Wants for Needs

[Tranquility]

It's going to stun you, but, medical users prefer different types of cannabis for different types of issues.

This study shows cancer patients prefer high THC flower while seizure and other neurological issues prefer high CBD.

https://www.eurekalert.org/pub_releases/2019-03/nlh-sst032219.php

People with and without cancer are more likely, over time, to use a more potent form of medical marijuana with increasingly higher amounts of tetrahydrocannabinol (THC), a new study shows.

In a report publishing in the Journal of Palliative Medicine on March 26, researchers say that cancer patients were more likely to favor forms of medical marijuana with higher amounts of THC, which relieves cancer symptoms and the side effects of cancer treatment, including chronic pain, weight loss, and nausea.

By contrast, marijuana formulations higher in cannabidiol (CBD), which has been shown to reduce seizures and inflammation in other studies, were more popular among non-cancer patients, including those with epilepsy and multiple sclerosis, say the study authors.

Cancer patients were also more likely to prefer taking oil droplets containing medical marijuana under the tongue than "vaping".

"Although there is growing patient interest in medical cannabis, there is a scarcity of solid evidence about the benefits, risks, and patterns of use of marijuana products in various disease settings," says study lead investigator Arum Kim, MD, an assistant professor of medicine and rehabilitation medicine at NYU School of Medicine and director of the supportive oncology program at its Perlmutter Cancer Center. "Such information is important for delivering the best care."

Since 1996, 31 states, including New York in 2014, have legalized medical marijuana.

For the study, researchers analyzed data from 11,590 men and women in New York, of whom 1,990 (17.2 percent of the total patient cohort) were cancer patients who purchased and used cannabis products from Columbia Care LLC., a dispensary licensed in New York State, between January 2016 and December 2017.

The researchers caution that their data did not include the type of cancer the purchasers had, how much of what they bought was used, or whether marijuana was used for symptoms unrelated to the cancer. Nevertheless, the patterns of use among cancer patients were distinctly different from those of non-cancer patients.

Specifically, the study found that cancer and non-cancer patients used different dosages of cannabis formulations with dramatically different THC:CBD ratios. The two most common formulations contained THC and CBD, but one had twenty times more THC than CBD, whereas the other had the opposite ratio.

Over the two years of the study, the research team found that all types of patients increased their THC dose by approximately 0.20 milligrams per week.

"Our study provides valuable new information about how cancer patients are using marijuana," says study senior investigator Benjamin Han, MD, MPH, an assistant professor of medicine and population health at NYU School of Medicine. "In the absence of strong clinical research data for medical marijuana, identifying patterns of use offers some sense of how to guide patients who come in with questions for using medical marijuana, and what may or may not help them."

Researchers say they next plan to get more detailed information about how medical marijuana affects patient response to therapy and functional status at different stages of their disease, as well as the risks and side effects of treatment. Furthermore, the profiles of other cannabinoids besides THC and CBD in medical marijuana products warrant further research, according to the study authors.

###​

 

[C No Ego]

It's going to stun you, but, medical users prefer different types of cannabis for different types of issues.

This study shows cancer patients prefer high THC flower while seizure and other neurological issues prefer high CBD.

https://www.eurekalert.org/pub_releases/2019-03/nlh-sst032219.php

People with and without cancer are more likely, over time, to use a more potent form of medical marijuana with increasingly higher amounts of tetrahydrocannabinol (THC), a new study shows.

In a report publishing in the Journal of Palliative Medicine on March 26, researchers say that cancer patients were more likely to favor forms of medical marijuana with higher amounts of THC, which relieves cancer symptoms and the side effects of cancer treatment, including chronic pain, weight loss, and nausea.

By contrast, marijuana formulations higher in cannabidiol (CBD), which has been shown to reduce seizures and inflammation in other studies, were more popular among non-cancer patients, including those with epilepsy and multiple sclerosis, say the study authors.

Cancer patients were also more likely to prefer taking oil droplets containing medical marijuana under the tongue than "vaping".

"Although there is growing patient interest in medical cannabis, there is a scarcity of solid evidence about the benefits, risks, and patterns of use of marijuana products in various disease settings," says study lead investigator Arum Kim, MD, an assistant professor of medicine and rehabilitation medicine at NYU School of Medicine and director of the supportive oncology program at its Perlmutter Cancer Center. "Such information is important for delivering the best care."

Since 1996, 31 states, including New York in 2014, have legalized medical marijuana.

For the study, researchers analyzed data from 11,590 men and women in New York, of whom 1,990 (17.2 percent of the total patient cohort) were cancer patients who purchased and used cannabis products from Columbia Care LLC., a dispensary licensed in New York State, between January 2016 and December 2017.

The researchers caution that their data did not include the type of cancer the purchasers had, how much of what they bought was used, or whether marijuana was used for symptoms unrelated to the cancer. Nevertheless, the patterns of use among cancer patients were distinctly different from those of non-cancer patients.

Specifically, the study found that cancer and non-cancer patients used different dosages of cannabis formulations with dramatically different THC:CBD ratios. The two most common formulations contained THC and CBD, but one had twenty times more THC than CBD, whereas the other had the opposite ratio.

Over the two years of the study, the research team found that all types of patients increased their THC dose by approximately 0.20 milligrams per week.

"Our study provides valuable new information about how cancer patients are using marijuana," says study senior investigator Benjamin Han, MD, MPH, an assistant professor of medicine and population health at NYU School of Medicine. "In the absence of strong clinical research data for medical marijuana, identifying patterns of use offers some sense of how to guide patients who come in with questions for using medical marijuana, and what may or may not help them."

Researchers say they next plan to get more detailed information about how medical marijuana affects patient response to therapy and functional status at different stages of their disease, as well as the risks and side effects of treatment. Furthermore, the profiles of other cannabinoids besides THC and CBD in medical marijuana products warrant further research, according to the study authors.

###​

the great thing with cannabis the patient can have multiple types and offset tolerance to said cannabis over time... issues with pharma drugs is the tolerable effects get diminished... anything we ingest that engages receptor activation will leave an imprint or tolerance to it thereafter.
having different types of cannabis used separately over time could reduce tolerance to just one type... I'm guessing most of the new States and their cannabis is a few types only they offer once a month or something... instant tolerance issues that leads into more use over time, an increase to keep dosage working... this is where the other type comes in and deceases amounts used until that one stops ... switch again ETC... instead of going back to pharma doctor try a diofferent type of cannabis ... thousands of different compound configurations available from one type of plant = A fucking Mazing

 

[fernand]

Yes, but I don't think we understand what exactly makes each
strain so different. First we had the CBD ratio theory. Then the
terpenes theory. None of thse really work. If you look at full
lab analyses, you can find very similar terpene profiles, and
CBD ratios, in say a Sour Diesel and a GrandDaddy purple.

But some vendors know. The cartridges I've found that really seem
to capture whatever it is that gives each strain its specific character
are the Absolute Extracts ABX carts. I've been building a collection.
I have maybe a dozen, and microdosing at the 2 second inhalation
level, I can witness that sure as shinola each one's different. Not
like different brands of single malt whisky. More like caffeine vs.
speed, vs. xanax, vs. codeine, vs. propofol. That IS amazing. And
quite empowering. The boys that did all that genetic manipulation
over the last 50 years have accomplished something astounding.

I lost interest in cannabis back when you'd buy a baggie and there
was no way to predict what it would be like. Not a very usable
remedy, as if the pharmacist threw everything off the shelf into
a hat and you'd pay $10 to reach in and grab a ... whatever.

Now, look up a strain in the Leafly compendium, and if you read
the summary and a couple dozen "reviews", you get a pretty good
idea of its specific effects. Better living through chemistry, genetics,
observation, you know, like Science, dude!

 

[C No Ego]

Yes, but I don't think we understand what exactly makes each
strain so different. First we had the CBD ratio theory. Then the
terpenes theory. None of thse really work. If you look at full
lab analyses, you can find very similar terpene profiles, and
CBD ratios, in say a Sour Diesel and a GrandDaddy purple.

But some vendors know. The cartridges I've found that really seem
to capture whatever it is that gives each strain its specific character
are the Absolute Extracts ABX carts. I've been building a collection.
I have maybe a dozen, and microdosing at the 2 second inhalation
level, I can witness that sure as shinola each one's different. Not
like different brands of single malt whisky. More like caffeine vs.
speed, vs. xanax, vs. codeine, vs. propofol. That IS amazing. And
quite empowering. The boys that did all that genetic manipulation
over the last 50 years have accomplished something astounding.

I lost interest in cannabis back when you'd buy a baggie and there
was no way to predict what it would be like. Not a very usable
remedy, as if the pharmacist threw everything off the shelf into
a hat and you'd pay $10 to reach in and grab a ... whatever.

Now, look up a strain in the Leafly compendium, and if you read
the summary and a couple dozen "reviews", you get a pretty good
idea of its specific effects. Better living through chemistry, genetics,
observation, you know, like Science, dude!

my observation is the more smelly volatile type terpene compounds are the first in line @ human cellular molecular expression, then the more stable / larger compounds express directly after ( Entourage??) ... the thing I have not figured out in all this is how long the half life of the smelly compounds are... you'd think they'd fizzle out quicker than more stable heavier cannabinoid forms but they have like 24 hour half life where the cannabinoids express much more quickly and fizzle out...
maybe it's the precursor catalytic metabolic activation as opposed to hydrolytic cannabinoid mechanisms responsible for the time of activity..
Also and so forth, one of the canna scientists mentioned that big pharma cannot in any way replicate the complex formulation of phytocannabinoids as they are formed on the plant with all the subtle enzymatic formations... the pharma copy lacks that trace enzymatic / subtle enzymatic residues on the compound

 

[fernand]

The pharma products aren't really copies. They are constrained
by regulations too, so e.g. a CBD product can't contain the very
important entourage cannabinoids, making for a formulation that
makes for unnecessarily high and difficult dosing. The others are
single molecule or at most two molecule preparations, like Marinol
or Sativex. No pharmaceutical company is even trying to replicate
a full spectrum cannabis.

 

[YaMon]

Green Flower Media's presentation on Breast Cancer recommends a whole plant 1:20 ratio of THC to CBD. I'd love to have some recommendations to ask about.

 

[C No Ego]

The pharma products aren't really copies. They are constrained
by regulations too, so e.g. a CBD product can't contain the very
important entourage cannabinoids, making for a formulation that
makes for unnecessarily high and difficult dosing. The others are
single molecule or at most two molecule preparations, like Marinol
or Sativex. No pharmaceutical company is even trying to replicate
a full spectrum cannabis.

that is until bio-synthetic cannabinoids are a thing made from yeast and e-coli... there will be greater expression provided from those type.
Sativex is a botanical drug substance from reall living plants not synthetic... that is full spectrum ... epidiolex adds THCv back into the formula ETC.... marinol is what it is... marinol will definitely become more than one compound when we metabolize it into something else through the ECS

I guess I think differently about it.... see whole plant with all of the hundreds of bio-available compounds in it = happy day... pharma boys seeing whole plant = We gotta take that Shit apart - Fuck!

 

[C No Ego]

Green Flower Media's presentation on Breast Cancer recommends a whole plant 1:20 ratio of THC to CBD. I'd love to have some recommendations to ask about.

Christina Sanchez is leading that research.. hearing her say Cannabinoid is like Ear candy

 

[YaMon]

Ugh,, just noticed my typo.. that ratio is 1:2 and not 1:20. Sorry all!

 

[fernand]

I wonder about Sativex. It's extracted from the plant, but it's hard to determine whether there's anything in there besides the stated approximately 1:1 THC:CBD.

 

[C No Ego]

I wonder about Sativex. It's extracted from the plant, but it's hard to determine whether there's anything in there besides the stated approximately 1:1 THC:CBD.

quote "
Sativex® (delta-9-tetrahydrocannibinol and cannabidiol in the EU; nabiximols in the US) is an oromucosal spray of a formulated extract of the cannabis sativa plant that contains the principal cannabinoids delta-9-tetrahydrocannibinol (THC) and cannabidiol (CBD) in a 1:1 ratio as well as specific minor cannabinoids and other non-cannabinoid components. We developed Sativex® to be administered as an oromucosal spray, whereby the active ingredients are absorbed in the lining of the mouth, either under the tongue or inside the cheek. Regulatory approval has been obtained in over 25 countries outside the United States for the treatment of spasticity (muscle stiffness/spasm) due to MS.

GW does not market Sativex® directly. All requests for product information and adverse events reporting should be directed through the individual websites for the distributors listed in the HCP section.

Nabiximols is an investigational product in the US, and the Company is planning to seek FDA-approval.

Sativex® is also under development for potential indications in schizophrenia and other neurological conditions. " unquote

"
Sativex contains ethanol and propylene glycol• Sativex contains about 50% v/v of ethanol (alcohol)i.e. up to 40 mg per dose.Sativex contains propylene glycol "

I know epidiolex adds a flavoring to the product that has a negative response in some people... sativex adds flavoring too like peppermint...

 

[fernand]

I wonder if GW publishes complete labs, like we can get with some prodding in California. I'd be curious to what degree they standardize all the wee lil' minor cannabinoids and "other non-cannabinoid components".

It's hard getting everything to match harvest to harvest, and conversely if you're going to reconstitute it, it's a lot of components to separate out and throw into the batch.

There's that Dosist outfit that markets a fantastic little inhaler, filled with a supposedly standardized series of formulations. But the two I tried didn't create much want. I only used a few inhalations, and tossed them in the Naaaah Box. The "Relief" feels mostly like a mallet to the noggin', and the supposedly "up" one called "Arouse" feels like driving with one foot on the gas and the other on the brake. Not like a good Indica and a nice Sativa. This wasn't a very controlled evaluation, and I wanted to like them - especially since the inhaler is second to none - but they both felt "fake", if that means anything.

 

[C No Ego]

I wonder if GW publishes complete labs, like we can get with some prodding in California. I'd be curious to what degree they standardize all the wee lil' minor cannabinoids and "other non-cannabinoid components".

It's hard getting everything to match harvest to harvest, and conversely if you're going to reconstitute it, it's a lot of components to separate out and throw into the batch.

There's that Dosist outfit that markets a fantastic little inhaler, filled with a supposedly standardized series of formulations. But the two I tried didn't create much want. I only used a few inhalations, and tossed them in the Naaaah Box. The "Relief" feels mostly like a mallet to the noggin', and the supposedly "up" one called "Arouse" feels like driving with one foot on the gas and the other on the brake. Not like a good Indica and a nice Sativa. This wasn't a very controlled evaluation, and I wanted to like them - especially since the inhaler is second to none - but they both felt "fake", if that means anything.

yeah, they are way more propriotory and will not release those lad results I assume... epidiolex @ 32k a year leads me to believe they are holding onto that $tatu$ and not letting up anytime soon

 

[fernand]

As far as I read Epidiolex is isolated CBD. No entourage cannabinoids. That's what makes it FDA-acceptable, but so hard to dose, and why the doses are so high. IMHO it only makes sense for a patient in a zero cannabis region. Otherwise, buying fuller extract CBD should work at lower dosages and not be so tricky to adjust. On the other hand, there is SO much fake "hemp oil" and "CBD oil" out there, that in itself would be a problem for the parents of a young epileptic patient. Kind of a rock and a hard place.

 

[C No Ego]

As far as I read Epidiolex is isolated CBD. No entourage cannabinoids. That's what makes it FDA-acceptable, but so hard to dose, and why the doses are so high. IMHO it only makes sense for a patient in a zero cannabis region. Otherwise, buying fuller extract CBD should work at lower dosages and not be so tricky to adjust. On the other hand, there is SO much fake "hemp oil" and "CBD oil" out there, that in itself would be a problem for the parents of a young epileptic patient. Kind of a rock and a hard place.

the only other phytocannabinoid in epidiolex besides CBD is THCv ... they add THCv back in at very low amounts... I used to have access to all the ingredients but am unable to find it or its not available anymore... people growing their own cannabis ( any type) and using it raw is basically like consuming CBD ... antagonist metabolism ETC

 

[Penny Wise]

Well isn't that interesting! Thank you for the article, that's a great read. I was sorta surprised to find out cancer patients in general prefer high-THC, I would've thought a balanced mix would be better for them.

 

[fernand]

From observation, it seems that high CBD isn't as good on mood and nausea. As to the cancer itself, who can say, every cancer cell type responds differently. Very few lab studies (even) have tried to pin down what cancer cells are more sensitive to which cannabinoids. We got very good results on stage 3+ colorectal cancer, in combination with old style chemo, mainly Folfox.

Not many patients are eager to try risking cannabinoid therapy alone, given that traditional chemo works, and they have been found to work synergistically together. After all, cannabinoids are just another type of chemotherapeutic agent, attacking cancer cells more than normal cells, and with a less drastic profile.

 

[C No Ego]

Well isn't that interesting! Thank you for the article, that's a great read. I was sorta surprised to find out cancer patients in general prefer high-THC, I would've thought a balanced mix would be better for them.

THC is an agonist compound, gets directly into the neuronla pathway and engages with it... CBD is antagonist, it sits on the periphery of the receptor and engages intraellular enzymes and catalysts that degrade lipids in the cells .. https://www.bionity.com/en/encyclopedia/Lipid_signaling.html