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Introduction: Welcome to AODstats, the Victorian alcohol and drug interactive statistics and mapping webpage.
AODstats provides information on the harms related to alcohol, illicit and pharmaceutical drug use in Victoria.

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Abstract

We provide a systematic review and meta-analysis on the efficacy, tolerability, and safety of cannabinoids in palliative medicine. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsycINFO, PubMed, Scopus, and http://clinicaltrials.gov, and a selection of cancer journals were searched up until 15th of March 2017. Of the 108 screened studies, nine studies with a total of 1561 participants were included. Overall, the nine studies were at moderate risk of bias. The quality of evidence comparing cannabinoids with placebo was rated according to Grading of Recommendations Assessment, Development, and Evaluation as low or very low because of indirectness, imprecision, and potential reporting bias. 

In cancer patients, there were no significant differences between cannabinoids and placebo for improving caloric intake (standardized mean differences [SMD]: 0.2 95% confidence interval [CI]: [-0.66, 1.06] P = 0.65), appetite (SMD: 0.81 95% CI: [-1.14, 2.75]; P = 0.42), nausea/vomiting (SMD: 0.21 [-0.10, 0.52] P = 0.19), >30% decrease in pain (risk differences [RD]: 0.07 95% CI: [-0.01, 0.16]; P = 0.07), or sleep problems (SMD: -0.09 95% CI: [-0.62, 0.43] P = 0.72). In human immunodeficiency virus (HIV) patients, cannabinoids were superior to placebo for weight gain (SMD: 0.57 [0.22; 0.92]; P = 0.001) and appetite (SMD: 0.57 [0.11; 1.03]; P = 0.02) but not for nausea/vomiting (SMD: 0.20 [-0.15, 0.54]; P = 0.26).

Regarding side effects in cancer patients, there were no differences between cannabinoids and placebo in symptoms of dizziness (RD: 0.03 [-0.02; 0.08]; P = 0.23) or poor mental health (RD: -0.01 [-0.04; 0.03]; P = 0.69), whereas in HIV patients, there was a significant increase in mental health symptoms (RD: 0.05 [0.00; 0.11]; P = 0.05). 

Tolerability (measured by the number of withdrawals because of adverse events) did not differ significantly in cancer (RD: 1.15 [0.80; 1.66]; P = 0.46) and HIV patients (RD: 1.87 [0.60; 5.84]; P = 0.28). Safety did not differ in cancer (RD: 1.12 [0.86; 1.46]; P = 0.39) or HIV patients (4.51 [0.54; 37.45]; P = 0.32) although there was large uncertainty about the latter reflected in the width of the CI. In one moderate quality study of 469 cancer patients with cancer-associated anorexia, megestrol was superior to cannabinoids in improving appetite, producing >10% weight gain and tolerability. In another study comparing megestrol to dronabinol in HIV patients, megestrol treatment led to higher weight gain without any differences in tolerability and safety. 

We found no convincing, unbiased, high quality evidence suggesting that cannabinoids are of value for anorexia or cachexia in cancer or HIV patients.

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New research, published in the journal JAMA Psychiatry, shows that a dose of the cannabis extract cannabidiol improves brain function in people living with psychosis.

A cannabis extract known as cannabidiol could be the 'ideal treatment' for psychosis.

The new study was conducted by scientists at King's College London (KCL) in the United Kingdom.

It was spearheaded by Sagnik Bhattacharyya, Ph.D., from KCL's Institute of Psychiatry, Psychology & Neuroscience.

Cannabidiol has already been proven to have antipsychotic effects. For instance, a 6-week clinical trial has shown that it relieves psychotic symptoms when taken in conjunction with antipsychotic medication. Likewise, a 4-week trial found that the compound is just as effective as traditional antipsychotics.

However, the neurological mechanisms responsible for this effect were unknown — until now. The new research sheds light, bringing us closer to a potential cannabidiol-based treatment for psychosis.

Studying cannabidiol's effects on the brain

Bhattacharyya and his colleagues examined the effects of cannabidiol on 33 study participants at "clinical high risk" of psychosis, who, although not diagnosed with the condition yet, had experienced psychotic episodes.

Of these, 16 participants took a single oral dose of 600 milligrams of cannabidiol, while 17 participants took a placebo.

Using functional MRI, the researchers scanned the participants' brains as they took a memory test. The memory tasks are known to activate three brain areas typically hyperactive in psychosis: the striatum, the medial temporal cortex, and the midbrain.

Cannabidiol normalizes brain activity

In the psychosis group, the brain activity of people who took cannabidiol was less intense than that of those who received placebo. The compound brought down the activity in these brain areas to near-normal levels.

Specifically, in each of the three brain regions, "the level of activation following administration of cannabidiol [...] was intermediate between the response in healthy control individuals who did not receive any drug and in patients at clinical high risk receiving placebo."

"These results," conclude the authors, "suggest that cannabidiol may normalize dysfunction in these brain regions, which are critically implicated in psychosis, and this may underlie its therapeutic effects in psychosis."

To the authors' knowledge, this is the first study to show the effect that cannabidiol has on the brain and the neurological mechanisms by which it could help relieve psychotic symptoms.

Cannabidiol may be the 'ideal treatment'

Bhattacharyya comments on these findings, saying, "Our results have started unraveling the brain mechanisms of a new drug that works in a completely different way to traditional antipsychotics."

In the near future, he and his team plan to launch a large multicenter clinical trial of cannabidiol for treating psychosis in young people who are at risk.

"There is an urgent need for a safe treatment for young people at risk of psychosis," Bhattacharyya explains.

"One of the main advantages of cannabidiol is that it is safe and seems to be very well tolerated, making it in some ways an ideal treatment. If successful, this trial will provide definitive proof of cannabidiol's role as an antipsychotic treatment and pave the way for use in the clinic."

Sagnik Bhattacharyya

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The Marijuana Policy Project promotes their drug as a substitute for opiate pain pills.  Like the worst offenders in the opiate industry, the cannabis lobby follows an addiction-for-profit business model. Their master plan needs 80% of the demand to be met by 20% of the users.  Science shows no evidence for using medical marijuana as a substitute for pain pills.

Governor David Ige of Hawaii wisely refused to cave to lobbyists, and he vetoed a measure that would have allowed medical marijuana to treat opiate addiction.

large-scale, major study from Australia demonstrates that cannabis doesn’t work as a substitute for opiate pills in instances of chronic, non-cancer pain.  The study came out in July, 2018 and it supports the findings of an American study published in September, 2017.

The three-year research  study by Olfson, Wall et. al., Cannabis use and the Risk of Prescription Opioid Use Disorder, 2018, concluded: “Cannabis use appears to increase rather than decrease the risk of developing nonmedical prescription opioid use and opioid use disorder.”   More than a year ago, Dr. Ken Finn, professional advisorto Parents Opposed to Pot, published Current Research on Marijuana in Pain is lacking.

It seems we should NOT be encouraging “medical” marijuana use if our goal is to stop  addiction. Theodore Caputi and Keith Humphreys recently published in the Journal of Addiction: Medical marijuana users are more likely to use prescription drugs medically and nonmedically.  They concluded: “Medical marijuana users should be a target population in efforts to combat nonmedical prescription drug use.”   See our page on Marijuana vs. Pain Pills.

The Canadian Family Physicians wrote an editorial about Medical Marijuana in February, 2018, p. 87, after devoting an entire issue to the journal on medical marijuana.  Like the NAS report in the United States, the Canadian physicians reviewed hundreds of relevant studies. In the editorial, they concluded:

“Evidence indicates the most consistent effects of medical cannabinoids are adverse events.  A variety of adverse events have a greater magnitude of effect than the potential benefits for the conditions targeted.

Read the Clinical Conundrum of Medical Marijuana for more information.   Dr. Ken Finn treats pain patients at of Springs Rehab in Colorado Springs.  He advises that there are more than 600 drug interactions with medical marijuana.   Are any medical marijuana dispensaries giving these warnings?  Another Colorado doctor who advocates marijuana for pain recently stated that marijuana edibles and concentrates should be banned.

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Jumping the Gun on ‘Marijuana as medicine’!  At What Price?

It is no accident that in almost the same week both Australia and UK have decided that cannabis is to be recommended for a host of medical disorders mostly in advance of gold standard clinical trials. This is a direct product of the organized transnational global drug liberalization movement orchestrated from New York 1.

I wish to most respectfully disagree with the points made by BMJ editor Dr. God lee. Diarrhoea and colic occur in cannabis withdrawal; Crohn’s disease has a prominent immune aspect, and cannabinoids are likely acting partly as immune modulators. Statements from patients are uninterpretable without understanding the treatments tried, their withdrawal symptomatology and their personal preferences.

Most importantly, as Dr Godlee states, cannabis is a mixture of 104 cannabinoids. The tide cannot be both out and in at the same time. Medicines in western nations are universally pure substances. This comprises a fundamental difficulty.

Medical research has confirmed that the body’s endocannabinoid system is a finely regulated and highly complex system which is involved in the detailed regulation of essentially all body systems including the brain and cardiovascular systems and stem cell niches.

Studies have shown that the rate of use of cannabis by expecting mothers closely parallels that in the wider community. In fact given the long half-life of cannabis in tissues even were a maternal habitual smoker to stop when she discovered her pregnancy, her infant would continue to be exposed to her on-board cannabinoid load for several months afterwards during critical periods of organogenesis. And other studies show that the father’s cannabis use is even more damaging than the mothers’ 2.

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Medical research has confirmed that the body’s endocannabinoid system is a finely regulated and highly complex system which is involved in the detailed regulation of essentially all body systems including the brain and cardiovascular systems and stem cell niches.  

Studies have shown that the rate of use of cannabis by expecting mothers closely parallels that in the wider community.  In fact given the long half-life of cannabis in tissues even were a maternal habitual smoker to stop when she discovered her pregnancy, her infant would continue to be exposed to her on-board cannabinoid load for several months afterwards during critical periods of organogenesis.  And other studies show that the father’s cannabis use is even more damaging than the mothers’.

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