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Ketamine Discoveries Continue to Come as Further Clarity is Needed

Does ketamine have more therapeutic value than we know?

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Ketamine continues to be a drug short on definitive answers despite the growing research. However, since its discovery in 1962, researchers have been able to cull together findings from research and anecdotal results. Much of those findings would reveal that its first use as anesthesia was just the iceberg’s tip.  

Much more is left to be answered about ketamine. What is abundantly clear is that ketamine has the potential to change lives in several ways. That said, many in the world want to make sure it remains inaccessible. 

Ketamine Piques to Interest of Physicians and the Public

The immense capabilities of ketamine have piqued the interest of various communities over the decades. The medical field has been enamored with the drug since its discovery. Meanwhile, the last three or four decades have seen ketamine become an illicit club drug.

While some continue to use ketamine, or Special K, for recreational purposes, most proponents for its use view ketamine as a therapeutic option. Like cannabis, ketamine has ample amounts of self-reports touting its success. Additionally, the drug has a wealth of lab studies over the past half-century. This wealth of information is achieved in the lab, sometimes in the United States. This type of outcome is not possible for drugs like cannabis that remain a Schedule I drug. Unlike cannabis, ketamine is a Schedule III substance in the U.S.

The scheduling of ketamine and an increased interest as of late fueled an uptick of patient treatments across the country in recent years. Dr. Leonardo Vando, medical director for guided psychedelics treatment platform Mindbloom, said the newest interest is fueled by the abundance of lab findings and ketamine’s 1970 FDA approval, the only for psychedelics.

“Like other psychedelics, ketamine has an extensive presence in the research literature dating back decades,” Vando told High Times. “Ketamine is spearheading the resurgence of these medicines because of its powerful effects as an antidepressant and its superb safety profile.”

Nations worldwide, including the U.S., have embraced ketamine treatments for its treatment potential and various effects on the market. 

Dr. Vando added, “Not only have we been able to bring this amazingly effective treatment into our psychiatric arsenal, but we have managed to do it with low cost, generic ketamine instead of an expensive new pharmaceutical drug.”

Lab Studies Further Fuel Ketamine Interest 

Ketamine studies continue to pour in, offering up new insights and market buzz. 

A June 2020 study was the latest in the field to generate such interest in the public forum. These findings come from a University of Cambridge study of ketamine-sedated sheep with hopes of understanding the drug’s effect of patients with Huntington’s disease. The study identified brain phenomena that may provide answers on how the drug produces out-of-body-like experiences and oblivion states in patients. 

“It’s likely that the brain oscillations caused by the drug may prevent information from the outside world being processed normally,” explained Lead Researcher Jenny Morton, who concluded that ketamine could “temporarily switch off the brain.”

Jackee Stang, founder and president of psychedelic wellness media venture Delic Corp, said that additional credible lab studies are the most efficient way of understanding ketamine and its treatments. 

“Perhaps more importantly, however, is that the more we can provide concrete evidence of efficacy through studies and research, the safer a mainstream audience will feel about considering new and progressive forms of treatment,” added Stang. 

The psychedelics media leader numerous studies are underway and could warrant their own discussion in time. While valuable to advancing the space, Stang pointed towards treatment centers in the U.S. and Canada as a sign of the progress already made. “We expect more to come over the coming years,” Stang added. 

More so, she highlighted MAPS’ ongoing Phase III clinical trials of MDMA-assisted psychotherapy, predicting that it could lead to further psychedelics reform in America. Stang forecasted that “We could see MDMA rescheduled very soon,” adding that “This will only pave the path for further psychedelic de-stigmatization and medicalization.”

Barriers Remain to Ketamine Access

Promising research provides promise that ketamine treatments will see additional reform around the world. That said, barriers remain in both the United States and abroad. 

In 2016, the World Health Organization (WHO) presented a ketamine fact file detailing the drug’s benefits and risk factors. Concerns noted include the possibility of illicit use, dependence and harm. While stating its worries, the WHO report noted that fatal intoxication is minimal, with only 12 recorded deaths between 1987 and 2000—with only three deaths solely caused by ketamine. 

Still, several nations have taken legislative action to thwart public use. China has been the most active and vocal on the world stage. The country has sought a tighter restriction on the drug for years, with it being the Chinese population’s drug of choice for several years due to its reported affordability. 

Despite its lobbying, influential global groups, like the WHO, have repeatedly rebuffed any efforts to prohibit ketamine access. Between 2006 and 2015, the group made four public recommendations that ketamine not be placed on any restriction lists, instead keeping it on the WHO’s list of essential medicines. 

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The organization’s stance is not linked to the mentally therapeutic potential of ketamine. Instead, the organization cites the low risk of public health threat coupled with the essential service ketamine provides in many in the hospitals of low-revenue and developing nations as anesthesia. 

“The Committee concluded that ketamine abuse does not pose a global public health threat, while controlling it could limit access to the only anesthetic and pain killer available in large areas of the developing world,” said a 2015 WHO statement. 

Meanwhile, a June 2020 report from the advocacy group Patients for Affordable Drugs reported that ketamine joined seven other drugs to experience a price hike while under an FDA-designated shortage. 

Much like cannabis, a lack of definitive lab data is likely holding up the progress on ketamine legislation. That said, current data and decades of use leave many nations and influential groups to understand that ketamine is far from a club drug. For numerous nations and patients, it is essential in getting through surgery as well as the pains of mental health.

Source: https://hightimes.com/health/science/ketamine-discoveries-continue-come-further-clarity-needed/?utm_source=rss&utm_medium=rss&utm_campaign=ketamine-discoveries-continue-come-further-clarity-needed

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CBG Study Shows Antimicrobial Properties of Cannabis

Cannabis has been used for its antimicrobial properties for thousands of years, but only recently have these benefits surfaced in Western medicine. A recent study highlights previously unknown antimicrobial properties of cannabis. While the study focuses on several cannabinoids, it brings out CBG as a cannabinoid to pay attention to in terms of its antibiotic […]

The post CBG Study Shows Antimicrobial Properties of Cannabis appeared first on CBD Testers.

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Cannabis has been used for its antimicrobial properties for thousands of years, but only recently have these benefits surfaced in Western medicine. A recent study highlights previously unknown antimicrobial properties of cannabis.

While the study focuses on several cannabinoids, it brings out CBG as a cannabinoid to pay attention to in terms of its antibiotic abilities.

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What is CBG?

CBG – cannabigerol – is a cannabinoid of the cannabis plant. Unlike it’s counterparts THC and CBD, it is found in only very small quantities, making up approximately 1% of a harvest-ready plant. Like CBD, and unlike THC, it doesn’t produce a psychoactive effect. CBG comes from its acidic precursor, CBGA. CBGA in turn is converted into cannabinoids like THCA – tetrahydrocannabinolic acid, CBDA – cannabidiolic acid, and CBCA – cannabichromenic acid. What is left of the CBGA converts to CBG through decarboxylation. This is why so little of the plant is made of CBG.

CBG has been cited already as an anti-cancer agent, and now adds antibiotic to its repertoire of uses.

Recent research

There has been an increasing amount of research into the medical benefits of CBD, and as that field has expanded, interest has been put on other cannabinoids like CBG. Now, a new study is out which backs up the idea that cannabinoids – CBG in particular – possess a strong antibacterial capability. This is especially important as the idea of antibiotic resistance has become an issue.

One of the big contenders when it comes to antibiotic resistance is MRSA, a type of Staphylococcus aureus which is resistant to the antibiotic methicillin, an antibiotic which was once used to treat the infection, but which is rarely used now because of resistance to its effects. In a study published earlier in 2020: Uncovering the Hidden Antibiotic Potential of Cannabis, different cannabinoids like CBG were shown to have an antibiotic effect on MRSA.

They also did something else interesting. They both showed an ability to inhibit biofilms from forming, as well as the ability to eliminate already formed biofilms. This has huge implications in the fight against antibiotic resistance.

What are biofilms?

Why is the idea of breaking through biofilms or keeping them from forming important? Because biofilms are one of the biggest culprits in the spread of disease, and the inability to stop it. Biofilms can occur inside the body, or on surfaces outside of it.

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A biofilm is a “community of micro-organisms irreversibly attached to a surface and encased in an EPS (extracellular polymeric substance matrix), with increased resistance to host cellular and chemical responses.” While most often associated with bacteria, they are also associated with fungi, protists, and viruses as well.

In some ways, biofilms inside the body cause a bigger issue in that they can’t be killed as easily. Anything used internally has to be sustainable by the human body in general, and hard-to-kill microbes often require means that are quite toxic internally. Externally this is also an issue, however, harsher methods can be used. On the other hand, biofilms outside the human body that exist on surfaces, pose a much bigger threat in terms of disease transmission.

Essentially a biofilm is like a cellular form of plastic wrap, but stronger, and harder to break. It forms a barrier between the microbes and the environment around which allows growth without interference. Biofilms have a specific architecture and allow a supreme environment for intercellular communication.

“Biofilms may form on a wide variety of surfaces, including living tissues, indwelling medical devices, industrial or potable water system piping, or natural aquatic systems.” This can create havoc, especially in medical settings where there is interaction with many forms of disease, and particularly when the biofilms are formed around antibiotic-resistant bacteria.

MRSA

When it comes to antibiotic resistance, Staphylococcus aureus is a key player in that it very well shows how quickly bacteria can change according to the environment around it. It started becoming resistant to antibiotics starting with penicillin, and steadily made its way through the varied antibiotics that have been used ever since. The particular strain MRSA, which is resistant to the antibiotic Methicillin, has become ubiquitous, showing up all over the place in hospital settings, and spreading quickly among patients with little recourse.

Staphylococcus aureus is a dangerous staphylococcal bacterial infection that can cause all kinds of issues from pneumonia, to skin and heart problems, bone infections and more. Even TSS, or Toxic Shock Syndrome, the infection associated with tampon use that can lead to death, is a result of toxins produced by Staphylococcus aureus.

Obviously, having this running rampant in a place with sick people is a recipe for further and continued disaster. To give an idea, in 2019 the CDC released a report stating that deaths due to antibiotic resistance had been underestimated, and that approximately 35,000 deaths occur each year in the US alone, out of 2.8 million yearly infections. That’s a lot of people dying because their medicine didn’t work.

Is cannabis a breakthrough with biofilms?

No, not at all. The idea of antimicrobial agents being found in plants is hardly new. Not only have different plants been used in this way for thousands of years, but studies have already been done into the power of different compounds like essential oils. This study from 2019 highlights the investigation into cinnamon, marjoram, and thyme essential oils with cinnamon and thyme showing the best inhibitory results.

2012 and there’s a study specifically investigating how different essential oils effect Staphylococcus aureus biofilms. Yup, the exact thing being cited as a breakthrough with cannabis, was actually established with other plants at least eight years ago. What that study found is that cassia, red thyme and Peru balsam essential oils were best at eradicating Staphylococcus aureus biofilms, and more effective than certain antibiotics. While the authors of the study do indicate that red thyme and cassia have not been tested against MRSA biofilms, they do indicate that essential oils like tea tree, thyme, and peppermint have shown effectiveness against MRSA biofilms.

This is important when looking at the antibacterial properties of cannabis, because when looking at progress into issues like antibiotic resistance, looking at the whole picture is necessary. Similar antimicrobial properties to cannabis can be found in plenty of other places in the plant world, some with a much likely higher rate of efficacy than cannabis.

Back to CBG and cannabinoids

In July of 2020, a systematic review was released investigating the antimicrobial properties of cannabis. The conclusion was that several cannabinoids are effective against gram positive bacteria like MRSA, and offer a possibly better treatment option to antibiotics which are harsh on the body and can’t be used indefinitely. Gram positive has to do with the classification of bacteria into two component groups according to their cell walls, with gram positive having thinner walls which sometimes makes them more receptive to antibiotic agents that target cell walls. This is not true all the time, as we find with MRSA, and with eliminating biofilms. The review also pointed out that beyond cannabinoids, terpenes have been shown to have antimicrobial benefits as well.

Why doesn’t MRSA become resistant to cannabis?

When dealing with cannabis, or any other plant as an antibiotic, the question becomes, why would cannabis, (or another plant), be effective without causing the bacteria strain to become resistant to it? The answer is rather simple, antibiotics are created to mimic the activity of plants, but they’re much more basic compounds that can very easily (apparently) be understood by the microbe which then mutates to resist effects of these simple antibiotics.

Plant compounds on the other hand are far more complicated and harder for a microbe to understand and fight. Plants have secondary metabolites which complicate them biologically, introducing tannins, alkaloids, flavonoids, and terpenes, which have been found in research to have antimicrobial properties, as well as helping to create a more complicated microbe-proof structure.

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Source: https://cbdtesters.co/2020/10/21/cbg-study-shows-antimicrobial-properties-of-cannabis/

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Research

Colorado: Institute of Cannabis Research Series Launches With CBD and Dogs

As one of the first two states in the United States to legalize cannabis, Colorado has been at the forefront of research. The Institute of Cannabis Research at Colorado State University Pueblo has just kicked off a series of virtual events during which researchers discuss their work, and where research is headed.  The first such […]

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As one of the first two states in the United States to legalize cannabis, Colorado has been at the forefront of research. The Institute of Cannabis Research at Colorado State University Pueblo has just kicked off a series of virtual events during which researchers discuss their work, and where research is headed. 

The first such webinar featured Stephanie McGrath, an associate professor of neurology and neurosurgery at the College of Veterinary Medicine and Biomedical Science at Colorado State University in Fort Collins. She focused her presentation on her work covering the use of cannabidiol (CBD) for dogs that have seizure disorders, and how glioma cancer cells in dogs respond to CBD treatment.  

The next CU Pueblo research webinar will feature David Shurtleff, deputy director of the National Center of Complementary and Integrative Health, and will focus on the National Institute of Health’s “interest in cannabis research.” 

(Read Cannabis Wire’s previous coverage of research out of Baylor College of Medicine, within the Texas Medical Center, on the therapeutic potential of CBD for dogs experiencing pain from arthritis.)

Like many medical professionals, McGrath didn’t enter medical school with a decision on which path she’d like to pursue, but she eventually settled on neurology. McGrath referred to epilepsy in dogs, the most common neurologic disorder in canines, as an “eye opener” that hit home, because existing treatments seemed inadequate, she said. 

“Until you witness this, it’s really hard to appreciate what owners are going through,” McGrath said, referencing dogs undergoing grand mal seizures. “But when you’re looking at this dog’s eyes and you’re looking into the eyes of this family that are going through this very emotional, very traumatic and violent disease,” she said, you connect to the “real emotional aspect of it like this.” 

While McGrath completed her residency in Colorado, legal adult use cannabis sales were taking off. McGrath referenced Charlotte Figi, a young girl whose family moved her to Colorado for access to CBD to treat her seizures. (Figi, who became internationally known for helping to catalyze the CBD-as-medicine movement, died in April). Watching the Sanjay Gupta special on Figi and CBD on CNN, McGrath wondered if CBD might have the same seizure-reducing effects on dogs. 

“I went through school knowing marijuana is toxic for dogs. ‘It’s terrible. Don’t use it. Stay away from it.’ We see marijuana toxicosis in our emergency rooms,” McGrath said. 

McGrath began her research on CBD at CSU under the 2014 Farm Bill, which allowed for states to launch hemp pilot programs. Hemp is abundant in CBD. But, she said, her work became easier when lawmakers passed the 2018 Farm Bill, which removed hemp, defined as cannabis plants containing .3% THC or less, from the list of controlled substances. 

“I think it’s made it a lot easier for collaborators and other researchers and scientists to start exploring cannabis at their institutions as well, which is great,” McGrath said. She added that her own research began, in some senses at ground zero, because there were so few studies on dogs and CBD that could serve as a starting point for additional work. 

“We had essentially no foundation for using this drug despite it being around forever. And so we had a lot of questions about bioavailability, whether this drug would even be absorbed,” she said. 

McGrath started with a pharmacokinetic study during which 30 dogs were given three different CBD formulations. The dogs received a six-week course of two doses daily. The beagles used for the study were research animals that were “purpose-bred” for pharmacokinetic studies and that are adopted out once they reach middle age. Researchers looked for safety, drug tolerance, and any major adverse effects.

“It was very encouraging that at least we had a foundation, somewhere to go with this,” McGrath said, referencing that the oral preparations were at least measurable in the dogs’ blood streams. “Fortunately for adverse events, those were also fairly well-tolerated,” she said. The only major side effect was diarrhea, “which was transient, but it did occur in all dogs at all dosages at various time points.” There also was an elevation in one of the liver enzymes, alkaline phosphatase, and while the researchers didn’t have concerns related to short-term liver toxicity concerns, “that was definitely something we noted and wanted to continue to monitor.” 

Overall, McGrath said, she felt that this study’s results would allow her to proceed to clinical trials in client-owned animals, starting with epilepsy. Her first effort was on the short-term effect of CBD on seizure frequency in dogs suffering from poorly-controlled idiopathic epilepsy. A total of sixteen dogs participated in this study, a limitation with such a small cohort, with nine in the treatment group and seven in the control group. All of these dogs had a confirmed diagnosis of idiopathic epilepsy, and they all had to remain on their standard anticonvulsant treatment during the three-month study. Researchers then added either CBD to the treatment regimen, or a placebo. 

“We did see a significant reduction in seizure frequency in the treatment group as compared with the control group,” McGrath said. But, she added, when they looked at “responders,” a common way of recording antiepileptic drug efficacy, they wanted the dogs to have at least a 50 percent reduction in seizure activity, which didn’t happen. 

“We concluded from this study that, although we did get some encouraging results, there’s still a lot more work to be done,” she said. 

McGrath said the most interesting part of the study, to her, was that she saw a “significant correlation” between plasma level and seizure change.

“As the dogs, that for whatever reason, metabolize the drug in such a way that they reached higher plasma levels, they actually had a further decrease in seizure activity than dogs that never reach that level. And so seeing that correlation really gave me a lot of hope that if we can get more dogs sort of across the … arbitrary threshold, that we may be able to see better, more positive results,” McGrath said.

McGrath’s next clinical study was funded by the American Kennel Club Canine Health Foundation, and was much larger, with 60 dogs. It was a prospective double blind, placebo-controlled crossover study. The dogs in the study received either CBD or placebo in the first phase, and then CBD or placebo for the second phase. 

“It gives us a bit more of a powerful study because each dog is able to be compared to itself as well as the treatment group and the control group,” she said. For this study, CBG was also added, and doses were increased in an effort to get more dogs into a higher-level plasma range. During the course of this study, Epidiolex, a CBD-based cannabis plant extract, was approved by the Food and Drug Administration, which McGrath and her team started using as part of the study. 

“Spoiler alert: I do not have results of the study yet,” McGrath said. She and her team wrapped up enrollment last month, and the last dog is expected to finish in March, allowing them to publish results sometime next year.  

“Overall, we didn’t see any clinical signs that were of concern. We are also measuring antiepileptic drug levels throughout the studies. So we are going to also assess whether CBD has any effect on raising or lowering the antiepileptic drug levels as well,” she said. 

Source: https://cannabiswire.com/2020/10/16/colorado-institute-of-cannabis-research-series-launches-with-cbd-and-dogs/

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Research

Study suggests cannabis consumers need more anesthesia, pain meds

Research on the effects of cannabis consumption on people needing anesthesia for medical procedures is growing. And new, first-of-its kind research presented Monday at the Anesthesiology 2020 annual meeting has shed new light on why medical professionals should know about a patient’s cannabis consumption.  An excerpt of this small retrospective review study has been published […]

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Research on the effects of cannabis consumption on people needing anesthesia for medical procedures is growing. And new, first-of-its kind research presented Monday at the Anesthesiology 2020 annual meeting has shed new light on why medical professionals should know about a patient’s cannabis consumption. 

An excerpt of this small retrospective review study has been published in the peer-reviewed Journal of Clinical Anesthesia; the authors expect that a full version under review will be published in the peer-reviewed Canadian Journal of Anesthesia. 

For this study, researchers compared cannabis consumers and non-consumers before and after surgery for a broken tibia, or shin bone. In total, 118 patients seeking treatment at the University of Colorado Hospital participated in the study. One-quarter (25.4%) reported that they consumed cannabis before the surgery, though researchers did not have data related to frequency, time or date of consumption, or whether the cannabis was smoked, vaped, or eaten.

Researchers compared the amount of anesthesia needed by both groups, those who consumed cannabis and those who didn’t, and also their pain scores and how much opioid-based medication was needed. 

The group who consumed cannabis needed more sevoflurane, an anesthesia. For example, this group needed 37.4 ml vs. 25 ml. This group also reported more pain, with their pain scores roughly a 6, versus 4.8, which researchers note is a “statistically significant difference.” This group also received 58% more opioid-based painkillers, or roughly an average of 155.9 morphine milligram equivalents daily vs. 98.6 milligrams for the non-consumer group. 

The findings related to the need for more anesthesia surprised researchers most, lead author Ian Holmen, who is also anesthesiology resident at the University of Colorado Hospital, Aurora, told Cannabis Wire

“We did not actually anticipate that. The main literature has suggested that there is an increased dose of Propofol required,” Holmen said, referencing a common anesthetic. “But, no one had previously reported across a broader group of patients an increased necessity for sevoflurane,” he added, referencing another drug used during anesthesia. 

The main takeaway, Holmen said, is that medical providers need to be aware that there is a possibility for increased doses of sevoflurane for some patients undergoing operations. Part of the reason for that, Holmen added, is that the drug can cause low blood pressure in some patients. 

“For a healthy young patient, that might not be a problem at all. But for a patient who maybe has lung problems or other heart problems, comorbidities going into that case, slight adjustments or changes in blood pressure can actually be fairly consequential, depending on how severe it is,” Holmen said. 

When asked whether there’s been a coordinated effort to encourage medical professionals and patients to communicate about cannabis use, Holmen said that, at least based on his time in medical school, he couldn’t recall any such “big movement.” And while doctors often ask patients about alcohol and “illicit” drug use during the collection of medical history, oftentimes a doctor won’t specifically isolate cannabis. Holmen said that in his personal practice in Colorado, where voters legalized in 2012, he’s moved to specifically asking patients about cannabis use.

“I think an initiative like that to be more deliberate about asking specifically about cannabis would be worthwhile, especially given the number of patients who are now presenting to the [operating room] with having had recreational cannabis use prior,” he said. 

While other literature on cannabis consumption and pain, or anesthesia required, have been published, the other main takeaway, Holmen said, is that more research is needed, especially given the pace of legalization. 

Holmen said he plans to continue research at the intersection of anesthesia and cannabis consumption. 

Source: https://cannabiswire.com/2020/10/05/study-suggests-cannabis-consumers-need-more-anesthesia-pain-meds/

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