aureus , and Salmonella . Oil quality depends on seed origin and extraction method. The formulated emulsions did not exhibit Marijuana for other diseases and health concerns Researchers are examining marijuana’s role in the relief of symptoms related to a number of disease and health concerns. The following are a few examples. Crohn’s disease Anecdotally, people have reported marijuana as having a positive effect on Crohn’s disease symptoms. In one study (Naftali et al., 2013), the sample size was 21 patients (mean age 40 years ± 14 years; 13 men) with Crohn’s Disease Activity Index (CDAI) scores greater than 200/600 (disease severity) who had not responded to therapy with steroids, immunomodulators, or antitumor necrosis factor-alpha agents. Patients were assigned randomly to two groups, one given marijuana cigarettes containing 115 mg of THC twice daily and the other given cigarettes containing marijuana flowers from which the THC had been extracted. Disease activity and laboratory tests were assessed during eight weeks of treatment and then two weeks thereafter. Complete remission (CDAI score < 150) was achieved by 5 of 11 subjects in the marijuana group (45%) and 1 of 10 in the placebo group (10%; p = 0.43). A clinical response (decrease in CDAI score of > 100) was observed in 10 of 11 subjects in the marijuana cigarettes group (90%; from 330 ± 105 to 152 ± 109) and four of 10 in the placebo group (40%; from 373 ± 94 to 306 ± 143; p =0.028). Three patients in the marijuana group were weaned from steroid dependency. Subjects receiving marijuana cigarettes reported improved appetite and sleep, with no significant side effects. Although the primary end point of the study (induction of remission) was not achieved, a short course (eight weeks) of THC-rich marijuana produced significant clinical, steroid- free benefits in 10 of 11 people with active Crohn’s disease as compared with those who received placebo, without side effects. Although this study had a small sample, the attention given to the botanical detail of the study design is superior. The investigators acknowledged and accounted for the problem that medicinal marijuana, and all other plants, contain various constituents in a mixture, making it difficult to measure the contribution of each one. They dealt with the standardization issue by choosing marijuana for the study from genetically identical plants grown from twigs of the same mother plant and in equal conditions. Plants were tested to verify an equal content of active ingredients. The investigators also standardized the machine-made cigarettes to contain equal weights of marijuana flowers (Naftali et al., 2013). Nonalcoholic Fatty liver disease A population-based, case-controlled correlational study tested the hypothesis that marijuana is associated with reduction in nonalcoholic fatty liver disease. The risk factors identified from more than six million patient records included age 40 to 60 years, being female, hyperlipidemia, hypertension, alcohol use, diabetes, metabolic syndrome, and being a non-Hispanic Caucasian person. The study found the hypothesis to be supported (Adejumo et al., 2017).
the anticipated antibacterial activity. However, unrefined cold- pressed hemp seed oil did show activity (Mikulcová et al., 2017).
AIDS-associated anorexia According to Lutge et al., (2013), the FDA approved dronabinol for the treatment of AIDS-associated anorexia using a study published in 1995 that at the time was the only study amenable to further analysis. With a sample size of 139 (88 evaluable), the study found that participants administered dronabinol were twice as likely to gain 2 kg or more in body weight. The mean weight gain was 0.1 kg, as compared to a loss of 0.4 kg in the placebo group. In 2016, the FDA approved an oral solution of dronabinol, which is easier to swallow than the capsules (Badowski & Yanful, 2018). It is important when prescribing dronabinol to be aware of psychiatric issues that patients might have, because the drug has been reported to exacerbate symptoms of some psychoses (Badowski & Yanful, 2018). Sleep disturbances The relationship between sleep and cannabis can be problematic. A large study of an outpatient psychiatric population found that, although CBD reduced anxiety, it had no sustained effect on improvement of sleep (Shannon et al., 2019). A review by Babson and colleagues (2017) found that, although THC may shorten the time in getting to sleep, it might cause long-term problems with sleep quality. Sleep disturbances are prominent symptoms in individuals with substance use disorders. A self-report online survey of 248 people suggests that those who are “risky” marijuana and/ or alcohol users are likely to report poor sleep quality rather than daytime sleepiness. Riskiness was determined by a score of lower than 6 for a 39-item instrument called the Marijuana Screening Inventory . Women typically have poorer sleep outcomes than men, as do people who use both alcohol and marijuana (Ogeil et al., 2015). A study of 13 daily marijuana users, all men, examined the effects of around-the-clock dosing with oral THC on sleep latency and ability to fall asleep. The participants were given an escalating dose up to 120 mg on days 5 and 6. The overall amount of nighttime sleep decreased slightly during the study. Although other reports have suggested that people typically have somnolent side effects after receiving oral THC, this study suggests, although it had a very small number of participants, that people may become tolerant to the effects of THC through sustained use (Gorelick et al., 2013). Rapid eye movement sleep behavior disorder (RBD), in which people act out their dreams, is considered a prodromal symptom of Parkinson’s disease (PD). Marijuana is being explored for its neuroprotective effects in RBD/PD. Four patients with RBD/PD were treated with CBD for 6 weeks. Three received 75 mg per day and one person received 300 mg per day. All four subjects experienced a significant decrease in symptoms (Chagas et al., 2014).
ORAL HEALTHCARE CONCERNS AND THE MARIJUANA USER
Smoking tobacco products has been linked to health hazards related to the heat of combustion and the inhalation of many chemicals and adjuvants into the lungs. Users of marijuana and healthcare professionals hold similar concerns about marijuana smoking. The herb can be rolled into a cigarette for smoking, called a “joint,” or smoked using a water pipe or “bong.” In a bong, the smoke from the burning marijuana bubbles through the bong water, where it is cooled. It is important to note that particulate matter from the burning action is not removed by the water. Hashish is typically smoked using a pipe or bong or mixed with marijuana and smoked as a joint or vaporized.
There are many people who smoke both tobacco and marijuana. A joint (marijuana cigarette) prepared with tobacco is known as a “spliff” or “kiff.” A systematic review of 28 studies showed that marijuana users who also smoked tobacco were more dependent on marijuana, had more psychosocial problems, and had poorer cessation outcomes than those who used marijuana but not tobacco (Peters et al., 2012). As electronic cigarettes (e-cigarettes) are becoming more popular with tobacco smokers, “vaping” with e-cigarettes and electronic vaporizers is emerging as a possible method for inhaling marijuana (Tashkin, 2015). People who use e-cigarettes believe that vaping is healthier, as well as more discreet because
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