Medical marijuana policies and hospitalizations related to marijuana and opioid pain reliever.

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“Twenty-eight states in the U.S have legalized medical marijuana, yet its impacts on severe health consequences such as hospitalizations remain unknown. Meanwhile, the prevalence of opioid pain reliever (OPR) use and outcomes has increased dramatically. Recent studies suggested unintended impacts of legalizing medical marijuana on OPR, but the evidence is still limited. This study examined the associations between state medical marijuana policies and hospitalizations related to marijuana and OPR.

Hospitalizations related to marijuana and OPR increased sharply by 300% on average in all states. Medical marijuana legalization was associated with 23% (p=0.008) and 13% (p=0.025) reductions in hospitalizations related to opioid dependence or abuse and OPR overdose, respectively; lagged effects were observed after policy implementation. The operation of medical marijuana dispensaries had no independent impacts on OPR-related hospitalizations. Medical marijuana polices had no associations with marijuana-related hospitalizations.

Medical marijuana policies were significantly associated with reduced OPR-related hospitalizations but had no associations with marijuana-related hospitalizations. Given the epidemic of problematic use of OPR, future investigation is needed to explore the causal pathways of these findings.”

https://www.ncbi.nlm.nih.gov/pubmed/28259087

It’s Colorectal Cancer Awareness Month. Please Be Aware:

“Prevention and Treatment of Colorectal Cancer by Natural Agents From Mother Nature. This review clearly demonstrates that various nutraceuticals provided by the Mother Nature have a huge potential for both prevention and treatment of Colorectal cancer (CRC). Since these agents can be administered chronically without any concern for safety and are highly affordable, their use has been the wave of the past and is likely to continue as the wave of the future.” http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693477/
“Links between inflammation and colon cancer metastasis” https://www.sciencedaily.com/releases/2015/08/150825094923.htm
“Inflammation and colon cancer. The connection between inflammation and tumorigenesis is well-established. Inflammation is also likely to be involved with other forms of sporadic as well as heritable colon cancer.https://www.ncbi.nlm.nih.gov/pubmed/20420949
“Cannabis-derived substances in cancer therapy–an emerging anti-inflammatory role for the cannabinoids. Chronic inflammation has been associated with neoplasia for sometime, and as a consequence, reducing inflammation as a way of impacting cancer presents a new role for these compounds. https://www.ncbi.nlm.nih.gov/pubmed/20925645
“Cannabinoids as gastrointestinal anti-inflammatory drugs.” https://www.ncbi.nlm.nih.gov/pubmed/28239924
“Colon Cancer Risk Linked To High-Fat Diet: How Eating More Fat Can Increase Intestinal Tumors” http://www.medicaldaily.com/colon-cancer-high-fat-diet-intestinal-tumors-376664
 
“Study: Red and Processed Meats Linked With Colon Cancer Risk” http://healthland.time.com/2011/05/27/study-red-and-processed-meats-linked-with-colon-cancer-risk/
 
“Eating hot dogs, ham and other processed meat can cause colorectal cancer, and eating red meat “probably” can cause cancer, the World Health Organization’s cancer agency reported” http://www.usatoday.com/story/news/nation/2015/10/26/experts-processed-meats-can-cause-cancer/74615390/
 
“Mediterranean Diet Reduces Risk of Colon Cancer”
 
 
“More evidence a veg diet might lower cancer risk” http://www.today.com/health/veggie-diet-lowers-colon-cancer-risk-t7671
 
 
 
“Omegas linked with colon cancer survival. A large, observational study has linked higher intake of omega-3s with a lower risk of dying from colon cancer.” http://www.newhope.com/breaking-news/omegas-linked-colon-cancer-survival
 “Study shows how high-fat diets increase colon cancer risk” http://news.temple.edu/news/2012-03-06/study-shows-how-high-fat-diets-increase-colon-cancer-risk
“Poor metabolic health linked to increased risk for colorectal cancer in normal-weight women” http://www.news-medical.net/news/20170201/Poor-metabolic-health-linked-to-increased-risk-for-colorectal-cancer-in-normal-weight-women.aspx
 
“Cheese, Milk, and Fatty Fish Can Help Fight Colon Cancer” https://munchies.vice.com/en_us/article/cheese-milk-and-fatty-fish-can-help-fight-colon-cancer
“Diet, exercise and aspirin: 3 tools to fight colon cancer” http://ktar.com/story/1314810/diet-exercise-aspirin-3-tools-fight-colon-cancer/
“Many Early Colon Cancers Linked to Inherited Genes” https://medlineplus.gov/news/fullstory_162574.html
“E.coli Bacteria Linked to Colon Cancer” http://www.ibtimes.co.uk/e-coli-bateria-linked-colon-cancer-375102
 
“Colorectal cancer prevalence linked to human papillomavirus: a systematic review with meta-analysis” http://www.scielo.br/scielo.php?pid=S1415-790X2016000400791&script=sci_arttext&tlng=en
“Colon cancer linked to viruses in beef, Nobel-winning scientist contends” http://www.scmp.com/lifestyle/health/article/1695757/colon-cancer-linked-viruses-beef-nobel-winning-scientist-contends
 
“Diet High in Choline Linked with Increased Risk of Colorectal Polyps. According to the results of a study published in the Journal of the National Cancer Institute, high intake of choline-a nutrient found in foods such as red meat, eggs, poultry, and dairy products-may be linked with an increased risk of colorectal polyps.” http://news.cancerconnect.com/diet-high-in-choline-linked-with-increased-risk-of-colorectal-polyps/
“High-Glycemic Foods Linked to Colon Cancer. These foods include breads, pastas, pancakes, and other carbohydrates made from refined “white” grains, as well as other processed or sugary foods such as cakes, cookies, and other snacks.” http://www.webmd.com/colorectal-cancer/news/20040203/high-glycemic-foods-linked-to-colon-cancer#1
 
“Low-carb diet cuts risk of colon cancer” https://www.utoronto.ca/news/low-carb-diet-cuts-risk-colon-cancer
 
“Common food additive promotes colon cancer in mice. Emulsifiers, which are added to most processed foods to aid texture and extend shelf life, can alter intestinal bacteria in a manner that promotes intestinal inflammation and colorectal cancer” https://www.sciencedaily.com/releases/2016/11/161107110639.htm
“Processed meats including bacon, hot dogs linked to colon cancer” http://www.cp24.com/news/processed-meats-including-bacon-hot-dogs-linked-to-colon-cancer-1.2627498
“Processed meat can cause colon cancer, World Health Organization says” http://www.cbc.ca/news/health/meat-cancer-world-health-organization-1.3288355
 
“Sweets, sugary snacks linked to colorectal cancer” http://www.cbsnews.com/news/sweets-sugary-snacks-linked-to-colorectal-cancer/
“Eating Nuts Linked to Lower Risk of Colon Cancer” http://www.livescience.com/54448-eating-nuts-may-lower-colon-cancer-risk.html
 
“Coffee consumption linked to lower risk of colorectal cancer” http://www.ctvnews.ca/health/coffee-consumption-linked-to-lower-risk-of-colorectal-cancer-1.2841834
“Alcohol Linked to Colorectal Cancer Risk” http://www.medscape.com/viewarticle/749886
“Excessive alcohol consumption favours high risk polyp or colorectal cancer occurrence among patients with adenomas: a case control study” http://gut.bmj.com/content/50/1/38.full
 
“High vitamin D levels linked to lower risk of colon cancer” http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_22-1-2010-13-46-0
 
“Anthocyanins in Purple, Blue and Red Foods Fight Colon Cancer” http://reliawire.com/anthocyanins-purple-blue-red-foods-fight-colon-cancer/
 
“Prunes reduce colon cancer risk by benefiting healthy gut bacteria” http://www.belmarrahealth.com/prunes-reduce-colon-cancer-risk-by-benefiting-healthy-gut-bacteria/
“BLACK RASPBERRIES A POTENTIALLY POWERFUL AGENT IN FIGHT AGAINST COLON CANCER” https://researchnews.osu.edu/archive/brberry.htm
 
 
 
 
 
“G‐protein coupled receptor 55 (GPR55), a lysophospholipid receptor, has been shown to play an important role in carcinogenesis. GPR55 is involved in the migratory behaviour of colon carcinoma cells and may serve as a pharmacological target for the prevention of metastasis.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688947/
“The putative cannabinoid receptor GPR55 promotes cancer cell proliferation.” http://www.ncbi.nlm.nih.gov/pubmed/21057532
 “L-α-lysophosphatidylinositol meets GPR55: a deadly relationship. Evidence points to a role of L-α-lysophosphatidylinositol (LPI) in cancer.” http://www.ncbi.nlm.nih.gov/pubmed/21367464
“Modulation of l-α-Lysophosphatidylinositol/GPR55 Mitogen-activated Protein Kinase (MAPK) Signaling by Cannabinoids*Here, we report that the little investigated cannabis constituents CBDV, CBGA, and CBGV are potent inhibitors of LPI-induced GPR55 signaling. The phytocannabinoids Δ9-tetrahydrocannabivarin, cannabidivarin, and cannabigerovarin are also potent inhibitors of LPI. Our findings also suggest that GPR55 may be a new pharmacological target for the following C. sativa constituents: Δ9-THCV, CBDV, CBGA, and CBGV. These Cannabis sativa constituents may represent novel therapeutics targeting GPR55.” http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249141/
 “Cannabinoids and cancer: potential for colorectal cancer therapy.” https://www.ncbi.nlm.nih.gov/pubmed/16042581
 “The endogenous cannabinoid system protects against colonic inflammation”  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC385396/
 “Cannabinoids in intestinal inflammation and cancer. In vivo, cannabinoids – via direct or indirect activation of CB(1) and/or CB(2) receptors – exert protective effects in well-established models of intestinal inflammation and colon cancer. Pharmacological elevation of endocannabinoid levels may be a promising strategy to counteract intestinal inflammation and colon cancer.” http://www.ncbi.nlm.nih.gov/pubmed/19442536
 “Cannabinoids have become a novel therapeutic approach against colon cancer with protective and anti-tumoral effects on colorectal carcinoma cell lines and in animal models of colon cancer” http://impactjournals.com/oncoscience/index.php?pii=119 
 “Possible endocannabinoid control of colorectal cancer growth. Inhibitors of endocannabinoid inactivation may prove useful anticancer agents.” https://www.ncbi.nlm.nih.gov/pubmed/12949714
“Increased endocannabinoid levels reduce the development of precancerous lesions in the mouse colon. Cannabinoids have been licensed for clinical use as palliative treatment of chemotherapy, but increasing evidence shows antitumor actions of cannabinoid agonists on several tumor cells in vitro and in animal models” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2755791/

“Loss of cannabinoid receptor 1 accelerates intestinal tumor growth”  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2561258/

“Turned-off Cannabinoid Receptor Turns On Colorectal Tumor Growth” https://www.sciencedaily.com/releases/2008/08/080801074056.htm

“Turning CB1 back on and then treating with a cannabinoid agonist could provide a new approach to colorectal cancer treatment or prevention. Cannabinoids are a group of ligands that serve a variety of cell-signaling roles. Some are produced by the body internally (endocannabinoids). External cannabinoids include manmade versions and those present in plants, most famously the active ingredient in marijuana (THC).” http://www.news-medical.net/news/2008/08/03/40485.aspx

“Cannabinoid Receptor Activation Induces Apoptosis through Tumor Necrosis Factor α–Mediated Ceramide De novo Synthesis in Colon Cancer Cells. The present study shows that either CB1 or CB2 receptor activation induces apoptosis through ceramide de novo synthesis in colon cancer cells. ” http://clincancerres.aacrjournals.org/content/14/23/7691.long

“The cannabinoid delta(9)-tetrahydrocannabinol inhibits RAS-MAPK and PI3K-AKT survival signalling and induces BAD-mediated apoptosis in colorectal cancer cells. Here, we report that CB1 and CB2 cannabinoid receptors are expressed in human colorectal adenoma and carcinoma cells, and show for the first time that THC induces apoptosis in colorectal cancer cells. The use of THC, or selective targeting of the CB1 receptor, may represent a novel strategy for colorectal cancer therapy.” http://www.ncbi.nlm.nih.gov/pubmed/17583570

“Programmed Cell Death (Apoptosis)” http://www.ncbi.nlm.nih.gov/books/NBK26873/

“Cannabis-Linked Cell Receptor Might Help Prevent Colon Cancer” http://www.medicinenet.com/script/main/art.asp?articlekey=91511

“Chemopreventive effect of the non-psychotropic phytocannabinoid cannabidiol on experimental colon cancer. Cannabidiol, a safe and non-psychotropic ingredient of Cannabis sativa, exerts pharmacological actions (antioxidant and intestinal antinflammatory) and mechanisms (inhibition of endocannabinoid enzymatic degradation) potentially beneficial for colon carcinogenesis. It is concluded that cannabidiol exerts chemopreventive effect in vivo and reduces cell proliferation through multiple mechanisms.” https://www.ncbi.nlm.nih.gov/pubmed/22231745

“CBD-Rich Marijuana Fights Colon Cancer, New Study Finds” http://blog.sfgate.com/smellthetruth/2014/01/06/cbd-rich-marijuana-fights-colon-cancer-new-study-finds/

“Inhibition of colon carcinogenesis by a standardized Cannabis sativa extract with high content of cannabidiol. Cannabis-based medicines are useful adjunctive treatments in cancer patients.” http://www.ncbi.nlm.nih.gov/pubmed/24373545

“Cannabigerol (CBG) is a safe non-psychotropic Cannabis-derived cannabinoid. CBG hampers colon cancer progression in vivo and selectively inhibits the growth of colorectal cancer cells. CBG should be considered translationally in colorectal cancer prevention and cure.” http://www.ncbi.nlm.nih.gov/pubmed/25269802

“According to researchers at the University of Texas in Houston chemicals in marijuana could be a potential cure in the treatment of colon cancer.” http://www.digitaljournal.com/article/258161

“Cannabis compound clue to colon cancer”  https://www.newscientist.com/article/mg19926685.000-cannabis-compound-clue-to-colon-cancer/

“Marijuana takes on colon cancer” https://www.newscientist.com/article/dn14451-marijuana-takes-on-colon-cancer/

“Cannabinoids appear to kill tumor cells but do not affect their nontransformed counterparts and may even protect them from cell death. Tumor specimens revealed that THC had antiangiogenic and antiproliferative effects. CBD has also been demonstrated to exert a chemopreventive effect in a mouse model of colon cancer. In in vitro experiments involving colorectal cancer cell lines, the investigators found that CBD protected DNA from oxidative damage, increased endocannabinoid levels, and reduced cell proliferation. In addition, both plant-derived and endogenous cannabinoids have been studied for anti-inflammatory effects. A mouse study demonstrated that endogenous cannabinoid system signaling is likely to provide intrinsic protection against colonic inflammation. As a result, a hypothesis that phytocannabinoids and endocannabinoids may be useful in the risk reduction and treatment of colorectal cancer has been developed.” http://www.cancer.gov/about-cancer/treatment/cam/hp/cannabis-pdq#section/_7

Potential of Cannabidiol for the Treatment of Viral Hepatitis.

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“Viral hepatitis B (HBV) and hepatitis C (HCV) pose a major health problem globally and if untreated, both viruses lead to severe liver damage resulting in liver cirrhosis and cancer. While HBV has a vaccine, HCV has none at the moment. The risk of drug resistance, combined with the high cost of current therapies, makes it a necessity for cost-effective therapeutics to be discovered and developed.

The recent surge in interest in Medical Cannabis has led to interest in evaluating and validating the therapeutic potentials of Cannabis and its metabolites against various diseases including viruses. Preliminary screening of cannabidiol (CBD) revealed that CBD is active against HCV but not against HBV in vitro. CBD inhibited HCV replication by 86.4% at a single concentration of 10 μM with EC50 of 3.163 μM in a dose-response assay.

These findings suggest that CBD could be further developed and used therapeutically against HCV. Cannabidiol exhibited in vitro activity against viral hepatitis C.”  https://www.ncbi.nlm.nih.gov/pubmed/28250664

“Cannabidiol (CBD) is a nonpsychoactive cannabinoid found in the Cannabis plants and is credited for several pharmacological properties. It is also known to have beneficial effects against inflammation/pain, neurological conditions, cancer, and other ailments. In general, with regard to antiviral activity, medical Cannabis was reported to be used as an accompanying remedy by HIV/AIDS patients to alleviate neuropathic pain, wasting, nausea, and vomiting. Given the increasing use and application of medical Cannabis along with its nonpsychoactive metabolite (CBD), and in line with our continuous effort to evaluate and validate the potential therapeutic properties of CBD, the major aim of this study was as such to evaluate the anti-HBV and anti-HCV activities of CBD in vitro. We report here for the first time in vitro studies to demonstrate the antiviral activity of CBD against HCV. CBD was shown to have activity against HCV in vitro but not against HBV. A review of the literature seems to suggest that CBD may also have activity in vivo based on its interaction with the CB2 receptor and as such using a host mechanism to indirectly slow the pathogenic process of the HBV virus. Based on these findings, CBD as such has potential to be further developed as a treatment for viral hepatitis, especially as a combination therapy with the currently existing therapies.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5330095/

Cannabinoids and epilepsy — Introduction.

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“Over the past five years, the lay press and families of children with catastrophic epilepsies popularized the use of cannabis and cannabinoids to treat seizures. Many state legislatures have responded to the pressure from lay groups and have legalized medical cannabis, which is now available to a majority of people in the United States. Patients throughout the world are also obtaining and using cannabinoids to treat their epilepsy. There is an enormous dissociation between the widespread use of cannabis-based therapies to treat diverse epilepsies and our understanding about the efficacy and safety of different cannabinoids in treating different epilepsy syndromes.”  http://www.epilepsybehavior.com/article/S1525-5050(17)30042-2/abstract

http://www.thctotalhealthcare.com/category/epilepsy-2/

Cannabinoids in treatment-resistant epilepsy: A review.

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“Treatment-resistant epilepsy (TRE) affects 30% of epilepsy patients and is associated with severe morbidity and increased mortality.

Cannabis-based therapies have been used to treat epilepsy for millennia, but only in the last few years have we begun to collect data from adequately powered placebo-controlled, randomized trials (RCTs) with cannabidiol (CBD), a cannabis derivative.

Previously, information was limited to case reports, small series, and surveys reporting on the use of CBD and diverse medical marijuana (MMJ) preparations containing: tetrahydrocannabinol (THC), CBD, and many other cannabinoids in differing combinations.

These RCTs have studied the safety and explored the potential efficacy of CBD use in children with Dravet Syndrome (DS) and Lennox-Gastaut Syndrome (LGS).

The role of the placebo response is of paramount importance in studying medical cannabis products given the intense social and traditional media attention, as well as the strong beliefs held by many parents and patients that a natural product is safer and more effective than FDA-approved pharmaceutical agents.

We lack valid data on the safety, efficacy, and dosing of artisanal preparations available from dispensaries in the 25 states and District of Columbia with MMJ programs and online sources of CBD and other cannabinoids. On the other hand, open-label studies with 100mg/ml CBD (Epidiolex®, GW Pharmaceuticals) have provided additional evidence of its efficacy along with an adequate safety profile (including certain drug interactions) in children and young adults with a spectrum of TREs.

Further, Phase 3 RCTs with Epidiolex support efficacy and adequate safety profiles for children with DS and LGS at doses of 10- and 20-mg/kg/day. This article is part of a Special Issue titled “Cannabinoids and Epilepsy”.”

https://www.ncbi.nlm.nih.gov/pubmed/28188044

Modulation of Human Peripheral Blood Mononuclear Cell Signaling by Medicinal Cannabinoids.

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“Medical marijuana is increasingly prescribed as an analgesic for a growing number of indications, amongst which terminal cancer and multiple sclerosis.

In this study we aimed to investigate the immune-cell modulatory properties of medical cannabis.

Healthy volunteers were asked to ingest medical cannabis, and kinome profiling was used to generate comprehensive descriptions of the cannabis challenge on inflammatory signal transduction in the peripheral blood of these volunteers.

Results were related to both short term and long term effects in patients experimentally treated with a medical marijuana preparation for suffering from abdominal pain as a result of chronic pancreatitis or other causes.

The results reveal an immunosuppressive effect of cannabinoid preparations via deactivation of signaling through the pro-inflammatory p38 MAP kinase and mTOR pathways and a concomitant deactivation of the pro-mitogenic ERK pathway. However, long term cannabis exposure in two patients resulted in reversal of this effect.

While these data provide a powerful mechanistic rationale for the clinical use of medical marijuana in inflammatory and oncological disease, caution may be advised with sustained use of such preparations.”

https://www.ncbi.nlm.nih.gov/pubmed/28174520

http://journal.frontiersin.org/article/10.3389/fnmol.2017.00014/full

[Cannabinoid applications in glaucoma].

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“Glaucoma is a slowly progressive optic neuropathy that is one of the leading causes of legal blindness throughout the world.

Currently there is a limited group of topical drugs for the medical treatment of glaucoma is currently limited, and research needs to be focused on new therapeutic horizons, such as the potential usefulness of the cannabinoid agonists for the treatment of glaucoma.

To review the current scientific literature related to the beneficial effects derived from the different ways of administration of cannabinoids indicated for the glaucomatous optic neuropathy.

Cannabinoid receptors have shown an intense expression in ocular tissues implicated in the regulation of the intraocular pressure, as well as inner layers of the retina. Through activation of CB1 and CB1 specific receptors and through other still unknown pathways, the cannabinoid agonists have shown both a clear hypotensive, as well as an experimentally proved neuroprotective effect on retinal ganglion cells.

CONCLUSIONS:

Some cannabinoid agonists (WIN 55212-2, anandamide) have demonstrated, in experimental studies, to act as «ideal drugs» in the management of glaucoma, as they have been shown to have good tolerability after topical application, efficiently reduce intraocular pressure, and behave as neuroprotectors on retinal ganglion cells.”

https://www.ncbi.nlm.nih.gov/pubmed/21414525

The Endocannabinoid System and Anxiety.

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“The medical properties of Cannabis sativa is known for centuries.

Since the discovery and characterization of the endogenous cannabinoid system, several studies have evaluated how cannabinoid compounds and, particularly, how the modulation of the endocannabinoid (eCB) system influences a wide range of functions, from metabolic to mental disorders. Cannabinoids and eCB system often exert opposite effects on several functions, such as anxiety. Although the mechanisms are not completely understood, evidence points to different factors influencing those effects.

In this chapter, the recent advances in research about the relationship between eCB system and anxiety disorders in humans, as well as in animal models, will be discussed. The recent data addressing modulation of the eCBs in specific brain areas, such as the medial prefrontal cortex, amygdaloid complex, bed nucleus of stria terminalis, hippocampus, and dorsal periaqueductal gray, will be summarized. Finally, data from animal models addressing the mechanisms through which the eCB system modulates anxiety-related behavior dependent on stressful situations, such as the involvement of different receptors, distinct eCBs, modulation of neurotransmitters release, HPA axis and immune system activation, and plastic mechanisms, will also be discussed.”

https://www.ncbi.nlm.nih.gov/pubmed/28061971

InMed Announces Progress on COPD Treatment Using Cannabinoids

InMed Announces Progress on COPD Treatment Using Cannabinoids

“Recent research has indicated that cannabinoid-based therapies might be effective in ameliorating the most important symptoms of COPD.”

“Researchers have observed that cannabinoids can be bronchodilatory, immunosuppressive, and anti-inflammatory, suggesting that cannabinoid-based therapies might offer safer and more effective treatment options for COPD.”

“Additionally, studies have suggested that cannabinoids might help promote better sleep, support the immune system, work as an expectorant, relieve pain, and have anti-microbial properties.”

https://copdnewstoday.com/2016/12/08/inmed-announces-progress-copd-treatment-using-cannabinoids/

http://www.thctotalhealthcare.com/category/copd-chronic-obstructive-pulmonary-disease/

Experts’ Perspectives on the Role of Medical Marijuana in Oncology: a semi-structured interview study.

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“Expansion of medical marijuana (MM) laws in the United States may offer oncology new therapeutic options.

This study qualitatively explored professional opinion around the role of MM in cancer care.

Expert opinion was divided between conviction in marijuana’s medicinal potential to guardedness in this assertion, with no participant refuting MM’s utility outright.

Emergent themes included: that MM ameliorates cancer-related pain and nausea and is safer than certain conventional medications.

Participants called for enhanced purity and production standards, and further research on MM’s utility.”

https://www.ncbi.nlm.nih.gov/pubmed/28040884