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Welcome to Pharmacology by Lecturio.
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Today’s topic are the cannabinoids
in our section in toxicology.
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Now, discussion about the
cannabinoids is highly politicized.
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I’m gonna try and stay away from the
politics of cannabinoids and legalization
and just focus on the pharmacology.
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Remember that most of the information that
patients are getting and by extension some doctors,
is poor research that is very
easily available on the internet.
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The good research that is being
done is far and few between.
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Much of the research that is being done
now is actually sponsored by companies
that sell cannabinoids so
it is particularly suspect.
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Most of us are very suspicious of research
that is positive for cures or claims of cures -
cures for cancer, cures for
depression, cures for AIDS,
cures for all kinds of diseases
are being put out by those people
who are proponents of cannabinoids.
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Peer reviewed studies are expensive
and often attacked in the public sphere
so one has to be very careful about
the information that you’re using
when you're talking about
cannabis and cannabinoids.
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Now, before we go on and talk about the
cannabinoids and the medical aspects of it,
let’s define what we’re talking about.
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Hemp is a plant, we often
confuse it with cannabis.
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Cannabis is also a plant that is derived from
hemp but it is a special kind of a hemp plant.
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Now we have different strains
of cannabis out there.
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There is Cannabis sativa, Cannabis indica,
Cannabis ruderalis and Cannabis americana.
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There are those proponents who will tell
you that there are significant differences
in pharmacological makeup, and effect when
smoked of these different types of cannabis.
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But I don’t believe that personally and
recent research that has come out of Britain
is also supporting that point of view.
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That there’s not really a lot of science behind
distinguishing between the different plants.
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Now, hemp is the plant from
which all cannabinoids originate.
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It is a good source of fiber, it’s a
good source oil including cooking oil.
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It is used as a mop crop, it is used for biodiesel,
it’s used for cordage, it’s used for paper,
and it can even be used for plastic.
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Burning hemp is not a dangerous thing.
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You can’t get high from burning hemp.
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In terms of the seeds of hemp, you get over
5,000 almost 6,000 calories per kilogram
from the hulled seeds so it’s a great source of
energy for either nutrition or for animal feed.
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The amino acid profile is very similar to milk
and soy so it can be used to produce milk.
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It has a very low THC concentrations in the
hemp plant so with respect to industrial hemp,
you’re not going to get high from industrial hemp
and the danger that hemp poses to society
is often overstated by certain elements.
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Now, cannabinoids are a little bit
different so let’s compare them.
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Hemp is applied to varieties of
cannabis that is used for non-drug use.
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It has very low levels of THC.
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Cannabis is applying to those varieties
that have been breed specifically
to produce some maximum amount of THC and CBD.
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Most cannabis has been genetically modified.
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Marijuana is a term used to refer
to the unrefined dried plant
that is rolled into joints or blunts
or used for a smoking purposes.
03:43
Decarboxylation, so what is decarboxylation?
We know from chemistry class that decarboxylation
is the process of taking off a carboxyl group.
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Now the terpenes, found in a cannabinoids
have a carboxyl group on them.
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The carboxyl group prevents binding of THC or CBD
to the cannabinoids receptor inside the human body,
therefore, a carboxylated terpene
does not cause you to get high.
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When you decarboxylate that agent, you end up
with decarboxylated product that can get you high.
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Now, as I said before, carboxylated
cannabinoids are referred to as terpenes,
so these are the different types
of terpenes that are available.
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Now the terpenes themselves are rumored
to have anti-inflammatory properties,
that’s more claims than it is science so we
don’t really know how seriously to take that.
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In terms of where you see the most
terpenes, you’ll tend to see it
in freshly picked plants less
than three days of refrigeration.
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How does one decarboxylate cannabinoids?
In the oven, you can put it at a 150° for 40
minutes, in a microwave for three minutes.
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You can do a sous-vide process for 90-100 minutes.
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The advantage of this process
being there’s no odors.
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And finally you can use a chemical decarboxylator
and that would take about two hours.
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I also wanted to find what
the entourage effect is.
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An entourage effects is kind of like
a drug interaction but not quite.
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Compounds in cannabis that are
non-psychoactive on their own might modulate
the psychoactive properties of other
products within the cannabinoids.
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So an example is this:
Take a look at CBD, it can modulate
the THC effects in the cannabinoid.
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It may reduce the negative effects of THC so
there may be an entourage effect of CBD on THC.
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Myrcene is another product that’s
found in many cannabinoids.
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It enhances the sedative effects of cannabinoids.
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Now you may hear some patients talk
about 'couch lock' when they smoke weed.
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That is seen often when people
are combining beer and cannabis,
or sometimes the myrcene itself
is in very high concentrations
and that particular brand of cannabis
or marijuana is causing the 'couch lock'.
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The treatment of it in terms of
what people will do at home is
sugary caffeinated type of drinks seem to help.
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You tend to used strains with more CBD to
prevent yourself from getting couch lock.
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Now in terms of the treatment with the
sugary drinks that’s just anecdotal,
there’s not really a lot of science behind it.
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In fact the whole idea behind the entourage
effect, there’s really not a lot of scientist,
more just sort of stories
told to us by our patients.
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Linalool is a particularly interesting phenomenon.
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So linalool is an asymmetric alcohol.
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Most alcohols chemically, structurally
speaking are symmetric alcohols.
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This is an asymmetric alcohol.
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You can see that there’s half of a
benzene ring on one side of the chain
and a double-bonded methyl group on the other.
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Now, these - because they’re asymmetric you could
have two enantiomers of that particular alcohol
and the alcohol is actually considered a terpene.
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Now we sometimes see these terpenes in spices and
flowers and it’s often used as a scent in perfume.
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Now this product modulates glutamate
and GABA neurotransmitter symptoms
to enhance the sedative and
anti-anxiety effects of THC.
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It also may worsen confusion; I would say
almost guaranteed to worsen confusion.
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Now there’s something that’s an absolutely
fascinating phenomenon called the 'ghost effect'
which has been clinically documented.
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The ghost effect is the reactivation
of THC sedation and confusion as well,
when linalool is inhaled in perfumes.
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So this is without further THC consumptions
so it’s an interesting concept,
it’s kind of fun for pharmacology types but what
is happening here is that people have ingested THC.
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They’ve already had their high from the
THC, and they go down to the grocery store
or to the local department store and
they smell a perfume with linalool
and all of a sudden, they get high again.
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This is the kind of process that’s happening and
it’s because the terpene linalool in the perfume
is reactivating the THC.
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Now, I talked about this as
being clinically documented.
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I talked about it kind of
as an interesting phenomenon
but it’s probably an overestimated effect.
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So those people who talk about being allergic
to perfumes may actually be concerned
about a THC reactivation syndrome more so
than they are actually allergic to the perfume
so you have to be particularly alert and aware to
what your patients are saying at any given time.