Cannabis Nurse Truths
Cannabis Nurse Truths is the voice of reason in a bureaucracy of nonsense. Dr. Denise Foster, PhD, MSN, RN, CNE is a nationally-recognized expert on the medicinal use of cannabis. She teaches doctors, nurses and other educators in its use in modern medicine. We talk about all things cannabis and highlight the research that continues to indicate that cannabis is medicine. New episodes every Wednesday!
Episodes
Wednesday Sep 25, 2024
Wednesday Sep 25, 2024
Prenatal cannabis exposure is associated with a higher risk of many different forms of birth defects and long-term neurodevelopmental effects. Cannabis during pregnancy not only exposes the developing fetus to harmful outcomes, but also can create adverse effects for offspring later in life.
In this episode of CNT, we review these known adverse birth outcomes, which underscores the significance of implementing preventative strategies for guiding cannabis use during pregnancy. The bottom line: Just Say No.
EPISODE RESOURCES
Allen, S., Natale, B.V., Ejeckam, A.O., Lee, K., Hardy, D.B., & Natale, D.R. (2024). Cannabidiol exposure during rat pregnancy leads to labyrinth-specific vascular defects in the placenta and reduced fetal growth. Cannabis and Cannabinoid Research, 9(3). https://doi.org/10.1089/can.2023.016
Braillon, A. & Bewley, S.(2018, January). Committee Opinion No. 722: Marijuana Use During Pregnancy and Lactation. Obstetrics & Gynecology 131(1), 164. https://pubmed.ncbi.nlm.nih.gov/28937574/
Cioffredi, L.A., Anderson, H., Loso, H., East, J., Nguyen, P., Garavan, H., & Potter, A. (2022). Prenatal cannabis exposure predicts attention problems, without changes on fMRI in adolescents. Neurotoxicology and Teratology, 91, 107089. https://pubmed.ncbi.nlm.nih.gov/35314358/
Dickson, B., Mansfield, C., Guiahi, M., Allshouse, A.A., Borgelt, L.M., Sheeder, J., ... & Metz, T.D. (2018). Recommendations from cannabis dispensaries about first-trimester cannabis use. Obstetrics & Gynecology, 131(6), 1031-1038. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5970054/
Evanski, J.M., Zundel, C.G., Baglot, S.L., Desai, S., Gowatch, L.C., Ely, S.L., ... & Marusak, H.A. (2024). The first “hit” to the endocannabinoid system? Associations between prenatal cannabis exposure and frontolimbic white matter pathways in children. Biological Psychiatry Global Open Science, 4(1), 11-18. https://pubmed.ncbi.nlm.nih.gov/38021250/
Lee, K., & Hardy, D.B. (2021). Metabolic consequences of gestational cannabinoid exposure. International Journal of Molecular Sciences, 22(17), Article 17. https://doi.org/10.3390/ijms22179528
Li, Y., Dewar, A., Kim, Y.S., Dey, S.K., & Sun, X. (2020). Pregnancy success in mice requires appropriate cannabinoid receptor signaling for primary decidua formation. eLife, 9, e61762. https://doi.org/10.7554/eLife.61762
Lin, A., Dent, G.L., Davies, S., Dominguez, Z.M., Cioffredi, L.A., McLemore, G.L., & Maxwell, J.R. (2023). Prenatal cannabinoid exposure: Why expecting individuals should take a pregnancy pause from using cannabinoid products. Frontiers in Pediatrics, 11, 1278227. https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1278227/full
Machado, A.S., Bragança, M., & Vieira-Coelho, M. (2024). Epigenetic effects of cannabis: A systematic scoping review of behavioral and emotional symptoms associated with cannabis use and exocannabinoid exposure. Drug and Alcohol Dependence, 111401. https://www-sciencedirect-com.proxy.lib.odu.edu/science/article/pii/S0376871624003247
Moore, B.F., Sauder, K.A., Shapiro, A.L., Crume, T., Kinney, G.L., & Dabelea, D. (2022). Fetal exposure to cannabis and childhood metabolic outcomes: The Healthy Start Study. Journal of Clinical Endocrinology & Metabolism, 107(7), e2862-e2869. https://pubmed.ncbi.nlm.nih.gov/35357471/
Nashed, M.G., Hardy, D.B., & Laviolette, S.R. (2021). Prenatal cannabinoid exposure: Emerging evidence of physiological and neuropsychiatric abnormalities. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.624275
Sorkhou, M., Singla, D.R., Castle, D.J., & George, T.P. (2024). Birth, cognitive and behavioral effects of intrauterine cannabis exposure in infants and children: A systematic review and meta-analysis. Addiction, 119(3), 411–437. https://doi.org/10.1111/add.16370
Tadesse, A.W., Ayano, G., Dachew, B.A., Tusa, B.S., Damtie, Y., Betts, K., & Alati, R. (2024). The association between prenatal cannabis use and congenital birth defects in offspring: A cumulative meta-analysis. Neurotoxicology and Teratology, 102, 107340. https://pubmed.ncbi.nlm.nih.gov/38460861/
Tadesse, A.W., Dachew, B.A., Ayano, G., Betts, K., & Alati, R. (2024). Prenatal cannabis use and the risk of attention deficit hyperactivity disorder and autism spectrum disorder in offspring: A systematic review and meta-analysis. Journal of Psychiatric Research, 171, 142-151. https://www-sciencedirect-com.proxy.lib.odu.edu/science/article/pii/S0022395624000591
Torres, J., Miller, C., Apostol, M., Gross, J., & Maxwell, J.R. (2024). The impact of recreational cannabinoid legalization on utilization in a pregnant population. Frontiers in Public Health, 12, 1278834. https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1278834/full
Wednesday Sep 18, 2024
Wednesday Sep 18, 2024
Cannabidiol, or CBD, was discovered in 1940 by Dr. Roger Adams in a sample of hemp he was testing for intoxicating compounds. Prior to the discovery of THC in 1964, scientists were busy looking for the magic ingredient that caused all of the impairing effects of cannabis and happened upon CBD during their search. Fast forward to modern day research, where we now understand how CBD works in the body to create many beneficial physiological and psychological effects.
On this episode of CNT, we highlight the wonders of CBD, the miracle drug that seems to be able to affect numerous chronic conditions, including hypertension, cancer, neurodegenerative disease, and even COVID-19 infection. It can also prevent numerous conditions, such as autoimmune and psychological disorders. So, why isn't CBD part of your daily wellness regimen?
Episode Resources
Appendino, G. (2020). The early history of cannabinoid research. Cannabis and Cannabinoids, 31(4), 919–929. https://doi.org/10.1007/s12210-020-00956-0
Bhunia, S., Kolishetti, N., Arias, A.Y., Vashist, A., & Nair, M. (2022). Cannabidiol for neurodegenerative disorders: A comprehensive review. Frontiers in Pharmacology, 13. https://doi.org/10.3389/fphar.2022.989717
Britch, S.C., Babalonis, S., & Walsh, S.L. (2021). Cannabidiol: Pharmacology and Therapeutic Targets. Psychopharmacology, 238(1), 9–28. https://doi.org/10.1007/s00213-020-05712-8
Dujic, G., Kumric, M., Vrdoljak, J., Dujic, Z., & Bozic, J. (2024). Chronic Effects of Oral Cannabidiol Delivery on 24-h Ambulatory Blood Pressure in Patients with Hypertension (HYPER-H21-4): A Randomized, Placebo-Controlled, and Crossover Study. Cannabis and Cannabinoid Research, 9(4), 979–989. https://doi.org/10.1089/can.2022.0320
Esposito, G., Pesce, M., Seguella, L., Sanseverino, W., Lu, J., Corpetti, C., & Sarnelli, G. (2020). The potential of cannabidiol in the COVID-19 pandemic. British Journal of Pharmacology, 177(21), 4967–4970. https://doi.org/10.1111/bph.15157
Mabou Tagne, A., Pacchetti, B., Sodergren, M., Cosentino, M., & Marino, F. (2020). Cannabidiol for Viral Diseases: Hype or Hope? Cannabis and Cannabinoid Research, 5(2), 121–131. https://doi.org/10.1089/can.2019.0060
Nguyen, L.C., Yang, D., Nicolaescu, V., Best, T.J., Gula, H., Saxena, D., Gabbard, J.D., Chen, S.-N., Ohtsuki, T., Friesen, J. B., Drayman, N., Mohamed, A., Dann, C., Silva, D., Robinson-Mailman, L., Valdespino, A., Stock, L., Suárez, E., Jones, K.A., … Rosner, M.R. (2022). Cannabidiol inhibits SARS-CoV-2 replication through induction of the host ER stress and innate immune responses. Science Advances, 8(8), eabi6110. https://doi.org/10.1126/sciadv.abi6110
Peng, J., Fan, M., An, C., Ni, F., Huang, W., & Luo, J. (2022). A narrative review of molecular mechanism and therapeutic effect of cannabidiol (CBD). Basic & Clinical Pharmacology & Toxicology, 130(4), 439–456. https://doi.org/10.1111/bcpt.13710
Seltzer, E.S., Watters, A.K., MacKenzie, D., Granat, L.M., & Zhang, D. (2020). Cannabidiol (CBD) as a Promising Anti-Cancer Drug. Cancers, 12(11), Article 11. https://doi.org/10.3390/cancers12113203
Wednesday Sep 11, 2024
Wednesday Sep 11, 2024
Cannabis is the most over regulated, yet under regulated prohibited drug on the market - and the most studied! Through eight decades of research, we know of all of the potential harms and risks associated with both use of the plant and access to the plant. Lab testing of all cannabis products is what helps keeps our consumers safe. But what if that's not the case?
On this episode CNT, we review cannabis testing industry considerations and highlight some of the issues we are already facing as we try to provide safe, lab-tested products to either medical or adult use consumers.
Episode Resources
Association of Public Health Laboratories. (2016, May). Guidance for State Medical Cannabis Testing Programs. Association of Public Health Laboratories.
Azwell, T., Ciotti, C., Adams, A., & Pauli, G.F. (2022). Variation among hemp (Cannabis sativus L.) analytical testing laboratories evinces regulatory and quality control issues for the industry. Journal of Applied Research on Medicinal and Aromatic Plants, 31, 100434. https://doi.org/10.1016/j.jarmap.2022.100434
Hazle,C., Hill, K. P., & Westreich, L. M. (2022). Workplace Cannabis Policies: A Moving Target. Cannabis and Cannabinoid Research, 7(1), 16–23. https://doi.org/10.1089/can.2020.0095
Jikomes, N., & Zoorob, M. (2018). The Cannabinoid Content of Legal Cannabis in Washington State Varies Systematically Across Testing Facilities and Popular Consumer Products. Scientific Reports, 8(1), 4519. https://doi.org/10.1038/s41598-018-22755-2
Kapur, B.M., & Aleksa, K. (2020). What the lab can and cannot do: Clinical interpretation of drug testing results. Critical Reviews in Clinical Laboratory Sciences, 57(8), 548-585.
Schwabe, A. L., Johnson, V., Harrelson, J., & McGlaughlin, M. E. (2023). Uncomfortably high: Testing reveals inflated THC potency on retail Cannabis labels. PLOS ONE, 18(4), e0282396. https://doi.org/10.1371/journal.pone.0282396
Shaffer, C. (2019). Medical Cannabis Poses Unique Testing Challenges. Genetic Engineering & Biotechnology News, 39(8), 22–24, 26. https://doi.org/10.1089/gen.39.08.07
Spindle, T.R., Cone, E. J., Schlienz, N.J., Mitchell, J.M., Bigelow, G.E., Flegel, R., Hayes, E., & Vandrey, R. (2019). Acute Pharmacokinetic Profile of Smoked and Vaporized Cannabis in Human Blood and Oral Fluid. Journal of Analytical Toxicology. https://doi.org/10.1093/jat/bky104
Valdes-Donoso, P., Sumner, D.A., & Goldstein, R. (2019). Costs of mandatory cannabis testing in California. California Agriculture, 73(3). https://doi.org/10.3733/ca.2019a0014
Wednesday Sep 04, 2024
Wednesday Sep 04, 2024
Medical or adult use? Which should you use? What are the differences? Are there differences? Currently in the United States, cannabis users have two legal options in states that have legalized either medical or adult-use cannabis. Although many of the differences between them are related to access, there are many other issues at hand when consumers make the decision to purchase at either a legal adult-use or medical dispensary.
In this episode of CNT, we highlight the differences between medical and adult-use cannabis, but keep in mind... it's all the same weed.
Episode Resources
French, M.T., Zukerberg, J., Lewandowski, T. E., Piccolo, K.B., & Mortensen, K. (2022). Societal Costs and Outcomes of Medical and Recreational Marijuana Policies in the United States: A Systematic Review. Medical Care Research and Review, 79(6), 743–771. https://doi.org/10.1177/10775587211067315
Gibson, L.P., Giordano, G.R., Bidwell, L.C., Hutchison, K.E., & Bryan, A.D. (2023). Acute Effects of Ad Libitum Use of Commercially Available Cannabis Products on the Subjective Experience of Aerobic Exercise: A Crossover Study. Sports Medicine (Auckland, N.Z.). https://doi.org/10.1007/s40279-023-01980-4
Lin, L.A., Ilgen, M.A., Jannausch, M., & Bohnert, K.M. (2016). Comparing adults who use cannabis medically with those who use recreationally: Results from a national sample. Addictive Behaviors, 61, 99–103. https://doi.org/10.1016/j.addbeh.2016.05.015
Page, R.L., Allen, L.A., Kloner, R.A., Carriker, C.R., Martel, C., Morris, A.A., Piano, M.R., Rana, J.S., & Saucedo, J.F. (2020). Medical Marijuana, Recreational Cannabis, and Cardiovascular Health: A Scientific Statement From the American Heart Association. Circulation, 142(10), e131–e152. https://doi.org/10.1161/CIR.0000000000000883
Szejko, N., Becher, E., Heimann, F., Grotenhermen, F., & Müller-Vahl, K.R. (2024). Medicinal Use of Different Cannabis Strains: Results from a Large Prospective Survey in Germany. Pharmacopsychiatry, 57, 133–140. https://doi.org/10.1055/a-2261-2269
Turna, J., Balodis, I., Munn, C., Van Ameringen, M., Busse, J., & MacKillop, J. (2020). Overlapping patterns of recreational and medical cannabis use in a large community sample of cannabis users. Comprehensive Psychiatry, 102, 152188. https://doi.org/10.1016/j.comppsych.2020.152188
Wednesday Aug 28, 2024
Wednesday Aug 28, 2024
In 2020, an estimated 209 million people around the world, or just less than four per cent of the global population, reported using cannabis in the past 12 months. Around the world, cannabis is being legalized or decriminalized and hundreds of thousands of patients are currently being treated with medicinal cannabis. Cannabis products are becoming increasingly diverse, and vary considerably in their concentrations of the one psychoactive cannabinoid found in cannabis, delta 9 tetrahydrocannabinol, also known as THC. It is in use of THC that we develop risks and harms from cannabis.
Currently, there is no standardized THC dose or measure that has been recommended by experts, and there are no approved treatments for THC intoxication. On this episode of Cannabis Nurse Truths, we review the concerns with standard THC dosing - just how high is too high?
Episode Resources
Bhaskar, A., Bell, A., Boivin, M., Briques, W., Brown, M., Clarke, H., Cyr, C., Eisenberg, E., de Oliveira Silva, RF., Frohlich, E., Georgius, P., Hogg, M., Horsted, T.I., MacCallum, C.A., Müller-Vahl, K.R., O’Connell, C., Sealey, R., Seibolt, M., Sihota, A., … Moulin, D.E. (2021). Consensus recommendations on dosing and administration of medical cannabis to treat chronic pain: Results of a modified Delphi process. Journal of Cannabis Research, 3(1), 22. https://doi.org/10.1186/s42238-021-00073-1
Freeman, T. P., & Lorenzetti, V. (2020). ‘Standard THC units’: A proposal to standardize dose across all cannabis products and methods of administration. Addiction, 115(7), 1207–1216. https://doi.org/10.1111/add.14842
Glare, P., Chye, R., Bloch, M., Arya, M., Moore, A., & Montgomery, J. (2023). Tolerability and Efficacy of a 10:25 Preparation of Δ9-Tetrahydrocannabinol and Cannabidiol for Treatment of Chronic Back or Neck Pain: A Multiple-Dose Escalation Study. Medical Cannabis and Cannabinoids, 6(1), 66–76. https://doi.org/10.1159/000531232
Leung, J., Stjepanović, D., Dawson, D., & Hall, W. D. (2021). Do Cannabis Users Reduce Their THC Dosages When Using More Potent Cannabis Products? A Review. Frontiers in Psychiatry, 12, 630602. https://doi.org/10.3389/fpsyt.2021.630602
Rozanc, J., Klumpers, L.E., Huestis, M.A., & Tagen, M. (2024). Tolerability of High-Dose Oral Δ 9 -THC: Implications for Human Laboratory Study Design. Cannabis and Cannabinoid Research, can.2023.0209. https://doi.org/10.1089/can.2023.0209
Wednesday Aug 21, 2024
Wednesday Aug 21, 2024
It is well known that individuals who use high doses of cannabis for a long period of time will develop tolerance to THC. To overcome tolerance to THC, there are two choices - use more THC or take a THC break, also known as a T- Break. Numerous online forums suggest varying ways to manage a T-Break; a recent Internet search resulted in over 36 million hits on how to reduce THC tolerance.
The problem with these online T-Break guides, however, is that none of them are empirically based, meaning that there is currently no evidence to support the methods suggested online. In this episode of Cannabis Nurse Truths, we consider the data related to cannabis tolerance and how numerous factors may interfere with your T-Break.
Episode Resources
Allsop, D. J., Copeland, J., Norberg, M. M., Fu, S., & Molnar, A. (2012). Quantifying the Clinical Significance of Cannabis Withdrawal. PLoS ONE, 7(9), e44864.
Ansell, E. B., Bedillion, M. F., Farris, S. R., Gilbert, J. M., Koch, M. M., & Thureen, S. E. (2023). Cannabis use breaks in young adults: The highs and lows of tolerance breaks. Drug and Alcohol Dependence, 249, 109951.
D'Souza, D., Cortes-Briones, J., Ranganathan, M., Thurnauer, H., Creatura, G., Surti, T., ... & Skosnik, P. (2015, December). Rapid changes in CB1 receptor availability in cannabis dependent males after abstinence from cannabis. In Neuropsychopharmacology (Vol. 40, pp. S589-S590).
Fontana, T. (2024). T-Break Guide: Take a Cannabis Tolerance Break. University of Vermont.
Fontana, T. J., Schulz, J. A., Budney, A. J., & Villanti, A. C. (2022). Feasibility and utility of a structured guide for cannabis tolerance breaks in young adults. Journal of American College Health, 1-5.
Ramaekers, J. G., Mason, N. L., & Theunissen, E. L. (2020). Blunted highs: Pharmacodynamic and behavioral models of cannabis tolerance. European Neuropsychopharmacology, 36, 191-205.
Spindle, T. R., Cone, E. J., Schlienz, N. J., Mitchell, J. M., Bigelow, G. E., Flegel, R., ... & Vandrey, R. (2019). Acute pharmacokinetic profile of smoked and vaporized cannabis in human blood and oral fluid. Journal of Analytical Toxicology, 43(4), 233-258.
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Wednesday Aug 14, 2024
Wednesday Aug 14, 2024
In 2018, the National Council of State Boards of Nursing published the National Nursing Guidelines for Medical Marijuana. This document provided a road map for nurses to learn and understand how cannabis works in the human body so that they could educate and assist our population as they began to use legal medical marijuana.
Fast forward to 2024, where cannabis nursing is now a recognized subspecialty of nursing, and cannabis nurses are poised to provide our population with safe and knowledgeable practice to promote patient safety as our population is increasingly finding that cannabis heals. On this episode of Cannabis Nurse Truths, we highlight how the American Nursing Association has led the way in providing professional guidelines for all nurses to practice cannabis nursing across the United States. Get ready... the cannabis nurses are going to heal the world.
Wednesday Aug 07, 2024
Wednesday Aug 07, 2024
Cannabis sativa L. is the botanical name for a family of plants that include three distinct types of cannabis. Cannabis has been used for centuries, long before the Christian era, in Asia, where it was used for construction, food, fabric, paper, and medicine. In modern society, we have confused the two cousins in this family, hemp and marijuana, and there is global confusion about differences within the plants. It doesn't help that marijuana has been demonized for decades and now, everyone is suffering from Reefer Madness as they think hemp is the devil's lettuce.
In this episode of Cannabis Nurse Truths, we break down the differences between hemp and marijuana and share why hemp will soon be part of every lifestyle in every culture around the world.
Wednesday Jul 31, 2024
Wednesday Jul 31, 2024
With over eight decades of research, we understand that there are over 500 compounds to be analyzed in cannabis. One of those compounds is a category known as terpenoids, familiarly known as terpenes or terps. Imagine walking through a pine forest and smelling pine, or how about through a field of lavender, and smelling that delicious, relaxing smell. If you are like me, I like my beer with hops, so imagine a hoppy beer smell or what citrus smells like. These are the compounds that are known as terpenes, and terpenes, while they are very great for what they do and smell like, they also have a physiological effect. In today's Cannabis Nurse Truths episode, we're going to discuss terpenes, because they are actually the 'bus drivers' of every cannabis effect known to man.
Wednesday Jul 24, 2024
Wednesday Jul 24, 2024
Our endocannabinoid system is primarily responsible for maintaining homeostasis, which is our body's balance of the internal environment against the external environment, and all living systems have an endocannabinoid system. Since the 1930s, our body's endocannabinoid system has lain dormant, as many of the processes in regulation of all of our body's systems require regular care and feeding. The issue at hand is - what do we feed this system with?
Well, as you can guess, we feed this system with endocannabinoids, either from our body or from a plant. A plant that is especially designed to interact with the systems for balancing and regulating our bodies to either maintain health or prevent disease. In this episode of Cannabis Nurse Truths, we explore Clinical Endocannabinoid Deficiency and why science is now making the case that we all carry this problem.