CBD for Seizure Disorders

Cooking with Cannabis

BY curt robbins >>> Understanding CBD for Seizure Disorder Support

ne of the most pronounced health

benefits of herbal phytocannabinoids such as cannabidiol (CBD) is their ability to assist in the treatment of seizure disorders. The most obvious metric of progress in such treatment is a reduction or elimination of seizure activity in conditions such as epilepsy, Dravet syndrome (DS), and Lennox-Gastaut syndrome (LGS).

Epilepsy is a disease of the central nervous system characterized by abnormal brain activity that causes seizures or “periods of unusual behavior, sensations, and sometimes loss of awareness” (according to the Mayo Clinic). Causes range from genetic influences and infectious disease to head trauma and brain conditions, including malformations and tumors. Prenatal injuries and developmental disorders sometimes lead to seizure disorders (which can also appear in those with autism).

According to the Centers for Disease Control and Prevention, epilepsy afflicts about 3.5 million people in the United States alone, including half a million children. Many forms of the disease are intractable, relegating traditional drugs and therapies ineffective in providing beneficial reductions in seizure activity— forcing patients and wellness practitioners to seek alternative treatment solutions.

Importance of Dosing Proper dosing (also called titration) is critical for consumers and patients seeking maximum efficacy from CBD products. While tinctures are, in some cases, more straightforward, capsules can result in doses that are unintentionally too strong or too weak. Correct dosing is an exercise in trial-and-error experimentation. Combined with careful journaling and healthcare practitioner oversight, dosing can result in maximum relief and efficacy (in addition to cost savings resulting from reduced product waste).

Dosing, however, extends beyond the volume, or amount, of an herbal extraction or concentrate consumed during a single session. Also of importance is the number of times per day that an extraction is consumed and the duration over which this routine occurs. Some studies have revealed that maximum efficacy results after a week or more of regular, sustained consumption of a supplement such as CBD or cannabigerol (CBG).

“I try to help my patients develop a dosing regimen that they can happily live with in the long term,” said Colleen Kibler, a state-licensed cannabis caregiver in Belgrade, Maine. “I like to speak to the patient several times through the first month to

ensure that we are on the right track with dosage,” said Kibler during an exclusive interview with Vegas Cannabis Magazine. She emphasized the subjective efficacy that plagues both patients and their caregivers when attempting to accurately dose cannabinoids such as CBD or CBG. “Each individual has a different set of needs,” stressed Kibler.

Sunil Pai, MD, an Integrative Medicine expert and author of the 2016 book An Inflammation Nation, echoes other medical professionals when he advocates a “start low and go slow” approach to dosing CBD. Pai recommends the following steps to his patients and readers to determine proper individual dosing of wellness products such as CBD tinctures:

1. Maintain a journal to record all daily consumption data, including exact dose and experienced efficacy (or lack thereof).

a) Take note of any environmental factors that might skew results(such as a flu or unusually high anxiety due to environmental stressors).

2. Take 0.25-1.0 dropper sublingually (hold under tongue for one minute) three times daily (after breakfast, lunch, and dinner) and at bedtime.

a) The final bedtime dose can be increased if extra support is needed to treat pain and sleep issues.

b) If consuming capsules, begin with approximately 7.5 mg.

3. Sustain this routine for 7-10 days.

4. Slowly increase the weekly dose until the desired effects are experienced.

5. Continue increasing the dose until:

a) Negative side effects are experienced.

b) Positive efficacy begins to wane.

6. Leveraging the journal, decrease the dose to the previous most-efficacious dose.

7. Sustain this level until efficacy wanes or undesired negative side effects are experienced.

Research Studies A variety of recent research studies have illustrated the ability of cannabinoids such as CBD to reduce seizure activity in users, as detailed below.

A 2018 research study entitled “Effect of Cannabidiol on Drop Seizures in the Lennox–Gastaut Syndrome” that was published in The New England Journal of Medicine investigated the effect of CBD on seizure occurrence. This double-blind placebo-controlled human trial—the most rigorous type of scientific investigation possible—involved 225 participants aged two to 55.

The study found that administration of CBD at various dosing levels decreased seizure activity among study participants. “The median percent reduction from baseline in the frequency of drop seizures per 28 days during the treatment period was 41.9% in the 20 mg cannabidiol group, 37.2% in the 10 mg cannabidiol group, and 17.2% in the placebo group,” reported the researchers.

The study noted a reduction in seizure activity of at least a 50% among large portions of each segment of study participants. Of those receiving 20 mg of CBD, nearly 40% achieved a 50% reduction in seizures, while 36% in the 10 mg CBD group did the same (providing more data regarding the importance of proper dosing).

Concluded the researchers, “Among children and adults with Lennox–Gastaut syndrome, the addition of cannabidiol at a dose of 10 mg or 20 mg per kilogram per day to a conventional antiepileptic regimen resulted in greater reductions in the frequency of drop seizures than a placebo.”

A 2017 study entitled “Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome” that was published in The New England Journal of Medicine explored the ability of CBD to reduce seizure activity in patients with Dravet syndrome. This double-blind placebo-controlled human trial study involved 120 participants (all children and young adults) with treatmentresistant Dravet syndrome.

The study’s authors reported significant reductions in seizures for the group consuming CBD. “The median frequency of convulsive seizures per month decreased from 12.4 to 5.9 with cannabidiol, as compared with a decrease from 14.9 to 14.1 with placebo.” This represented a reduction in seizure activity of more than 50% when participants used CBD instead of a placebo.

While most study participants experienced a reduction in seizures, 5% of those receiving CBD became seizure free. Interestingly, the study observed all seizure activity reductions for convulsive seizures, but no reduction for the nonconvulsive variety. “The frequency of total seizures of all types was significantly reduced with cannabidiol, but there was no significant reduction in nonconvulsive seizures.” Concluded the study’s researchers, “Among patients with Dravet syndrome, cannabidiol resulted in a greater reduction in A 2017 study entitled “Cannabinoids in the Treatment of Epilepsy: Hard Evidence at Last?” that was published in the Journal of Epilepsy Research investigated the ability of CBD and other cannabinoids to decrease seizure activity in patients with DS and LGS varieties of epilepsy.

Reported the literature review study, “CBD was found to be superior to placebo in reducing the frequency of convulsive (tonic-clonic, tonic, clonic, and atonic) seizures in patients with Dravet syndrome and the frequency of drop seizures in patients with Lennox-Gastaut syndrome.”

Like many other studies, the researchers found the safety profile of CBD to be consistently acceptable, offering no opportunity for addiction or other common negative side effects encountered with traditional treatments, such as opioids. “CBD is mostly devoid of adverse psychoactive effects and possesses anticonvulsant, analgesic, anti-anxiety, antiemetic, immune-modulating, antiinflammatory, neuroprotectant, and anti-tumorigenic properties.”

The researchers concluded that their survey of the existing research illustrated the efficacy of CBD for seizure disorders. “For the first time, there is now class 1 evidence that adjunctive use of CBD improves seizure control in patients with specific epilepsy syndromes,” wrote the researchers.

Conclusions Research is revealing that the wellness molecules called cannabinoids that are produced by hemp and cannabis, including CBD, sometimes exhibit considerable benefits for patients suffering from a wide range of serious diseases. Among these are seizure disorders affecting millions of North Americans.

In addition to its role as an anticonvulsant in reducing seizure activity, current research has demonstrated many other benefits of CBD, including analgesia (pain management), reduced anxiety (therapeutic for Post-traumatic Stress Disorder sufferers), the prevention of nausea and vomiting (helpful for cancer and Crohn’s disease patients undergoing chemotherapy), decreased systemic inflammation (good for those suffering from arthritis and fibromyalgia), and neuroprotection (helpful for some pain patients and those suffering from Alzheimer's disease and Parkinson's disease)

Patients who consume CBD on a regular and monitored basis sometimes exhibit considerable improvements (especially when they consume full-spectrum hemp and cannabis products that contain other beneficial cannabinoids). This sometimes includes a significant reduction in the occurrence of seizures and other negative side effects of life-altering diseases. As additional research is conducted, wellness professionals, patients, and consumers are beginning to better understand the ability of phytochemicals from herbs like hemp to deliver significant relief for a range of ailments.

A Legal Perspective for Cannabis Consumers The “Cannab-Esq.” Chronicles

I hope everyone had a wonderful holiday season and is ready to start off the new year with a bang! If your life is anything like mine, by the time January comes around, I’ve had my fair share of holiday music, family gatherings, and flavorful Starbucks drinks. Of course, I made sure to stock up my cannabis collection well before the holiday season started, so thankfully I had plenty of provisions to help get me through the rest of 2019! And now that it is a new year and new decade, it is time to recap 2019 a little bit before we look forward and see what is in store for the Nevada cannabis industry in the year to come!

The State of Nevada’s biggest cannabis drama in 2019 came about as a result of the state allegedly doing a sub-par job at sifting through, scoring, and awarding marijuana establishment licenses to the potential applicants. After months of hours-long Court hearings, Judge Elizabeth Gonzalez issued a preliminary injunction which prevented the state from moving forward with issuing the licenses. In response to the allegations of impropriety, Governor Sisolak created a taskforce of sorts to investigate and audit the state’s marijuana licensing process. In a not-so-surprising conclusion, the selected auditors told state officials in December that the process, “while not perfect, was adequate, and conditional licenses were granted to more qualified applicants.”

Despite finding that the application process was adequate, the auditors did point out areas where the state could improve in order to make the process more transparent. For one, public forums should be held where marijuana establishment license applicants can seek answers from the state before submitting the actual applications. In addition, the scoring process for the applications should be automated as opposed to being manually entered by state employees. This would cut down on human error and – potentially – prevent undue influence being exerted by the scorers. The auditors’ recommendations can be summed up in one word – TRANSPARENCY! Had there been adequate transparency in the marijuana license application process from the get-go, much of the legal fighting and legal costs that state had to expend could have been avoided. Hopefully the state will take the auditors’ recommendations to heart and this type of drama can be avoided in the future. Continued and substantiated allegations of favoritism and impropriety in the marijuana establishment application process cannot occur if we want to keep pushing Nevada toward the top of the marijuana game.

The other major headache that plagued Nevada’s cannabis industry in 2019 was the allegation that Nevada’s licensed marijuana laboratories could not be trusted and were fudging their testing results. For example, there were a few occasions where the state had to issue a release notifying the public that tainted weed was being sold at certain dispensaries. Obviously, this same product had been (allegedly) tested at a licensed laboratory before getting the go-ahead to be put on the shelves. So either the laboratory doesn’t have reliable, capable testing equipment, or someone was trying to pull a fast one on the state and cannabis consumers.

But tainted weed wasn’t the only problem – there were also allegations that a certain marijuana testing laboratory was intentionally spitting out results that showed higher-than-legitimate THC content. While this type of tomfoolery may not be as dangerous as allowing tainted weed to hit the shelves, it is just as egregious. Many people look at those exact test results when determining which product or brand to purchase. This is a prime example of false advertising if I’ve ever seen one! At the end of the day, the state suspended the license of that specific testing laboratory – Certified Ag Labs, based in Sparks, NV – for 30 days and issued a fine of $70,000. The state is also requiring that Certified Ag Labs provide a “plan of correction” before they will be allowed to resume testing cannabis. Hopefully the short suspension and fine will prevent this nonsense from occurring again, especially at Certified Ag Labs. Fool the State once, shame on you. Fool the State twice, shame on the State!

As for 2020, I’m confident this upcoming year is going to be the best one yet for cannabis consumers. Not only has the federal push to legalize marijuana grown stronger, but the protections provided by the State of Nevada for cannabis consumers have grown significantly stronger as well. On January 1, 2020, Assembly Bill 132 (PreEmployment Marijuana Drug Testing) officially took effect in the State of Nevada. Assembly Bill 132 prohibits Nevada employers from refusing to hire someone because of a THC-positive pre-employment drug screening. Of course, there are limited exceptions to this prohibition such as firemen, emergency personnel, job positions that require the operation of a vehicle, and jobs that “in the determination of the employer, could adversely affect the safety of others.” While the passage of Assembly Bill 132 was a major win for cannabis consumers, I can already envision the last exception resulting in a plethora of lawsuits and litigation while Nevada employers test the boundaries of the “discretion” afforded to them with the “in the determination of the employer” language that was used. Hopefully the courts will tone this down and at least give some further guidance on how wide-ranging this discretion is. If not, I foresee employers running wild and taking advantage of this little loophole – to the detriment of the pot-smoking employees!

Have any questions, comments, ideas or suggestions? Please feel free to contact me at mike@nevadahempassociation.com or check out the website at Nevadahempassociation.com. until next month SMOKE NEVADA HEMP! And last but not least, who could forget that 2020 is also the year that we finally get a whole MONTH to claim as our own. This April we get to throw caution to the wind and spend a full thirty days enjoying 4/20! Get prepared my people! 4/20 is coming! #StayWoke Follow me: www.cannab-esq.com IG: @Cannab_Esq FB: @MitchellSBissonEsq

TERPENE TALK Caryophyllene

Picture it: Lake Tahoe, Nevada, 2020. After wrapping up your holiday festivities, you decide that decompressing from the pressures of the season by frollicking in the powdery mountain snow would be the most relaxing and serene setting in which to welcome the new year. You bundle up, gas up your truck (being sure to apply those snow chains we’re always being told to affix to our tires) pack up your resolutions and 2020 predictions, snow gear and of course, your cannabis. Heading north on I-80, you’re filled with the excitement and anticipation of a relaxing getaway. Pulling up to your cabin retreat, you’re enticed by the pungent, smoky aroma of crisp wooden logs crackling in a campfire, the fresh scent of the brisk outdoors and the spice of your cinnamon-topped hot beverage. No, this is not the screenplay prologue for a winter themed Rom-Com, it’s a metaphorical description of a dayin-the-life if life were summed up as one cannabis terpene: caryophyllene. Caryophyllene is one of the most common terpenes found in nature and within the cannabis plant. Often detected by a distinctive outdoorsy, wood and spice fragrance, beloved strains like OG Kush, White Widow and Sour Diesel boast healthy levels of this beloved terp. Excellent for treating neuropathic pain and ailments pertaining to neurodegenerative disease, caryophyllene has extraordinary antioxidant effects. Other benefits of caryophyllene-rich cannabis strains include inflammation reduction, antimicrobial properties and the ability to assist in the body’s protection against diseaseespecially those of the brain and neurological variety.

One of the most interesting qualities of caryophyllene is that it has the ability to act as both a terpene and a cannabinoid. As a cannabinoid, binding to CB2 receptors allows caryophyllene’s

relationship to the endocannabinoid system to promote a myriad of painrelieving and anxiety reducing benefits. Distinctively musky fragrance notes often accompany this terpene with added flavors of spice and subtle citrus. Cloves, pepper, cinnamon, rosemary and basil contain caryophyllene, as well.

Strains with higher caryophyllene profiles are great at keeping anxiety at bay and promoting pleasantly euphoric feelings of wellbeing. As a terpene, it provides assistance with digestive issues and can be used in the treatment of addiction as well as skin maladies and irritations. Caryophyllene has also been credited for containing anti-cancer and anti-tumor qualities. By ebbing the growth of tumors in the body, it acts similarly to CBD- the cannabinoid behavior and effects of caryophyllene make it multifaceted and multidimensional.