Medical Marijuana/Psychadelics Flashcards
1
Q
Legalities
A
- Illegal at the federal level.
~ Research in the US greatly limited. - Medical and/or recreational access in 48 states.
~ Illegal in Nebraska and Idaho.
~ Legal in D.C.
2
Q
Cannabis
A
- Contains over 480 biochemical compounds.
~ Cannabinoids
> THC
> CBD
3
Q
Endocannabinoids
A
- Plant cannabinoids mimic the action of
endocannabinoids.
~ Endocannabinoids and their receptors
are found throughout the human
body including the nervous and
immune systems.
> Similar to the opioid system.
4
Q
Endocannabinoids: Receptors
A
- Two main receptors:
~ СВ1
~ CB2
> Both bind with endocannabinoids
and plant cannabinoids.
> THC has good affinity for both
receptors
> CBD affinity is low for both
receptors
5
Q
CB1 Receptors
A
- High concentration in the central and peripheral nervous systems.
~ Found in both GABA and Glutamate
releasing neurons
> Binding to CB1 can be excitatory or
inhibitory depending on the
neurons involved
6
Q
Effects of CB1 Binding: Food
A
- Increases food intake when neurons in area of the brain that control feeding are excited (“munchies”)
- Increases odor detection, which can increase feeding behavior.
- Good for AIDs and cancer patients experiencing weight loss
7
Q
Effects of CB1 Binding: Glaucoma
A
- Mechanism is not clear, but there are CB1 receptors in most eye tissues related to glaucoma.
~ May decrease aqueous humor
production - MM can decrease intraocular pressure (25%), but effect lasts only 3-4 hours.
8
Q
Effects of CB1 Binding: Antiemetic
A
- Decreases nausea & vomiting.
~ Shown to be as effective if not more
effective than prescription antiemetic
drugs
~ THC shown to inhibit both control and
peripheral nerve impulses - Good for cancer pts. going through chemo
9
Q
Effects of CB1 Binding: Pain
A
- Inhibit pain afferents centrally and peripherally
- May indirectly affect opioid receptors by increasing endogenous opioid production or release.
~ Studies do support the pain reducing
properties of cannabinoids.
~ Studies show that when cannabinoids
are used with opioid medication the
amount of opioid medication needed
is reduced.
10
Q
Effects of CB1 Binding: Multiple Sclerosis
A
- Autoimmune disease affecting myelin covering of nerves.
- Can result in motor, sensory and cognitive dysfunction.
- MM used mostly to manage the pain and muscle spasticity associated with the disease.
~ Does appear to reduce pain and
perception of spasticity through CNS
nerve inhibition
~ Doesn’t appear to reduce to actual
spasticity - Because of the distribution of CB2 receptors in the immune system there may be some efficacy in modulating the autoimmune mechanism for the disease.
11
Q
CB2 Receptors
A
- High concentrations throughout the immune system.
~ Bone Marrow - Monocytes
~ Spleen - B-Cells
~ Thymus - T-Cells
12
Q
Effects of CB2 Binding: Inflammatory Response
A
- Inhibitory to the inflammatory response
~ Reduces inflammation associated
with atherosclerotic plaque
development.
> Heart Attack
> Stroke
13
Q
Effects of CB2 Binding: Osteoblasts
A
- Enhances osteoblasts reproduction and activation
~ Good for Osteoporosis
14
Q
OTC “Supplements”: CBD Oil
A
- OT CBD comes from hemp rather than marijuana plants.
~ The Charlotte’s Web strain has been
reclassified as hemp because of the
low THC levels. - CBD oil can also come from the marijuana plant, but it’s not OTC
15
Q
Epilepsy
A
- Some anecdotal evidence that MM can help those with epilepsy.
~ Recent study does show efficacy. - Focus is on those with forms of treatment resistant epilepsy.
~ Dravet Syndrome
> Pt. has 1,200 seizures over the
course of a month - Inhibits neurons in the brain
~ CBD is favored since it doesn’t have
psychoactive properties (no high)
16
Q
Psychedelics Legalities
A
- Ilegal at the federal level.
~ MDMA - 3,4-methylenedioxy-
methamphetamine
~ LSD - lysergic acid diethylamide
~ Psilocybin
~ Converted to psilocin.
17
Q
Psychedelics Exceptions
A
- Denver - decriminalized psilocybin/psychedelic mushrooms.
- Somerville, Cambridge, D.C., Oakland, Santa Cruz, Ann Arbor - decriminalized entheogenic plants and fungi.
~ Plants used for religious purposes/
ceremonies - Oregon
~ Legalized psilocybin for medical use.
~ Decriminalized for personal use,
schedule I - IV drugs.
18
Q
Serotonin/5-HT Receptors
A
- Found in central and peripheral nervous systems.
- Receptors are activated when bound to serotonin.
~ 7 general types with a number of
sub-types.
~ Role in mood, cognition, sex drive,
memory. - Psilocin and LSD are 5-HT receptor agonists (takes place of serotonin)
- In addition to stimulating serotonin receptors, these drugs appear to change connections between areas of the brain, changing throughout patterns
19
Q
Dopamine Receptors
A
- Found in the CNS.
~ 5 general types.
~ Role in locomotion, attention, sleep,
memory, learning, reward.
~ LSD is also a D2 receptor agonist - May also have a role in changing connections within the brain
- Over stimulation can result in delusions, hallucinations, disorganized behavior, and cognitive difficulties
~ Not good for Schizophrenia or Bipolar
Disorder
20
Q
MDMA
A
- Appears to inhibit the transporters required for reputake of serotonin, norepinephrine, and dopamine
~ Increases amounts of these chemicals
available for binding to target tissues/
receptors.
~ Interacts strongest with serotonin
transporters.
21
Q
Psychedelic Clinical Applications
A
- Since LSD, psilocin, and MDMA appear to affect SE and dopamine receptors, and or levels of SE, NE, and dopamine, recent studies have examined their use in treatment of mental health conditions.
~ Depression
~ Anxiety
~ PTSD - One study examining use of psilocin showed 71% of subjects experienced
50% reduction in major depression symptoms. 50% of all subjects experienced remission of the condition.
