Cannabidiol (CBD) is a naturally occurring compound found in the resinous flower of (THC), the compound that causes the high that cannabis is famous for . CBD, or cannabidiol, is a compound of marijuana that's becoming the new "it" drug amid widespread cannabis legalization. Is it safe?. Cannabidiol (CBD) is an active ingredient in cannabis derived from the hemp plant. It may help treat is CBD? Why is it suddenly so popular?.
Cannabinoid; CBD?: What the Is Famous
A total of 28 states, the District of Columbia, Guam, and Puerto Rico now allow comprehensive public medical marijuana and cannabis programs.
Medicinal Cannabis Indications for Use by State 10 , 60 , Table adapted with permission from the Marijuana Policy Project; 60 table is not all-encompassing and other medical conditions for use may exist. The reader should refer to individual state laws regarding medicinal cannabis for specific details of approved conditions for use. In addition, states may permit the addition of approved indications; list is subject to change. Some of the most common policy questions regarding medical cannabis now include how to regulate its recommendation and indications for use; dispensing, including quality and standardization of cultivars or strains, labeling, packaging, and role of the pharmacist or health care professional in education or administration; and registration of approved patients and providers.
The regulation of cannabis therapy is complex and unique; possession, cultivation, and distribution of this substance, regardless of purpose, remain illegal at the federal level, while states that permit medicinal cannabis use have established individual laws and restrictions on the sale of cannabis for medical purposes. In a U. Department of Justice memorandum to all U.
Cole noted that despite the enactment of state laws authorizing marijuana production and sale having a regulatory structure that is counter to the usual joint efforts of federal authorities working together with local jurisdictions, prosecution of individuals cultivating and distributing marijuana to seriously ill individuals for medicinal purpose has not been identified as a federal priority.
There are, however, other regulatory implications to consider based on the federal restriction of cannabis. Medical cannabis expenses are not reimbursable through government medical assistance programs or private health insurers. As previously described, the Schedule I listing of cannabis according to federal law and DEA regulations has led to difficulties in access for research purposes; nonpractitioner researchers can register with the DEA more easily to study substances in Schedules II—V compared with Schedule I substances.
For example, the Center for Medicinal Cannabis Research at the University of California—San Diego had access to funding, marijuana at different THC levels, and approval for a number of clinical research trials, and yet failed to recruit an adequate number of patients to conduct five major trials, which were subsequently canceled.
The limited availability of clinical research to support or refute therapeutic claims and indications for use of cannabis for medicinal purposes has frequently left both state legislative authorities and clinicians to rely on anecdotal evidence, which has not been subjected to the same rigors of peer review and scrutiny as well-conducted, randomized trials, to validate the safety and efficacy of medicinal cannabis therapy.
Furthermore, although individual single-entity pharmaceutical medications, such as dronabinol, have been isolated, evaluated, and approved for use by the FDA, a plant cannot be patented and mass produced by a corporate entity.
The Schedule I designation of cannabis causes hospitals and other care settings that receive federal funding, either through Medicare reimbursement or other federal grants or programs, to pause to consider the potential for loss of these funds should the federal government intercede and take action if patients are permitted to use this therapy on campus. Similarly, licensed practitioners registered to certify patients for state medicinal cannabis programs may have comparable concerns regarding jeopardizing their federal DEA registrations and ability to prescribe other controlled substances as well as jeopardizing Medicare reimbursements.
Attorney General Eric Holder recommended that enforcement of federal marijuana laws not be a priority in states that have enacted medicinal cannabis programs and are enforcing the rules and regulations of such a program; despite this, concerns persist. The argument for or against the use of medicinal cannabis in the acute care setting encompasses both legal and ethical considerations, with the argument against use perhaps seeming obvious on its surface.
States adopting medical cannabis laws may advise patients to utilize the therapy only in their own residence and not to transport the substances unless absolutely necessary.
Canada has adopted national regulations to control and standardize dried cannabis for medical use. The argument can be made that an herb- or plant-based entity cannot be identified by pharmacy personnel as is commonly done for traditional medicines, although medicinal cannabis dispensed through state programs must be labeled in accordance with state laws. Dispensing and storage concerns, including an evaluation of where and how this product should be stored e. Inpatient use of medicinal cannabis also carries implications for nursing and medical staff members.
The therapy cannot be prescribed, and states may require physicians authorizing patient use to be registered with local programs. Despite the complexities in the logistics of continuing medicinal cannabis in the acute care setting, proponents of palliative care and continuity of care argue that prohibiting medicinal cannabis use disrupts treatment of chronic and debilitating medical conditions.
Patients have been denied this therapy during acute care hospitalizations for reasons stated above. Legislation in Minnesota, as one example, has been amended to permit hospitals as facilities that can dispense and control cannabis use; similar legislative actions protecting nurses from criminal, civil, or disciplinary action when administering medical cannabis to qualified patients have been enacted in Connecticut and Maine.
Despite lingering controversy, use of botanical cannabis for medicinal purposes represents the revival of a plant with historical significance reemerging in present day health care. Legislation governing use of medicinal cannabis continues to evolve rapidly, necessitating that pharmacists and other clinicians keep abreast of new or changing state regulations and institutional implications.
Ultimately, as the medicinal cannabis landscape continues to evolve, hospitals, acute care facilities, clinics, hospices, and long-term care centers need to consider the implications, address logistical concerns, and explore the feasibility of permitting patient access to this treatment. Whether national policy—particularly with a new presidential administration—will offer some clarity or further complicate regulation of this treatment remains to be seen.
The authors report no commercial or financial interests in regard to this article. National Center for Biotechnology Information , U. Journal List P T v. Author information Copyright and License information Disclaimer. This article has been cited by other articles in PMC. Open in a separate window. Access to marijuana through home cultivation, dispensaries, or some other system that is likely to be implemented;.
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Cannabinoids for treatment of chronic noncancer pain: Br J Clin Pharmacol. Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy. Cochrane Database Syst Rev. Gloss D, Vickrey B. But THC is only one of the scores of chemicals — known as cannabinoids — produced by the cannabis plant.
So far, CBD is the most promising compound from both a marketing and a medical perspective. While studies have shown CBD to have anti-inflammatory, anti-pain and anti-psychotic properties , it has seen only minimal testing in human clinical trials, where scientists determine what a drug does, how much patients should take, its side effects and so on.
Despite the government ruling, CBD is widely available over the counter in dispensaries in states where marijuana is legal. The piece, reported by Dr Sanjay Gupta, featured a little girl in Colorado named Charlotte, who had a rare life-threatening form of epilepsy called Dravet syndrome. At age five, Charlotte suffered grand mal seizures a week, and was constantly on the brink of a medical emergency.
It was controversial to pursue medical marijuana for such a young patient, but when they gave Charlotte oil extracted from high-CBD cannabis, her seizures stopped almost completely. Instead of moving, other families obtained CBD oil through the illegal distribution networks. If Epidiolex wins approval it would be the first time the agency approves a drug derived from the marijuana plant. Epidiolex was developed by the London-based GW Pharmaceuticals , which grows cannabis on tightly controlled farms in the UK.
While parents treating their children with CBD had to proceed based on trial and error, like a folk medicine, they also had to wonder whether dispensary purchased CBD was professionally manufactured and contained what the package said it did.
GW brought a scientific understanding and pharmaceutical grade manufacturing to this promising compound.
What is CBD? The 'miracle' cannabis compound that doesn't get you high
In early May, a federal court declined to protect cannabidiol (CBD), a chemical produced by the cannabis plant, from federal law enforcement. But there's another term on the rise: CBD. CBD, one of the more than chemicals in cannabis, is emerging as a popular wellness ingredient. The most well-known eCB ligands are N-arachidonyl-ethanolamide ( anandamide or Unlike THC, CBD elicits its pharmacological effects without exerting any.