Being a mature consumer is not just a matter of age. It also means maintaining a mature perspective on the information available on the benefits and risks associated with using cannabis.
A mature consumer can’t dismiss or ignore research on cannabis just because the findings of the research might be considered inconvenient.
For example, a recent article by Kaitlin Sullivan on NBC News.com reports on a study published in the Journal of the American College of Cardiology that indicates using cannabis may be a risky proposition for individuals taking medication to treat heart disease.
According to Sullivan, lead author of the study, Dr. Muthiah Vaduganathan, a cardiologist at the Brigham and Women’s Hospital in Boston, contends cannabis can interact with common heart medications, including statins and blood thinners, potentially putting patients at risk by changing how the medication works in the body.
Sullivan writes that a particular problem is that the same liver enzymes that break down statins or blood thinners also break down the compounds in marijuana. Researchers believe using marijuana can potentially change the effectiveness or the potency of the medications.
So, what is to be done? It appears that it is not just a matter of choosing between statins and cannabis. It does, however, require that individuals choose wisely. According to Vaduganathan, those who are on heart-related medications and choose to use marijuana should tell their doctor and pharmacist, so the medication dosages can be adjusted if needed.
Vaduganathan added, “The first step is having an open discussion with clinicians, because it does influence some parts of their care.”
Sullivan does an excellent job unpacking a complex issue. To learn more, we suggest visiting her article in the January 20, 2020 edition of NBCNews.com.
www.nbcnews.com/health/heart-health/marijuana-risky-people-taking-common-heart-medications-n1118181
Ask The Pharmacist
In this edition of Ask The Pharmacist, Jay Sochoka, R. Ph., tackles the topic of terpenes.
Cannabis and the medicinals made from the plant are far beyond THC and CBD. There are 111 other known cannabinoids and over 200 terpenes in the cannabis sativa and indica families. Terpenes can do anything—giving a distinctive flavor and aroma to the plant vapors, providing antibiotic activity against bacteria, viruses, and fungi, and even affecting the way that THC works. Plant breeders seek out specific percentages of certain terpenes for their effects. Let’s take a look at some of the more prominent ones.
Myrcene is the most common terpene in today’s commercial cannabis. It is known to produce calming effects in a patient and is used to treat insomnia, pain, and inflammation. Myrcene is also found in hops, which are also in the cannabaceae botanical family, and in mango. For years it has been said that the psychoactivity of THC is increased when mango is eaten with it. Myrcene is the reason.
Limonene, as you could probably guess by the name, is found in citrus rinds. Also shown to relieve stress and elevate mood, limonene can be used in treating anxiety, depression, inflammation, and pain. It is also believed to help fight cancer cells.
Caryophyllene is a terpene that actually activates the endocannabinoid system to provide anti-inflammatory effects. It also provides stress relief, which makes it useful in treating pain, anxiety/depression, and ulcers. Found also in pepper, cinnamon, and cloves, it makes one wonder if they would have been banned like the cannabis plant, had they not been used as food seasonings for thousands of years.
Terpinolene is well known and sought after by patients for its uplifting effects. It is also found in lilacs, nutmeg, and cumin. Having used a few strains with a healthy terpinolene percentage, I can vouch for the effects it provides.
Pinene is the most common terpene in the world. Found in pine needles, rosemary, and basil, it has shown to be useful in treating pain, inflammation, and anxiety. It is also a bronchodilator, making it a useful natural treatment for asthma.
Humulene is also found in hops and has shown to be an anti-inflammatory.
Ocimene provides antiseptic qualities and has even been shown to work as a decongestant.
Linalool is found in lavender and is believed to produce relaxation and calming effects. Potentially, it can treat anxiety, depression, insomnia, pain, inflammation, and neuropathies. Before legalization of cannabis, I would vaporize lavender and get decent effects. However, with THC, its effects are even more pronounced.
This just scratches the surface of which types of terpenes are found in the cannabis plant, but it gives a good picture of what the modern medical cannabis patient is looking for when it comes to selecting a strain. While research is not as in depth as it will become once federal legalization occurs, what has been shown so far is promising. There are no guarantees in any branch of medicine, but, based on what patients say about certain strains, I find what we believe about terpenes to be credible and worth pursuing for certain disease states.
The sources for this article were leafly.com, the book “Cannabis Pharmacy” by Michael Backes, and the knowledge gained from years of study. The book and website are fantastic references and worth a look.
Jay Sochoka, R.Ph. is a consultation pharmacist at Columbia Care in Scranton, Pennsylvania.
Cannabis and Bacteria
There is hopeful news from researchers looking for a new weapon in the fight against drug-resistant bacteria—and the source of that hope may be found in cannabis plants.
According to an article in The Guardian, scientists at McMaster University in Hamilton, Ontario found that cannabigerol (CBG), a compound found in cannabis, was particularly potent at killing methicillin-resistant Staphylococcus aureus (MRSA), one of the most common hospital superbugs.
After tests in the lab showed that CBG, which is not psychoactive, killed common MRSA microbes and “persister” cells that are especially resistant to antibiotics and that often drive repeat infections, researchers found that CBG cured MRSA infections in mice as effectively as vancomycin, a drug widely considered to be the last line of defense against drug-resistant microbes. The study is under review at the ACS Infectious Diseases journal.
To learn more, visit the article in the January 19, 2020 issue of The Guardian.com.
Legalization Update
The drive for legalization of cannabis at the state level may play a role in the 2020 presidential election. So says Mona Zhang reporting for Politico. She believes having a legalization initiative on a state ballot can help to get voters—both pro and con—to the polls. She is also of the opinion that over 40 states will allow some form of legal marijuana by the end of 2020.
Zhang contends that in some cases the argument for legalization is making for some strange bedfellows, citing the initiative to make medical marijuana legal in MIssissippi. There, the effort has the support of several Republican state representatives, the president and CEO of the Mississippi Center for Public Policy, a conservative think tank, and the president of Mississippi Christian Living magazine, who told Mississippi Today that medical marijuana, “has a lot of potential to alleviate pain and do something really good for people in the state who are suffering.”
For a state-by-state breakdown of the initiatives advocates hope to get on the ballot for this fall’s election, read Mona Zhang’s article in the January 20, 2020 issue of Politico.com
www.politico.com/news/2020/01/20/marijuana-legalization-federal-laws-100688
Senior Cannabis Digest is compiled and edited by Joe Kohut and John Kohut. You can reach them at joe.kohut@gmail.com or at 347-528-8753.
