For too long, societies worldwide have prohibited Cannabis, a historically useful and valuable commodity.  The predominant concern has been Cannabis delta-9-tetrahydrocannabinol (THC) content and its psychoactive effects.  How does THC affect mental states? Is it beneficial?  What are its liability concerns?   CESC’s Cannabis Mind Initiative focuses on the psychoactive or intoxicating effects of Type I (THC dominant) Cannabis and its subtypes of varying potencies.
 
Cannabis typically contains one of two dominant phytocannabinoids, THCA or cannabidiolic acid (CBDA), and several combinations of other active ingredients.   Consumers might inhale, apply, or ingest a product without apparent psychoactivity. However, it is the use of THC (derived from its THCA precursor) in products that most often leads to intoxicating states. THC’s psychoactive effects are mostly attributed to its activity on CNR1 (CB1), a prevalent G-coupled protein receptor in the brain.  THC consumption may cause adverse effects; however, it also leads to meaningful subjective experiences.  Despite a diverse and rich potential for Cannabis in the marketplace, THC is the elephant in the room.  CESC’s study of THC dominant Cannabis addresses its psychoactive and intoxicating effects
 
In the past decade, we have seen unprecedented shifts in the availability of Cannabis.  Increased access to Cannabis has been associated with an increase in high potency THC products.  From 1995 to 2014, THC potency tripled (4%-12%) in confiscated Cannabis flowers.  Today, markets sell Cannabis flowers with 20% or more THC content.  Extracted and concentrated oil products have potencies of 50-80% THC. Jurisdictions that have tried to prohibit D-9 THC see legal hemp products converted to other isomers of THC as companies work around regulations to offer a product with more psychoactivity.
 
Americans have a love-hate relationship with Cannabis. Harry J Anslinger, head of the US Treasury Department's Narcotics Bureau, wrote his opinion in a 1937 article titled Marijuana, Assassin of Youth.  “How many murders, suicides, robberies, criminal assaults, holdups, burglaries and deeds of maniacal insanity it causes each year can only be conjectured.”  The ludicrous notion that a plant could initiate such behavior had been popularized in a movie called Reefer Madness. Relative to the history of worldwide use, Anslinger’s perspective didn’t last long.  By the 1960s, Anslinger had already conceded that the criminal penalties in force for Cannabis use were too severe. In 1967, mainstream voices of Life, Newsweek, and Look magazines questioned why the plant was illegal at all.  By 1996, California had legalized Cannabis use for medicinal purposes through a proposition titled The Compassionate Use Act.
 
Contrasting perceptions and opposing effects are a hallmark of Type I Cannabis. The relaxing and euphoric effects are contradicted by concerns of anxiety and psychosis.  It’s well understood that acute psychosis from THC can be debilitating, especially when unexpected.  Dr. Nora Volkow, Director of the National Institute of Drug Abuse, notes that high potency Cannabis products are associated with acute psychosis.  However, intentional Cannabis experiences with appropriate doses of THC can also be used as therapy. The hypothesis is that THC may help expand the walls of perception and engender psychological flexibility, which leads to improved mental health conditions.
 
In a Natural Language Processing analysis of open-sourced reviews by respondents that used Type I Cannabis flowers, CESC identified commonly used words.  These descriptors group into three categories; states of altered consciousness (high, stoned, buzzed), a relaxed-energetic dichotomy, and a broad range of psychosomatic states.  We anticipate that this categorization scheme will facilitate correlation with underlying pharmacologic mechanisms.
 
With access to a Northern California community of 2,000 active users, CESC investigates the risk factors and therapeutic benefits of Type I Cannabis use.  Data is gathered on the acute and chronic effects of Cannabis use.  Longitudinal observations track health and wellness endpoints of Cannabis users.  Quantitative EEG analysis provides an objective biomarker in comparisons of subjective mood and consciousness scales.  Our community serves as a model in our investigations of the “Cannabis Mind.”

See more in the Cannabinoid Monthly Playbook by 8th Revolution

Psychoactives, a peer-reviewed scientific publication, recently published a study proposing that a pleasant Cannabis aroma (not THC content) predicts pleasant effects from smoking or vaporizing Cannabis.  The story struck me for several reasons; 1) There are very few Cannabis studies that report positive outcomes after smoking, 2) This study is an indication that Cannabis science is maturing beyond the novelty of THC to finer qualities of Cannabis. 
 
As a Cannabis Scientist, I spend a lot of time following the advances in Cannabis science.  From my perspective, Cannabis research is split into two camps.  The first camp focuses on single agents like THC, CBD, or synthetic cannabinoids and is more aligned with traditional research paradigms.  The second camp studies the whole plant with its broad spectrum of active ingredients.  Although more complex, this camp reflects the real-world usage of Cannabis. Most published studies are of the first camp.
 
Cannabis aromas range from sweet floral to pungent fuel. In the study, 278 healthy Cannabis users selected or were given 8-10 one-gram samples of Cannabis flowers with varying aromas to take home. They were asked to smoke each sample on separate occasions and rate their experience.  One caveat, they had to abstain from using Cannabis for 48 hours before judging each sample, which was difficult for the daily users. 
 
Here are the highlights…
 

• On an appeal scale, older people reported a more pleasant experience than younger people.  Participants aged 40 or older reported more subjective appeal after smoking than those 40 or younger.  And the 60 + demographic reported the most pleasant experience.

 

• There was negative correlation with the frequency of consumption.  In other words, those who smoked less than once per week reported a more pleasant experience than those who smoked multiple times per day.  That probably has something to do with tolerance.

 

• Participants who consumed small doses reported a more pleasant experience.  THC potency, in general, did not correlate with subjective appeal. Neither did terpene content. However, males did report more pleasant experience with higher THC potency when the results were stratified by biological gender.

 

• The strongest correlation with a pleasant experience was the Cannabis flower aroma.  The more pleasant the aroma, the more pleasant the experience.

 
Traditional academic researchers (the first camp) raise concerns about high content THC products and their propensity to be associated with Cannabis Use Disorder, Cannabinoid Hyperemesis Syndrome, and Psychosis.  In response, offering Type II (THC & CBD equivalent) and Type III (CBD dominant) Cannabis flowers institutes product differentiation and attracts the more mature consumer.
 
So, there you have it. It’s not all about THC.  In fact, Cannabis companies have already responded by adding Cannabis with less THC and more CBD, CBG, or THCv to their inventory.  Garden Society and Pure Beauty, brands that provide lower THC alternatives, offer pre-rolls with 10% THC or less.  Science indicates that Cannabis aroma is likely an important quality attribute of the plant.  In response, marketing “floral”, “pungent”, “sweet”,  and “earthy” aromas may soon replace the unsupported designations that frequent the Cannabis marketplace
 

Skilled nursing facilities, assisted living facilities, or nursing homes are institutions where much of us will spend the last decade of our lives.  There are about 1.3 million residents in U.S. nursing homes. There are over 26,000 nursing homes in the U.S. 70% of people who reach the age of 65 will need long-term care at some point in life. By 2050, up to 30 million people in the Americas will require long-term care services. Whether bed bound or just needing help with activities of daily living, the extra help that these facilities provide is crucial.  As we reach this stage in our lives, the question is; “How do I get access to Cannabis at a nursing home?”
 
Shelby Grebbin writes in Skilled Nursing News about a skilled nursing facility in New York called Hebrew Home at Riverdale’s.  In 2014, when New York passed their Compassionate Care Act, Dr. Zachary Palace, the Medical Director of Hebrew Home, was faced with a perplexing question: By permitting residents to exercise their full rights as citizens of the state to access Cannabis, could he put the senior care center at risk for non-compliance?
 
In the 21st century, Cannabis use continues to be decriminalized and de-stigmatized, and baby boomers are the major reason why.  Remember, publicly displayed pro-Cannabis sentiments started back in the 70s.  A couple of decades of “Say No to Drugs” was followed by a movement that permitted legal access Cannabis worldwide.  
 
As a compassionate geriatrician, Dr. Palace recognizes the potential benefits of Cannabis for his patients.  His clients need help with chronic pain, insomnia, poor appetite, and neurological conditions like Parkinson’s, Alzheimer’s, and seizures.   Dr. Palace is also aware that Cannabis is a Schedule I drug and any skilled nursing facility receiving federal aid is in jeopardy of losing their Medicare and Medicaid reimbursements.  In response, Dr. Palace and Hebrew Home CEO Daniel Reingold set out to create a Medical Cannabis program for their residents that legally works with the rules.
 
Most states allows residents to access Cannabis via recommendation from a physician.  “They’re able to maintain it in their own space in their room,” says Dr. Palace. “They get a lock box that only they have the key to. It’s truly their property. And it’s not in the facility’s possession, but it’s in their own personal possession.  Another participation condition requires residents to self-administer the Cannabis — unless they have a companion or family member who can administer it for them.”