Cannabidiol (CBD) seems to reduce the unpleasantness of pain, a finding that surprised the researchers behind a new, first-of-its-kind study.
- Cannabidiol (CBD) is a compound of the cannabis plant that's significantly less psychoactive than THC, the active ingredient of marijuana.
- CBD is often used to treat chronic pain, but there's been a lack of empirical research on the cannabinoid's analgesic effects.
- The new study was designed to test whether CBD actually relieves pain or whether its perceived benefits are the result of expectations.
As more U.S. states ease regulations on marijuana, cannabis' second-most widely used compound, cannabidiol (CBD), has become one of the world's fastest-growing industries. Currently worth more than $1 billion, the industry is expected to grow to $16 billion by 2025. And that's largely due to the perceived therapeutic benefits of CBD.
One of the top three reasons people consume CBD is to treat chronic pain, according to a cross-sectional study of more than 2,400 CBD users. But can CBD actually treat pain?
Putting CBD to the test
A new study published in Experimental and Clinical Psychopharmacology is the first to explore that question using experimental pain trials. The results suggest that CBD really does treat pain, rather than just delivering a placebo effect at prices that sometimes match dispensary-grade marijuana.
"For science and the public at large the question remained, is the pain relief that CBD users claim to experience due to pharmacological effects or placebo effects," Martin De Vita, a researcher in the psychology department in the College of Arts and Sciences, said in a press release.
"That's a fair question because we know that simply telling someone that a substance has the ability to relieve their pain can actually cause robust changes in their pain sensitivity. These are called expectancy effects."
To differentiate between expectancy effects and genuine pharmacological effects, the researchers asked 15 healthy adults to participate in a study involving a device that induces controlled levels of heat pain. After assessing participants' initial response to the heat pain, they completed four sessions, each of which involved taking pure CBD oil or a placebo.
But the participants weren't always correctly told which was which. The sessions were structured like this:
- Participants were told the substance was a placebo, and were given a placebo
- Told it was CBD, given placebo
- Told it was placebo, given CBD
- Told it was CBD, given CBD
By structuring the study this way, the researchers "could parse out whether it was the drug that relieved the pain, or whether it was the expectation that they had received the drug that reduced their pain," De Vita said.
Human CBD Receptor ChartAbout time via Adobe Stock
"We hypothesized that we would primarily detect expectancy-induced placebo analgesia (pain relief). What we found though after measuring several different pain outcomes is that it's actually a little bit of both. That is, we found improvements in pain measures caused by the pharmacological effects of CBD and the psychological effects of just expecting that they had gotten CBD. It was pretty remarkable and surprising."
CBD didn't seem to reduce pain intensity, but participants who consumed it did report reductions in the unpleasantness of pain — even when they were told they were consuming a placebo. While reducing pain intensity might seem like the preferable metric, De Vita noted that pain exists not only in a sensory dimension but also an emotional one.
Effects of cannabidiol and expectancies on pain. Credit: De Vita et al.
"It's not sunshine and rainbows pleasant, but something slightly less bothersome," he said. "We replicated that in this study and found that CBD and expectancies didn't significantly reduce the volume of the pain, but they did make it less unpleasant—it didn't bother them as much."
Ultimately, the researchers said they were surprised to find that CBD's pain-relieving attributes extend beyond mere expectancy. But understanding exactly how CBD interacts with the body's pain-response processes, and how its analgesic aspects might help treat other conditions like anxiety, remain topics for further study.
It's "the biggest blow to the war on drugs to date," said Kassandra Frederique, executive director of the Drug Policy Alliance.
- Oregon voted to decriminalize possession of small amounts of all drugs, including heroin, cocaine and methamphetamine.
- The state also legalized the therapeutic use and sale of psilocybin mushrooms.
- As the laws go into effect, other U.S. states will be watching to see how the experiment plays out, influencing future votes across the country.
Amid the uncertainty of the unfolding U.S. 2020 presidential election, Americans decided one thing on November 3 with refreshing clarity and unity: It's time to move away from the war on drugs.
In the nine states where ballots featured legalization or decriminalization measures, all passed. That includes recreational and medicinal marijuana in South Dakota, medical marijuana in Mississippi, and recreational marijuana in Arizona, Montana and New Jersey.
But Oregon passed the most sweeping and historic reforms, voting to partially decriminalize all drugs—even heroin, cocaine and methamphetamine. Oregon's measure 109 also legalized the therapeutic sale and use of psilocybin mushrooms, which, as a new era of psychedelic research continues to show, have proven remarkably effective at treating conditions like depression, anxiety and post-traumatic stress disorder.
Of course, drug decriminalization isn't legalization. Oregonians caught in possession of small amounts of hard drugs will be fined $100, whereas they would've been fined up to $6,250 and sentenced up to a year in jail under the previous law. The initiative, called the Addiction Treatment and Recovery Act, also allows people caught with drugs to avoid paying the fine if they undergo a health assessment at an addiction recovery center.
"Today's victory is a landmark declaration that the time has come to stop criminalizing people for drug use," said Kassandra Frederique, executive director of the Drug Policy Alliance, which was behind the measure. "Measure 110 is arguably the biggest blow to the war on drugs to date."
Oregon made history tonight by becoming the first state to decriminalize drug possession! Our c4 @DrugPolicyAct led… https://t.co/s9pNxUn4HI— Drug Policy Alliance (@Drug Policy Alliance)1604462857.0
The new laws aim to reframe drug use as a public health issue.
"People suffering from addiction are more effectively treated with health care services than with criminal punishments," Oregon's initiative says. "A health care approach includes a health assessment to figure out the needs of people who are suffering from addiction, and it includes connecting them to the services they need."
Marijuana and hard drugs remain illegal on the federal level. But as Americans generally continue to shift toward favoring drug reforms, citizens and policymakers will be watching Oregon to see how the experiment plays out, and the outcomes will likely influence voters in other states. Here are a few things to keep an eye on.
Arrest and incarceration rates
Reduced arrest and incarceration rates for drug possession are likely to be the most obvious changes. The Oregon Criminal Justice Commission estimates that the new laws will reduce convictions for drug possession by about 90 percent, from 4,057 convictions in 2019, to a projected 378 in 2021.
The commission's report also estimates that drug convictions among Black and Indigenous Oregonians may drop by 94 percent, and that racial disparities in drug arrests could drop by the same amount.
If more Oregonians stay out of the criminal justice system, it could help more people find employment, housing, addiction services and student loans, all of which can be harder to access with a drug conviction on your record.
It's also conceivable that the new initiative will reduce contentious interactions between Oregonians and law enforcement, which, potentially, could lead to lower arrest rates for other infractions, and create fewer opportunities for police interactions to turn violent.
Alternatively, if the initiative frees up time and resources for Oregon law enforcement, the state could see arrests rise for other types of crimes. That may include arresting more dealers and traffickers, considering the new laws only apply to users carrying small amounts. If police focus on the suppliers, it will likely change the dynamics of Oregon's illegal drug trade.
Drug use rates
How will removing the threat of jail and steep fines change drug use and overdose rates? It's hard to say for sure, but Portugal's 2001 decision to decriminalize drugs provides some clues. In the years following decriminalization, the nation's drug overdose deaths and HIV infection rates dropped significantly, while drug usage either stayed constant or decreased.
That drug use remained constant or decreased may be because Portugal only decriminalized drugs, meaning drugs weren't legally available for purchase at something like a marijuana dispensary. But it's also worth noting that Portugal invested money in addiction treatment services, as Oregon plans to do with tax revenues from marijuana sales and savings on correctional services.
"Most accounts of the Portugal experiment have focused on decriminalization, but decriminalization was part of a broader effort intended to encourage treatment," Hannah Laqueur, an assistant professor in the Department of Emergency Medicine at the University of California, Davis, told The New York Times.
Oregon will be a particularly interesting case study for decriminalization's effects on drug usage, considering the state ranks among the worst for rates of addiction, use, and overdose.
Although Oregon plans to expand investments in treatment programs for drug users, some are worried the new initiative will discourage people from seeking help.
John Kitzhaber, a former E.R. physician in Oregon, called for Oregonions to reject the measure, writing on his blog:
"Measure 110 would eliminate this invaluable tool by reducing the possession of highly addictive drugs like heroin, cocaine, methamphetamine and oxycodone to a "violation," which means the court will no longer have the ability to offer people the choice to pursue treatment. It also means that a teenager caught in possession of heroin or meth will only receive a ticket, which in many counties means that parents won't be informed of their child's drug use."
Still, even if Oregon's measure reduces the number of people who get treatment, that wouldn't necessarily be an indictment of decriminalization writ large, but rather the specific way the state is allocating funds. Kitzhaber concluded his post with a sentiment shared by both drug reform advocates and some of the measure's opponents: "Incarcerating people who suffer from addiction should not be tolerated."
While many people don't think its all that bad, a new study suggests you should lay off while expecting.
- A new study suggests that smoking weed during pregnancy reduces birth weight and gestational age.
- The study follows on the heels of several others suggesting that marijuana has a variety of negative side effects.
- Despite this, many people still consider marijuana to be harmless.
What happens when you smoke for two
The study worked with 5628 pregnant women in Australia, New Zealand, Ireland, and the United Kingdom who were also part of a separate study investigating the relationship between marijuana use and pregnancy complications. These women had their demographic information, lifestyle characteristics, and medical history collected by a midwife.
All participants were asked if they ever smoked marijuana and, if so, if had they smoked it at any point during their pregnancy. Those who did smoke were further asked how many times a week they partook. Similar questions were asked for alcohol and tobacco usage. The midwives also recorded socio-economic data, noted if the test subject had used other illicit drugs during their pregnancy, and administered tests checking for depression and anxiety. After the test subjects gave birth, the midwives recorded infants' size and weight.
The babies born to women who smoked past the 15-week point in their pregnancies had lower birth weights, head size, body length, and lower gestational age. The reductions were comparable to the known effects of an expecting mother smoking nine cigarettes a day. These effects were more dramatic for children born to mothers who smoked more frequently. The risk of infant death and the rate of severe infant morbidity increased with the frequency of smoking as well.
Women who stopped smoking before the 15th week gave birth to babies with similar measurements to those born to women who did not smoke.
The evidence behind these findings remained even after factoring for tobacco and alcohol usage. While those lower on the socio-economic scale were more likely to continue smoking during pregnancy than others, their lower social standing was found to have no direct relation to birth outcomes.
The study was not without limitations. The number of women who reported continuing to smoke throughout their pregnancy was comparatively low, though not so small as to reduce the validity of the findings.
The researchers only looked at the number of times a person smoked and not at the potency of the marijuana or how it was consumed. They also looked at the effects of taking other illicit substances, but the number of women taking them was low enough to make serious investigation impossible during this study.
Perhaps most importantly, the study did not investigate what mechanism is at work. It could be simple carbon monoxide production by the act of smoking cutting down on oxygen that is getting to the fetus, as with tobacco smoking. Or it could be that the chemicals in marijuana were affecting the fetus. This is an area where further research is needed.
So, what does this mean for me?
The first take away here is that you shouldn't smoke weed while pregnant. The second is that it might not be too late to stop.
Previous studies have suggested that a lower gestational age at birth is associated with lower literacy later in life and that children in families with lower social standing start behind their wealthier peers in literacy tests. The finding here that lower-income women are more likely to smoke during pregnancy suggests that their children may be subject to particular difficulties.
The study is yet another one suggesting that marijuana isn't as harmless as many people suppose. The drug is known to cause memory trouble, anxiety, and increase the risk of psychotic symptoms. Previous studies similar to this one already hinted at the effects of smoking on the newly born. This one didn't break new ground so much as remove hidden variables in previous experiments on the same subject.
Despite this, up to a third of women think marijuana can't harm a gestating fetus, and the popular conception of the drug has yet to incorporate notions of its various adverse side effects.
Perhaps the take away for those who are not or cannot become pregnant is that marijuana isn't completely harmless and should be interacted with as such.
A new study on rats suggests that using marijuana as an adolescent "reprograms the initial behavioral, molecular, and epigenetic response to cocaine."
- In the study, adolescent and adult rats were first given a synthetic cannabinoid and then cocaine.
- The results showed that the young rats' brains were more sensitive to the effects of cocaine, but these effects weren't observed in the adult rats.
- The researchers suggest that research like this can help to develop better treatments for substance abuse disorders.
A new study suggests that using marijuana in your teenage years may prime your brain to respond positively to your first experience with cocaine. The findings offer molecular insight into the question of whether marijuana is a gateway drug. After all, studies have repeatedly shown that having a good first experience with a drug makes you more likely to use it again, and therefore potentially become addicted.
The study is published in the journal PNAS.
"We know from human epidemiological studies that individuals who abuse cocaine have a history of early cannabis use, and that a person's initial response to a drug can have a large impact on whether they continue to use it. But many questions remain on how early cannabis exposure affects the brain," epidemiologist Denise Kandel, PhD, a professor of Sociomedical Sciences in Psychiatry at Columbia's Vagelos College of Physicians and Surgeons and co-senior author of the new study, told Science Daily.
In the study, researchers gave a synthetic psychoactive cannabinoid called WIN 55,212-2 (WIN) to adolescent and adult rats. Then, both groups of rats were given cocaine, and the researchers monitored how the animals responded.
Fig 1. Cross-sensitization between WIN and cocaine in adolescent rats is associated with histone hyperacetylation in the PFC.
Scherma et al.
The results showed that young rats who had been exposed to WIN were more sensitive to the effects of cocaine. This early exposure "reprograms the initial behavioral, molecular, and epigenetic response to cocaine" in young rats. These changes were not observed in adult rats.
Past research has shown that young rats that have been exposed to cannabinoids become "cross-sensitized" to cocaine, and that cross-sensitization can alter the extent to which rats crave cocaine and experience withdrawal symptoms.
The new study took a close look at how cannabinoids prime bodily systems for cocaine.
Changes in the prefrontal cortex
One such system is the endocannabinoid system, which is impaired by the use of cannabis or cannabinoids. Studies have linked impaired endocannabinoid signaling with increased stress responsivity, negative emotional states, and drug craving.
"The endocannabinoid system has a modulatory role in brain reward and cognitive processes," the researchers wrote. "It has been hypothesized that repeated interference with endocannabinoid signaling (e.g., through abuse of cannabis or synthetic cannabinoids) can remodel the adolescent brain and make it respond differently to more addictive substances, such as cocaine. In the present study, we demonstrate that a history of synthetic cannabinoid exposure in adolescent animals results in distinct molecular and epigenetic changes following initial exposure to cocaine."
In addition to affecting the endocannabinoid system and (potentially) the glutamatergic system, the study found that early cannabinoid use seems to cause epigenetic changes in the prefrontal cortex. This area of the brain controls executive functions like long-term planning and self-control.
"Our findings suggest that exposure to psychoactive cannabinoids during adolescence primes the animals' prefrontal cortex, so that it responds differently to cocaine compared to animals who had been given cocaine without having previously experienced cannabis," study co-senior author Philippe Melas told Science Daily.
One consequence of priming the prefrontal cortex in this way seems to be that cocaine becomes more enjoyable.
"This study suggests that teenagers who use cannabis may have a favorable initial reaction to cocaine, which will increase their likelihood of engaging in its repeated use so that they eventually become addicted, especially if they carry additional environmental or genetic vulnerabilities," Kandel told Science Daily.
The researchers noted several limitations in their study, including:
- The use of experimenter-administered drug regimens instead of self-administration procedures
- The use of synthetic cannabinoids instead of Δ9-THC
- The assessment of neurobiological changes in bulk tissue instead of cell type-specific analyses
- The lack of in vivo causality experiments rendering the molecular data correlational in nature
They also noted that someone won't necessarily develop an addiction if they happen to have a good first experience with a drug. Still, they suggested that research like this can help to develop better treatments for substance abuse disorders.
"These and other experiments are key to understanding the molecular changes to the brain that occur during drug use," said Dr. Eric Kandel, who is also University Professor and Kavli Professor of Brain Science at Columbia. "This knowledge will be crucial for developing effective treatments that curb addiction by targeting the disease's underlying mechanisms."
Check out the curriculum for the nation's first cannabis-focused bachelor's program.
- Colorado State University-Pueblo will offer the first undergraduate weed degree in the U.S.
- The program will include intensive coursework focused on chemistry and advanced biology.
- Cannabis has become one of the fastest-growing job markets.
Weed can now get you a degree. A public university in southern Colorado has announced that it will offer the United State's first cannabis-focused major.
The new Cannabis Biology and Chemistry Program was created after students at Colorado State University-Pueblo expressed intense interest in the field. The "rigorous" science degree will include coursework focused on chemistry and advanced biology according to David Lehmpuhl, dean of CSU-Pueblo's College of Science and Mathematics. In other words, it isn't going to be a chill party degree. Dean Lehmpuhl emphasizes that students in the CBC program won't be working with anything that has a high amount of THC, the main psychoactive compound in weed.
The Colorado Commission on Higher Education passed the university's request for a cannabis-related degree earlier this month. Lehmpuhl recently told WBUR that the response has been "overwhelming."
"I've been fielding inquiries almost nonstop since the announcement came out," he said. "There's definitely a demand."
A budding industry
The ban on weed, which was outlawed in the 1930s, has only recently started to lift. Though it's still federally illegal, cannabis is now recreationally legal in 11 states plus Washington, D.C. It's also legal for medical usage in 33 states. As a result, cannabis has become one of the fastest-growing job markets. Forbes estimates that the industry is responsible for the employment of around 300,000 full-time workers.
"We kind of looked at the industry, and the sector as a whole, and what was needed for students to get jobs," said Lehmpuhl to Quartz. "We have a lot of businesses in the area that are clamoring for workers." In fact, CSU-Pueblo is also home to the state-funded Institute for Cannabis Research.
The new degree is intended to prepare students for opportunities to work in chemistry, biology, or natural products labs. That could mean jobs ranging from CBD extraction to analyzing soil chemistry.Though perceptions of marijuana and hemp have evolved over the last decade, the cannabis plant is still shrouded in cultural and political controversy. CSU-Pueblo's bachelor's program is not intended to be political or an attempt to legitimize cannabis consumption. It's rigidly focused on the scientific aspects of the weed plant. WBUR reports that Lehmpuhl wants the students to study the plant from an unbiased, scientific viewpoint that is neither pro- or anti-weed usage. He said that studying cannabis in relation to the human body, the industrial world, and the environment will bring new insights into the field, potentially revealing new "creative applications of the cannabis plant."
What the CBC program looks like
There's a cluster of U.S. schools that offer similar courses, certificates, and master's degrees in cannabis-centric studies for students looking to pursue the up-and-coming industry. Northern Michigan University, for instance, offers a degree in Medicinal Plant Chemistry with a capstone course named CH420 (haha). What's unique about CSU-Pueblo is that it is the first undergraduate program in the country to put the word cannabis in its name, which has resulted in media attention and a flood of inquiries from prospective students.
The major will offer two tracks students can choose from: one is "natural products," which places more emphasis on biological aspects of weed, while the "analytical" track focuses on chemistry. The program overview states that through the degree, "students will understand cannabis physiology and growth, the pharmaceutical implications, and the practical applications for the industry."
The CBC program will officially start in the fall semester of 2020 with courses that include Cannabis Physiology and Growth, Medicinal Chemistry and Pharmacology, Medicinal Plant Biochemistry, and Natural Products Extraction and Analysis. You can check out the program's full curriculum here.