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Hemp is Cannabis

Learn about the differences between hemp and marijuana, the benefits of CBD, the Farming Act of 2018, and the potential medical uses of cannabis. Explore the various cannabinoids and their effects on the body.

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Hemp is Cannabis

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  1. Hemp is Cannabis Dr. Jeffrey Tucker 11620 Wilshire Blvd. #710 Los Angeles, CA 90025 310-444-9393 www.DrJeffreyTucker.com www.DrJeffreyTucker.com

  2. Schedule 1-5 drugs • Examples of substances listed in Schedule I:Marijuana (cannabis) • Heroin • LSD • Peyote (mescaline) • Methaqualone (Quaalude) • 3,4-methylenedioxymeth amphetamine (“ecstasy”) • “bath salts” • Schedule 2: Vicodin, Cocaine, Meth, OxyCodin, Adderall • Schedule 3: Tylenol with Codeine, Steroids, Ketamine, Testosterone • Schedule 4: Xanax, Valium, Darvon, Ativan, Ambien, Traumadol • Schedule 5: Robitussin AC, Lomotil, Motofin, Lyrica www.DrJeffreyTucker.com

  3. Hemp vs Marijuana • Both are considered Cannabis sativa but there is a distinction between hemp and marijuana. • Marijuana contains significant amounts of the psychoactive phytocannabinoid known as THC. • Industrial Hemp is cultivated very differently and has very little if any THC after extraction. • Cannabidiol (CBD) - the non-psychoactive component of marijuana. • Hemp CBD products can technically come from either cannabis plant – it just really boils down to being below that magic number of 0.3% of THC in the product. www.DrJeffreyTucker.com

  4. PhytocannabinoidsMarijuana vs Hemp • Tetrahydrocannabinol (THC) • Psychoactive • Has medicinal value • Cannabidiol(CBD) • Not Psychoactive • Has anxiety relieving properties • Antagoniseseffects of THC • Has medicinal value www.DrJeffreyTucker.com

  5. Farming Act • Hemp Farming Act of 2018 became law December 20, 2018 removing hemp (defined as cannabis with less than 0.3% THC) from Schedule I controlled substances and making it an ordinary agricultural commodity. www.DrJeffreyTucker.com

  6. Farm Bill passed but the FDA… • Hemp (contains no more than .03% THC) has been removed from the Government’s Controlled Substance Acts. • However, the Food and Drug Administration (FDA) has not approved CBD’s use in food or beverages. • The FDA controls the regulation of Cannabidiol (CBD), NOT the Farm Bill. www.DrJeffreyTucker.com

  7. Depending on where you live, you may be able to obtain a medical cannabis card for conditions like: • Alzheimer's – interference with amyloid plaque formation • Glaucoma – lowers intraocular pressure • Multiple sclerosis – may relieve painful muscle contractions • Crohn's Disease/IBD - enhanced gut permeability • Adverse effects of chemo/Anorexia – appetite-stimulating effects • PTSD – improvement in symptoms, undergoing further research • Arthritis – e.g. RA & OA; pain reduction & improvement in mobility • Epilepsy – e.g. Darvet’s Syndrome • Chronic pain HelloMDwith Brightfield Group. Usage study. 2017. www.DrJeffreyTucker.com

  8. CANNABINOIDSEndocannabinoid system (ECS)Phytocannabinoids (Flowers)Synthetic cannabinoids ECS plays a critical role in most major functions of the body… inflammation motor control and coordination memory and learning anxiety and stress reward and addiction... and a lot more.  Globally, the ECS is primarily involved in maintaining balance in the body (homeostasis). There are many conditions associated with reduced levels of endocannabinoids in the body…that’s why we take it from flowers! www.DrJeffreyTucker.com

  9. Cannabinoids • Cannabinoids occur naturally in cannabis. • Some have not even been identified. • Only recently has anyone been able to extract enough of any of them in a quantity worth studying. Each one has a different effect, and they have still other effects in combinations. • Cannabinoids or combinations of them may turn out to be important therapeutic treatments. www.DrJeffreyTucker.com

  10. Inhalation is the fastest method, with peak blood levels achieved within 5-20 minutes. Oral ingestion is slower because cannabinoids go through the gastrointestinal tract before entering the blood stream.

  11. PubMed.gov THC (Tetrahydrocannabinol) CBD (Cannabidiol) Non-psychoactive Analgesic Anti-inflammatory Antioxidant Anti-emetic Anxiolytic Anti-psychotic Anti-convulsant/spasmotic Anti-epileptic Immunomodulatory Neuroprotective Decrease THC psychoactivity • Psychoactive • Analgesic • Anti-inflammatory • Antioxidant • Anti-emetic • Euphoric • Anti-neoplastic • Anti-spasmodic • Anti-tremor • Appetite Stimulant www.DrJeffreyTucker.com

  12. THC Side Effects • Anxiety • Paranoia • Tachycardia • Sedation/sleepiness • Dizziness www.DrJeffreyTucker.com

  13. www.DrJeffreyTucker.com

  14. Cannabinoid Receptors • CBD can increase levels of the body’s own naturally-produced cannabinoids (known as endocannabinoids) by inhibiting the enzymes that break them down. • CB1, CB2 • Ananadamide, FAAH www.DrJeffreyTucker.com

  15. Terms - Hemp • CBD - is from flower only. • Hemp oil - a carrier oil made from seed and/or stalk. • Full spectrum – is from the whole (full) plant. • Isolate– extracts are rendered down to a single molecule – CBD using a variety of post processing steps. www.DrJeffreyTucker.com

  16. Labeling • Hemp extract is code word for CBD (ex. 28 mg per 1 ml serving) • Hemp seed is made from the seed and virtually no CBD; they contain omega 3 & 6 • Hemp oil is a carrier or base that they are using - does not have CBD • Hemp stalk is a source of many beneficial phytocannabinoids • Phytocannabinoidmay contain some CBD • CBDA – cannabinoid; you won’t know how much is CBD unless you test it. www.DrJeffreyTucker.com

  17. Labels • Hemp oil • Isolates • “whole plant, full spectrum hemp oils and extracts containing naturally occurring cannabinoids” www.DrJeffreyTucker.com

  18. Drug TestingWhat does all this mean? • SAMHSA (Substance Abuse and Mental Health Services Administration) guidelines. • Drug tested through urine for THC. • THC is responsible for marijuana’s psychoactivityand euphoria. • A consumer who uses a high-quality, scientifically vetted hemp-based product at the standard serving size is highly unlikely to test positive for THC. • Extremely high doses may result in a positive urine screen. • Consumers need to be fully informed of the specific regulations posed by their employers. www.DrJeffreyTucker.com

  19. Is it legal for Chiropractors to use marijuana- and hemp-derived products? • It depends on where the doctor practices, and on the type of (topical, tincture, etc.) product he or she intends to use. • Whether marijuana is legal for medical, recreational or both types of use, there are myriad laws regarding the use of THC-containing products—and in some states, no regulations specifically addressing topicals, tinctures, etc. • Therefore, Chiropractors must obtain information directly from their state. www.DrJeffreyTucker.com

  20. CVS in the CBD business • More than 800 stores in Alabama, California, Colorado, Illinois, Indiana, Kentucky, Maryland, and Tennessee now offer CBD products. • “These products include topicals such as creams, sprays, roll-ons, lotions and salves. We are not selling any CBD-containing supplements or food additives.  We have partnered with CBD product manufacturers that are complying with applicable laws and that meet CVS’s high standards for quality,” CVS statement. www.DrJeffreyTucker.com

  21. Challenges www.DrJeffreyTucker.com

  22. Summary • FDA has taken the position that CBD is not a dietary supplement. • IND’s pertain to purified CBD. • Industrial Hemp stalk oil is a wholesome food with a naturally occurring entourage. • DEA regulations require THC content to be <0.3%. www.DrJeffreyTucker.com

  23. Summary • Evidence proves that cannabidiol(CBD) is an effective medication for a number of medical conditions. Therefore, it would seem logical for those in the chiropractic community to embrace these forms of treatment because they are effective. • As more evidence is discovered that CBD will help a tremendous amount of people who need help, it would be logical for it to be used as a legitimate treatment. • It will be employed as a valid option in an ever-growing number of situations. • CBD may be one of the largest components found in a rather substantial percentage of medical treatments of the future. www.DrJeffreyTucker.com

  24. Social Concerns? • Based on what is known about the safety of products containing cannabis and cannabis-derived compounds, are there particular safety concerns that Chiropractors should consider? • What should the Chiropractic Boards consider regarding its regulatory oversight? www.DrJeffreyTucker.com

  25. ReferencesMedical uses 1. CDC. Provisional drug overdose death counts. Atlanta, GA: National Center for Health Statistics, Centers for Disease Control. Available at: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm. Accessed 08/01/2018 2. Bradford AC, et al. Association between US state medical cannabis laws and opioid prescribing in the Medicare Part D population [published online April 2, 2018]. JAMA Intern Med. 3. Boehnke KF, Litinas E, Clauw DJ. Medical cannabis use is associated with decreased opiate medication use in a retrospective cross-sectional survey of patients with chronic pain. J Pain. 2016;17(6):739-744.4. Reiman A: Patient Profiles: Medical cannabis patients and health care utilization patterns. Complementary Health Practice Review. 2000;12:31-50).5. Mikuriya T. Medical marijuana in California, 1996-2006. O'Shaughnessy's: Journal of the California Cannabis Research Medical Group. Spring 2007: 2-8-10.6. Wilkie G, Sakr B, Rizack T. Medical marijuana use in oncology: a review. JAMA Oncol. 2016 Mar 17.7. Parker LA, Rock EM, Limebeer CL. Regulation of nausea and vomiting by cannabinoids. Br J Pharmacol. 2011 Aug;163(7):1411–1422.8. HelloMD with Brightfield Group. Usage study. 2017. Available at: https://www.hellomd.com/health-wellness/5980e279f15fe13b757557d3/largest-cbd-usage-study-published-by-hellomd-with-brightfield-group. Accessed 08/01/2018.9. Grant I, Cahn BR. Cannabis and endocannabinoid modulators: Therapeutic promises and challenges. Clinical Neuroscience Research. 2005; 5(2-4):185-199.10. Wilsey B, et al. Low dose vaporized cannabis significantly improves neuropathic pain. J Pain. 2013 Feb;14(2):136–148. www.DrJeffreyTucker.com

  26. References 1. McPartland JM. Pathogenicity of Phomopsisganjae on Cannabis sativa and the fungistatic effect of cannabinoids produced by the host. Mycopathologia 1984; 87:149-153. 2. Devane WA, et al. Determination and characterization of a cannabinoid receptor in rat brain.MolPharmacol 1988;34:605-613. 3. Devane WA, et al. Isolation and structure of a brain constituent that binds to the cannabinoid receptor. Science 1992;258:1946-1949. 4. Ruh MF, et al. Failure of cannabinoid compounds to stimulate estrogen receptors. BiochemPharmacol 1997;53:35-41. 5. Reynolds JR. On the therapeutical uses and toxic effects of Cannabis indica. Lancet1890;i:637-638. 6. Zurier RB, et al. Dimethylheptyl-THC-11 oic acid: A nonpsychoactiveantiinflammatory agent with a cannabinoid template structure. Arthritis Rheum 1998;41:163-170. 7. Schmid PC, et al. Changes in anandamide levels in mouse uterus are associated with uterine receptivity for embryo implantation. Proc Natl AcadSci USA 1997;94:4188-4192. 8. Wenger T, et al. Effects of anandamide on gestation in pregnant rats. Life Sci1997;60:2361-2371. 9. Weidenfeld J, et al. Effect of the brain constituent anandamide, a cannabinoid receptor agonist, on the hypothalamo-pituitary-adrenal axis in the rat.Neuroendocrinology 1994;59:110-112. 10. Rodrguez de Fonseca F, et al. Activation of corticotropin-releasing factor in the limbic system during cannabinoid withdrawal. Science 1997;276:2050-2054. www.DrJeffreyTucker.com

  27. References 11. Wenger T, et al. Effects of anandamide (endogen cannabinoid) on anterior pituitary hormone secretion in adult ovariectomized rats. Life Sci 1995;56: 2057-2063. 12. Fernandez-Ruiz JJ, et al. Time course of the effects of different cannabimimetics on prolactin and gonadotropin secretion: Evidence for the presence of CB1 receptors in hypothalamic structures and their involvement in the effects of cannabimimetics. BiochemPharmacol 1997;53:1919-1927. 13. Block RI, et al. Effects of chronic marijuana use on testosterone, luteinizing hormone, follicle stimulating hormone, prolactin and cortisol in men and women. Drug Alcohol Depend 1991;28:121-128. 14. Sauer MA, et al. Marijuana: Interaction with the estrogen receptor. J PharmacolExpTher 1983;224:404-407. 15. Kuiper GG, et al. Interaction of estrogenic chemicals and phytoestrogens with estrogen receptor beta. Endocrinology 1998;139:4252-4263. 16. Wang C, Kurzer MS. Effects of phytoestrogens on DNA synthesis in MCF-7 cells in the presence of estradiol or growth factors. Nutr Cancer 1998;31:90-100. 17. De Petrocellis L, et al. The endogenous cannabinoid anandamide inhibits human breast cancer cell proliferation. Proc Natl AcadSci USA 1998;95:8375-8380. 18. Joy JE, et al. Marijuana and Medicine: Assessing the Science Base. National Academy Press, Washington, DC; 1999. 19. Voth EA. Marijuana and its reviews. New Engl J Med 1995;332:274. 20. McPartland JM, Pruitt PL. Medical marijuana and its use by the immunocompromised. AlternTher Health Med 1997;3:39-45. 21. McPartland JM, et al. Side effects of pharmaceuticals not elicited by comparable herbal medicines: The case of tetrahydrocannabinol and marijuana. Manuscript accepted by AlternTher Health Med 1999. www.DrJeffreyTucker.com

  28. ReferencesReceptors • Hua T, Vemuri K, Pu M, et al. Crystal Structure of the Cannabinoid Receptor CB1. Cell. 2016;167(3):750-762.e14. • Huang WJ, Chen WW, Zhang X. Endocannabinoid system: Role in depression, reward and pain control (Review). Mol Med Rep. 2016;14(4):2899-2903. • Richardson D, Pearson RG, Kurian N, et al. Characterisation of the cannabinoid receptor system in synovial tissue and fluid in patients with osteoarthritis and rheumatoid arthritis. Arthritis Res Ther. 2008;10(2):R43. • Kaufmann I, Hauer D, Huge V, et al. Enhanced anandamide plasma levels in patients with complex regional pain syndrome following traumatic injury: a preliminary report. EurSurg Res. 2009;43(4):325-9. • Cravatt BF, Lichtman AH. The endogenous cannabinoid system and its role in nociceptive behavior. J Neurobiol. 2004;61(1):149-160. • Herkenham M, Lynn AB, Little MD, et al. Cannabinoid receptor localization in brain. Proc Natl AcadSci USA. 1990;87(5):1932-1936. www.DrJeffreyTucker.com

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