The notion that vaping is always a safe way to consume cannabis may be going up in smoke. Since late June over 300 cases of severe respiratory illness possibly related to vaping have been reported across the country. A number of patients have required hospitalization and some are said to have lingering lung problems that require the use of a ventilator or a stay in an intensive care unit.
According to Sheila Kaplan, reporting for the New York Times, the Centers for Disease Control (CDC) has taken the unusual step of issuing several recommendations — including telling people worried about their health that anyone who uses e-cigarette products should not buy these products off the street (e.g., e-cigarette products with THC, other cannabinoids) and should not modify e-cigarette products or add any substances to these products that are not intended by the manufacturer.
Kaplan also wrote that in some cases, patients acknowledged using e-cigarettes containing THC and some doctors have said that cannabinoid oils vaporized in cartridges may be causing some of the lung inflammation. In many cases, patients reported a gradual occurrence of symptoms, the agencies said, including difficulty breathing, and chest pain, before hospitalization.
“We know some of this is associated with THC,” said Dr. Scott Gottlieb, the former commissioner of the Food and Drug Administration
Many seniors have turned to using vaping devices to consume cannabis or to quit smoking tobacco because they do not produce the tar and other carcinogens of traditional tobacco products. However, vaping has its own challenges. To become inhalable, nicotine or THC must be mixed with solvents that dissolve and deliver the drugs. The CDC acknowledges not enough is known about the long-term effects of exposure to such chemicals.
Also, NPR reports that nearly three dozen of the cases of lung disease are in New York state, and investigators there say they have detected high levels of vitamin E in cartridges of cannabis vaping products used by people who vaped and suffered serious lung damage.
“At least one vitamin E acetate containing vape product has been linked to each patient who submitted a product for testing,” according to a statement from the New York State Department of Health.
New York State’s Health Commissioner Howard Zucker told NPR,” When it is “inhaled deep in the lung, [it] can cause problems.” He says the State Health Department lab has found very high amounts of vitamin E in 13 of the patient-submitted cartridges they’ve analyzed. “As high as even 50 percent of the liquid that is in the vaping [cartridge].”
David Downs reported for Leafly that as of the time he wrote the article none of the reported cases involving marijuana are associated with adult-use or medical cannabis products from legal state-licensed stores. Almost all states where cases have been reported do not have adult-use legalization in effect. They include Connecticut, Illinois, Indiana, Iowa, Minnesota, Michigan, North Carolina, New Jersey, New Mexico, New York, Pennsylvania, Texas, Utah, and Wisconsin.
He went on to point out that in legal state-regulated markets, vape carts undergo mandatory lab testing to insure potency and purity. But in the illegal markets, “anything goes.”
All of which points to the risks of using grey-market THC products purchased on the street as opposed to commercially manufactured and regulated products sold at dispensaries and adult use stores.
While it is true that mature consumers are less likely to purchase cannabis “on the street,” until more is known as to the cause behind this outbreak of cases of what appears to be vaping-related lung disease, mature consumers would be wise to remain vigilant about the source and pedigree of their cannabis products and continue to pay attention to this developing story.
For more information, you can read Sheila Kaplan’s article in the August 30, 2019 issue of the New York Times, David Down’s article in the August 30, 2019 edition of Leafly and Joe Neel and Allison Aubrey’s report for the September 5, 2019 edition of NPR.
https://www.leafly.com/news/health/vape-pen-lung-disease-thc-oil-additive-investigation
www.nytimes.com/2019/08/30/health/vaping-e-cigarettes-marijuana-cdc.html
CBD News and Notes
Many mature consumers turn to CBD to address various physical ailments, such as chronic pain, inflammation and epilepsy, as well as psychological conditions, including stress, depression, and anxiety.
Fortunately, if you have strong opinions about the percentage of CBD in cannabis products you use, there is helpful news. There is a new list that identifies seven of the most popular high-CBD strains of cannabis specifically bred to offer therapeutic benefits attributed to CBD without intoxicating levels of THC. The list, which was created by the experts at Weedmaps, also appeared on the website Green Entrepreneur. Here are three of their choices.
Harle-Tsu is a high-CBD strain that was awarded first place for best CBD flower at the 2014 Emerald Cup. Lab testing at that time showed that Harle-Tsu yielded 21.05 percent CBD and 0.86 percent THC. Subsequent testing has shown, however, on average most Harle-Tsu strain samples contain about 18 percent CBD. The combination of terpenes and high CBD in the strain is said to generate a number of potentially therapeutic benefits for various conditions, such as epilepsy, chronic pain, inflammation, depression, stress, and others and is reported to give users the feeling of complete relaxation.
Harlequin is a high-CBD strain of Sativa that tends to maintain a consistent 5:2 CBD-to-THC ratio. Lab tests conducted on samples of Harlequin found the strain contained between 8 percent to 16 percent CBD content and 4 percent to 7 percent THC content. according to the NCSM. Many experts believe the strain’s balance of CBD and THC makes it a likely candidate to treat a range of medical and psychological conditions, such as anxiety, chronic pain, headaches, fatigue, and stress. The strain’s terpenes, such as myrcene, a-pinene, and b-caryophyllene are said to give it an earthy aroma with hints of mango and citrus.
Sour Tsunami is one of the first known cannabis strains created specifically for medicinal purposes. Test results have demonstrated CBD levels from 10 percent to 11 percent and THC levels ranging from 1 percent to 10 percent. This high-CBD Sativa dominant strain—popular for its therapeutic properties—is used to relieve ailments such as chronic pain, back pain, stress, nausea, anxiety, and insomnia. The main terpenes found in high-CBD strain include myrcene, terpinolene, and b-caryophyllene, giving the flower a distinct aroma that is said to include diesel and chocolate.
For the complete list of CBD-heavy strains visit the September 11, 2019 edition of GreenEntrepreneur. For more information on strains of cannabis in general visit Weedmaps/strains.
https://www.greenentrepreneur.com/article/339298
Marijuana and Pain
When it comes to treating pain, there is some indication whole dried marijuana in flower form and other products that are high in THC can be more effective than other cannabis products.
That’s the opinion of researchers from the University of New Mexico. Their study—which used a mobile app to measure how commercially available cannabis products affect pain intensity— found that most people who reported self-medicating with marijuana have short-term, yet significant, relief from pain. On average, users reported their starting pain to be 5.87 on a scale of 1 to 10. After consuming marijuana, that number fell to 2.77—a decrease of 3.1 points.
According to University of New Mexico Newsroom, the researchers relied on information collected with Releaf App, a mobile software program developed by co-authors Franco Brockelman, Keenan Keeling and Branden Hall. The app enables cannabis users to monitor the real-time effects of available cannabis-based products.
“Among the limited number of product characteristics that are typically made available to consumers, we found that consumption of whole, natural Cannabis flower was associated with greater anesthetic potential than were most other types of products,” the authors wrote.
The study—published in Complementary Therapies in Medicine in late July, 2019—also found subjects reported edibles, pills and tinctures offered less relief than flower, while products labeled as hybrid strains were more effective at relieving pain than those labeled indica or sativa.
Patients with back, joint or muscle pain, headache or migraine and non-specified pain reported they experienced more relief with products that had higher levels of THC, while products with higher levels of CBD did not offer as much relief. Patients with gastrointestinal/abdominal-related pain reported they found more relief with lower levels of THC.
In general the researchers held the opinion that THC was more effective than CBD when it came to momentary changes in pain intensity explored in the study. It is not clear however, how or if the researchers explored the role played by CBD in relief from chronic anti-inflammatory pain or discomfort, if at all.
The authors of the study contend there are multiple mechanisms by which cannabis alleviates pain suffering. In addition to its anti-inflammatory properties, “Cannabis with high THC also causes mood elevation and adjusts attentional demands, likely distracting patients from the aversive sensations that people refer to as ‘pain,’” said researcher Jacob Miguel Vigil.
Said lead author Xiaoxue Li in a statement, “Perhaps the most surprising result is just how widespread relief was with symptom relief reported in about 95 percent of cannabis administration sessions and across a wide variety of different types of pain.”
This investigation was supported in part by private donations from individuals to the University of New Mexico Medical Cannabis Research.
For more information you can read Kimberly Lawson’s article in the August 21,2019 edition of Marijuana Moment and the article “UNM study confirms cannabis flower is an effective mid-level analgesic medication for pain treatment” which appeared in the August 20 edition of the UNM online newsroom.
Perhaps a key takeaway from this study is not that CBD is not effective for addressing some pain and discomfort, but that a higher THC content in a flower form can, for a variety of reasons, often be an effective way to manage more severe pain.
Pets and CBD
If you are a mature consumer of cannabis who wants to share your CBD products with a pet you are not alone. A number of industry experts predict the CBD pet care market may reach as high as $125 million by 2022. That would make it one of the fastest-growing sectors of a CBD market that is already growing by leaps and bounds. CBD oil, for example, has been used to treat a variety of conditions in dogs, including seizures, nausea, stress, anxiety, arthritis, back pain, symptoms of cancer, and gastrointestinal issues.
However, there are still many unknowns when it comes to using CBD to address medical conditions in pets. To help, Danielle Kosecki, who covers the cannabis beat for CNET, offered these tips in her recent article:
Effectiveness For starters, much like the CBD products created for humans, CBD pet care products come in a variety of forms including edibles—such as chewable treats and capsules—oils that can be added to food or placed under the tongue and topical creams or lotions that are rubbed directly on the skin.
Stephanie McGrath, assistant professor of neurology at Colorado State University College of Veterinary Medicine and Biomedical Sciences, started studying CBD in 2016. One of her first studies analyzed how three different delivery methods—a capsule, an oil and a cream—affected the way CBD moved through the bodies of healthy dogs.
McGrath found the oil reached the highest concentration in the blood, stayed in the bloodstream the longest, and performed the most consistently across the different dogs. The capsule also performed well but the cream less so. It performed too inconsistently for McGrath and her team to draw any conclusions.
Safety According to a 2017 World Health Organization report, CBD, in its pure state appears to be safe and well-tolerated by animals. However, both subsequent studies have noted an increase in the liver enzyme alkaline phosphatase (ALP) during CBD treatment.
Said McGrath, “I would definitely be a little concerned about giving CBD to a dog that has known liver issues.” Because CBD appears to be metabolized by the liver, she said she’d also be cautious about giving CBD to a dog who already takes a medication that’s metabolized by the liver.
Quality Control Because regulation of the CBD market is still a patchwork, CBD products can contain ingredients that aren’t listed on their labels. One way to avoid potentially harmful ingredients is to only use products that come with a certificate of analysis, or COA (the batch number on the COA should match the number on the product’s label or packaging). A COA is issued when an independent lab tests the product to confirm its ingredients and potency, among other things. Whenever possible, stick to CBD pet care products that contain 0.0 percent THC .
Researchers are studying the effectiveness of using CBD to treat an ever widening range of conditions, such as osteoarthritis in dogs and cats, epilepsy in dogs and post-operative pain, but it will be a while before the results are published. Until then, experts suggest consulting your veterinarian on a case by case basis before giving your animal CBD
To learn more you can read Danielle Kosecki’s article in the August 31, 2019 issue of CNET.
https://www.cnet.com/news/is-cbd-safe-for-pets/
Travel Tips
If you think packing a batch of homemade edibles is a safe way to take cannabis across the border between the U.S. and Canada you may want to reconsider. Just because you or your fellow travelers can’t detect the odor of cannabis in a batch of brownies, the same is not true for dogs working as part of the Dog Detector Service (DDS) of Canada’s Border Service Agency. DDS teams are strategically located at various ports of entry across Canada.
Commercially made edibles are no less risky. According to Todd Knupp, extraction specialist at Colorado’s University of Cannabis Technologies, most commercially made edibles use a standardized extract of THC that does not typically include terpenes, the fragrant compounds that give cannabis its aroma. Said Knupp, “It’s not that the odour of THC in edibles is undetectable, it’s just a matter of how thoroughly the dog was trained to pick up on the scent.”
Sydney Perelmutter writing for the Website The Growth Op, reports that dogs can be trained to detect the scent of cannabis in any form. Said Master trainer Sid Murray of ATS K9 Detection Services,“The dogs can hit on edibles, oils and sprays as well as paraphernalia such as pipes, pens, bottles, and residual odours.” Murray pointed out that dogs have a sense of smell as much as 100,000 times more powerful than humans. But certain super sniffer breeds, such as bloodhounds and beagles, are able to detect some odours at one part per trillion (ppt).
Despite the fact cannabis is legal for recreational and medicinal use in Canada, drug-sniffing dogs may still be capable of detecting those edibles packed away in your luggage. Judith Gadbois-St.-Cyr, the CBSA’s Greater Toronto Area’s regional spokesperson, says the role of the DDS has always remained the same. “DDS plays an integral role in helping the CBSA keep prohibited drugs, including cannabis products, from entering Canada.”
The Canadian government has made it clear: not declaring cannabis products at the Canadian border remains a serious criminal offense. Transporting cannabis across the border in any form – including any oils containing THC or cannabidiol (CBD) – without a permit or exemption authorized by Health Canada—is a serious criminal offense. Travelers who violate the law are subject to arrest and prosecution, despite the legalization of cannabis in Canada. The prohibition applies regardless of the amount of cannabis you have with you, whether you hold a medical document authorizing the use of cannabis for medical purposes and whether you are traveling from an area with legalized or decriminalized cannabis.
To learn more, read Sydney Perelmutter’s article in the May 17, 2019 edition of The Growth Op and the Canadian Government’s statement on entering Canada with cannabis.
https://travel.gc.ca/travelling/cannabis-and-international-travel
Senior Cannabis Digest is compiled and edited by Joe Kohut and John Kohut. They can be reached at joe.kohut@gmail.com or at 347-528-8753.