Cannabidiol can be sourced from both marijuana plants and hemp plants, which are legal in most countries as they contain minor amounts of THC. CBD is the. Cannabidiol (CBD) is a phytocannabinoid discovered in It is one of some identified cannabinoids in cannabis plants, accounting .. This legislation defined hemp as cannabis containing less than % of THC delta-9, grown within. Thirty-three states have passed medical marijuana laws. Twelve states have enacted CBD-explicit medical laws. It will carve out an exemption for traditional hemp plants, defined as having a maximum of % of THC.
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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;.
Allows either smoking or vaporization of some kind of marijuana products, plant material, or extract. Schedules of controlled substances. Department of Justice; Management of substance abuse: Behavioral health trends in the United States: Office of National Drug Control Policy. Answers to frequently asked questions about marijuana.
Medicinal use of marijuana—polling results. N Engl J Med. Kondrad E, Reid A. J Am Board Fam Med. Moeller KE, Woods B. Am J Pharm Educ. National Conference of State Legislatures. State medical marijuana laws. Food and Drug Administration. FDA work on medical products containing marijuana. Food and Drug Administration; Mar, A Complete Guide to Cannabis. Park Street Press; Early medical use of cannabis.
The Marihuana Tax Act of The advisability and feasibility of developing USP standards for medical cannabis. Pharmacopeial Convention; [Accessed August 5, ]. Encyclopedia of Drug Policy. State marijuana laws in map. Comparing cannabis with tobacco—again. National Institute on Drug Abuse. Should marijuana be a medical option?
MacDonald K, Pappas K. A multi-facet therapeutic target. Care and feeding of the endocannabinoid system: International Union of Basic and Clinical Pharmacology. Cannabinoid receptors and their ligands: Current status and prospects for cannabidiol preparations as new therapeutic agents. Zhornitsky S, Potvin S. Cannabidiol in humans—the quest for therapeutic targets. Pharmaceuticals Basel ; 5: Is legalization impacting the way people use cannabis?
Int J Drug Policy. Pharmacokinetics and metabolism of the plant cannabinoids, delta9-tetrahydrocannabinol, cannabidiol, and cannabinol. Controlled cannabis vaporizer administration: Plasma delta-9 tetrahydrocannabinol concentrations and clinical effects after oral and intravenous administration and smoking. Pharmacokinetics and pharmacodynamics of cannabinoids. Exogenous cannabinoids as substrates, inhibitors, and inducers of human drug metabolizing enzymes: Sativex oral mucosal spray.
Marinol dronabinol capsules USP prescribing information. Adverse health effects of marijuana use. Association between cannabis and psychosis: Keep off the grass? Cannabis, cognition, and addiction. Marijuana and lung diseases. Curr Opin Pulm Med. Cannabis use and risk of psychiatric disorders: Early cannabis use and estimated risk of later onset of depression spells: Cannabis, ischemic stroke, and transient ischemic attack: Adverse cardiovascular, cerebrovascular, and peripheral vascular effects of marijuana: Acute and long-term effects of cannabis use: Examining the roles of cannabinoids in pain and other therapeutic indications: Adverse effects of medical cannabinoids: Lynch ME, Campbell F.
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. American Academy of Neurology. Efficacy and safety of the therapeutic use of medical marijuana cannabis in selected neurologic disorders. Efficacy and safety of medical cannabinoids in older subjects: State-by-state medical marijuana laws.
Guidance regarding marijuana enforcement. DEA Form —New application for registration. Center for Medicinal Cannabis Research.
University of California; San Diego: New Jersey Department of Health. Guidelines for patients and caregivers. Quebec hospitals allow inpatient use of weed. There is a massive amount of scientific research being done on CBD right now, and we are likely to see many medical breakthroughs in the next decade. It found that extract taken from whole plant CBD-rich cannabis is therapeutically superior to single-molecule extract. The scientists behind this study noticed that science had been utilizing pure, single-molecule CBD, which resulted in a bell-shaped dose-response curve.
The study from Israel essentially documented the synergistic effects of whole plant cannabinoid profiles; as noted above, this is the entourage effect. The difference here, however, is that this most recent study dove into what extent whole-plant CBD can be more therapeutic than single-molecule CBD extract. Although both hemp and marijuana are cannabis, hemp produces less than 0. This means that producing a single 10 mL dose of CBD would require the cultivation and extraction of far more hemp than it would from whole-plant marijuana; thus raising the risk of exposing users to more contaminants.
Also, CBD derived from industrial hemp lacks the the incredibly diverse profile of different cannabinoids and terpenes found in whole-plant marijuana. CBD derived from hemp boasts a greatly weaker entourage effect. Federal law in the United States prohibits the use of hemp leaves and flowers to make drug products. In this case, the differences between industrial hemp and whole-plant marijuana are far less significant.
Consumers should be aware that a handful of hemp products on the market pay lip service to governmental regulations by labeling themselves as hemp, despite containing cannabinoids and terpenoids. A potent pain-reliever, Cannatonic hails from Spain and stands as one of the earliest cultivars to be bred for its high CBD content.
This cultivar is a cross between MK Ultra and G13 Haze, and it helps relieves anxiety, muscle spasms, pain, and migraines while providing uplifting energy. Cannatonic tends to relax and loosen muscles without locking users to their couches. This cultivar was bred by crossing classic landraces from Nepal, Switzerland, and Thailand.
It smells of a fresh pine forest dotted with hints of cherry. Harlequin helps mute pain and stress without fogging the mind. This cultivar typically sports a 1: This Sativa-dominant Hybrid smells of musky diesel but refreshes the soul like a warm cup of tea.
This cultivar is named after the cannabidiol pioneer, Lawrence Ringo. Shortly thereafter, other scientists began testing isolated cannabinoids on lab animals; notably, Walter S. Cannabis made another leap forward in when Israeli scientist Dr. Raphael Mechoulam identified the structure of deltatetrahydrocannabinol, or THC. This discovery earned him godfather status of modern cannabis.
In February of , Dr. Mechoulam teamed up with South American researchers to publish a study regarding cannabis and epilepsy. This study is seen as one of the earliest double-blind studies of CBD on clinical subjects. Mechoulam and his team conducted included 16 people, many of whom were children, who all suffered from severe epilepsy. The results were startling: Every subject who received CBD experienced improvement in their condition with little to no side effects.
This anticonvulsant study has since proven to be an integral milestone in the world of clinical marijuana research, but largely went unnoticed at the time. In , a group of scientists researched and studied the effects of CBD on anxiety and found that it has potent anxiolytic, or anti-anxiety, properties as well.
This groundbreaking moment paved the way for public support and lucrative research opportunities. Geoffrey Guy and Dr. Brian Whittle to found GW Pharmaceuticals, a company that would utilize clinical trials to unpack various cannabinoid formulations as potential therapies with the overriding focus of developing what would later be known as Sativex Nabiximols.
These mounting developments in the elicited a problem amongst cannabis cultivators across the US: Essentially, CBD had been selectively bred out of existence across the country. Years passed, and more studies rolled out with medically beneficial findings regarding cannabis until when Steep Hill Laboratory in Oakland, California, tested cannabis samples provided by Harborside Health Center to discover that a handful of cultivars contained more CBD than THC. This discovery kicked other labs into gear.
They wanted to study medical cannabis to understand and potentially calibrate their cannabinoid ratios. Soon thereafter, laboratories uncovered CBD-dominant strains boasting Cannabidiol is as versatile as THC — perhaps even more so. Through science and determination, CBD has worked its way into an entire host of products. Combusting or vaporizing flower allows users to almost immediately feel the therapeutic effects of CBD. CBD isolate is cannabidiol in its purest form: CBD can also be purchased in concentrate form, including raw CBD oil, cartridges, vape pens, syringes and more.
Research and opportunity have driven chefs and chemists to infuse CBD into all sorts of readily usable products, such as edibles to elixirs, sublingual sprays, capsules and even topicals. Much like concentrates, each infusion sports specific combinations or isolations of CBD, THC, and other cannabinoids, allowing users to pick and choose products that suit their exact needs.
Medicinal Cannabis: History, Pharmacology, And Implications for the Acute Care Setting
In a nutshell, the Farm Bill makes it legal to possess, manufacture, and distribute CBD extracted from all cannabis plants that meet the definition. States where recreational weed is legal: Michigan joins the party . CBD—from the Drug Enforcement Agency's definition of marijuana. eventually loosen laws around the popular marijuana extract CBD. of the bill places industrial hemp — which is defined as a cannabis.