A-06 Medical cannabis

Claude Cyr, Canada

Faculty lecturer
family medicine
McGill University

Questions Submitted

  • For which type of anxiety is CBD an appropriate treatment? For which types should it be avoided?

  • Is there are maximum dose of CBD for cannabinoid-naive patients? What should be a starting dose for pain management and-or anxiety?

  • I have to the value that I do not see any benefits of using of marijuana products in my patients at the same time I see lots of side effects including very severe, several teenagers and young people develop severe psychotic disease and now suffered from schizophrenia and bipolar disease 1 of the girl developed severe vomiting leading to the superior mesenteric artery tear and 3 m of gangrene was small bowel resection had to be performed, it is still very political does not sound like medicine to me, because everything becomes very organized after 5 years since marijuana legalization is like election sausage for 1 political party could be promoted in the young voters, once again I do not see any benefits in my patient is a the the do not have pain by the do not walk more they just get stand, and very pessimistic about use of marijuana may be it is useful in oncological patients but not in my nursing home patients etc. however interesting presentation

Overview

The word “cannabis” is commonly used to describe the plant from which numerous pharmacologically active compounds are obtained. However, it is a clinically inaccurate term, since many of these plant compounds interact with different molecular targets, producing widely different and even opposing biological effects. Integrating this emerging class of pharmaceuticals in clinical practice requires that we distinguish the role of each individual compound. This talk will focus on the potential benefits of the most studied cannabinoids to date,THC and CBD.

Studies using THC and CBD are still too few to draw any evidence-based recommendations.

However, THC has been shown to produce numerous biological effects, in great part via the cannabinoid receptors CB1 and CB2 which are found mostly in the CNS and immune systems, respectively. Patients who may benefit from THC will likely experience some level of psychoactivity, and should be counseled accordingly. Other risks include potential drug-drug interactions with CNS and cancer immunotherapy drugs. 

The role of CBD is less clear. Preliminary data suggests that it may provide benefits in wide variety of clinical settings, but further research is required in order to validate efficacy, establish a therapeutic window, and determine relevant drug interactions, among others. 

 

Objectives

  • Dealing with the authorization process for medical cannabis in a legal recreational market 

  • Determining which are the clinically relevant active components of cannabis
  • Deciphering product labels: potency and ratios

  • Initiating treatment with cannabinoids: purified CBD, THC or both?

  • Monitoring THC use and cannabis use disorder: impact, frequency and dose

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