Neurological Aspects of Medical Use of Cannabidiol

Mannucci, Carmen; Navarra, Michele; Calapai, Fabrizio; Spagnolo, Elvira Ventura; Busardò, Francesco Paolo; Roberto, Denis; Ippolito, Francesca; Calapai, Gioacchino

doi:10.2174/1871527316666170413114210

Cited by 76 publications

(57 citation statements)

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“…Cannabis chemovars ('strains') and medicinal cannabis products often contain significant levels of cannabidiol (CBD), a nonintoxicating cannabinoid with anxiolytic, anticonvulsant, and antipsychotic properties. [26][27][28] For example, the 'light cannabis' products that are legally available in a number of EU countries must contain less than 0.2% THC but may contain up to 40% CBD. 29 Medicinal cannabis products containing both THC and CBD include Nabiximols (Sativex), a buccal spray with a 1:1 ratio of THC and CBD, as well as commercially available cannabis botanicals and extracts 30 and homegrown illicit artisanal preparations.…”

Section: Introductionmentioning

confidence: 99%

Detection of Δ⁹ THC in oral fluid following vaporized cannabis with varied cannabidiol (CBD) content: An evaluation of two point‐of‐collection testing devices

Arkell

Kevin

Stuart

et al. 2019

Drug Testing and Analysis

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Point‐of‐collection testing (POCT) for Δ9‐tetrahydrocannabinol (THC) in oral fluid is increasingly used to detect driving under the influence of cannabis (DUIC). However, previous studies have questioned the reliability and accuracy of two commonly used POCT devices, the Securetec DrugWipe® 5 s (DW5s) and Dräger DrugTest® 5000 (DT5000). In the current placebo controlled, double‐blind, crossover study we used liquid chromatography‐tandem mass spectrometry (LC–MS/MS) to accurately quantify cannabinoid concentrations in the oral fluid of 14 participants at various timepoints (10, 60, 120, and 180 minutes) following vaporization of 125 mg of THC‐dominant (11% THC; <1% CBD), THC/CBD equivalent (11% THC; 11% CBD) and placebo (<1% THC; <1% CBD) cannabis. At each timepoint, oral fluid was also screened using the DW5s (10 ng/mL THC cut‐off) and DT5000 (10 ng/mL THC cut‐off). LC–MS/MS analysis showed peak oral fluid THC concentrations at the 10 minute timepoint with a rapid decline thereafter. This trajectory did not differ with THC dominant and THC/CBD equivalent cannabis. With a 10 ng/mL confirmatory cut‐off, 5% of DW5s test results were false positives and 16% false negatives. For the DT5000, 10% of test results were false positives and 9% false negatives. Neither the DW5s nor the DT5000 demonstrated the recommended >80% sensitivity, specificity and accuracy. Accuracy was lowest at 60 minutes, when THC concentrations were often close to the screening cut‐off (10 ng/mL). POCT devices can be useful tools in detecting recent cannabis use; however, limitations should be noted, and confirmatory LC–MS/MS quantification of results is strongly advisable.

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Section: Introductionmentioning

confidence: 99%

Detection of Δ⁹ THC in oral fluid following vaporized cannabis with varied cannabidiol (CBD) content: An evaluation of two point‐of‐collection testing devices

Arkell

Kevin

Stuart

et al. 2019

Drug Testing and Analysis

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“…Athletes are known as early adopters of new and innovative modalities to aid in recovery and performance (Conrad et al 2019;Caine et al 2012), particularly since pain, insomnia, and anxiety are common and difficult to solve problems among athletes (Hainline et al 2017;Mann et al 2007;Halson 2014). Cannabis is a modality that has reportedly improved symptoms among sufferers of pain, insomnia, and anxiety (Stith et al 2019;Mannucci et al 2017), but has rarely been studied in the context of adult athlete use. Historically, cannabis use in athletes has typically been studied in the framework of abuse among adolescent, university, and elite athletes (Ware et al 2018;Buckman et al 2011;Peretti-Watel et al 2003a).…”

Section: Introductionmentioning

confidence: 99%

Age related differences in cannabis use and subjective effects in a large population-based survey of adult athletes

Zeiger¹,

Silvers

Fleegler³

et al. 2019

J Cannabis Res

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Background: There is a paucity of information regarding cannabis use behaviors in adult community-based athletes as most research in athletes has focused on misuse of cannabis in elite, adolescent, university-based athletes. We aimed to determine whether age related differences exist in patterns of cannabis use and subjective effects to cannabis in adult athletes. Methods:The Athlete PEACE Survey used mainly social media and email blasts to recruit and SurveyGizmo to collect data. Cannabis patterns of use (duration of use, frequency of use, routes of administration, cannabinoid used, concurrent use with exercise), benefits, and adverse effects were reported. Age was reported by decade from 21 to ≥60. Age trends in cannabis use patterns and subjective effects were assessed using linear trend analysis.Results: Of the 1161 participants, 301 (26%) athletes currently used cannabis. Younger athletes compared to older athletes reported significantly more positive and adverse subjective effects to cannabis, used cannabis longer, and used both tetrahydrocannabinol and cannabidiol for medical and recreational purposes. Younger athletes used cannabis concurrently with exercise more often than older athletes and consumed edibles, vaporized, and smoked more than older athletes. Conclusions:We found age-related cannabis patterns of use and subjective effects to cannabis. Concerns about cannabis mis-use and abuse in athletes maybe overstated with the potential benefits (improved sleep, decreased anxiety, less pain) outweighing the adverse effects (increased anxiety, increased appetite, difficulty concentrating).

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“…Pre-clinical research showed CBD to be anticonvulsant in experimental animal models of epilepsy and to produce antipsychotic effects in experimental schizophrenia in humans [18,19]. Results from laboratory and human studies suggest that it could be a promising novel agent for central nervous system diseases, including schizophrenia [7] and epilepsy [20][21][22]. In humans, treatment with CBD is able to decrease the frequency of seizures showing a good risk/benefit profile [23,24].…”

Section: Introductionmentioning

confidence: 99%

Cannabinoids, Blood–Brain Barrier, and Brain Disposition

et al. 2020

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Potential therapeutic actions of the cannabinoids delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are based on their activity as analgesics, anti-emetics, anti-inflammatory agents, anti-seizure compounds. THC and CBD lipophilicity and their neurological actions makes them candidates as new medicinal approaches to treat central nervous system (CNS) diseases. However, they show differences about penetrability and disposition in the brain. The present article is an overview about THC and CBD crossing the blood-brain barrier (BBB) and their brain disposition. Several findings indicate that CBD can modify the deleterious effects on BBB caused by inflammatory cytokines and may play a pivotal role in ameliorating BBB dysfunction consequent to ischemia. Thus supporting the therapeutic potential of CBD for the treatment of ischemic and inflammatory diseases of CNS. Cannabinoids positive effects on cognitive function could be also considered through the aspect of protection of BBB cerebrovascular structure and function, indicating that they may purchase substantial benefits through the protection of BBB integrity. Delivery of these cannabinoids in the brain following different routes of administration (subcutaneous, oral, and pulmonary) is illustrated and commented. Finally, the potential role of cannabinoids in drug-resistance in the clinical management of neurological or psychiatric diseases such as epilepsy and schizophrenia is discussed on the light of their crossing the BBB.

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Neurological Aspects of Medical Use of Cannabidiol

Cited by 76 publications

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Detection of Δ⁹ THC in oral fluid following vaporized cannabis with varied cannabidiol (CBD) content: An evaluation of two point‐of‐collection testing devices

Detection of Δ⁹ THC in oral fluid following vaporized cannabis with varied cannabidiol (CBD) content: An evaluation of two point‐of‐collection testing devices

Age related differences in cannabis use and subjective effects in a large population-based survey of adult athletes

Cannabinoids, Blood–Brain Barrier, and Brain Disposition

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Neurological Aspects of Medical Use of Cannabidiol

Cited by 76 publications

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Detection of Δ9 THC in oral fluid following vaporized cannabis with varied cannabidiol (CBD) content: An evaluation of two point‐of‐collection testing devices

Detection of Δ9 THC in oral fluid following vaporized cannabis with varied cannabidiol (CBD) content: An evaluation of two point‐of‐collection testing devices

Age related differences in cannabis use and subjective effects in a large population-based survey of adult athletes

Cannabinoids, Blood–Brain Barrier, and Brain Disposition

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Detection of Δ⁹ THC in oral fluid following vaporized cannabis with varied cannabidiol (CBD) content: An evaluation of two point‐of‐collection testing devices

Detection of Δ⁹ THC in oral fluid following vaporized cannabis with varied cannabidiol (CBD) content: An evaluation of two point‐of‐collection testing devices