Alexandersenhoffmann8639

license when deciding whether to serve a CRB client. The study also found that a Certified Public Accountant must commit to acquiring and maintaining substantial specialized knowledge related to tax Code Section 280E, internal controls for a cash-only or cash-intensive business, and the workings of the cannabis industry under the current regulatory conditions.

CRB owners need to carefully consider the industry knowledge and experience of a potential Certified Public Accountant prior to engaging them. This study shows that US Certified Public Accountants should weigh the risk of federal prosecution and potential loss of the Certified Public Accountant license when deciding whether to serve a CRB client. The study also found that a Certified Public Accountant must commit to acquiring and maintaining substantial specialized knowledge related to tax Code Section 280E, internal controls for a cash-only or cash-intensive business, and the workings of the cannabis industry under the current regulatory conditions.Δ9-Tetrahydrocannabivarin (THCV) is a cannabis-derived compound with unique properties that set it apart from the more common cannabinoids, such as Δ9-tetrahydrocannabinol (THC). The main advantage of THCV over THC is the lack of psychoactive effects. In rodent studies, THCV decreases appetite, increases satiety, and up-regulates energy metabolism, making it a clinically useful remedy for weight loss and management of obesity and type 2 diabetic patients. The distinctions between THCV and THC in terms of glycemic control, glucose metabolism, and energy regulation have been demonstrated in previous studies. Also, the effect of THCV on dyslipidemia and glycemic control in type 2 diabetics showed reduced fasting plasma glucose concentration when compared to a placebo group. In contrast, THC is indicated in individuals with cachexia. However, the uniquely diverse properties of THCV provide neuroprotection, appetite suppression, glycemic control, and reduced side effects, etc.; therefore, making it a potential priority candidate for the development of clinically useful therapies in the future. Hopefully, THCV could provide an optional platform for the treatment of life-threatening diseases.

In 2018, the Farm Bill mandated the United States Department of Agriculture to develop regulations governing the cultivation, processing, and marketing of industrial hemp. Industrial hemp is defined as Cannabis sativa L. with a total Δ-9-tetrahydrocannabinol (Δ-9-THC) content ≤0.3%. Therefore, for hemp to become an agricultural commodity, it is important to regulate production by developing standard methods for sampling and testing of the plant material.

An ultra-performance liquid chromatography-tandem mass spectrometry analytical method for the quantification of twelve cannabinoids was developed. The method was applied to a regulatory sampling trial of three hemp varieties cultivated for cannabidiol (CBD) production. Two samples were taken from 28 plants with one sample being flower only while the other was a composite sample that included flowers, leaves, and stems.

The assay method was validated for specificity, range, repeatability, reproducibility, and recovery in accordance with all applicable standards for analytical methods. The results of the regulatory study indicated a significant decrease in the concentration of total Δ-9-THC and total CBD of 0.09% and 1.32%, respectively, between a flower only and a composite sample.

There are many factors that may influence reported total Δ-9-THC content in industrial hemp. A robust analytical method was developed to analyze hemp samples in a trial regulatory study. The results indicate that the way hemp is sampled and analyzed may influence the legality of a crop, which could have negative economic and legal consequences.

There are many factors that may influence reported total Δ-9-THC content in industrial hemp. A robust analytical method was developed to analyze hemp samples in a trial regulatory study. The results indicate that the way hemp is sampled and analyzed may influence the legality of a crop, which could have negative economic and legal consequences.The purpose of this review is to advance the field of applied cannabis research by providing insights into the patenting of medical cannabis and current intellectual property rights (IPR) data.Medical cannabis (MC) patent and plant breeders' rights (PBR) registrations are filed on industrially applicable aspects of research. Studying the filing data and trends informs researchers of both gaps in current applied knowledge in MC (where patents have not been filed) and prior knowledge (where patents have already been filed).Our focus is on those intellectual property rights (IPR) that are registered and germane to technical innovations in MC and related products. These are patents and PBR and thus exclude trade secrets, copyrights, franchises, or trademarks. Methods used for surveying the defined IPR landscape include searches of publicly available patent and PBR data and classifying the data according to the upstream-midstream-downstream innovation paradigm of the MC industry.The findings suggest that the techne industry briefly discussed. Patent data on leading and emerging patentee companies and institutions are shown. We also provide evidence of prior art and freedom to operate.

People report using cannabis as a substitute for prescription medications but may be doing so without the knowledge of their primary health care providers (PCPs). This lack of integration creates serious concerns, e.g., using cannabis to treat medical conditions that have established treatment options.

We conducted an anonymous, cross-sectional online survey among patrons of a medical cannabis dispensary in Michigan (n = 275) to examine aspects of their relationship with their PCP and their perceptions of PCP knowledge related to cannabis.

Overall, 64% of participants initiated medical cannabis use based on their own experiences vs. 24% citing advice from their PCP. Although 80% reported that their PCP knew they currently used medical cannabis, 41% reported that their PCP had not always known. Only 14% obtained their medical cannabis authorization from their PCP. Only 18% of participants rated their PCP's knowledge about medical cannabis as very good or excellent and only 21% were very or completely conghlight the need for standardized physician education around appropriate medical cannabis use.

Nowadays, medical cannabis still remains inaccesible for patients in the former Union of Soviet Socialist Republics (USSR). Even registered medicinal products based on herbal or synthetic cannabinoids, like Sativex, are practically unavailable due to their high cost and narrow scope of application (for example, in Lithuania). However, before the absolute prohibition of medical cannabis in the USSR, in line with Single Convention of 1961, the State Pharmacopoeia of the USSR (eighth edition) published monographs on such medicinal products as "Herba Cannabis indicae", "Extractum Cannabis indicae spissum" and "Fructus Cannabis", which could be prescribed by physicians with precaution.

Formation of a holistic approach aimed at the creation of appropriate conditions for the development of medical cannabis market and the improvement of life quality and health of Ukrainian patients.

We analyzed legislation and regulation mechanisms for medical cannabis in the USSR, and the present availability of these productsove health and life quality of Ukrainian patients through cannabis-based medicinal products. It consists of three components changes in legislation and regulation procedures; changes to value orientations in society; observance of stakeholders' interests and purposes. Specific recommendations are worked out to realize this approach in Ukraine.

The holistic approach is aimed to improve health and life quality of Ukrainian patients through cannabis-based medicinal products. It consists of three components changes in legislation and regulation procedures; changes to value orientations in society; observance of stakeholders' interests and purposes. Specific recommendations are worked out to realize this approach in Ukraine.With the improvement in modern medicine, the world's human and feline (Felis catus, the domestic cat) population is aging. As the population grows older, there is an increase of age-related diseases, such as Alzheimer's disease in humans and feline cognitive dysfunction in felines, which shares many similarities with Alzheimer's disease. They both result in cognitive decline and lack effective treatments. In light of their pathological similarities, both occur at old age, and as domestic cats share the human environment and risk factors (cats are considered an indicator to the effect of environmental contaminants on humans as they share exposures and diseases), cats have the potential to be a spontaneous model for Alzheimer's disease. Classic animal models in many cases fail to predict the results in humans, and a natural model can lead to better prediction of results, thus being both time and cost-effective. The feline disease can be researched in trials that could be simultaneously clinical trials for cats and preclinical trials for humans, also referred to as reverse translational medicine. As both maladies lack effective medical intervention, new potential treatments are merited. Cannabidiol (CBD) is a promising agent that may improve the life of these patients, as it was shown to potentially treat several of the pathologies found in both conditions. yet there is a need for further research in order to establish the benefits and safety of CBD to both human and feline patients.

Little is known about how cannabis knowledge and attitudes impact cannabis use behavior.

To test the knowledge-attitudes-behavior paradigm in active adult athletes.

The Athlete Pain, Exercise, and Cannabis Experience (PEACE) Survey, a cross-sectional survey study, used social media and email blasts to recruit participants and SurveyGizmo to collect data.

Self-defined active adult athletes (n = 1161).

Knowledge about cannabis was evaluated with four questions. Attitudes toward cannabis was evaluated with 11 questions. The attitudes questions were used in a TwoStep Cluster analysis in SPSS to assign group membership by attitudes. Chi-square was used to determine if there were differences in cluster membership by demographic factors and if knowledge about cannabis differed by cluster membership. Regression analysis was performed to determine if cannabis attitudes mediated the relationship between cannabis knowledge and cannabis use.

A three-cluster solution was the best fit to the data. The clusters nabis.

Cannabis education needs to consider attitudes about cannabis, especially among those who might benefit from medical cannabis.

While the link between frequent cannabis use and alcohol use disorders is well documented, it is not clear whether alcohol drinkers who use cannabis less frequently are also vulnerable to alcohol use disorders. We estimate the association of frequency of past 12-months cannabis use with alcohol-associated adverse effects variables in the same time frame alcohol dependence, heavy drinking, driving under alcohol influence, alcohol-related interpersonal problems, use after interpersonal problems, alcohol-related risky behaviors, and alcohol-related legal problems.

We analyzed data from U.S. individuals aged 12 to 25 years who participated in annual, cross-sectional U.S. National Surveys on Drug Use and Health from 2002 to 2014. Logistic regression models were used to examine the association of cannabis use with six alcohol-associated adverse effects variables. Frequency of cannabis use served as the primary independent variable, and were divided into four categories frequent use (21-30 days per month), less ken under careful consideration in alcohol use disorder treatment setting and policy planning.

Given that 72% of internet users seek out health information using an internet search engine (Google being the most popular); we sought to investigate the public internet search interest in cannabis as a health topic when cannabis legislation appeared on state ballots and during presidential elections.

We searched Google Trends for "cannabis" as a health topic. Google Trends data were extracted during the time period of May 1, 2008 to May 1, 2019 for the United States (US) and select states (18) within the US including Alaska, Arizona, Arkansas, California, Colorado, Florida, Maine, Massachusetts, Michigan, Missouri, Nevada, North Dakota, Ohio, Oregon, Oklahoma, South Dakota, Utah, and Washington when cannabis was on the ballot. These state elections were referenda, not legislative votes. We then compared the internet search interest for cannabis before and after each election. To evaluate whether any associations with changes in the volume of cannabis internet searches were specific to the cannabis topicntrol policies, only two showed an increase in internet search interest during both Presidential Elections and neither exceeded the internet search increase of cannabis. These results may indicate the growing awareness of cannabis in the US and mark a possible target for the timely dissemination of evidence-based information regarding cannabis and its usage/side-effects during future elections. Consequently, the results of this study may be important to physicians since they will likely receive an increased volume of questions relating to cannabis and its therapeutic uses during election season from interested patients. We recommend establishing a cannabis repository of evidence-based information, providing physician education, and a dosing guide be created to enable physicians to provide high quality care around the issue of cannabis.

Frequent cannabis use can pose risks to health and safety. Multiple governments have legalized the sale of cannabis for recreational use and mandated health and safety warnings for recreational cannabis packages or signs at sales locations. The purposes of this study were to identify common themes across warnings and to compare the actual warnings with those previously recommended by cannabis experts and cannabis users.

We searched Google and Google Scholar for online lists of governments that allow or will soon allow the sale of cannabis for recreational use. Using the online lists we found, we searched for laws mandating the warnings, using the search terms "mandated warnings for recreational use marijuana" in addition to the name of the jurisdiction under review. We evaluated the content of the warnings and compared them with warnings recommended by cannabis experts and by users of recreational cannabis.

Each search led to millions of results. Within the top results of each of the searches there werehelp improve the warnings, either in presentation or in content. Cannabis researchers can use the list to identify additional risks suitable for inclusion in mandated warnings.

Hyperemesis Gravidarum (HG) responds only partially to standard antiemetic medications. Cannabis has been known to possess antiemetic effects and there are several medicinal cannabinoids used as anti -emetics for cancer chemotherapy. Its favorable use for HG has been described in social media, but not in the medical literature.

We evaluated 4 women with HG counseled by the Motherisk Program, before and following the use of cannabis. Using the validated Pregnancy Unique Quantification of Emesis (PUQE) scoring system and employing the Student's paired t test, we compared changes in symptoms following initiation of cannabis.

There was a highly significant improvement in symptoms PUQE score improved from 14.5+/- 1 to 7.5+/- 0.58(p = 0.0004). Cannabis use was associated with a significant increase in the PUQE Quality of Life scale, from 2+/- 0.82 to 7+/- 0.82 (p = 0.0012).

The results suggest that cannabis may be effective for HG, and should be studied in appropriately powered, controlled studies, fully considering potential fetal risks.

The results suggest that cannabis may be effective for HG, and should be studied in appropriately powered, controlled studies, fully considering potential fetal risks.

The therapeutic application of cannabidiol (CBD) is gaining interest due to expanding evidence for its use.

To summarize the clinical outcomes, study designs and limitations for the use of CBD and nabiximols (whole plant extract from Cannabis sativa L. that has been purified into 11 ratio of CBD and delta-9-tetrahydrocannabinol) in the treatment of psychiatric disorders.

A systematic review was conducted including case reports, case series, open-label trials, non-randomized and randomized controlled trials (RCTs). The search resulted in 23 relevant studies on CBD and nabiximols in the treatment of a wide range of psychiatric disorders. The quality of evidence was judged by using the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence that ranges from Level 1 to Level 5 based on the quality and study design. These levels of evidence help in grading the recommendations, including Grade A (strong), Grade B (moderate), Grade C (weak), and Grade D (weakest).

CBD and CBD-containing compounds sisorder, posttraumatic stress disorder, and Tourette syndrome. The evidence for the use of CBD and CBD-containing compounds for psychiatric disorders needs to be explored in future studies, especially large-scale and well-designed RCTs.

CBD and CBD-containing compounds such as nabiximols were helpful in alleviating symptoms of cannabis-related disorders, schizophrenia, social anxiety disorder, and comorbidities of ASD, and ADHD with moderate recommendation. However, there is weaker evidence for insomnia, anxiety, bipolar disorder, posttraumatic stress disorder, and Tourette syndrome. The evidence for the use of CBD and CBD-containing compounds for psychiatric disorders needs to be explored in future studies, especially large-scale and well-designed RCTs.

Despite reduced sanctions and more permissive attitudes toward cannabis use in the USA and Europe, the prevalences of adolescent cannabis use have remained rather stable in the twenty-first century. However, whether trends in adolescent cannabis use differ between socioeconomic groups is not known. The aim of this study was to examine trends in cannabis use according to socioeconomic status among Finnish adolescents from 2000 to 2015.

A population-based school survey was conducted biennially among 14-16-year-old Finns between 2000 and 2015 (n = 761,278). Distributions for any and frequent cannabis use over time according to socioeconomic adversities were calculated using crosstabs and chi-square test. Associations between any and frequent cannabis use, time, and socioeconomic adversities were studied using binomial logistic regression results shown by odds ratios with 95% confidence intervals.

At the overall level, the prevalences of lifetime and frequent cannabis use varied only slightly between 2000 and 2015. Cannabis use was associated with socioeconomic adversities (parental unemployment in the past year, low parental education, and not living with both parents). The differences in any and frequent cannabis use between socioeconomic groups increased significantly over the study period.

Although the overall changes in the prevalence of adolescent cannabis use were modest, cannabis use increased markedly among adolescents with the most socioeconomic adversities. Socioeconomic adversities should be considered in the prevention of adolescent cannabis use.

Although the overall changes in the prevalence of adolescent cannabis use were modest, cannabis use increased markedly among adolescents with the most socioeconomic adversities. Socioeconomic adversities should be considered in the prevention of adolescent cannabis use.Priapism (persistent and painful erection of the penis) is a notable urological emergency, with over 90% of those remaining erect for 24 h losing sexual function. Drug-induced priapism is common in the adult population, with intracavernosal injectables for erectile dysfunction topping the list. A variety of illicit drugs associated with priapism have been described; however, we are not aware of any other case reports showing cannabis alone as the inciting factor. Here, we present a case of a healthy 32-year-old African American man with a history of stuttering (recurrent) priapism secondary to mild cannabis substance use without comorbid substance use, licit or illicit.

While cannabis has a long history of spiritual use, its normalization in Western societies during the last decades has led to more recreational use. This study aimed to explore the characteristics of spiritual cannabis use as compared to recreational use and to the use of psychedelics such as LSD and psilocybin.

The study employed a mixed methods research design that involved both qualitative interviews and a quantitative survey. Participants in interviews (N= 29) were recruited at various online fora for individual interviews via private messaging, and were queried in depth about their use of entheogens such as psilocybin, LSD, and DMT in spiritual contexts. The Cannabis and Psychedelics User Survey (CPUS) was constructed on the basis of the reports from these interviews, and recruited 319 participants (median age 33; 81% male) from seven different online communities. The online survey consisted of three main sections, with the first asking about demographics, personality, current and past affiliation toeriences that in some aspects resembled experiences with psychedelics. Recent research has not given much attention to spiritual aspects of cannabis use, but the study indicates that spiritually motivated use remains prevalent and deserves further study.

Medical cannabis users report that their knowledge regarding cannabis is predominantly from their own personal experiences and the Internet.

We summarize and describe information found through Internet searches on medical cannabis in English language websites.

We used terms related to medical cannabis in the Google search engine between November and December 2019. Resulting websites were catalogued and coded for content, including mentions of health and medical conditions, pharmacology, dosage, harmful or adverse effects, harm reduction techniques, cautions or warnings, products for sale, and credentials.

We coded 344 web pages on 179 unique websites. Cannabis was mentioned for the treatment of 151 different medical and health conditions, only four of the twenty most frequently mentioned conditions have received substantial empirical support for cannabis or cannabinoid treatment. Information content varied widely across sites, only a small proportion of sites included information on pharmacology, dosage, risks, and other aspects that are requirements for pharmaceutical drugs. Information provided was only moderately related to conclusions in the emerging scientific literature.

Given the rise in cannabis use within the U.S. and the reliance on the Internet as a source of information, considerable efforts are needed to provide accurate on-line cannabis education to minimize harms and maximize benefits for individuals and society.

Given the rise in cannabis use within the U.S. and the reliance on the Internet as a source of information, considerable efforts are needed to provide accurate on-line cannabis education to minimize harms and maximize benefits for individuals and society.Renewed and sustained Cannabis chemistry exploration was initiated by Roger Adams at the University of Illinois Chemistry Department with cooperation from the Treasury Department Narcotics Laboratory in the early 1940's. This partnership and time investment by both parties made practical sense. Adams was able to explore natural products chemistry and the Narcotics Laboratory began to clarify the chemistry mysteries of Cannabis. Minnesota wild hemp, often viewed as just a roadside weed, was employed as the critical botanical source. Based on its widespread cultivation during World War II, this was also a very pragmatic decision. Although the unique Illinois - Washington D. C. collaboration lasted only a few short years (1939-1942), the stunning results included the isolation and extensive characterization of cannabidiol, the structure elucidation and total synthesis of cannabinol as well as the identification of the tetrahydrocannabinol structure as an intoxicating pharmacophore. Furthermore, this research well prepared many junior chemists for prolific careers in both academia as well as industry, inspired the discoveries of later Cannabis investigators and also provided a successful model of a productive academic-government partnership.

Over the past decade, cannabis use has become increasingly popular in states that include Colorado. During this time, alcohol use disorders (AUDs) and alcohol-related medical conditions have also been consistently recognized as public health problems with increasing prevalence in the state. Despite the widespread use of cannabis in Colorado, the epidemiology of cannabis use among those with AUDs has been poorly described. Therefore, we sought to examine cannabis use among individuals with likely AUDs and individuals with low-risk alcohol use during a time of major Colorado legislative changes before and after legalization of recreational cannabis in 2012.

This study was a secondary data analysis conducted with information from 303 participants (80% male) in the Denver, CO metropolitan enrolled between August 2007 and April 2016 for studies related to alcohol and lung health. Of these participants, 188 (62%) were completing inpatient alcohol detoxification with likely AUDs. All participants completed the Annabis. Targeted investigations into the medical and psychiatric consequences of combined alcohol and cannabis use are urgently needed to define its health impact in these vulnerable individuals.

Our findings highlight the exceptionally high odds of cannabis use among individuals with likely AUDs undergoing alcohol detoxification at a Colorado treatment facility before and after legalization of recreational cannabis. Targeted investigations into the medical and psychiatric consequences of combined alcohol and cannabis use are urgently needed to define its health impact in these vulnerable individuals.

Dental plaque is a global health problem affecting people of various age groups. Cannabinoids are gaining enormous research attention due to its beneficial properties for various applications. A preliminary observation on antimicrobial property of cannabinoids against dental plaque bacteria has been reported recently. As a follow-up research, here we report the in vitro evaluation of cannabinoids infused mouthwash products against total culturable (aerobic) bacterial content from dental plaque samples.

We tested two cannabinoid-infused mouthwash products containing cannabidiol (CBD) and cannabigerol (CBG) respectively (each mouthwash containing < 1% cannabinoid by weight) in vitro against total-culturable bacteria from dental plaque samples collected from 72 adults aged between 18 and 83 years. The participants were grouped on the basis of Dutch periodontal screening index (DPSI) score. To compare the efficacy of our products, we included two most commonly available products over the counter (Product And safer mouthwash products and next generation oral care products without fluoride and alcohol.

Our in vitro results demonstrate the potential of cannabinoids in developing efficient and safer mouthwash products and next generation oral care products without fluoride and alcohol.

The taxonomic classification of Cannabis genus has been delineated through three main types sativa (tall and less branched plant with long and narrow leaves), indica (short and highly branched plant with broader leaves) and ruderalis (heirloom type with short stature, less branching and small thick leaves). While still under discussion, particularly whether the genus is polytypic or monotypic, this broad classification reflects putative geographical origins of each group and putative chemotype and pharmacologic effect.

Here we describe a thorough investigation of cannabis accessions using a set of 23 highly informative and polymorphic SNP (Single Nucleotide Polymorphism) markers associated with important traits such as cannabinoid and terpenoid expression as well as fibre and resin production. The assay offers insight into cannabis population structure, phylogenetic relationship, population genetics and correlation to secondary metabolite concentrations. We demonstrate the utility of the assay for rapid, Genetic markers related to secondary metabolite production will be important in many sectors of the cannabis marketplace. For example, markers related to THC production will be important for adaptable and compliant large-scale seed production under the new US Domestic Hemp Production Program.

The final chemical compositions of cannabis products have key traits related to their genetic identities. Our analyses in the context of the NCBI Cannabis sativa Annotation Release 100 allows for hypothesis testing with regards to secondary metabolite production. Genetic markers related to secondary metabolite production will be important in many sectors of the cannabis marketplace. For example, markers related to THC production will be important for adaptable and compliant large-scale seed production under the new US Domestic Hemp Production Program.

Multiple cases of e-cigarette or vaping product use-associated lung injury (EVALI) have been reported in the USA, which have been attributed to informally obtained cannabis oil vaping devices. This report estimated whether cumulative incidence of EVALI differed according to state-level cannabis policy.

Publicly available information was used to estimate the cumulative incidence of EVALI. Odds of incident EVALI were calculated according to policy status (active, legal adult-use recreational policy vs. no legal access). Figures were statistically compared using chi-square tests.

Estimated cumulative incidence of EVALI was 5.19 per 100,000 cannabis users across all states with recreational cannabis policies (95% CI 4.70-5.72), and 15.89 per 100,000 cannabis users across all states with no legal access to cannabis (95% CI 14.88-16.96). Odds of EVALI were 3.06 times higher (95% CI 2.71-3.45) among users living in states with no legal access to cannabis compared to users in states with active recreational policies, with significant differences detected according to policy exposure (χ

= 385.57, p < 0.0001).

Estimates suggest there may have been a protective effect of state-level, recreational adult-use cannabis policies on incident EVALI. Effects of specific state-level regulations (e.g., laboratory testing, product quality standards, tracking systems) should be considered alongside additional geographic indices in future assessments of EVALI causes.

Estimates suggest there may have been a protective effect of state-level, recreational adult-use cannabis policies on incident EVALI. Effects of specific state-level regulations (e.g., laboratory testing, product quality standards, tracking systems) should be considered alongside additional geographic indices in future assessments of EVALI causes.

Trends toward legalizing cannabis may increase experimentation with the drug among less experienced users with limited knowledge of possible adverse reactions. This study explores the prevalence, frequency, and levels of distress produced by various acute adverse reactions to cannabis, as well as predictors of these reactions.

The Adverse Reactions Scale (ARS) was created and administered to a large sample of undergraduate college students (n = 999) who were predominantly white (> 70%), female (> 70%), recreational (> 90%) cannabis users. The ARS was administered in an anonymous online survey measuring demographics, cannabis use patterns, cannabis use motives, personality, and negative affect.

The most prevalent adverse reactions to cannabis were coughing fits, anxiety, and paranoia, which > 50% of the sample reported experiencing. The most frequently occurring reactions were coughing fits, chest/lung discomfort, and body humming, which occurred on approximately 30-40% of cannabis use sessiod cannabis users, as well as medical professionals and budtenders who provide information about cannabis use.

Substantial advancements were achieved in the management of postoperative pain, however the need for further improvement remains. This study explores the pharmacokinetics and safety of the CannaHaler, a metered dose inhaler for plant material made by Kite-Systems situated in Tel-Aviv, Israel.

The study was conducted on 12 healthy adult volunteers divided into four arms (each arm/group holds 3 volunteers) with the evaporated plant material being Alaska strain provided by "Tikun Olam". This strain is a hybrid of 70% Sativa and 30% Indika strains, consisting of 20-22% THC and 0% CBD. Each arm received a single dose and groups were divided in an ascending dose fashion Group I-IV receiving 10, 15, 20, 25 mg of THC respectively. The volunteers inhaled a single dose of THC using the CannaHaler, device. Blood samples for Δ

- Tetrahydrocannabinol (THC) and 9-THCCOOH were taken at base line and up to 30 min after dosing. Adverse events were monitored following the inhalation. Pharmacokinetics profile was obtainednistrator.

The current study showed that the use of Kite-Systems CannaHaler as a smokeless medical cannabis inhalation device is feasible and efficient. The low coefficient of variation together with the high Cmax values, suggest the potential use of the CannaHaler device as a pharmaceutical cannabis dosing administrator.

Widespread commercialization of cannabis has led to the introduction of brand names based on users' subjective experience of psychological effects and flavors, but this process has occurred in the absence of agreed standards. The objective of this work was to leverage information extracted from large databases to evaluate the consistency and validity of these subjective reports, and to determine their correlation with the reported cultivars and with estimates of their chemical composition (delta-9-THC, CBD, terpenes).

We analyzed a large publicly available dataset extracted from Leafly.com where users freely reported their experiences with cannabis cultivars, including different subjective effects and flavour associations. This analysis was complemented with information on the chemical composition of a subset of the cultivars extracted from Psilabs.org . The structure of this dataset was investigated using network analysis applied to the pairwise similarities between reported subjective effects and/or cheerited and less influenced by environmental factors, flavour perception could represent a reliable marker to indirectly characterize the psychoactive effects of cannabis. Our novel methodology helps meet demands for reliable cultivar characterization in the context of an ever-growing market for medicinal and recreational cannabis.

Cannabis contains Δ

-tetrahydrocannabinol (Δ

-THC) and cannabidiol (CBD) as the primary constituents responsible for pharmacological activity. However, there are numerous additional chemically-related structures to Δ

-THC and CBD that are pharmacologically active and may influence the pharmacological properties of Δ

-THC and CBD. This study chemically characterized the cannabinoid constituents in a series of cannabis chemovar extracts and investigated the potential cannabinoid entourage effect in two behavioral assays.

Six chemovar extracts were compared to pure Δ

-THC, CBD and morphine for effects on the following behavioral assays in mice hot plate and tail suspension. The battery of behavioral tests was conducted post intravenous administration of cannabis chemovar extract. Cannabinoid profiles of extracts were analyzed using high performance liquid chromatography. Cannabis extracts were administered at equal doses of Δ

-THC to investigate the role of their cannabinoid profiles in modulating the ces between cannabis chemovars and pure Δ

-THC.

Commercially available cannabis chemovars vary widely in cannabinoid content, but when equalized for Δ9-THC content, they produce similar behavioral effects with two exceptions. These findings provide only limited support for the entourage hypothesis. Further studies are necessary to characterize the nature of these pharmacological differences between cannabis chemovars and pure Δ9-THC.

Chronic obstructive pulmonary disease (COPD) is commonly associated with both a pro-inflammatory and a T-helper 1 (Th1) immune response. It was hypothesized that cannabis oil extract can alleviate COPD symptoms by eliciting an anti-inflammatory Th2 immune response. Accordingly, the effects of cannabis oil extract on the expression of 84 Th2 and related immune response genes in human small airways epithelial cells (HSAEpC) were investigated.

HSAEpC from a single donor were treated with three dilutions of a standardized cannabis oil extract (1400, 1800 and 11600) along with a solvent control (0.25% [2.5 ul/ml] ethanol) for 24 h. There were four replicates per treatment dilution, and six for the control. RNA isolated from cells were employed in pathway-focused quantitative polymerase chain reaction (qPCR) microarray assays.

The extract induced significant (P< 0.05) changes in expression of 37 tested genes. Six genes (CSF2, IL1RL1, IL4, IL13RA2, IL17A and PPARG) were up-regulated at all three dilutions. Another two (CCL22 and TSLP) were up-regulated while six (CLCA1, CMA1, EPX, LTB4R, MAF and PMCH) were down-regulated at the 1400 and 1800 dilutions. The relationship of differentially-expressed genes of interest to biologic pathways was explored using the Database for Annotation, Visualization and Integrated Discovery (DAVID).

This exploratory investigation indicates that cannabis oil extract may affect expression of specific airway epithelial cell genes that could modulate pro-inflammatory or Th1 processes in COPD. These results provide a basis for further investigations and have prompted in vivo studies of the effects of cannabis oil extract on pulmonary function.

NONE (all in vitro experiments).

NONE (all in vitro experiments).

Ohio's medical cannabis program is one of three states that require physicians to become certified to recommend medical cannabis to their patients. The current study examines the attitudes of Ohio physicians toward medical cannabis and Ohio's program to ascertain how likely physicians are to participate in Ohio's program.

Physicians were invited to complete an internet survey that asked them about their concerns regarding medical marijuana, Ohio's program, their likelihood of recommending medical cannabis, and becoming certified within the state. Ordinal and logistic regressions were used to understand the physicians' likelihood of recommending cannabis, of becoming certified to recommend cannabis, and their attitude toward Ohio's program.

In total, 11,665 physicians licensed to practice in Ohio were contacted by email, and 344 responses were received for a response rate of 2.9%. Only 42 physicians reported being certified or had plans to become certified to recommend marijuana, and 62% were unlikely toing cannabis in healthcare, along with requiring "certified recommenders" to have training could result in a fractured healthcare system.

The results show that many physicians have concerns about medical cannabis and Ohio's program, and many physicians may not participate in the program. This could be a problem for patients who would like to use cannabis for medical reasons; therefore, these patients, may need to utilize one physician for cannabis and another for regular care. Physicians will likely be caring for patients who are using cannabis regardless of their own beliefs about it. The lack of training regarding cannabis in healthcare, along with requiring "certified recommenders" to have training could result in a fractured healthcare system.

Fibromyalgia is a chronic health condition characterized by widespread, severe musculoskeletal pain that affects an estimated 5-7% of the global population. Due to the highly comorbid nature of fibromyalgia, patients with the disorder often respond poorly to traditional pain treatments. Recent studies suggest that patient response may be more favorable to alternative analgesics, such as cannabis. However, the therapeutic potential of cannabis-based pain treatment for fibromyalgia remains unclear. The present study examined the most recent cannabis literature (2015-2019) and provides a critical review of current research on the safety and efficacy of medical cannabis treatments for fibromyalgia.

We followed Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines in searching the PubMed and Medline databases using the search terms "cannabis + fibromyalgia" and then "cannabinoids + fibromyalgia." Inclusion criteria were a) English language, b) published in peer review journals, c) published from 2015 to 2019, d) all study designs except for systematic reviews and meta-analyses, and e) all cannabis preparations.

The search identified five applicable studies involving 827 participants that used six different treatments. Review suggested several methodological problems pertaining to generalizability and validity.

Although the critically reviewed studies superficially suggest that medical cannabis is a safe and effective treatment for fibromyalgia pain, serious methodological limitations prevent a definitive conclusion regarding the use of cannabinoids for pain management in fibromyalgia patients at this time.

Although the critically reviewed studies superficially suggest that medical cannabis is a safe and effective treatment for fibromyalgia pain, serious methodological limitations prevent a definitive conclusion regarding the use of cannabinoids for pain management in fibromyalgia patients at this time.

Recent Canadian legalization of cannabis for non-medical use underscores the need to understand patterns and correlates of cannabis use among men who may be more likely than women to become problematic cannabis users. Evidence supporting an association between substance use and violence is accumulating. Current knowledge of relationships among patterns of cannabis use, violence, gender and health is limited by dichotomous measurement of cannabis use and a focus on individual types of violence rather than lifetime cumulative violence.

We collected online survey data between April 2016 and Septermber 2017 from a community convenience sample of 589 Eastern Canadian men ages 19 to 65 years and explored how socio-demographic characteristics, gender, and health varied by past-year patterns of cannabis use (i.e., daily, sometimes, never) in the total sample and by higher and lower cumulative lifetime violence severity (CLVS) measured by a 64-item CLVS scale score (1 to 4).

Overall prevalence of cannabis use waraphic indicators and health problems and may inform theoretical models for future testing. Additionally, findings provide critical information for the design of health promotion strategies targeted towards those most at risk in the current climate of cannabis legalization.

These results add substantively to knowledge of relationships among lifetime cumulative violence, patterns of cannabis use, gender, socio-demographic indicators and health problems and may inform theoretical models for future testing. Additionally, findings provide critical information for the design of health promotion strategies targeted towards those most at risk in the current climate of cannabis legalization.

Neonatal Abstinence Syndrome (NAS) leads to increased length of stay (LOS), which leads to increased healthcare costs, and can cause financial burdens for hospitals. The purpose of the study was to determine the impact of substance use by pregnant women on a Colorado (CO) community hospital after state legalization of recreational cannabis.

Data were gathered retrospectively through the electronic health record at an inpatient facility and described 607 mothers and 419 newborns (total N = 1026) who tested positive for drugs (urinalysis or blood for mother and urine, meconium, or cord blood for newborns). Screening for drugs was at discretion of healthcare provider if mother reported use or newborn showed symptoms of NAS. The patients who were not screened or tested negative were excluded from consideration. Newborns exposed to cannabis were compared to those exposed to other drugs (opioids, methadone, cocaine, barbiturates, benzodiazepines, amphetamines) on costs of newborn hospitalization, based on type thcare costs, largely due to more expensive bed placement and longer LOS.

Drug-exposed newborns have a significant financial impact on hospital healthcare costs, largely due to more expensive bed placement and longer LOS.

Growing interest in the medicinal properties of cannabis has led to an increase in its use to treat medical conditions, and the establishment of state-specific medical cannabis programs. Despite medical cannabis being legal in 33 states and the District of Colombia, there remains a paucity of data characterizing the patients accessing medical cannabis programs.

We retrospectively reviewed a registry with data from 33 medical cannabis evaluation clinics in the United States, owned and operated by CB2 Insights. Data were collected primarily by face-to-face interviews for patients seeking medical cannabis certification between November 18, 2018 and March 18, 2020. Patients were removed from the analysis if they did not have a valid date of birth, were less than 18, or did not have a primary medical condition reported; a total of 61,379 patients were included in the analysis. Data were summarized using descriptive statistics expressed as a mean (standard deviation (SD)) or median (interquartile range (IQR)) aconditions, anxiety, insomnia, depression and PTSD would benefit a large number of patients, many of whom use medical cannabis to treat multiple conditions.

This retrospective study highlighted the range and number of conditions for which patients in the US seek medical cannabis. Rigorous clinical trials investigating the use of medical cannabis to treat pain conditions, anxiety, insomnia, depression and PTSD would benefit a large number of patients, many of whom use medical cannabis to treat multiple conditions.

Terpenes contribute to the pharmacology, efficacy, aroma, and flavor of cannabis inflorescence, improving the experience for medical and recreational users. Terpenes are inherently volatile, resulting in the loss of terpene content as inflorescence ages. A method to establish and/or maintain a desired terpene content of cannabis inflorescence is needed. A novel packaging method was investigated for the preservation of native terpenes and the replenishment of terpenes to depleted inflorescence over various storage durations.

Inflorescence samples from two different chemotypes (DJ's Gold, Cream Caramel) were obtained from a state licensed medical cannabis organization. Samples from the DJ's Gold chemotype were depleted of terpenes whereas samples from the Cream Caramel chemotype had a terpene content representative of inflorescence available for medicinal or recreational purposes. Inflorescence samples were stored using the novel packaging approach, in airtight containers in the presence of external terpeners.

Thymoma is an uncommon cancer often associated with myasthenia gravis, an autoimmune disorder of the neuromuscular junction characterized by muscular fatigability. In patients with advanced nonmetastatic thymoma, primary chemotherapy may be required to induce tumor shrinkage and to achieve radical resection. Cancer chemotherapy has been anecdotally reported as a trigger factor for worsening of myasthenia gravis in thymic epithelial cancers. The study of uncommon cases of chemotherapy-related myasthenic crisis is warranted to gain knowledge of clinical situations requiring intensive care support in the case of life-threatening respiratory failure.

We report a case of an 18-year-old Caucasian woman with advanced Masaoka-Koga stage III type B2 thymoma and myasthenia gravis on treatment with pyridostigmine, steroids and intravenous immunoglobulins, who developed a myasthenic crisis 2 hours after initiation of cyclophosphamide/doxorubicin/cisplatin primary chemotherapy. Because of severe acute respiratory failered an absolute contraindication for the continuation of primary chemotherapy with curative intent.The ratio of ∆9-tetrahydrocannabinol (THC) to cannabidiol (CBD) varies widely across cannabis strains. CBD has opposite effects to THC on a variety of cognitive functions, including acute THC-induced memory impairments. However, additional data are needed, especially under naturalistic conditions with higher potency forms of cannabis, commonly available in legal markets. The goal of this study was to collect preliminary data on the acute effects of different THCCBD ratios on memory testing in a brief verbal recognition task under naturalistic conditions, using legal-market Colorado dispensary products. Thirty-two regular cannabis users consumed cannabis of differing THC and CBD levels purchased from a dispensary and were assessed via blood draw and a verbal recognition memory test both before (pretest) and after (posttest) ad libitum home administration in a mobile laboratory. Memory accuracy decreased as post-use THC blood levels increased (n = 29), whereas performance showed no relationship to CBD blood levels. When controlling for post-use THC blood levels as a covariate, participants using primarily THC-based strains showed significantly worse memory accuracy post-use, whereas subjects using strains containing both THC and CBD showed no differences between pre- and post-use memory performance. Using a brief and sensitive verbal recognition task, our study demonstrated that naturalistic, acute THC use impairs memory in a dose dependent manner, whereas the combination of CBD and THC was not associated with impairment.

Pharmacists possess a skillset suited to provide evidence-based guidance to current and potential users of cannabis. Clinical pharmacogenomics research has made significant progress in defining which genetic variations are important for influencing inter-patient variability in response to cannabis. This study aims to evaluate the practicality and impact of pharmacogenetic testing in the community pharmacy to help guide in the safe use of cannabis.

The pilot program was designed as open-label, non-randomized, and observational. Two busy, urban community pharmacies, operating under the brand Shoppers Drug Mart, in Toronto, Ontario, Canada offered pharmacogenomic testing to cannabis users as part of their professional services program over a period of 2 months. Eligible patients received buccal swabs using a DNA cheek swab kit. De-identified, barcoded samples were then sent by regular mail to an off-site CLIA-certified laboratory for analysis in Mississauga, Canada. A pharmacogenetic testing platform from Lobo Genetics® was utilized for translation of participants' DNA with respect to CYP2C9, AKT1 and COMT genetic polymorphisms.