Cannabis Culture in Western Massachusetts
Summer 2019
Summer 2019
The Herbalist • 1
2 • The Herbalist
Summer 2019
Summer 2019 In this issue Good chemistry How THC and CBD shape your cannabis experience
4
Legal weed: a world tour International marijuana law, charted
10
Cannabis, Alzheimer’s and dementia Marijuana brings hope to patients and caregivers
12
New tricks for old dogs Medical cannabis is growing on the veterinary community
17
On the cover: Robert Nelson/UnSplash This page: Metro Creative Connection The Herbalist is an advertising supplement published by New England Newspapers Inc. To contact us, please email advertising@newendlandnewspapers.com. Please consume responsibly. The Herbalist and its publisher, New England Newspapers Inc., do not endorse consumption of any controlled substance outside the bounds of Massachusetts state law. No content within this magazine is intended as medical or legal advice.
Welcome back. Here at The Herbalist, we're thrilled to present our second issue. This time around, we're taking a good look at medical marijuana: what it does, how it works and why we've still got a lot of research left to do. Despite promising anecdotal evidence and widespread public interest, only one cannabis-derived drug has managed to secure FDA approval. Much-needed clinical studies are held back by lingering social stigma and a complex, often contradictory web of legal restrictions. Is marijuana a miracle drug? Probably not. Could it offer life-changing relief to sufferers of chronic pain, neurological disorders and a host of other illnesses? Early evidence says yes, and that alone should be enough cause to fight for sensible and humane cannabis legislation at all levels of government. Kimberly Kirchner Editor, The Herbalist
Summer 2019
The Herbalist • 3
4 • The Herbalist
Summer 2019
By Jessica Edwards Herbalist correspondent Marijuana, ganja, weed, trees, herb, Mary J, bud or flower. There's a lot of misinformation, disinformation, and propaganda about this one plant, which, prior to becoming illegal in the 1930s, was widely used as a medication. After decades of being stigmatized and with the spread of medical and recreational cannabis laws in this country, we are finding our way back to understanding the unique relationship our bodies have with this plant. The cannabis plant presents in two main varieties: cannabis sativa and cannabis indica. Sativas are recognized by their thin, light green leaves and buds, while indica varieties have dark, thick leaves and buds that are short, thick and dense. Sativas tend to produce a “head high” that is euphoric; these strains are the ones known to make people more talkative, social and engaged. Sativas can be useful in the treatment of depression and social anxiety because of these characteristics. Indicas are known for giving a “body high”; these strains are for relaxation and can result in what is known as “couch-lock,” where the person has very little physical motivation and can become more introspective as opposed to social. This makes indicas an ideal strain for nighttime use, especially for those who suffer from insom-
nia or nighttime restlessness. Most strains available these days are a blend of both sativa and indica, and are known as a hybrid; hybrids combine the known, desirable effects of two or more strains. A sativa-leaning hybrid can give people mood enhancement, with just enough indica to keep an uplifting effect from becoming paranoia or anxiety. An indica-leaning hybrid can deliver all the pain relief and relaxation with just enough Sativa to allow people to still function during the day. The active compounds that affect the brain and body are all found in a structure on the plant called trichomes. Trichomes are small resinous glands, formed mostly on the buds, or flowers, of the cannabis plant. Trichomes contain the three types of active compounds found in the cannabis plant: flavonoids, terpenes and cannabinoids. Flavonoids are a group of plant-based compounds believed to provide health benefits. Fruits, vegetables and some beverages like tea and wine contain high amounts of flavonoids. Terpenes are the essential oils of the cannabis plant. They are aromatic oils that vaporize at low temperatures and produce strong effects on the body; they also affect receptors and neurotransmitters in the brain. Cannabinoids are chemical compounds that signal cannabinoid receptors. These receptors, CB1 and CB2, are located throughout the body. CB1 re-
ceptors are found mostly in the brain. CB2 receptors are found throughout the body; they work with our immune system. THC, tetrahydrocannabinol, is the most famous cannabinoid, and the one responsible for the "high" or psychoactive effect. CBD, cannabidiol, is now the second most wellknown cannabinoid. THC and CBD have been the most researched of the phytocannabinoids, the powerhouse elements of the cannabis plant.
THC THC is the most famous cannabinoid because it’s “the fun one.” It is the psychoactive compound that provides the euphoric effect that people associate with being high or “stoned” when smoked or ingested. That’s because THC is what is known as an agonist; this means it activates receptors in a part of the brain that affects memory, motor function, cognition, focus, and most notably, pleasure. THC is the plant-based version of the cannabinoid we naturally produce in our own bodies, anandamide. Known as the “bliss molecule,” it’s responsible for what is commonly known as the runner’s high. THC binds to cannabinoid receptors found mostly in the brain and central nervous system. This produces the intoxicating effects that everyone associates with cannabis. THC has a wide range of potential short-term side effects. De-
pending on the strain and a person's own body chemistry, they can experience increased social effects or decreased social effects, decreasing anxiety or an increase in anxiety. The method of THC consumption also plays a role in how a person reacts to the substance. Smoking THC causes absorption through the lungs, and the consumer experiences a more immediate effect, within seconds to a couple of minutes. When consuming THC in an edible form, the liver converts delta-9 THC to delta-11 THC. This is a slightly different chemical compound than is produced when smoking cannabis. Smoking can wear off within 30 minutes to a couple of hours at the most. The effects of ingesting edible forms of cannabis can last from about 2 to 8 hours. Consumers also tend to feel the effects more strongly when taken in an edible form. Medical cannabis patients report better long-term effects and longer-lasting effects when using edible forms of cannabis. Vaping is also a popular form of consumption. This involves heating the cannabis just high enough to vaporize the cannabinoids without actually burning the plant material. The consumer inhales the vaporized cannabinoids in what is basically an essential oil form. What is left behind is ground cannabis flower in a mostly brown condition. This is known as “already vaporized bud,” or AVB. It still contains
Photo: Pixabay Summer 2019
The Herbalist • 5
many active compounds and can be added directly to any food source and consumed to reap the benefits of compounds left behind in the vaporization process. Aside from THC's intoxicating effects, researchers continue to explore the medical potential of this compound. Efforts to study these potentials have been blocked largely by legislation and the federal drug scheduling of THC as a Schedule 1 drug, identified by the government as having has no known medical value. Despite this designation, limited studies have shown
THC to have a positive effect on pain, inflammation, nausea, Crohn's disease, fibromyalgia, Alzheimer's disease and appetite loss, among a host of other conditions. Many veterans organizations have reported success in helping disabled vets treat their pain, depression, anxiety and post-traumatic stress disorder. As a result, the federal Department of Veterans Affairs has loosened the regulations regarding veterans use of cannabis and their ability to maintain ongoing treatment. Veterans in states with medical and recreational programs can no longer be penal-
ized for cannabis use. Doctors at the VA are still not allowed to prescribe or suggest cannabis; they can only document their patients use. Pharmaceutical companies have previously isolated and created a synthesized form of THC to be used in medications. Synthetic forms of marijuana have not been as effective in treatment as the whole plant therapy consumers experienced when smoking or eating edible forms. Researchers now believe that this is because cannabis works best when all of its constituents are present. This is called the
“Entourage effect.� The compounds need to be together to work at maximum benefit. This is much the same as taking the active ingredient in Tylenol, acetaminophen and combining it with caffeine to make the brand name Excedrin. The combination with caffeine is especially effective in treating headaches. The mechanics of cannabinoids work similarly. As perceptions change, regulations and laws will also change. With that change will come the research and study necessary to understand the potential benefits of THC and all of the other cannabinoids.
TETRAHYDROCANNABINOL (THC)
6 • The Herbalist
Summer 2019
CANNABIDIOL (CBD)
H
OH
H HO CBD Cannabidiol, better known as CBD, is the second most abundant cannabinoid found in the cannabis plant and the most abundant cannabinoid found in the hemp plant. Until recently, much less was known about CBD and it's more famous relative, THC. It has gained in popularity and can now be found on the shelves of most stores and gas stations. CBD lacks the psychoactive effects of THC: While your body will react to it in various ways, it will not get you high. The most important thing to know about CBD is that not all CBD is created equal-
Summer 2019
ly. Some CBD available on the market doesn't even contain the active CBD; it is just the carrier oil. There are many multilevel marketing scams and low-quality CBD flooding the market as the popularity and demand for CBD increases. Full-spectrum CBD derived from the hemp plant is the best option for high quality. Companies with a quality product will provide lab reports showing the various levels of cannabinoids present. Some low-level quality CBD is produced by pressing hemp seeds, and then isolating and extracting solely the CBD. This ensures that there is absolutely no THC in the
extract. However, this method removes all of the other cannabinoids, terpenes and flavonoids that have their own associated mechanisms and benefits. High-quality CBD is produced through various methods using a whole plant extraction process. The plant is stripped of its active cannabinoids and compounds, and concentrated for the end consumer. Sold in its dried and cured form, CBD-rich hemp can be a smokable product. This leaves the cannabinoids, terpenes and flavonoids intact and available for the consumer. CBD is gaining in popular-
ity because it has shown to be useful in the treatment of inflammation and pain, and also provides a deeply relaxing effect without the psychoactive effects of THC. CBD reacts mainly with our CB2 receptors found in their highest concentration, in our immune system. The lack of a psychoactive effect can be a positive benefit for those who might have anxiety or experience fear when consuming traditional cannabis products that include THC. The methods for consuming CBD are the same as THC. CBD-rich hemp looks, smells and tastes a lot like traditional cannabis. It can be used in
The Herbalist • 7
a vaporizer, extracted into oils and added to food, or smoked. Forms of CBD concentrate are also available on the market. Consumers can choose from raw isolates and distillates, or purchase disposable, prefilled vape pens. There are even CBD-infused coffees on the market. In June, the Massachusetts Department of Agricultural Resources added regulations to CBD that prohibit the sale of unprocessed hemp to consumers. In addition, the sale of any food or edible form of processed CBD is now prohibited. This means any stores currently selling CBD-infused gummies, tinctures or other ingestible forms of CBD will have to remove these items from the shelves. The sale of these products is regulated by both the FDA on the federal level and the state. Local health inspectors will start enforcing these regulations soon.
8 • The Herbalist
The FDA prohibits the sale of any CBD product as a food additive, dietary supplement, animal feed ingredient or in the form of any products making health benefit or medicinal claims. The research into CBD is in even earlier stages than that of THC. There have been several studies that confirm anecdotal evidence, but, to date, there have been no studies with the proper controls to prove or disprove the links between CBD and the effects and benefits consumers have reported. This is set to change because the federal government scheduled and regulated hemp and hemp-derived CBD in a different category than traditional high THC forms of cannabis. As such, studies and more research should be forthcoming, while consumer demand and marketing continues to expand. •
Photo: Pixabay
Summer 2019
Summer 2019
The Herbalist • 9
Where in the world
All uses illegal: Afghanistan, Albania, Algeria, Andorra, Angola, Armenia, Azerbaijan, Bahamas, Bahrain, Barbados, Belarus, Benin, Bhutan, Bosnia and Herzegovina, Botswana, Brunei, Bulgaria, Burkina Faso, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, China, Comoros, Cuba,
Democratic Republic of the Congo, Djibouti, Dominica, Dominican Republic, East Timor, El Salvador, Equatorial Guinea, Eritrea, Eswatini, Ethiopia, Fiji, Gabon, Gambia, Ghana, Greenland, Grenada, Guatemala, Guinea, Guinea-Bissau, Guyana, Haiti, Honduras, Hong Kong, Hungary, Iceland, India, Indonesia, Iraq, Ivory Coast,
Japan, Jordan, Kazakhstan, Kenya, Kiribati, Kosovo, Kuwait, Kyrgyzstan, Latvia, Lebanon, Liberia, Libya, Liechtenstein, Macau, Madagascar, Malawi, Malaysia, Maldives, Mali, Marshall Islands, Mauritania, Mauritius, Micronesia, Monaco, Mongolia, Montenegro, Mozambique, Namibia, Nepal, Nicaragua, Niger, Nigeria,
Oman, Palau, Panama, Papau New Guinea, Qatar, Republic of the Congo, Russia, Rwanda, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Samoa, Sao Tome, Saudi Arabia, Senegal, Serbia, Seychelle, Sierra Leone, Singapore, Slovakia, Solomon Islands, Somalia, South Sudan, Sudan, Surina-
me, Sweden, Syria, Taiwan, Tajikistan, Tanzania, Togo, Tonga, Trinidad and Tobago, Tunisia, Turkmenistan, Tuvalu, Uganda, Ukraine, United Arab Emirates, Uzbekistan, Vatican City, Venezuela, Yemen, Zambia
KEY
All uses illegal
Unenforced for recreational use, illegal for medical use
Decriminalized for recreational use, Illegal for medical use
All uses legal
Decriminalized for recreational use, legal for medical use
Unenforced for recreational use, legal for medical use
Illegal for recreational use, legal for medical use
Unknown Special case NOTE: The definitions of "legal," "decriminalized," and "unenforced" vary from nation to nation. Always be sure to brush up on the local laws before partaking.
is marijuana legal? Unenforced for recreational use, illegal for medical use: Bangladesh, Cambodia, Egypt, Iran, Laos, Lesotho, Morocco, Myanmar, Pakistan, Vietnam
Belize, Bolivia, Costa Rica, Ecuador, Moldova, Paraguay
Decriminalized for recreational use, Illegal for medical use: Antigua and Barbuda,
Decriminalized for recreational use, legal for medical use: Argentina, Austria, Belgium,
All uses legal: Canada, Georgia, South Africa, Spain, Uruguay
Bermuda, Chile, Colombia, Croatia, Czech Republic, Estonia, Israel, Italy, Jamaica, Luxembourg, Malta, Peru, Portugal, Slovenia, Switzerland Unenforced for recreational use, legal for medical use: Finland, Mexico, Thailand
Illegal for recreational use, legal for medical use: Brazil, Cyprus, Denmark, France, Germany, Greece, Ireland, Lithuania, New Zealand, North Macedonia, Philippines, Poland, Romania, San Marino, South Korea, Sri Lanka, Turkey, United Kingdom, Vanuatu, Zimbabwe
Unknown: North Korea Special Cases: United States, Australia (legality varies by state), Denmark (decriminalization of recreational use in progress) Updated June 2019
Cannabis, Alzheimer’s and dementia By Jessica Edwards Herbalist correspondent All humans eventually face the reality that their lives will end. For those of us who have been afflicted with or affected by Alzheimer’s disease or dementia, the end can be brutal, for caregivers and patients alike. With an eye toward hope, researchers now are finding that cannabis might hold the key to unlocking an effective treatment for — and possibly the prevention of — diseases of the brain that come for many with old age. Alzheimer’s is a progressive brain disorder, getting worse over time. It leads to memory loss and can impair a person’s ability to manage daily tasks; simple thoughts, such as “socks go on feet,” are lost in people in the advanced stages of the illness. The disease affects more than five million Americans and is a leading cause of death,
12 • The Herbalist
according to the National Institute of Health; it is also the most common cause of dementia. The institute defines dementia as the loss of cognitive functioning — thinking, remembering and reasoning — and behavioral abilities to such an extent that it interferes with a person's daily life. The most promising area of the research is in treating the agitation and aggression present in many people living with these brain diseases, as seen in studies in the United States and Israel, in particular. There also have been studies done using genetically modified, or transgenic, mice. Scientists have added human genes to the mice to better understand the mechanics of the diseases and medications that treat them. Israel is leading the charge in this new area of research with numerous studies examining the potential link between medical cannabis oil and improved treatments for Alzheimer’s and dementia patients.
Summer 2019
Photo: Pixabay Summer 2019
The Herbalist • 13
“When she takes the THC, she perks up. It reminds me of the movie, ‘Awakenings.’ She is more engaged with people, primarily her caregivers. She is talkative. She seems less anxious. She laughs." — Gillian Jones, on using THC to treat her mother's dementia and related ailments Photo: Kimzy Nanney/UnSplash
Disease prevention
Treating symptoms
While treating symptoms such as these could be the most promising area of research, the most exciting is the potential cannabis might hold for the prevention of these disorders. For instance, another group of researchers is examining the potential cannabis might hold as a neuroprotectant. This means that it might provide mechanisms for keeping the human brain healthy, destroying plaque that builds up in the brain and protecting healthy cognitive functions. Specifically, cannabis reduces beta amyloid proteins in the neurons in the brain, according to a 2016 study from the Salk Institute in California. This means cannabinoids remove the toxic proteins that cause the plaque buildup that is believed to contribute to Alzheimer's. Salk researchers found that high levels of the protein were
Many people living with these conditions experience bouts of aggression. This can cause injury to themselves and their caretakers, as well as taking an emotional toll on everyone involved. In 2016, a group of researchers in Tel Aviv, Israel, published a study in the Journal of Alzheimer's Disease, showing that cannabis had a positive effect on the behavioral and psychological symptoms of dementia. They found a significant decrease in delusions, agitation, irritability, apathy, sleep and caregiver distress. Their conclusion was that adding medical cannabis oil to Alzheimer's and dementia patients’ medication regimen is safe and a promising treatment option. 14 • The Herbalist
linked with inflammation and higher levels of neuron degeneration. They found that exposing these cells to cannabinoids reduced the toxic protein levels and also stopped the inflammation response of the nerve cells. This allows the nerve cells to survive and function.
Caregiver perspectives Gillian Jones is a longtime employee of The Berkshire Eagle and its parent company New England Newspapers Inc., the publisher of The Herbalist. A photographer, Jones is also the primary caregiver to her mother, Rita, 86, who has dementia and suffers from a multitude of related maladies, including arthritis, back pain, knee pain, swelling in her legs, lethargy, depression and anxiety. Jones told The Herbalist that, even though her mom takes five different prescrip-
tion meds, “overall, I was not satisfied with her pain management medications. Nothing seemed to really help”. Looking for an alternative, Jones first turned to CBD oil. “She didn't like the taste. The capsules were hard for her to swallow and felt a lot like more medication,” said Jones. She then tried some CBD gummies, purchased at the Wild Oats Coop in Williamstown, as well as THC gummies from Berkshire Roots in Pittsfield and THC gummies or chocolate from Silver Therapeutics in Williamstown. “The dosing is very conservative. I started with half and waited to see how she responded,” said Jones. “A little THC goes a long way, and you absolutely must be patient. I think that people have negative experiences because they take too much, because they don't feel anything right away.” The Herbalist asked Jones Summer 2019
how has it affected her mom’s daily life. “Well, for starters, the swelling in her legs has decreased tremendously. We have not had to use compression socks in months. Furthermore, she seems to have more mobility when she is walking around. She is still slow but seems to be moving more easily and rarely complains about knee pain, as she did before taking daily CBD,” said Jones. “When she takes the THC, she perks up. It reminds me of the movie, ‘Awakenings.’ She is more engaged with people, primarily her caregivers. She is talkative. She seems less anxious. She laughs. Even the foot nurse who visits quarterly noticed a difference. She said before, ‘She was just there.’ This last visit, she was chatty and interacting with the nurse.” Jones said that, while her mother still experiences pain at times, she believes it is
Summer 2019
greatly reduced with the daily CBD and occasional THC. Moreover, Jones’ mom takes the edibles without conflict, unlike her regular prescription medications, which she often refuses to take, said Jones. “I also think that she experiences less anxiety.” “While sometimes she does act ‘high,’ as it were, when she takes the THC, she appears happy and comfortable, and frankly that is really all I want for her at this point,” said Jones.
Changing attitudes Attitudes toward cannabis within the medical community are beginning to change, as more research and studies like these are published. Sherri Tutkus is a registered nurse, founder of the GreenNurse Group, founding member of the Cannabis Nurses Network and a member of the American Cannabis Nurses
Association. Having worked with Alzheimer's patients, she has seen firsthand that starting cannabis therapy earlier in the progression leads to better results than when started in the later stages of the disease. Tutkus said that other countries might be ahead of the curve with research, but actual change will be affected closer to home with the help of medical professionals and advocates. “Nurses here in the USA are going to be the game changers in the industry, because patients trust us,” Tutkus said. She believes the key to understanding how cannabis affects the body and brain lies in the endocannabinoid system. The endocannabinoid system is a series of receptors spread throughout the body. There are two known receptors that interact with cannabinoids, CB1 and CB2. CB1 receptors are found mostly in the brain and to a lesser extent, the
body. CB2 receptors are located mostly within the immune system and the organs associated with it, such as the spleen. Cannabinoids work with these receptors like a lock and key. The study of this interaction will be the foundation of all research into the potential cures, treatments, and therapies cannabinoids might provide, said Tutkus. Researchers, medical professionals and regulators all agree that cannabis requires expanded study with control groups that do not rely on self-reporting by patients. With research well on its way in other countries and gaining momentum within the US, discoveries, understanding and treatment protocols are expected to start moving at an increasing pace. “Nurses are going to be required to learn and know the endocannabinoid system in order to pass their nursing board examinations,” said Tutkus. •
The Herbalist • 15
16 • The Herbalist
Summer 2019
New tricks for old dogs Medical cannabis for people is a controversial, convoluted subject. When it comes to animals, things get even hairier. By Kimberly Kirchner Herbalist Contributor American pet owners are spectacularly big spenders. The American Pet Products Association reports that consumers spent over $72.5 billion on their animal companions in 2018, and predicts 2019 totals will surpass $75 billion. If that doesn't impress you, consider that the National Retail Federation estimates Americans forked over $480 million last year just for their pets’ Halloween costumes. With that kind of money on the table, it’s no
surprise that cannabis producers have expanded into the pet supply market. Sales of cannabis products for pets quadrupled in the last two years — going from $8 million in 2017 to $32 million in 2018 — according to industry research firm Brightfield Group. But while sales surge ahead, actual medical research proceeds at a slow trickle, held back by the same legal uncertainty that has complicated medical marijuana research for humans. Owners interested in cannabis treatments for their pets face a maze of regulatory and scientific questions.
Photo: Ken Reid/UnSplash Summer 2019
The Herbalist • 17
First, the good news Is veterinary cannabis worth all this confusion? Early research says “yes.” The endocannabinoid system — the network of receptors that interact with cannabinoids like THC and CBD — is common to all vertebrates, with a similar function across species. Proponents suggest that some of the positive results seen in human cannabis users can be replicated in companion animals. The most well-known scientific study of veterinary cannabis, published this June in the Journal of the American Veterinary Medical Association, builds on CBD’s status as an FDA-approved epilepsy treatment to address the condition in dogs. Researchers at Colorado State University performed a double-blind, placebo-controlled study on 16 epileptic dogs, and found that
nearly 90% of the dogs receiving CBD oil saw a decrease in seizures, compared to just 20% of the dogs receiving the placebo. While small, the study heightened interest in veterinary cannabis and prompted the American Kennel Club’s Canine Health Foundation to sponsor an expanded version of the study, testing the same product on a larger pool of participants over a three-year period. A clinical study at Cornell University assessed comfort and activity levels of dogs with osteoarthritis, with and without twice-daily doses of CBD oil. Participants received four weeks of CBD treatment and four weeks of a placebo, in random order. Dogs showed noticeable improvement to their OA symptoms while receiving CBD oil, and researchers concluded that there was enough evidence to warrant a larg-
er-scale study in the future. Participants in both studies suffered no serious side effects, indicating that, as in humans, CBD may be a safer alternative to more traditional drugs. The descheduling of hemp in the 2018 Farm Bill (more on that shortly) jump-started medical research into CBD. A flurry of new studies, many of them sponsored by major veterinary cannabis distributors like ElleVet and VetCS, are currently in progress. The studies cover a wide range of species and ailments, including epilepsy, cancer and postsurgical pain in dogs; pain and anxiety in cats; arthritis and laminitis in horses; and a viral gastrointestinal disease in birds.
Legal complications The laws concerning veterinary cannabis, particularly CBD, are murky at best,
and flat-out contradictory at worst. The 2018 Farm Bill took a step towards clarity by defining hemp (cannabis containing less than 0.3% of the psychoactive chemical THC) as distinct from marijuana, which remains a Schedule 1 controlled substance. This lifts federal restrictions on products made with hemp, but individual states are still free to impose their own restrictions. The Massachusetts Department of Agricultural Resources issued a formal policy statement this June explicitly banning the use of hemp-derived CBD in food products, including dietary supplements, animal feed and any product making therapeutic or medicinal claims. In addition, the Federal Food and Drug Administration continues to classify hemp-derived CBD as a drug, and requires CBD products
Photo: Pixabay 18 • The Herbalist
Summer 2019
When things go wrong Unfortunately, not all animal cannabis use is owner-sanctioned. The American Society for the Prevention of Cruelty to Animal’s Poison Control Center reported more than 1,800 calls about pets consuming marijuana products in 2018, a 765% increase since 2008. The good news is that marijuana consumption alone is almost never fatal. While THC is toxic to animals in large doses, it’s virtually impossible for one pet to consume enough product to cause lasting damage. On its website, the American Veterinary Medical Association notes that “several deaths have been reported due to Cannabis toxicity, and these appear to be the result of associated complications, such as aspiration.” Marijuana edibles, however, often contain ingredients that are dangerous and even potentially fatal to pets. Chocolate, raisins and particularly the sweetener xylitol can drastically decrease chances of recovery. Regardless of the form in which it was consumed, any signs of cannabis poisoning warrant an emergency trip to the vet.
to undergo the same review process as any other medication. To date, only one CBDbased medicine has earned the FDA’s approval. The FDA also prohibits the use of CBD as an additive in food, drinks or dietary supplements. As a result, CBD products currently on the market have not been inspected by the FDA for safety and quality, raising concerns about contamination and mislabeling. To further complicate things, medical marijuana laws apply only to human patients; they grant doctors the right to prescribe cannabis for medical use, but do not explicitly expand that right to veterinarians. The result is a legal gray area that leaves animal health practitioners unsure of how and when they can discuss cannabis with their clients. In 2018, California legislature approved a bill granting legal protection to veterinarians who discuss veterinary cannabis products with their clients; in New York, a similar bill is under review by the Senate Health Committee. The Summer 2019
California law stops short of allowing vets to make specific product recommendations, however, and the state’s Veterinary Medical Board has yet to publish formal guidelines for talking to clients about cannabis. The majority of state veterinary associations have no written policy for cannabis use on animals, regardless of the state’s laws on human cannabis consumption. A study published in the January 2019 issue of Frontiers in Veterinary Science found that less than 22% of veterinarians polled felt that their state veterinary organization “has provided sufficient guidance for me to practice within the state or federal laws” when it comes to cannabis. In March, the Boston Globe reported that the Massachusetts Veterinary Medical Association was preparing an advisory assuring vets that talking about cannabis for patients was legal, though treatments should be approached with extreme caution due to the lack of research and oversight. As
Signs of cannabis toxicosis include: • Depression • Low body temperature • Low blood pressure • Decreased heart rate • Sleepiness
• Unsteady movement • Dribbling urine • Vomiting • Hypersalivation • Dilated pupils
Treatment for cannabis toxicosis is usually focused on easing symptoms and making the animal comfortable until the effects have worn off. Vets may also administer activated charcoal to prevent further absorption of the toxins as they work their way through the digestive system. The most effective treatment? Prevention. Keep pets safe by making sure all cannabis product, be it in plant or processed form, is well-secured and out of reach of curious paws.
of late June, the organization had not made any public statements on the matter. At least one major veterinary organization has come forward with a definitive statement on discussing cannabis treatment options. The Colorado Veterinary Medical Association, in a position statement adopted in 2016, asserts that while it is illegal for veterinarians to prescribe marijuana products for animal use, “veterinarians have an obligation to provide companion animal owners with complete education in regard to the potential risks and benefits of marijuana products in animals.”
CBD in practice Regardless of where they stand on the legality of CBD for pets, animal health experts agree that pet owners should consult their veterinarian before beginning any kind of cannabis treatment. Veterinary Cannabis Education and Consulting, a veterinarian-run group dedicated to educating owners and
practitioners on the ins and outs of cannabis use, encourages pet owners to be upfront about their interest in or use of CBD treatment options. Like all drugs, CBD has the potential to interact negatively with other medications, so it’s important to consult a medical professional before diving into a new treatment. Pet owners should also discuss possible risks and withdrawal symptoms before discontinuing any current medications. CBD may be available without a prescription, but it should be treated with the same care and caution and as any other medication. Since CBD pet products are not FDA-inspected, owners must take it upon themselves to ensure what they’re buying is safe and accurately labeled. One way to go about this is to ask for a Certificate of Analysis (COA) for every product before purchase. The COA indicates that the product was tested by an independent third party, and details the amount and concentration of any cannabinoids present. It also The Herbalist • 19
analyses the product for heavy metals, toxic chemicals and bacteria, so owners can be sure the product is free of any harmful substances. Veterinary Cannabis suggests owners bring the COA and product packaging to their vet for a review if they’d like extra assurance. When it comes to administering CBD, the common wisdom is “start low and go slow.” The Cornell osteoarthritis study identified 2 mg/kg as a safe starting dose. Owners can then gradually increase the dosage, if needed, until the desired result is achieved. Veterinary Cannabis recommends keeping a journal of the pet’s activity over the course of treatment to spot any gradual changes, good or bad. Tinctures (liquid cannabis products) are the most widely recommended form of cannabis for animals, since they allow for precise dosing and have been subjected to the
20 • The Herbalist
Photo: Pixabay
most clinical research so far. Tinctures should be oil-based, not alcohol-based. CO2 and alcohol are considered the safest extraction method for pets; butane or propane extraction can leave behind dangerous residue. Edibles designed for human consumption may contain ingredients that are toxic to animals and should not be administered to pets. Products containing THC are best avoided — at least for now — as legal restrictions have prevented any in-depth studies on prolonged use in animals. There’s a lot of ground left to cover when it comes to making veterinary cannabis safe and readily available to all patients. But if Americans put half as much effort into policy reform and clinical research as they do into doggie birthday parties and Instagram accounts for their cats, change won’t be far away. •
Summer 2019
