Clinical uses of cannabis and cannabinoids in the United States

Levinsohn, Erik; Hill, Kevin P.

doi:10.1016/j.jns.2020.116717

Cited by 66 publications

(48 citation statements)

References 58 publications

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“…Several medical products with marketing authorization contain THC as their main component, including dronabinol (synthetic THC), commercialized as oral capsules (Marinol ® ) or as an oral solution (Syndros ® ), and nabilone (a synthetic THC analogue), which is marketed as oral capsules (Cesamet ® or Canemes ® ). Nabiximols (Sativex ® ), available as a buccal spray, also includes CBD in its formulation [ 14 , 24 , 25 , 26 ]. However, few cannabis products have sufficient evidence to obtain approval for therapeutic use in the USA and several European countries.…”

Section: Introductionmentioning

confidence: 99%

Oral Administration of Cannabis and Δ-9-tetrahydrocannabinol (THC) Preparations: A Systematic Review

et al. 2020

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Background and objective: Changes in cannabis legalization regimes in several countries have influenced the diversification of cannabis use. There is an ever-increasing number of cannabis forms available, which are gaining popularity for both recreational and therapeutic use. From a therapeutic perspective, oral cannabis containing Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) is a promising route of administration but there is still little information about its pharmacokinetics (PK) effects in humans. The purpose of this systematic review is to provide a general overview of the available PK data on cannabis and THC after oral administration. Materials and Methods: A search of the published literature was conducted using the PubMed database to collect available articles describing the PK data of THC after oral administration in humans. Results: The literature search yielded 363 results, 26 of which met our inclusion criteria. The PK of oral THC has been studied using capsules (including oil content), tablets, baked goods (brownies and cookies), and oil and tea (decoctions). Capsules and tablets, which mainly correspond to pharmaceutical forms, were found to be the oral formulations most commonly studied. Overall, the results reflect the high variability in the THC absorption of oral formulations, with delayed peak plasma concentrations compared to other routes of administration. Conclusions: Oral THC has a highly variable PK profile that differs between formulations, with seemingly higher variability in baked goods and oil forms. Overall, there is limited information available in this field. Therefore, further investigations are required to unravel the unpredictability of oral THC administration to increase the effectiveness and safety of oral formulations in medicinal use.

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Section: Introductionmentioning

confidence: 99%

Oral Administration of Cannabis and Δ-9-tetrahydrocannabinol (THC) Preparations: A Systematic Review

et al. 2020

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“…31 CBD, a nonintoxicating cannabinoid, has potential therapeutic properties and a favorable safety profile, 32 but there is limited clinical data to support its touted medical benefits. 33,34 Pharmaceutical-grade cannabis products have recently entered medical practice. The US Food and Drug Administration has approved one cannabis-derived drug product and three synthetic cannabisrelated drug products.…”

Section: Medicalmentioning

confidence: 99%

Cannabis and work: Need for more research

Howard

Osborne

2020

American J Industrial Med

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Cannabis sativa is one of the oldest and most widely used plants in the world with a variety of industrial, medical, and nonmedical applications. Despite its long history, cannabis-derived products remain a source of controversy across the fields of medicine, law, and occupational safety and health. More favorable public attitudes about cannabis in the US have resulted in greater access to cannabis through legalization by states, leading to more consumption by workers. As more states adopt cannabis access laws, and as more workers choose to consume cannabis products, the implications for existing workplace policies, programs, and practices become more salient. Past workplace practices were grounded in a time when cannabis consumption was always viewed as problematic, considered a moral failing, and was universally illegal. Shifting cultural views and the changing legal status of cannabis indicate a need for research into the implications and challenges relating to cannabis and work. This commentary suggests research needs in the following areas: (a) data about industries and occupations where cannabis consumption among workers is most prevalent; (b) adverse health consequences of cannabis consumption among workers; (c) workplace supported recovery programs; (d) hazards to workers in the emerging cannabis industry; (e) relationship between cannabis consumption and occupational injuries; (f) ways to assess performance deficits and impairment from cannabis consumption; (g) consumption of synthetic cannabinoids to evade detection by drug testing; (h) cannabis consumption and its effect on occupational driving; and (i) ways to craft workplace policies and practices that take into consideration conflicting state and federal laws pertaining to cannabis. 1 | INTRODUCTION Cannabis sativa is one of the oldest and most widely used plants in the world. 1 Native to Asia, the different cultivars of C. sativa have been used for a wide variety of industrial, medical, and nonmedical uses for thousands of years. 2 Despite its long history, the use of cannabisderived products remains a source of controversy across the fields of medicine, law, and occupational safety and health. 3-6 More favorable public attitudes about cannabis in the United States have resulted in greater access to cannabis through legalization by states and led to more consumption. In 2018, 40.3 million Americans aged 18 or older used cannabis at some time during that year. 7 Increases in use were greater in states that adopted medical cannabis access laws than nonadopting states. 8 Nearly 18% of workers employed full-time, and nearly 21% of workers employed part-time, used

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“…Preclinical and limited clinical research evidence seems to be mounting for the potential therapeutic benefit of CBD in 3 major types of disease states: neuropsychiatric disorders, neurodegenerative or motor disease, and inflammatory diseases. 13 In the area of neurologic disorders, preclinical in vitro and in vivo animal studies have demonstrated that CBD possesses neuroprotective, antioxidant, antidepressant, and anxiolytic properties. [14][15][16] The documented neuroprotective effects of CBD have led to further examination of its role in neurodegenerative diseases.…”

Section: Aphaeaprsmentioning

confidence: 99%

Role of the pharmacist in the care of patients using cannabis

El‐Alfy¹

2020

Journal of the American Pharmacists Association

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Clinical uses of cannabis and cannabinoids in the United States

Cited by 66 publications

References 58 publications

Oral Administration of Cannabis and Δ-9-tetrahydrocannabinol (THC) Preparations: A Systematic Review

Oral Administration of Cannabis and Δ-9-tetrahydrocannabinol (THC) Preparations: A Systematic Review

Cannabis and work: Need for more research

Role of the pharmacist in the care of patients using cannabis

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