MedReleaf Research Initiatives

1.

History of Medical Cannabis

Understanding the cultural and medical history of cannabis use is an important component to the successful integration of cannabis in modern clinical practices. This review chronicles over six thousand years of documented cannabis use in cultural practices, medical applications, breeding practices to enhance the pharmacological properties, and the various methods by which people have consumed the plant.

Andrew Hand, MSc, Alexia Blake, MSc, Paul Kerrigan, BSc, Phineas Samuel, and Jeremy Friedberg*, PhD
Location: MedReleaf Corp, Markham Industrial Park, Markham, Ontario, Canada
Correspondence: Dr. Jeremy Friedberg, MedReleaf Corp., Markham Industrial Park, Markham, Ontario, Canada, L3R 6C4, P.O. Box 3040. E-mail: jfriedberg@medreleaf.com Published in: Journal of Pain Management 2016;9(4):387-394 ISSN: 1939-5914 © Nova Science Publishers, Inc. 1276-1280.e1, October 2013.

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2.

The Pharmacological Properties of Cannabis

The efforts to understand the nature of how the consumption of cannabis affects the human body are ongoing, complex, and multifaceted. Documentation on the use of cannabis dates back thousands of years; however, it is only now with the recent softening of legal restrictions that modern research approaches have been able to initiate an appropriate level of detailed investigations For clinicians, researchers and policy makers, this paper reviews the general structure of cannabinoids, the current understanding of cannabinoids on cellular systems, the deference of inhalation and oral consumption on cannabinoid bioavailability, the variance among purified cannabinoids versus whole plant extract, and the potential activities of another prominent family of secondary metabolites found in cannabis, the terpenes.

Istok Nahtigal, MSc, Alexia Blake, MSc, Andrew Hand, MSc, Angelique Florentinus-Mefailoski, MSc, Haleh Hashemi, PhD, and Jeremy Friedberg*, PhD
Location: MedReleaf Corp, Markham Industrial Park, Markham, Ontario, Canada
Correspondence: Dr. Jeremy Friedberg, MedReleaf Corp., Markham Industrial Park, Markham, Ontario, Canada, L3R 6C4, P.O. Box 3040. E-mail: jfriedberg@medreleaf.com
Published in: Journal of Pain Management 2016;9(4):481-491 ISSN: 1939-5914 © Nova Science Publishers, Inc.

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3.

Plants as Medical Tools

Cannabis has been used for centuries for its fiber, food and as medicine. This review highlights the history of cannabis, its uses as a medical tool and the active ingredients found in this versatile plant. Many pain management pharmaceuticals widely accepted and used today, such as opioids and aspirin, contain plant derived extracts. The evolving cannabis story is paralleled to the history of current plant extracts used as pharmaceuticals. Usage, side effects and mortality rates of current pain medications are compared to cannabis and reveal great potential for cannabis as a safe and effective alternative in pain management.

Haleh Hashemi, PhD, Andrew Hand, MSc, Angelique Florentinus-Mefailoski, MSc, Paul Kerrigan, BSc, Phineas Samuel, BSc, and Jeremy Friedberg*, PhD
Location: MedReleaf Corp, Markham Industrial Park, Markham, Ontario, Canada
Correspondence: Dr. Jeremy Friedberg, MedReleaf Corp., Markham Industrial Park, Markham, Ontario, Canada, L3R 6C4, P.O. Box 3040. E-mail: jfriedberg@medreleaf.com
Published in: Journal of Pain Management 2016;9(4):493-504 ISSN: 1939-5914 © Nova Science Publishers, Inc.

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4.

Medical Cannabis: Four Patient Perspectives

The use of medical cannabis has been increasing in recent years. This paper provides the perspectives of four patients with very different clinical backgrounds and their reported experiences using medical cannabis. Not all patients respond the same way to cannabis and effective use requires a degree of experimentation as these patients’ perspectives illustrate. In these perspectives, it is important to note the reported effective management of specific symptoms, but also of importance is the reported improvement in general well-being and vast improvement in reported quality of life.

Jeremy Friedberg*, PhD
Location: MedReleaf Corp, Markham Industrial Park, Markham, Ontario, Canada
Correspondence: Dr. Jeremy Friedberg, MedReleaf Corp., Markham Industrial Park, Markham, Ontario, Canada, L3R 6C4, P.O. Box 3040. E-mail: jfriedberg@medreleaf.com
Published in: Journal of Pain Management 2016;9(4):517-519 ISSN: 1939-5914 © Nova Science Publishers, Inc.

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5.

Medical Cannabis and Patient Characteristics

Medical cannabis has been prescribed by physicians to treat a variety of symptoms including pain, nausea and vomiting, anxiety, depression, and sleep disorders in patients with severe or chronic illnesses. This paper presents the baseline demographics and characteristics of patients using medical cannabis in Canada. Patients were invited to complete a voluntary online survey after registering with a single medical cannabis provider. The survey included questions on demographics, medical history, current medical conditions and symptoms, and their corresponding severities. A total of 2,753 patients completed the survey (average age of 43.0 years old, SD=13.7). Patients were predominantly male (68.4%, n=1,882) and Caucasian (80.3%, n=2,089). Most patients were employed (49.4%, n=1133), while 18.7% (n=428) were retired, and 3.9% (n=89) were students. Of the surveyed patients, 25.1% (n=580) smoked tobacco cigarettes, and 74.9% (n=1782) reported having previous experience with cannabis. The most frequently reported conditions were anxiety disorder (31.7%, n=723), depression (31.6%, n=729), pain (29.5%, n=681), and sleep disorder (25.5%, n=589). The most frequently reported symptoms included pain (73.0%, n=2011), anxiety (72.6%, n=1998), and sleep problems (69.8%, n=1922). These findings are consistent with results from other North American studies, suggesting their generalizability in defining patient populations that may benefit from medical cannabis use. Understanding patient characteristics will be useful in informing the design of future clinical research initiatives and identifying the needs of patients using medical cannabis.

Bo Angela Wan, MPhil1, Alexia Blake, MSc2, Stephanie Chan, BSc(C)1, Amiti Wolt, BA2, Pearl Zaki, BSc(C)1, Liying Zhang, PhD1, Marissa Slaven, MD3, Erynn Shaw, MD3, Carlo DeAngelis, PharmD1, Henry Lam, MLS1, Vithusha Ganesh, BSc(C)1, Leila Malek, BSc(Hons)1, Edward Chow, MBBS1 and Shannon O’Hearn, MSc2
Location: 1Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada, 2MedReleaf, Markham, Ontario, Canada and 3Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada
Correspondence: Ms. Shannon O’Hearn MSc, Project Manager, Clinical Research, MedReleaf, Markham Industrial Park, Markham, Ontario, Canada. Email: sohearn@medreleaf.com
Published in: Journal of Pain Management

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6.

Medical Cannabis Symptom Clusters

Medical cannabis has been reported to be efficacious for managing symptoms associated with a variety of conditions, including cancer, anxiety, depression, and post-traumatic stress disorder. Symptom clusters have been identified in patients across a variety of conditions, and can be used by healthcare professionals to better manage patient quality of life. We aimed to identify baseline symptom clusters in patients registered with a Canadian medical cannabis provider. Principal component analysis (PCA) was performed using the PRINQUAL procedure to identify symptom clusters among the 10 most prevalent symptoms patients reported through a voluntary online survey administered after registration with their cannabis provider. The majority of respondents were male (69.2%), Caucasian (91.8%) and employed (50.9%). The average age of respondents was 46.5 years. Common conditions reported included chronic pain, sleep disorders, anxiety disorders, depression and post-traumatic stress disorder. Three clusters were identified using PCA, and displayed in biplots. Cluster 1 contained anxiety, depression, exhaustion, and sleep interference. Cluster 2 consisted of limited mobility, numbness, and pain. Cluster 3 included constipation, digestion problems, and headache. All clusters displayed good internal consistencies. Three symptom clusters were identified at baseline using PCA, with cluster 1 previously observed in cancer patients. The demographic and symptom profiles of respondents in the present study are also consistent with the limited literature that currently exists. Identifying symptom clusters in medical cannabis patients may allow physicians to make dosing and strain recommendations that will more effectively manage patients’ overall condition(s) and commonly associated symptoms.

Nicholas Lao, BMSc(C)1, Vithusha Ganesh, BSc(C)1, Liying Zhang, PhD1, Leah Drost, BSc(C)1, Bo Angela Wan, MPhil1, Alexia Blake1, MSc2, Stephanie Chan, BSc(C)1, Amiti Wolt, BA2, Pearl Zaki, BSc(C)1, Marissa Slaven, MD3, Erynn Shaw, MD3, Carlo DeAngelis, PharmD1, Henry Lam, MLS1, Leila Malek, BSc(Hons)1, Edward Chow, MBBS1 and Shannon O’Hearn, MSc2
Location: 1Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, 2MedReleaf, Markham, Ontario and 3Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada
Correspondence: Ms. Shannon O’Hearn MSc, Project Manager, Clinical Research, MedReleaf, Markham Industrial Park, Markham, Ontario, Canada. Email: sohearn@medreleaf.com
Published in: Journal of Pain Management

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7.

Cannabis in Common Conditions

The potential clinical utility of medical cannabis in the management of a wide variety of symptoms and conditions is gaining increasing attention. The present study investigated possible benefits and side effects associated with the use of cannabis in patients diagnosed with non-cancer-related conditions. All patients received cannabis from a single Canadian medical cannabis provider. 2,588 patients completed a voluntary online survey prior to the initiation of cannabis use, defined as baseline. Follow-up (FU) surveys were completed at 4 and 10 months after baseline. The survey collected information pertaining to patient demographics, medical conditions, presence and severity of symptoms, and quality of life (QOL). The most commonly reported medical conditions other than cancer were anxiety disorder (32.9%, n=713), depression (32.6%, n=706), sleep disorders (26.7%, n=579), post-traumatic stress disorder (PTSD) (22.6%, n=489), and arthritis (22.5%, n=488). At 4-month FU, a majority of patients demonstrated improvement in all conditions: arthritis (70.0%, n = 98), anxiety (77.5%, n=162), depression (71.6%, n=211), sleep disorders (79.2%, n=154) and PTSD (76.9%, n=160), with significant improvements seen in anxiety (p=0.0006), PTSD (p=0.006), and sleep disorders (p=0.0006). Reductions in symptoms and symptom severity, as well as improvement in QOL were also demonstrated at 4-month FU and remained stable from 4-month to 10-month FU. Pain severity was significantly reduced from baseline to 10-month FU (p<0.0001). To achieve optimal patient outcomes, future studies should investigate the efficacy of medical cannabis including effects of different cannabis varieties, doses, and methods of consumption when used for various medical conditions.

Pearl Zaki, BSc(C)1, Vithusha Ganesh, BSc(C)1, Shannon O’Hearn, MSc2, Amiti Wolt, BA2, Stephanie Chan, BSc(C)1, Liying Zhang, PhD1, Henry Lam, MLS1, Bo Angela Wan, MPhil1, Marissa Slaven, MD3, Erynn Shaw, MD3, Carlo DeAngelis, PharmD1, Leila Malek, BSc(Hons)1, Edward Chow, MBBS1 and Alexia Blake, MSc2
Location: 1Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, 2MedReleaf, Markham, Ontario and 3Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada
Correspondence: Ms Alexia Blake, MSc, MedReleaf Corp, Markham Industrial Park, Markham ON, Canada. E-mail: ablake@medreleaf.com
Published in: Journal of Pain Management

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8.

Cannabis in Cancer Patients

Therapeutic applications of medical cannabis within the cancer population, particularly for pain, treatment-related nausea and vomiting, and loss of appetite, have been investigated by few studies. The present study examined the efficacy of cannabis treatment for symptom relief among cancer patients receiving cannabis treatment from a single Canadian medical cannabis provider. Data was obtained from a voluntary online survey that consisted of questions related to demographic information, current medical conditions, presence and severity of symptoms, and quality of life (QOL). Follow-up (FU) surveys were completed at 4 and 10 months following initial use. 164 patients reported a current or previous diagnosis of cancer, of which the most common types of primary tumours were gastrointestinal (17.7%, n=29), breast (13.4%, n=22), leukemia and lymphoma (13.4%, n=22), gynaecologic (9.2%, n=15), prostate (7.3%, n=12), and lung (7.3%, n=12). While improvements were seen in commonly reported symptoms, including pain, depression, anxiety, exhaustion, and sleep problems, the observations were not statistically significant. Statistical significance was demonstrated in patients’ ability to cope with pain at 4-month FU (p<0.0001). QOL was stable from baseline to 4-month FU, where most reported good QOL (66.7%). Of associated QOL factors, only experience with sleep was found to be improved with statistical significance (p=0.02). Side effects of cannabis use included dry mouth, psychoactive effects, decreased concentration and memory, and sleepiness. Further studies are needed to determine the efficacy of medical cannabis in comparison to conventional first-line therapies for management of symptoms in cancer patients in both short- and long-term treatment.

Pearl Zaki, BSc(C)1, Alexia Blake, MSc2, Amiti Wolt, BA2, Stephanie Chan, BSc(C)1, Liying Zhang, PhD1, Angela Wan, MPhil1, Henry Lam, MLS1, Carlo DeAngelis, PharmD1, Marissa Slaven, MD3, Erynn Shaw, MD3, Vithusha Ganesh, BSc(C)1, Leila Malek, BSc(Hons)1, Edward Chow, MBBS1 and Shannon O’Hearn, MSc2
Location: 1Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; 2MedReleaf, Markham, Ontario, Canada; 3Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada
Correspondence: Ms Shannon O’Hearn MSc, MedReleaf Corp, Markham Industrial Park, Markham ON, Canada. E-mail: sohearn@medreleaf.com
Published in: Journal of Pain Management

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9.

Efficacy of Different Varieties of Medical Cannabis in Relieving Symptoms

Traditionally, cultivars of Cannabis sativa L. have been divided into sub-species based on their morphological properties, metabolic profile, and geographical origin. Interbreeding subspecies renders hybrids characterised by varying sativa and indica profiles, and unique cannabinoid ratios. As cannabinoid compounds like tetrahydrocannabinol (THC) and cannabidiol (CBD) are thought to be primarily responsible for the physiological effects of cannabis, unique strain profiles may provide different therapeutic benefits suitable for managing different symptoms and conditions. This study aims to assess the efficacy of different cannabis varieties in patients using medical cannabis from one Canadian licensed provider. Information pertaining to current medical conditions, symptoms, and quality of life were collected through a voluntary online survey administered to patients after registration, and at 4 and 10 month follow-up intervals. 837 patients provided information about their experience with medical cannabis at 4-month follow-up. Patients reported that the variety MidnightMR (sativa-leaning, 8-11% THC, 11-14% CBD) was most efficacious for reducing pain (27.4%), and that LuminariumMR (very sativa-dominant, 25-28% THC, 0% CBD) was effective for managing both anxiety disorder (30.4%) and depression (35.5%). Patients most commonly attributed improvements in sleep (29.0%), appetite (24.8%), and bowel function (24.6%) to MidnightMR, improvements in concentration (22.0%) to CognitivaMR (sativa-leaning, 15-18% THC, 0% CBD), and improvements in sexual function (26.5%) to LuminariumMR. The efficacy of different cannabis varieties in managing various symptoms should be further investigated in a controlled clinical setting, to enable patients and physicians to make informed decisions on which varieties are best suited to achieve optimal symptom management.

Bo Angela Wan, MPhil1, Patrick Diaz, PhD(C) 1, Alexia Blake, MSc2, Stephanie Chan, BSc(C)1, Amiti Wolt, BA2, Pearl Zaki, BSc(C)1, Liying Zhang, PhD1, Marissa Slaven, MD3, Erynn Shaw, MD3, Carlo DeAngelis, PharmD1, Henry Lam, MLS1, Vithusha Ganesh, BSc(C)1, Leila Malek, BSc(Hons)1, Edward Chow, MBBS1 and Shannon O’Hearn, MSc2
Location: 1Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, 2MedReleaf, Markham, Ontario and 3Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada
Correspondence: Ms. Shannon O’Hearn MSc, Project Manager, Clinical Research, MedReleaf, Markham Industrial Park, Markham, Ontario, Canada. E-mail: sohearn@medreleaf.com
Published in: Journal of Pain Management

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10.

Medical Cannabis Use in Military and Police Veterans Diagnosed with Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental illness with intrusive symptoms related to a traumatic event(s), usually treated with pharmacotherapy and psychotherapy. This study aimed to assess outcomes in military and police veterans with PTSD treated with medical cannabis, through a retrospective chart review. Veterans with PTSD using medical cannabis after unsuccessful pharmacotherapy and psychotherapy treatment were assessed in a single centre review at baseline and follow-up. Changes in outcomes and PTSD medications from baseline to follow-up were reported with percent change and effect size (ES) and then compared to the minimal clinically important difference. A total of 100 patients (97% male, average age 43 years old) were assessed from January 2014 to January 2016. The aggregate score of PTSD symptoms was reduced from a mean score of 7.0 at baseline to 2.9 at follow-up (59% reduction, ES 1.5, very large effect; p<0.0001). Suicidal thoughts decreased from 4.1 to 0.9 (77% reduction, ES 1.0, large effect; p<0.0001). The aggregate score for the impact of PTSD on social and family life was reduced from 6.6 to 2.7 (59% reduction, ES 1.2, large effect; p<0.0001). Pain severity decreased from an average of 6.6 to 3.4 (48% reduction, ES 1.5, very large effect). Consumption of PTSD-related medications reduced by 50% from baseline to follow-up. Treatment with medical cannabis in military and police veterans with PTSD who had failed conventional therapy resulted in significant improvements across all PTSD symptoms, as well as social and family impact outcomes and pain severity.

Paul A Smith, MD1, Stephanie Chan, BSc(C)2, Alexia Blake, MSc3, Amiti Wolt, BA3, Liying Zhang, PhD2, Bo Angela Wan, MPhil2, Pearl Zaki, BSc(C)2, Henry Lam, MLS2, Carlo DeAngelis, PharmD2, Marissa Slaven, MD4, Erynn Shaw, MD4, Vithusha Ganesh, BSc(C)2, Leila Malek, BSc(Hons)1, Edward Chow, MBBS2 and Shannon O’Hearn, MSc3
Location: 1Dr Paul Smith Professional Corporation, Fredericton, New Brunswick, 2Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario and 3MedReleaf, Markham, Ontario, Canada; 4Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada
Correspondence: Ms Shannon O’Hearn MSc, MedReleaf Corp, Markham Industrial Park, Markham ON, Canada. Email: sohearn@medreleaf.com
Published in: Journal of Pain Management

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11.

Efficacy of Different Varieties of Medical Cannabis in Relieving Symptoms in Post-Traumatic Stress Disorder (PTSD) Patients

Post-traumatic stress disorder (PTSD) is a crippling condition that affects individuals who have experienced severe traumatic event(s). Cannabis is emerging as a treatment option for patients experiencing PTSD. The objective of this study is to determine which varieties of cannabis PTSD patients perceive to be most effective for relieving their symptoms. PTSD patients using medical cannabis from a Canadian licensed provider voluntarily completed an online survey at baseline, 4 and 10 months, which collected information pertaining to their medical conditions, symptoms, and use of medical cannabis. The majority of PTSD patients reported improvement in all most commonly reported symptoms, including depression, anxiety, sleep problems, and pain, following the use of medical cannabis (p<0.0001). SedamenMR was reported to be effective in relieving overall PTSD at 4 and 10 months, and also helped manage each of the four common symptoms. LuminariumMR was also reported to be beneficial for PTSD at 4 and 10 months, as well as for depression, anxiety, and pain. AlaskaMR was reported beneficial for PTSD after 4 months as well as for depression, anxiety, and sleep problems. MidnightMR was reported to be effective in relieving PTSD after 10 months, and also was reportedly beneficial for all four common symptoms. Study results demonstrated that PTSD patients perceived notable differences in the effectiveness of cannabis varieties for managing their symptoms. Further research in a controlled clinical setting to determine which varieties manage PTSD symptoms most effectively will help clinicians make better recommendations to patients.

Leah Drost, BSc(C)1, Bo Angela Wan, MPhil1, Alexia Blake, MSc2, Stephanie Chan, BSc(C)1, Amiti Wolt, BA2, Vithusha Ganesh, BSc(C)1, Liying Zhang, PhD1, Marissa Slaven, MD3, Erynn Shaw, MD3, Carlo DeAngelis, PharmD1, Henry Lam, MLS1, Pearl Zaki, BSc(C)1, Leila Malek, BSc(Hons)1, Edward Chow, MBBS1 and Shannon O’Hearn, MSc2
Location: 1Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, 2MedReleaf, Markham, Ontario and 3Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada
Correspondence: Ms Shannon O’Hearn MSc, MedReleaf Corp, Markham Industrial Park, Markham ON, Canada. Email: sohearn@medreleaf.com
Published in: Journal of Pain Management

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12.

The Effect of Medical Cannabis on Alcohol and Tobacco Use in Veterans with Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental illness that commonly affects military and police service veterans after experiencing traumatic events throughout their service. Alcohol and tobacco are often overused by this population to help relieve the symptoms of PTSD. The objective of this paper is to examine if alcohol and tobacco use in military and police service veterans with PTSD changed after using medical cannabis for PTSD symptom management. A retrospective chart review was conducted to analyse information about alcohol, tobacco, and medical cannabis use, as well as previously attempted PTSD treatment methods. 101 patients (average age 43 years, 96.0% male, 60.4% married, and 81.2% with children) who visited a single treatment center between January 2014 and April 2016 were included in this study. The most common treatments patients tried prior to using medical cannabis included self-treatment with non-medical cannabis (87.8%), medication for depression (86.6%) and anxiety (85.4%), and psychotherapy (82.9%). At baseline, 81.2% consumed alcohol (average 8.1 drinks/week) and 84.2% smoked tobacco cigarettes (average 2.7 packs/week). At follow-up, 67.3% consumed alcohol (average 5.5 drinks/week) and 67.3% smoked tobacco cigarettes (average 2.5 packs/week). The use of medical cannabis was correlated with a reduction in alcohol and tobacco use. However, statistical significance was not reached (p=0.11 and p=0.65, respectively). Medical cannabis has the potential to reduce alcohol or tobacco use in PTSD patients. Further investigation is required to understand how medical cannabis can alleviate PTSD-related symptoms, and to identify its impact on other lifestyle factors, such as tobacco and alcohol consumption.

Shicheng Jin, MD(C)1, Bo Angela Wan, MPhil1, Stephanie Chan, BSc(C)1, Paul A Smith, MD2, Alexia Blake, MSc3, Amiti Wolt, BA3, Liying Zhang, PhD1, Henry Lam, MLS1, Carlo DeAngelis, PharmD1, Marissa Slaven, MD3, Erynn Shaw, MD3, Vithusha Ganesh, BSc(C)1, Pearl Zaki, BSc(C)1, Leah Drost, BSc(C)1, Nicholas Lao, BMSc(C)1, Leila Malek, BSc(Hons)1, Edward Chow, MBBS1 and Shannon O’Hearn, MSc3
Location: 1Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, 2Dr Paul Smith Professional Corporation, Fredericton, New Brunswick and 3MedReleaf, Markham, Ontario, Canada; 4Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada
Correspondence: Ms Shannon O’Hearn MSc, MedReleaf Corp, Markham Industrial Park, Markham ON, Canada. Email: sohearn@medreleaf.com
Published in: Journal of Pain Management

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MedReleaf Partner Research Initiatives

1.

A Review of Medical Cannabis in Cancer Pain Management

Opiates are often prescribed as a first-line analgesic treatment to reduce cancer-related pain. Cannabis and other cannabinoid-based medications, such as Sativex, may be prescribed as an alternative or adjunct analgesic treatment. A review of clinical trials involving cannabinoid-based treatments in advance cancer populations is presented below. The presented findings suggest that further research is needed to establish the efficacy of medical cannabis, either as an alternative to opiates or as an adjunctive therapy, and to identify how to dose and administer cannabis to achieve optimal analgesic efficacy with minimal side effects.

Alexia Blake, MSc, Shannon O’Hearn, MSc, and Carlo DeAngelis, Dpharm
Published by: Odette Cancer Centre – supplement to Hot Spot

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2.

A Review of Medical Cannabis in Post-Traumatic Stress Disorder (PTSD) Management

Post-traumatic stress disorder (PTSD) is a mental illness originating from experiencing or witnessing a severe traumatic event(s), resulting in debilitating symptoms in each of the four symptom clusters defined by the “Diagnostic and statistical manual of mental disorders, 5th 2 Edition” (DSM-5). PTSD is conventionally treated with pharmacotherapy and psychotherapy. Traditional pharmacotherapy for PTSD includes selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, adrenoceptor agonists or antagonists, anticonvulsants, antipsychotics and monoamine oxidase inhibitors (MAOIs). Recently, medical cannabis has emerged as a potential adjunct therapy, or alternative treatment option for managing PTSD symptoms when traditional methods are unsuccessful. The following review summarizes the findings of five recent studies investigating the safety and efficacy of medical cannabis in this patient population.

Nicholas Lao, BMSc, Shannon Ohearn, MSc, Alexia Blake, MSc and Carlo DeAngelis, DPharm
Published by: Odette Cancer Centre – supplement to Hot Spot

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3.

Overcoming the Bell‐Shaped Dose‐Response of Cannabidiol by Using Cannabis Extract Enriched in Cannabidiol

Cannabidiol (CBD), a major constituent of Cannabis, has been shown to be a powerful anti-inflammatory and anti-anxiety drug. However, a bell-shaped dose-response was observed, which limits its clinical use. In the present study, In stark contrast to purified CBD, the clone 202 (Avidekel) extract, provided a clear correlation between the anti-inflammatory and anti-nociceptive responses and the dose, with increasing responses upon increasing doses, making this plant medicine ideal for clinical uses.

Head Researcher: Dr R. Gallily. Zhannah Yekhtin, Lumír Ondřej Hanuš
Location: The Lautenberg Center for General and Tumor Immunology, The Hadassah Medical School, The Hebrew University of Jerusalem, Jerusalem, Israel.
Published in: Scientific Research Vol. 6 No.2, February 2015

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4.

Cannabis Induces a Clinical Response in Patients with Crohn’s Disease: a Prospective Placebo-Controlled Study.

Clinical research study that was conducted to examine whether or not cannabis brings about clinical and bio-chemical improvement in cases of active Crohn’s disease, without the use of steroids.

Head Researcher: Dr. Timna Naftali
Location: Gastroenterology Hospital: Meir Medical Center, Kfar Saba, Israel.
Published in: Clinical Gastroenterology and Hepatology, Volume 11, Issue 10, Pages 1276-1280.e1, October 2013.

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5.

Treatment of Crohn’s Disease with Cannabis: An Observational Study

The retrospective research study was conducted by interviewing 20 patients suffering from Crohn’s disease that were granted a license for medical cannabis treatment to measure the effectiveness of the treatment. The study has found very positive effects on the symptoms of the disease (number of bowel movements, quality of bowel activity, blood in stool samples, pain, etc).

Head Researcher: Dr. Timna Naftali, Gastroenterology
Location: Meir Medical Center, Kfar Saba, Israel.
Published in: IMAJ – The Israel Medical Association Journal, Volume 13, Pages 455-458, August 2011. 

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6.

The Effects of Cannabis on Dystonia and Spasticity of Cerebral Palsy Pediatric Patients

This clinical trial will examine the effects of cannabis on dystonia and spasticity in children with neurological diseases. The clinical trial will consist of 40 patients divided into four groups which will be administered either a 6:1 or a 20:1 ratio CBD-THC oil. The study will be carried out at the Wolfson Medical Center in Israel.

Head Researcher: Luba Blumkin, Wolfson Medical Center 

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