoactive effects of THC in check. The drug is now available in the United Kingdom, Spain and Germany, and it’s in trials to see if it works for cancer pain.

McKernan says Sativex might just be one of the first in a line of future pharmaceuticals using cannabis compounds for a variety of serious illnesses.

“We know which genes govern CBD and THC, but not the other 83 compounds,” McKernan tells Shots. “Now that we’ve sequenced this genome, we can sequence other strains, and then we can tie the differences in DNA to different traits.”

Opening up access to the data is especially important for a plant like Cannabis, McKernan says, because many scientists who’d like to study it in the U.S. and other countries can’t get a license to grow it.

“A lot of people who want to contribute to this field can’t, but now that this information is available, a lot of research can get done without growing any plants,” McKernan said.

source: NPR

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