A new study has linked cannabis use to suicidal ideation – but it doesn’t look at the whole picture, say medical experts.
According to researchers from the National Institute on Drug Abuse (NIDA) cannabis consumption was associated with a higher prevalence of suicidal ideation and attempts among US young adults, with or without depression.
This was true for both sexes, but appeared to be more prevalent in women.
The study used data from 281,650 participants of the National Surveys of Drug Use and Health (NSDUH) between 2008 and 2019.
The findings suggest that both daily and occasional cannabis use increased the risk of suicidal ideation, plan, and attempt increased from 40 percent to 60 percent over this time period.
The authors conclude that more research is needed to examine the increase in suicidality and to determine “whether it is cannabis use or overlapping risk factors that increase risks for both.”
It could be argued that these findings point to existing evidence linking cannabis use with mood disorders and self-harm, but the study failed to take into account some important factors, according to medical experts..
Dr Dani Gordon is a world leading expert in clinical cannabinoid medicine, having prescribed medical cannabis to thousands of patients.
Studies such as these should be treated with caution, she warns, and are often erroneously used to justify blocking or restricting wider access to cannabis for medical purposes in appropriate patients.
Firstly, those in the study were using self-administered cannabis, which was not accessed through a prescription by a trained medical doctor, under medical guidance.
So-called ‘recreational’ or self-administered, non-medical cannabis use generally contains higher levels of THC and is very different from how medical cannabis would normally be prescribed.
This study likely has “little or no bearing” on the risks and therapeutic indications of medical cannabis, especially for those over the age of 25, says Dr Gordon.
It was also conducted on young adults, aged 18-35, a small subset of the age group where medical cannabis tends to be most utilised.
“In patients under the age of 25, due to possible deleterious effects on the developing brain in young people of high THC consumption, medical cannabis containing THC is used very sparingly and only when clinically necessary and when other medications have been tried first, for example, in severe epilepsy and other serious conditions that have not responded to other drugs,” she explains.
“Already this study has skewed the patient population towards more harm, especially when the cannabis is self-administered for ‘recreational’ use.”
While the NSDUH took into account sociodemographic characteristics, such as age, sex, race/ethnicity, education, employment status, family income and health insurance, it does not mention any controlls for underlying health conditions.
Previous researchers have suggested that the perception of cannabis as having a negative impact on mental health could be the result of how data has been interpreted over the years.
Psychology professor at Washington State University, Dr Carrie Cuttler, has been researching cannabis and mental health for several years.
According to her work, the top three reasons given by patients for consuming cannabis were pain management, followed by depression and anxiety.
In a study published last year she found that people living with common mental health issues including anxiety, depression, post-traumatic stress disorder (PTSD) and obsessive compulsive disorder (OCD) reported that cannabis use had actually reduced their symptoms by more than half in the short-term.
She told Cannabis Health at the time that the correlation between cannabis use and mental health problems has been interpreted in “potentially the wrong direction.”
On top of this, mental health issues, including depression and suicide ideation are a common issue among many patients living with chronic illness, particularly those with pain conditions, who are more likely to be self-medicating with cannabis.
“Of people who use cannabis ‘recreationally’ a significant number of those people will be using it for a health related condition or symptom. A lot of the time that’s anxiety, mental health or pain of some variety, often when other conventional drug treatments have failed or been only partially successful,” explains Dr Gordon, who will open her Resilience Medicine clinic in the UK in the coming weeks.
“Anyone who suffers from chronic pain that has been poorly treated, or neuropsychiatric symptoms and other poorly treated conditions such as chronic fatigue syndrome/ME or fibromyalgia and many women’s health symptoms are often very marginalised in the medical experience.
These patients will tell me that their experience with the medical care they have received and with the medical system in general has had a huge impact on the way they experience their illness, for example suffering more, and these experiences have also negatively impacted their mental health.
“While they may not have been actively suicidal in the past, many may have had passive suicidal ideation as a result of feeling marginalised, hopeless about their condition and their chances of getting symptom relief or feeling better.
“This hopelessness can lead to feelings of despair, although unless a doctor asks specifically about this, many patients will not offer up this information for fear of being further stigmatised.
“That is the nature of the types of people who tend to utilise cannabis rather than cannabis causing this phenomenon.”
Dr Gordon also notes that while this type of data may show an association between cannabis and suicidal thoughts, it doesn’t confirm that it is at the root of the cause.
“This type of data is correlational versus causational,” she adds.
“It’s just an association and doesn’t mean that cannabis has caused this issue or has improved this issue either, it’s two completely different things.”
CBGA may be ‘more potent’ than CBD against seizures in Dravet syndrome
Dr Lyndsey Anderson said there is more to explore when it comes to creating more treatment options for Dravet syndrome.
Scientists say they have found the ‘Mother of all cannabinoids’ which may help to reduce seizures in Dravet syndrome.
A new study on mice from the University of Sydney found that three acidic cannabinoids found in cannabis reduced seizures in Dravet syndrome, an intractable form of childhood epilepsy.
The three cannabinoids are cannabigerolic acid (CBGA), cannabidivarinic acid (CBDVA), cannabigerovarinic acid (CBGVA). All three but CBGA in particular “may contribute to the effects of cannabis-based products in childhood epilepsy” noted the researchers and were found to potentially have ‘anticonvulsant properties.”
The study marks the first time that three acidic cannabinoids were found to potentially help reduce seizures for Dravet syndrome.
Speaking with Cannabis Health News, the lead author of the study, Dr Lyndsey Anderson, said: “We found that CBGA exhibited both anticonvulsant and pro-convulsant effects. CBGA was more potent than CBD against febrile seizures in a mouse model of Dravet syndrome. We also found that a combination of CBGA and clobazam was more effective than either treatment alone. Additionally, we found that CBGA was anticonvulsant in the maximal electroshock acute seizure model, a model for generalized tonic-clonic seizures.”
She added: “CBGA did, however, present some proconvulsant effects. The frequency of spontaneous seizures in the mouse model of Dravet syndrome was increased with a high dose of CBGA. Also, CBGA was proconvulsant in the 6-Hz acute seizure model, a model of focal, psychomotor seizures.”
Although CBGA shows promise, Dr Anderson also stressed that it needs more research before it can replace CBD. She cautioned that Dravet syndrome patients may still need to proceed with caution.
“Artisanal cannabis-based products are believed to reduce seizures in Dravet syndrome patients,” she said. “As these oils contain rare cannabinoids like CBGA, it is possible CBGA then contributes to the anticonvulsant effects of these artisanal cannabis oils. However, there were proconvulsant effects observed with CBGA, suggesting that Dravet syndrome patients may need to proceed with caution. The proconvulsant liability of CBGA would need to be addressed before it replaced CBD as an anticonvulsant.”
What is CBGA?
Sometimes referred to as ‘the mother of all cannabinoids,’ CBGA is the precursor molecule to many different cannabinioids including CBD and THC. It is thought to help some diseases such as colon cancer, metabolic disease and cardiovascular disease. It is a non-intoxicating cannabinoid much like CBD.
Dr Anderson explains that more research is needed to explain how the three cannabinoids work together.
“We don’t know how they work together yet,” she said. “We found that CBGA, CBDVA and CBGVA were all individually anticonvulsant against thermally induced seizures in the mouse model of Dravet syndrome. We did not investigate whether a combination of these three cannabinoids would result in a greater anticonvulsant effect than either cannabinoid alone. Future work will definitely explore this possibility.”
CBGA future research
This isn’t the end of the research into CBGA for Dravet Syndrome. Dr Anderson said there is more to explore when it comes to creating more treatment options for Dravet syndrome.
She said: “Next on the horizon for this research is to explore whether the anticonvulsant properties of CBDVA and CBGVA translate to other seizure types including spontaneous seizures in the mouse model of Dravet syndrome. Additionally, we have extensively interrogated the anticonvulsant potential of individual cannabinoids and identified ten with anticonvulsant properties.”
“We are now interested in investigating what happens when we combine these anticonvulsant properties. It remains an open possibility that greater anticonvulsant effects are achieved when the cannabinoids are administered in combination.”
New York regulators vote to allow home grow for medical cannabis patients
The new regulations would allow medical cannabis patients and carers in the state a safe, cost-effective way to access their medication
The proposed regulations would allow medical cannabis patients and carers in New York to grow up to six plants, indoors or outdoors, for therapeutic use.
New York cannabis regulators voted unanimously for the proposed regulations which would not only allow qualified patients to grow their own plants.
According to a slide from the Cannabis Control Board presentation, patients would be allowed six plants each but carers with more than one patient, can “cultivate 1 additional cannabis plant for each subsequent patient.”
The new regulations would impose a duty on patients to ensure no one under the age of 21 can access the plants or any products cultivated from them.
Landlords would also have the option to prohibit their tenants from growing cannabis on their property if they chose. The products must not be processed using anything other than alcohol.
The regulations will now have a 60-day public commentary period before review.
Tremaine Wright, chair of the Cannabis Control Board (CCB) said: “We are proud to present those proposed regulations. The home cultivation of medical cannabis will provide certified patients with a cost-effective means of obtaining cannabis through personal cultivation while creating a set of standards governing the conduct and activities relating to the personal cultivation of cannabis.”
In a press release, the CCB also gave an update on the expungement of cannabis convictions. “Approximately 203,000 cannabis-related charges are presently being suppressed from criminal background searches and are in process of being expunged, adding to the approximately 198,000 records that were expunged as part of the first round of cannabis expungement following legislation enacted in 2019.”
New York recreational market
Earlier this year, New York. It would become the 16th US state to legalise recreational cannabis creating thousands of jobs and tax revenue. The bill was signed into law by Governor Andrew Cuomo in March.
The law would allow for possession of up to three ounces of marijuana for personal use. It would allow licensed dispensaries to sell cannabis products to those over 21.
Neighbouring states who have already legalised marijuana, including New Jersey and Massachusetts, meant that New York citizens were leaving to access cannabis losing tax revenue in the process.
It is expected that home grow for recreational users will follow the proposed regulations for medical cannabis patients but only after the new market is established.
CiiTECH announces new CPD-accredited training course
It aims to support and encourage UK pharmacists, physicians and nurses.
Cannabis healthcare company CiiTECH has been awarded CPD accreditation for its academy course, which aims to support and encourage UK pharmacists, physicians and nurses.
CiiTECH’s Cannabis Science and Therapeutics course has had tremendous success after launching the course earlier this year.
The new and innovative course offers an interactive digital platform with a 12 chapter syllabus comprising of medical cannabis, CBD knowledge and information, specifically catered for healthcare professionals in the UK.
Industry experts in the UK could potentially face serious challenges if the trainers in question who are both recommending, and dispensing information are not up to the required standards in the field.
People currently working in the industry, such as pharmacy professionals will feel more secure and confident after taking the course. With such an array of knowledge from the experts, they are better able to recommend, treat and understand benefits and causes of their patients.
Besides all the learning and comprehensive information, simple FAQ questions by patients can be simply downloaded to have at hand as an ongoing reference.
The CBD industry is an extremely fast growing market, people are becoming more and more aware of benefits and common usage. It’s said that by 2025 the market in the UK only will be worth over £3 billion.
This means that clinics and pharmacies must be sourcing trustworthy information to their customers.
This course is aimed at filling an education gap in the market, by covering several points in intricate detail, from plant history to dosing, and patient care. A lot of occupations in the UK require an on going learning process each year, with positive results overtime, leading to a greater service in the industry.
“Through years of experience serving UK customers with our portfolio of CBD brands it was abundantly clear that the level of misinformation was enormous and confusing for everyone involved,” says Clifton Flack, CEO and founder of CiiTECH.
“Formal education is always important but with little to no existence in the UK we could not see a better way to help lead the industry than to establish our own online academy and give healthcare professionals the opportunity to not only learn about cannabis therapeutics but to earn further education points at the same time.”
Flack adds: “With the rise in UK cannabis prescriptions and CiiTECH’s long awaited move into the THC medical cannabis arena, now is the time to increase professional education and it is exactly why we have embarked on this education journey. CiiTECH is fast becoming the UK’s one stop shop for all your cannabis needs; research, education, consumer brands.”
CiiTECH collaborated with Medical Cannabis Mentor to produce the course and prepare it for CPD certification.
Joe Dolce, founder and CEO of Medical Cannabis Mentor, comments: “The course synthesises the most up-to-date scientific research and clinical guidelines in an engaging format to help professionals make informed treatment decisions.”
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