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Medical Marijuana for Autism

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Medical Marijuana for Autism

 

Although the research on cannabis and autism spectrum disorders is in its infancy, there has been much controversy and confusion. Over the years, more patients and their families are seeking guidance from doctors on using cannabis to alleviate symptoms. From preventing seizures to calming aggression, a slow trickle of research is suggesting that cannabidiol (CBD), a component of cannabis, may be the wonder drug families have been searching for. But does it hold up to this standard? Should we be recommending it to patients? How do we weigh the benefits and the risks?

Unfortunately, many clinicians lack adequate training on the subject, making them unprepared to have a meaningful discussion with patients and families. Efforts to advance research have been limited for technical and logistical reasons, often leaving doctors with just as many questions as patients.

Cannabis: An Overview

Cannabis is a genus of flowering plants belonging to the family Cannabaceae that includes 3 species: cannabis sativa, indica, and ruderalis. Marijuana specifically refers to the parts of the cannabis plant that contains high amounts of delta-9-tetrahydrocannabinol (THC). Medicinal use of the cannabis plant dates back thousands of years in cultures all around the world. Today, it is used to treat an assortment of conditions, such as arthritis, cancer, HIV/AIDS, glaucoma, seizures, and more.

Used recreationally, it produces a high or mind-altering effect when smoked or consumed. It is also used therapeutically. The National Institute on Drug Abuse defines medical cannabis as “using the whole, unprocessed marijuana plant or its basic extracts to treat symptoms of illness and other conditions.”1

The plant produces more than 500 different chemical substances. These include 100 unique cannabinoids, which bind to the CB1 and CB2 receptors in the body’s endocannabinoid system. CB1 receptors are more common in the central and peripheral neurons, while CB2 receptors are expressed only in peripheral tissues, predominating the immune system.2

THC and CBD are 2 cannabinoids found in cannabis that have particular clinical importance.3

In medical applications, THC is typically used to relieve pain, nausea, insomnia, and poor appetite. THC is a partial agonist of the CB1 and CB2 receptors.4 It produces the high, which is why it is included in so many recreational marijuana products.

CBD is less controversial than THC because it does not produce mind-altering or euphoric effects. It has low affinity for CB1/CB2, acting as an antagonist.5 It affects various receptor systems in the body (TRPV1, GPR55, PPAR.) Of note is its agonism on the 5HT1A (serotonin) receptor at high concentrations to help with anxiety, sleep, pain perception, and nausea.6 It also appears to be a partial dopamine receptor agonist, pointing toward its possible antipsychotic properties. Additionally, CBD appears to influence the glutamate-GABA system.7

Endocannabinoids are naturally occurring lipid mediators in the body that bind to the cannabinoid receptors. Unlike other neurotransmitters, they are produced on demand in the body and are quickly inactivated. The most common ones include: N-arachidonoylethanolamine (anandamide), 2-arachidonylglycerol (2-AG), and 2-arachidonylglyceryl ether.

Anandamide, also known as the “bliss molecule,” is currently one of the most-studied endocannabinoids.8 The cannabinoid receptor system has a very complex role in the body, which includes regulation of cell function, maintenance of homeostasis, motor coordination (basal ganglia), brain reward system, stress response, memory function (hippocampus), appetite, modulation of pain, and reduction of inflammation.

Anandamide causes inhibition of the release of neurotransmitters such as glutamate and gamma aminobutyric acid (GABA). It also affects norepinephrine, dopamine, serotonin, histamine, prostaglandins and opioids.9 An imbalance in the GABA and glutamate system is often linked with autism.

The Challenges of Autism

Autism spectrum disorder (ASD) is a neurodevelopmental disability characterized by impairment in 3 major domains: social interaction, communication, and behavior patterns. It is called a spectrum disorder because it has a broad range of severity and symptom type. These usually appear within the first few years of life, although it can be diagnosed at any age.

In 2016, 1 in 54 children by the age of 8 was diagnosed with ASD, according to Centers for Disease Control and Prevention statistics. This was a 10% increase over 2014, when the estimate was 1 in 59. Boys are 4 times more likely than girls to be diagnosed.10

The causes of autism are not clearly understood. It is a complex disorder thought to be multifactorial in origin, involving genetic and environmental factors.11 It is associated with several conditions, such as Fragile X, Rett syndrome, tuberous sclerosis, phenylketonuria, and certain genetic conditions involving the deletion or duplication of chromosomes. Additionally, roughly 20% to 25% of individuals with autism are diagnosed with epilepsy at some point during their lives. Intellectual disability is also highly prevalent in autism, and there is a close association with seizure risk in autistic individuals.6

Environmental factors being explored by research include viral infections, air pollutants, dietary factors, medications, and perinatal complications. Other common risk factors include children born to older parents, siblings of affected children (especially in the case of identical twins), and a family history of autism.11,12

There are no medications that address autism’s core symptoms. Existing medications are used to target comorbid symptoms such as anxiety or mood symptoms and aggressive behavior. But these may not be very effective and often cause several side effects, limiting their use.

The Case for and Against

With autism cases on the rise, the need for effective treatments is rising too. Treatments in childhood carry special risks and potential rewards. Because a child’s brain is still developing, it is a good opportunity to make significant changes, but for the same reason, it is a dangerous time to experiment with certain compounds like THC and cannabis. Many of us have encountered desperate families who have found traditional treatments inadequate or resulting in undesirable side effects. At their wit’s end, they are willing to try just about anything. By not approaching the topic, patients and families may seek unsubstantiated advice on the Internet, leading them to use substandard and potentially dangerous products in an unregulated market.

Today, cannabis is easily accessible and popular with millions of Americans, but as noted, cannabis can be a mixture of many things. While the federal government considers cannabis a Schedule I drug, it has been legalized in 33 states and Washington, DC. Meanwhile, CBD is a schedule 5, the lowest degree of regulation by the US Food and Drug Administration. As a treatment for autism, cannabis has been prescribed in 14 states since 2019, according to the Autism Support Network.13

Whether we accept cannabis as a psychiatric treatment or not, our patients and their families are curious and interested in learning about all options. That is why it is vital for us as psychiatrists to educate ourselves on the use of cannabis to treat autism spectrum disorder (ASD), recognizing that the both the risks and benefits of use in ASD are indirect and insufficient. This might be the only way we can guide our patients to weigh all the facts before making a treatment choice.

Current Research Results

Research on cannabis’ impact on autism is still very much in its infancy, but there are several important studies to consider, with more on the way. In a 2018 Stanford University study, anandamide concentration was significantly lower in children with ASD as compared to controls.14 Research studies have suggested that anandamide produces effects similar to, but less intense than, those associated with THC.15 Because of this similarity, researchers theorize THC has therapeutic potential in the treatment of autism.

Another study in 2013 found an increased expression of CB2 receptors in peripheral blood mononuclear cells in autistic children, suggesting an imbalance in the endocannabinoid system.16 Oxytocin is a neuropeptide crucial for social behavior, and studies indicate the oxytocin-driven anandamide signaling system may be defective in autism patients, leading researchers to theorize whether CBD can correct this.17

Terpenoids are aromatic compounds present in the cannabis plant that give each strain its unique smell. Cannabinoids and terpenoids are thought to interact with each other as well as the brain in an entourage effect to produce synergistic results. This effect potentially increases the therapeutic value and tames the mind-altering effects of THC in a product. Similarly, there is some evidence proposing that the simultaneous use of THC and CBD is more effective than either alone. While still theoretical, it explains why both are often used together in medical applications.18 Further, the ratio of THC to CBD in a preparation determines the fine balance between its therapeutic use and mind-altering effects.

Epidiolex is the first CBD prescription approved by the US Food and Drug Administration (FDA) in 2018 to treat seizures associated with Lennox-Gastaut syndrome (LGS), Dravet syndrome (DS), and tuberous sclerosis (TS) in patients as young as 1 year old. It does not contain THC. This approval was based on 3 double-blind randomized controlled trials (RCT) and an open label extension study for LGS and DS, and one RCT for TS, all with positive findings.19-22 About 25% of children with treatment-resistant epilepsy have comorbid ASD. Both LGS and DS have been commonly linked to ASD.

It is important to note that medical cannabis has its own significant side effects (Table 1). A 2012 research study by Duke University found that persistent users of cannabis had reduced neuropsychological functioning, with adolescent onset users experiencing greater decline in IQ and executive functioning.23 These effects did not reverse fully on stopping cannabis use for one year or more, suggesting it has potential neurotoxic effects.

Another study shows that cannabis use in adolescence can significantly increase the risk of developing psychotic symptoms and persistent use can precipitate psychotic disorders in later life.24 Studies have also shown that cannabis use and the development of psychosis in adolescents is dose-dependent, with poorer outcomes associated with an earlier age and higher frequency of use.24

One 2015 to 2017 study conducted in Israel sought to gauge the safety and efficacy of cannabis.25 It observed 188 autism patients, most of whom were treated with an oil containing 30% CBD and 1.5% THC. It was not placebo controlled. After 6 months of treatment, parameters of activities of daily living, mood, and quality of life were assessed. It found that 30.1% of patients reported significant improvement, 53.7% moderate and 6.4% slight improvement, while 8.6% experienced no change to their condition. About 25% of self-reporting patients experienced at least 1 side effect from the treatment, the most common of which was restlessness. The study concluded that CBD and THC in autism patients appeared to be well-tolerated, safe, and effective.

In 2018, a study conducted at the Shaare Zedek Medical Center assessed the effect of a whole plant cannabis extract (20:1 CBD:THC ratio) on 60 autistic children with severe behavioral problems.26 Parents reported that 61% of behavioral symptoms in patients had either “much improved” or “very much improved,” 39% of children experienced improved anxiety level, and 47% improved in communication. Additionally, 24% of children were able to stop taking medication, 30% received either lower dose or fewer medications, while 8% had to increase medication intake. The incidence of side effects and adverse effects was quite high, reported by 57 parents. Common side effects included hypervigilance leading to sleeping difficulty (14%), irritability (9%), loss of appetite (9%), and restlessness (9%).

In another Israeli study published in 2019, 53 children with autism were given a 20:1 ratio CBD to THC dose for a median duration of 66 days in order to study its effect on comorbid symptoms with ASD.27 Symptoms were assessed every 2 weeks through phone call interviews with parents. Changes in individual symptoms cohorts were compared to available data from published studies. Of note, significant improvement was noted in self-injury and rage attacks (67.6%), hyperactivity symptoms (68.4%), sleep problems (71.4%), and anxiety (47.1%) within the groups of patients reporting these symptoms. The overall improvement in ASD comorbidities was calculated to be 74%. Common side effects included somnolence and reduced appetite.

It is important to note, however, that the aforementioned studies are limited because they were observational studies conducted without a placebo control group for comparison. Additionally, results were based on parental reports, which may have been heavily influenced by expectations, thus undermining results.

Adi Aran, MD, MSc, PhD, the Shaare Zedek study’s26 lead author, recently published a double-blinded, randomized placebo-controlled trial in February 2021 to study the role of cannabis in autism further.28 The study used 2 oral cannabinoid solutions (whole plant extract and purified forms of cannabis) with a 20:1 CBD to THC ratio along with a placebo. The purpose was to assess behavioral problems in 150 children and youth with autism with a unique crossover design that included 2 phases of 12 weeks, separated by a 4-week washout phase. It showed mixed results with no difference in one of the primary and secondary outcomes among the groups.

The study assigned 2 primary outcome measures to assess behavioral problems: the Home Situation Questionnaire-ASD (HSQ-ASD) and the Clinical Global Impression-Improvement scale, with anchor points related to behavioral difficulties (CG-I). Secondary outcomes were measured by the Social Responsiveness Scale-second edition (SRS-2,) the Autism Parenting Stress Index (APSI) and modified Liverpool Adverse Events Profile. There was no difference in the total score of HSQ-ASD and APSI between the groups. However, disruptive behavior assessed by CGI-I scale was “much” or “very much” improved in 49% of participants who were given a whole-plant extract, versus 21% of participants on placebo (P = .005). The SRS-2 scale median score also improved by 14.9% on plant extract versus 3.6% placebo (P = .009). Common side effects included somnolence and decreased appetite. The study advised caution that while the CBD/THC solution was well-tolerated, the study had several limitations. The data on efficacy was mixed or insufficient, warranting more research.28

A study conducted by the Institute of Psychiatry, Psychology, and Neuroscience at King’s College in London used magnetic resonance spectroscopy to examine the effects of a single oral dose of CBD versus a placebo on the brains of 34 male participants, half of whom were diagnosed with autism.29 It is important to note that the study excluded any comorbid major psychiatric or neurological conditions, including traumatic brain injury, certain genetic disorders linked with autism, low IQ, and those receiving medicines with effects on glutamate-GABA pathways. The study found that while CBD affected the glutamate-GABA systems, the prefrontal-GABA systems responded differently in patients with autism. The authors were clear that the results did not apply to the efficacy of CBD.

Future Trials

There are other clinical trials currently underway that are worth following to see what they discover. Children’s Hospital of Philadelphia recently completed an observational study in collaboration with Zelda Therapeutics, an Australian biopharmaceutical company, to track children with autism who are independently using medical cannabis to address symptoms. Results have not been published yet.30 Another ongoing phase 2, 12-week double-blind, randomized, placebo-controlled trial study, funded by the US Department of Defense, is studying how behavior in children with autism might be affected by cannabidivarin, a nonpsychoactive phytocannabinoid, which is a safer alternative to CBD.31

The University of San Diego is conducting a phase 3 clinical trial in partnership with the Wholistic Research and Education Foundation through the Center for Medicinal Cannabis Research. It seeks to explore the role of CBD on behavioral symptoms in children with autism.32 The University of Colorado, Denver, is currently also recruiting participants for a randomized placebo-controlled study with a predetermined crossover design to assess CBD’s impact on common behavioral problems related to autism.33 All participants will receive CBD for at least 12 weeks. Some will receive CBD for the entire 27 weeks of treatment.

New York University’s Langone Health research facility is in the recruiting stage for a 6-week open trial to study CBD use in participants aged 7 to 17 with autism. It will assess dosing, symptoms changes, side effects, and primary and secondary outcomes to guide future controlled studies.34

Barriers to Research

While interest grows in cannabis, the medical community is eager for more research on how it might affect autism. In the United States, tight controls and a lack of adequate funding limits how cannabis is studied.

The National Institute on Drug Abuse (NIDA) contracts with the University of Mississippi, the only facility in the country registered with the Drug Enforcement Agency (DEA) to grow and supply the cannabis that scientists are allowed to study. However, these strains are often not the ones widely distributed to the public in states that have legalized medical cannabis.

Different strains of cannabis have diverse chemical variations, according to Donald Abrams, MD, an integrative oncologist at Zuckerberg San Francisco General Hospital and Trauma Center.35 Products with higher amounts of THC, for example, are often used to treat cancer-related nausea and poor appetite, while CBD tends to be used for chronic pain, inflammation, and insomnia. Abrams also pointed out that NIDA’s supply included mostly low-THC, zero-CBD strains, which can challenge researchers struggling to move with the times and study emerging products on the market. NIDA’s focus on substance abuse also means it is more focused on the negatives of cannabis, rather than any potential benefit.

Even NIDA has acknowledged federal limitations on cannabis research. In 2015, Nora Volkow, MD, NIDA’s director, spoke before the US Senate Caucus on International Narcotics Control.36 She acknowledged application barriers to research and the lack of well-controlled clinical trials. She also noted CBD’s potentially positive effect on a variety of symptoms, including children with drug-resistant epilepsy.

Approval to conduct cannabis research comes from both the FDA and the DEA. The process takes more than a year, with some researchers waiting even longer. Strict protocols govern how cannabis is stored, requiring limited access in an alarm-controlled, locked container physically attached to a floor or wall, according to the UCSF report.35 These obstacles create a catch-22 for medical marijuana research, according to the State of Cannabis Research Legislation in 2020, a report led by Ali Zarrabi, MD, associate director of outpatient support and palliative care at Emory University.37

“Investigators cannot conduct research on cannabis until they demonstrate that it has a medical use, and they cannot show that it has a medical use until they conduct research,” the report states.37

Treading With Caution

The American Academy of Child and Adolescent Psychiatry discourages the use of marijuana and cannabinoids in children with autism, a stance that has not changed despite the FDA’s approval to use cannabidiol to treat seizures. The American Academy of Pediatrics holds a similar stance, although it acknowledges it may provide an option for children with life-limiting or severely debilitating conditions when current therapies are inadequate.

Despite these cautions, individuals with any number of ailments are flocking to cannabis for treatment. But there is a huge gap between the desire for treatment and the research needed for doctors to give approval. Additionally, it is rare for any cannabis curriculum to be included in residencies and fellowships, but this is changing.

We are taught to practice evidence-based medicine as psychiatrists, placing the highest importance on meta-analysis and well-designed double-blinded RCT in research. Most psychiatrists try to adhere to the established standards of evidence-based medicine. However, there are times when we prescribe medications for off-label purposes based on clinical experience, often with reasonable or good results. Could CBD be used in the same way, especially in cases where we are hitting a dead end with existing treatment strategies?

There is some anecdotal evidence that cannabis can positively affect autism. But there is a lack of well-designed clinical trials with adequate sample sizes to study its efficacy and assess for safety. We need to study pure CBD separate from pure THC, without the confounding unknown effects of other molecules present. At this time, however, clinical trials of THC in individuals under the age of 20 are probably unwise.

As of today, we lack evidence-based recommendations to support CBD and cannabis use in children with autism. We lack guidelines on overall safety and efficacy, as well as factors like dosage, the required ratio of CBD to THC, symptoms that will likely respond, and the duration of treatment. We also lack guidance on how to discuss this sensitive topic with our patients, who may be asking for advice and are ready to pursue it on their own. See Table 2 for some tips on how to advise patients.

Therefore, psychiatrists must direct patients and families in their approach toward this treatment option with exercised caution to its risks, benefits, and costs. Additionally, they must understand the data that does exist, and then explain that current data, with its significant lack of evidence-based results, to our patients and their families.

Dr Parmar is a double board-certified adult and child psychiatrist with Community Psychiatry based in Newark CA. She earned her medical degree at Terna Medical College & Hospital in Mumbai, India.

References

1. National Institute on Drug Abuse. Marijuana as medicine. Drug Facts. Accessed May 21, 2021. https://www.drugsandalcohol.ie/18946/1/marijuanamedicinedrugfacts_july2019_.pdf

2. Pertwee RG. The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: delta9-tetrahydrocannabinol, cannabidiol and delta9-tetrahydrocannabivarin. Br J Pharmacol. 2008;153(2):199-215.

3. Freeman TP, Hindocha C, Green SF, Bloomfield MAP. Medicinal use of cannabis based products and cannabinoids. BMJ. 2019;365:1141.

4. Pertwee RG. The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: delta9-tetrahydrocannabinol, cannabidiol and delta9-tetrahydrocannabivarin. Br J Pharmacol. 2008;153(2):199-215.

5. Parker LA, Rock EM, Limebeer CL. Regulation of nausea and vomiting by cannabinoids. Br J Pharmacol. 2011;163(7):1411-1422.

6. Hrdlicka M, Komarek V, Propper L, et al. Not EEG abnormalities but epilepsy is associated with autistic regression and mental functioning in childhood autism. Eur Child Adolesc Psychiatry. 2004;13:209-213.

7. Agarwal R, Burke SL, Maddux M. Current state of evidence of cannabis utilization for treatment of autism spectrum disorders. BMC Psychiatry. 2019;19:328.

8. Scherma M, Masia P, Satta V, et al. Brain activity of anandamide: a rewarding bliss? Acta Pharmacol Sin. 2019;40(3):309-323.

9. Fišar Z. Cannabinoids and monoamine neurotransmission with focus on monoamine oxidase. Prog Neuropsychopharmacol Biol Psychiatry. 2012;38(1):68-77.

10. Centers for Disease Control and Prevention. Data & statistics on autism spectrum disorder. Accessed May 21, 2021. https://www.cdc.gov/ncbddd/autism/data.html

11. Chaste P, Leboyer M. Autism risk factors: genes, environment, and gene-environment interactions. Dialogues Clin Neurosci. 2012;14(3):281-92.

12. Durkin MS, Maenner MJ, Newschaffer CJ, et al. Advanced parental age and the risk of autism spectrum disorder. Am J Epidemiol. 2008;168(11):1268-1276.

13. Buglione N. Marijuana madness. Autism Support Network. Accessed May 21, 2021. http://www.autismsupportnetwork.com/news/autism-treatment-marijuana-madness-8763721

14. Karhson DS, Krasinska KM, Dallaire JA, et al. Plasma anandamide concentrations are lower in children with autism spectrum disorder. Mol Autism. 2018;9:18.

15. Justinova Z, Solinas M, Tanda G, et al. The endogenous cannabinoid anandamide and its synthetic analog R(+)-methanandamide are intravenously self-administered by squirrel monkeys. J Neurosci. 2005 ;25(23) :5645-5650.

16. Siniscalco D, Sapone A, Giordano C, et al. Cannabinoid receptor type 2, but not type 1, is up-regulated in peripheral blood mononuclear cells of children affected by autistic disorders. J Autism Dev Disord. 2013;43:2686-2695.

17. Wei D, Lee D, Cox CD, et al. Endocannabinoid signaling mediates oxytocin-driven social reward. Proc Natl Acad Sci U S A. 2015;112(45):14084-14089.

18. Russo EB. Taming THC: potential cannabis synergy and phytocannabinoid‐terpenoid entourage effects. Br J Pharmacol. 2011;163(7):1344-1364.

19. Devinsky O, Patel AD, Cross JH, et al. Effect of cannabidiol on drop seizures in the Lennox-Gastaut syndrome. N Engl J Med. 2018;378(20):1888-1897.

20. Thiele EA, Marsh ED, French JA, et al. Cannabidiol in patients with seizures associated with Lennox-Gastaut syndrome (GWPCARE4): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2018;391(10125):1085-1096.

21. Devinsky O, Cross JH, Laux L, et al. Trial of cannabidiol for drug-resistant seizures in the Dravet syndrome. N Engl J Med. 2017;376(21):2011-2020.

22. US Food and Drug Administration. FDA approves new indication for drug containing an active ingredient derived from cannabis to treat seizures in rare genetic disease. July 31, 2020. https://www.fda.gov/news-events/press-announcements/fda-approves-new-indication-drug-containing-active-ingredient-derived-cannabis-treat-seizures-rare#:~:text=Today%2C%20the%20U.S.%20Food%20and,year%20of%20age%20and%20older

23. Meier MH, Caspi A, Ambler A, et al. Persistent cannabis users show neuropsychological decline from childhood to midlife. Proc Natl Acad Sci U S A. 2012;109(40):E2657-64.

24. Kuepper R, van Os J, Lieb R, et al. Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study. BMJ. 2011;342:d738.

25. Bar-Lev Schleider L, Mechoulam R, Saban N, et al. Real life experience of medical cannabis treatment in autism: Analysis of safety and efficacy. Sci Rep. 2019;9(1):200.

26. Aran A, Cassuto H, Lubotzky A, et al. Brief report: Cannabidiol-rich cannabis in children with autism spectrum disorder and severe behavioral problems-a retrospective feasibility study. J Autism Dev Disord. 2019;49(3):1284-1288.

27. Barchel D, Stolar O, De-Haan T, et al. Oral cannabidiol use in children with autism spectrum disorder to treat related symptoms and comorbidities. Front Pharmacol. 2019;9:1521.

28. Aran A, Harel M, Cassuto H, et al. Cannabinoid treatment for autism: a proof-of-concept randomized trial. Mol Autism. 2021;12(1):6.

29. Pretzsch CM, Freyberg J, Voinescu B, et al. Effects of cannabidiol on brain excitation and inhibition systems; a randomised placebo-controlled single dose trial during magnetic resonance spectroscopy in adults with and without autism spectrum disorder. Neuropsychopharmacology. 2019;44(8):1398-1405.

30. Children’s Hospital of Philadelphia. Medical cannabis registry and pharmacology (Med Can Autism.) Updated January 27, 2020. https://clinicaltrials.gov/ct2/show/NCT03699527

31. Hollander E. Cannabidivarin (CBDV) vs. placebo in children with autism spectrum disorder (ASD). Updated February 18, 2021. https://clinicaltrials.gov/ct2/show/NCT03202303

32. Trauner D. Trial of cannabidiol to treat severe behavior problems in children with autism. Updated August 18, 2020. https://clinicaltrials.gov/ct2/show/NCT04517799?term=epidiolex&cond=Autism&draw=1&rank=1

33. University of Colorado, Denver. Cannabidiol study in children with autism spectrum disorder (CASCADE). Updated Febrauary 26, 2021. https://clinicaltrials.gov/ct2/show/NCT04520685

34. NYU Langone Health. Cannabidiol for ASD open trial. Updated January 14, 2021. https://clinicaltrials.gov/ct2/show/NCT03900923

35. Wells J. Dazed and confused: marijuana legalization raises the need for more research. University of California San Francisco. June 20, 2017. https://www.ucsf.edu/news/2017/06/407351/dazed-and-confused-marijuana-legalization-raises-need-more-research

36. Volkow N. The biology and potential therapeutic effects of cannabidiol. National Institute on Drug Abuse. June 24, 2015. https://archives.drugabuse.gov/testimonies/2015/biology-potential-therapeutic-effects-cannabidiol

37. Zarrabi AJ, Frediani JK, Levy JM. The state of cannabis research legislation in 2020. N Engl J Med. 2020;382(20):1876-1877.

CBD

CBD Capsules or Oils – Which Is Better?

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CBD is popular today; From tinctures to creams, there are many types of CBD products that anyone can use. But before buying it is necessary to know how each of them reacts in the body or on the skin. Choosing a particular product will depend on a person’s preferences and wellness goal.

Hence, it is important to know how each product works and what the health benefits are. Many CBD products are popular, but the most common are oils and capsules. Are the oils better than the capsules? We will discuss each and how they work for our benefit. We will also highlight the factors that should influence your choice.

This article does not necessarily reflect the opinion of the editors or management of EconoTimes.

What is a CBD capsule?

This capsule is made from 100% organic ingredients. Although similar to oil tinctures, CBD pills are made using a different process. Cannabidiol is obtained as an isolate from the hemp plant.

This powder substance is then filled into a gelatin capsule or a capsule with cannabidiol oil. Coconut powder is added because it contains MCT, which improves the rate of absorption of cannabidiol in the body.

What is CBD Oil?

This is hands down the most popular CBD product out there. It’s more common among CBD enthusiasts than other products. One drop of this oil contains full-spectrum cannabidiol, which has been shown to be beneficial for the body system.

It is extracted using various methods. One popular method is carbon dioxide extraction, which produces safe, non-toxic and natural oil. There are three common types of CBD oil: full spectrum, broad spectrum, and isolate.

The full spectrum contains all cannabinoids including THC (this is contained in a trace amount of 0.3%). The broad spectrum, on the other hand, contains all cannabinoids except THC (which can be found in traces). Then the isolates only contain cannabidiol.

What’s better between CBD capsules and oils?

To answer this question well, let’s look at some key differences and how they relate to each product.

1. Bioavailability

This refers to how a drug is absorbed by the body. The process takes place in the digestive system. Water-based products tend to be absorbed faster by the body than oils. This is because much of the body is made up of water.

But CBD oil is absorbed into the body faster than the capsules. It is deposited under the tongue and goes straight into the bloodstream instead of our digestive system. But the capsule goes to the digestive organs, as a result of which it slowly dissolves and is absorbed by the body. You can visit https://dailycbd.com/en/cbd-bioavailability/ for more information on CBD bioavailability.

2. Dosage

Both products are easy to measure. You can measure the required amount of oil with a pipette. A capsule also contains a certain amount of cannabinoid.

However, capsules are better than oil in this regard as human error allows you to ingest a large dose of oil with the dropper. However, this is not possible with capsules unless you just want to overdose.

3. Ease of use

Unlike the oils, it’s easier to swallow capsules without making a mess. There is the ease of transportation with the pills. But with oils, you might be concerned about spilling and contaminating them. When visible, people may not notice you are taking the pills, but the oils are more noticeable.

4. Versatility

Due to its nature, cannabidiol oils are easily absorbed into beverages and foods. You can easily add it to your cereal or coffee. This is not possible with the capsules because they are sealed in soft gels. You can also give your furry friends CBD oils, but not the pills.

5. Taste

The oils taste bland and grassy. If you have very sensitive taste buds, you may find it difficult to like these tinctures. However, you can swallow the tablets quickly with water, so you hardly know what it tastes like.

CBD Capsules or Oils – Factors That Should Influence Your Choice

Before choosing a product, you should consider the following factors:

1. Your lifestyle

The way you live your life can affect which one is better for you. If you are a busy person who works in an office and you need an accurate CBD measurement, a capsule is the best choice for you. If you travel a lot, capsules are better so you don’t have to worry about spilling.

2. The purpose it will serve

CBD is amazingly effective in the body. Each product can serve different purposes when ingested. If you have anxiety or insomnia, the oils are perfect for regulating your sleep. However, if you are having digestive issues, capsules are a great choice.

3. Onset time

If you want a product that works faster, go for the oil tinctures. They are easily absorbed into the bloodstream. Capsules are slower because the body digests them first before they enter the bloodstream. If you want the effects of CBD to last a long time in your system, go for the capsules. You can read this article to learn more factors that should influence your choice.

Conclusion

Both oils and capsules have maximum benefits for the human body. The decision to go with one of the others is based on personal preference, your lifestyle, what you need and how you plan to use it. If you want quick action, an easily absorbed, and versatile product, CBD oils are perfect for you. But if you want extended potency, easy to travel and use, go for the capsules.

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CBD

Pure Craft CBD Launches Vegan, Nano-Infused Delta-8 THC Gummies – WRCBtv.com

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SAN DIEGO, April 20, 2021 / PRNewswire / – Pure Craft CBD, a CBD brand that uses nanotechnology to create premium bioavailable products, is launching delta-8-THC gums in response to growing consumer demand. All Pure Craft CBD products are vegan and come with a third-party laboratory analysis certificate (COA) so consumers know exactly what’s in them and how they were tested.

The nano-infused Delta-8 gummies are each enriched with 25 mg of the nano-optimized Delta-8 THC from Pure Craft CBD. They come in different flavors of watermelon, lemon, raspberry, and orange. The Delta-8 rubbers are in 30-count jars for the price of. available $ 55.

The rubbers are available here: https://purecraftcbd.com/products/nano-delta-8-infused-vegan-gummies.

Delta-8 THC is one of over 112 cannabinoids found in the hemp plant. Delta-8 THC was federally legalized by the 2018 Farm Bill, which allows all derivatives, isomers, and cannabinoids of hemp with the exception of Delta-9 THC. Delta-8 can produce some psychotropic effects that are less potent than Delta-9 THC.

“We are proud to bring these vegan Delta-8 gummies to market,” said Jason Navarrete, an 18 year old cannabis industry veteran who is the CEO, owner, and founder of Pure Craft CBD. “Delta-8 THC is the next big cannabinoid and our goal is to offer the purest, highest quality products on the market. These gums are organically grown, vegan, GMO-free and aromatic and at the same time offer an additional effect for consumers who want more than CBD. “

Pure Craft CBD also recently launched Immune Boost CBD gummies, a vegan product fortified with 25 mg of Pure Craft CBD’s nano-optimized broad-spectrum CBD. The rubbers, available in jars of 30 for $ 55, provide additional immune system support through elderberry, vitamin C and zinc.

As with its immune boosting gums and regular gums, Pure Craft CBD not only focuses on absorption by nano-optimizing its broad spectrum CBD, it also ensures that the product does not have a bitter, flaky, and green aftertaste.

Pure Craft CBD products, all made in FDA-approved laboratories, follow the strictest guidelines and quality controls, making them pharmaceutical grade. They are 90% bioavailable, which means that Pure Craft CBD products get into the body much faster as they are highly nanotized and broken down into particles that the body can absorb immediately.

While many CBD companies trying to nanotize their product have hit 150-200 nanometers, Pure Craft CBD has broken that threshold to below 100 nanometers and, in some cases, down to five nanometers.

All Pure Craft CBD products come with third-party laboratory COAs (Certificates of Analysis) so consumers know exactly what is in them and how it has been tested. Pure Craft CBD offers 16 different cannabis products and free two-day shipping.

For more information and to purchase the vegan Delta-8 rubbers, visit www.PureCraftCBD.com.

About Pure Craft CBD:
Pure Craft CBD believes in a “seed-to-sale” philosophy to offer high quality products that are consistently made with full transparency. Its mission is to bring the industry to market in bringing high quality hemp cannabidiol (CBD) -based products to market and educating the world about the benefits of hemp extract. The product line includes nano-optimized, water-soluble, broad-spectrum CBD tinctures, as well as soft gels, vegan gums, CBD with melatonin, CBD animal tincture, and CBD broad-spectrum oil. Please visit https://purecraftcbd.com/ for more information.

Purecraft is federally compliant with the Farm Bill 2018.

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CBD

How CBD Can Help With Sunburn

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June 14, 2021 6 minutes to read

This story originally appeared on Cannabis.net

CBD has great potential to heal the skin from sun damage

Summer is just around the corner. It’s almost time for us to dive into beaches and pools. Take tours to beautiful places and just enjoy the warmth of the sun on our skin. Wonderful activities to do, meet people and places to see.

As such, it is not uncommon for many of us not to take enough precautions to protect our skin. Although taking some time to apply and reapply sunscreen, despite these precautions, sometimes they still suffer from excruciating sunburns.

Related: Why CBD and Turmeric Can Help With Inflammation

Aloe is widely used around the world to correct the effects of sunburn, but this article would examine whether or not cannabidiol products are a good option for treating sunburn.

Many of us, regardless of skin tone or age, have experienced the inflammation and reddening of the skin after being outdoors for too long. Fortunately, sunburn has several natural remedies, each of which takes a certain amount of time to produce results.

This is how sunburn works

The sun gives off ultraviolet (UV) rays, and the skin has a limited number of UV rays that it can tolerate. When this limit is reached, these rays begin to trigger or trigger an inflammatory response in the body. Some compare this inflammation to scalding yourself with something hot.

UV rays come in two forms, UVA and UVB rays. The first has a longer wavelength and can cause very severe damage such as aging and cancer growth, while the second has a shorter wavelength and is responsible for sunburns.

Fortunately, our skin can tolerate passive sunburn episodes and, with the right products, can repair damaged cells. Care must be taken not to damage the skin too much than it can tolerate.

The immune system and sunburn

Sunburn can be divided into first-degree or second-degree burns, depending on the extent of the damage. Medical professionals claim that sunburn on its own cannot cause third degree burns. Sunburn can only damage the outer and lower layers of the skin; that is the epidermis and dermis.

The immune system works immediately to correct the damage caused as soon as the skin is no longer exposed to these harmful rays. Several symptoms are noticed a few hours after exposure. Some of these symptoms are:

  • Redness

  • Pain

  • nausea

  • Cold

  • Peeling the skin

  • fever

  • Weakness

  • Passes out

  • Low blood pressure

Patients often state that they can spend several hours in the sun without feeling anything, only to come home and notice these symptoms.

CBD and sunburn

Studies have shown that CBD has anti-inflammatory effects. It has been used to treat conditions such as muscle pain in rheumatoid arthritis and neuropathic pain. It has also been shown to be effective in patients with psoriasis and acne. Because of this, researchers believe that CBD would be a great option for sunburn prevention or aftercare.

Dr. Jeanette Jacknin, a state-certified dermatologist, claims that CBD has high potential for healing the skin from sun damage. She based her claims on studies showing the hearing effects of CBD on wounds.

Although there is still a lot of research to be done. Meanwhile, it has been suggested that CBD could be blended into existing sunburn precautions.

Accordingly, CBD compounds have been extracted and infused into lotions for their anti-inflammatory magical effects.

Related: CBD Vaping: What’s the Difference Between CBD E-Liquid and CBD Oil?

CBD lotion

Preclinical research is currently being conducted to examine the effects of CBD not only on sunburn, but on other dermatological inflammatory diseases as well.

At least science has established that our skin is a complex ecosystem that is partially modulated by the existing endocannabinoid system. Yes! They have cannabinoid receptors all over your skin. These receptors react uniquely with CBD. Another reason these CBD lotions can have antibacterial properties when used.

CBD compound can affect how the user feels and thinks, thereby minimizing the symptoms perceived by the user. Most of these benefits are not yet clearly defined, but some of the benefits that have justified their use as the main ingredient in skin care lotions include:

  1. Inability to get the user high.

  2. Very low toxicity.

  3. Can soothe irritated skin.

  4. Reduce the rate of skin aging.

  5. Works well with other ingredients.

  6. Promotes a balanced immune response.

Using CBD products for sunburn

Topical creams and lotions infused with CBD compounds are effective for localized effects. These lotions are applied directly to the affected areas. The results can be observed a few hours after use.

First-time users are always advised to apply a very small amount to unaffected areas of skin to observe reactions. In addition to CBD lotions, CBD tinctures, capsules, vapes and oils can also be taken.

Oral ingestion of CBD can help combat the psychological effects of sunburn; especially if the physical symptoms have been successfully treated.

The lack of toxicity of CBD compounds makes it easy to experiment with different approaches. In this way, the best application method can be chosen. For example, the most suitable method for you is to apply CBD cream directly and consume a few drops of CBD oil under your tongue.

You may not know until you try.

Related: Why It’s Not Too Late To Enter The CBD Market

Is CBD the Best Way to Treat Sunburn?

Humans have a different genetic makeup, the amount of sunburn that can irreparably damage your skin cells can be different from mine. Hence, prevention is the best way to treat sunburn.

When choosing a sunscreen that or not contains CBD, try to review the ingredients used and choose one with broad spectrum protection that will protect against both types of UV rays.

Remember that the sun doesn’t have to shine that much for your skin to burn. Most UV rays can penetrate the clouds and get to you.

Basic care for sunburn

If you’ve tried everything and symptoms persist, contact your doctor as soon as possible.

With further research, the viable therapeutic benefits of CBD for sunburns are being discovered and used to create better lotions for quick relief of patients.

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