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Review: Cannabinoids as Medicinals

Khalsa, Jag H; Bunt, Gregory; Blum, Kenneth; Maggirwar, Sanjay B; Galanter, Marc; Potenza, Marc N
Purpose of review/UNASSIGNED:There have been many debates, discussions, and published writings about the therapeutic value of cannabis plant and the hundreds of cannabinoids it contains. Many states and countries have attempted, are attempting, or have already passed bills to allow legal use of cannabinoids, especially cannabidiol (CBD), as medicines to treat a wide range of clinical conditions without having been approved by a regulatory body. Therefore, by using PubMed and Google Scholar databases, we have reviewed published papers during the past 30 years on cannabinoids as medicines and comment on whether there is sufficient clinical evidence from well-designed clinical studies and trials to support the use of CBD or any other cannabinoids as medicines. Recent findings/UNASSIGNED:Current research shows that CBD and other cannabinoids currently are not ready for formal indications as medicines to treat a wide range of clinical conditions as promoted except for several exceptions including limited use of CBD for treating two rare forms of epilepsy in young children and CBD in combination with THC for treating multiple-sclerosis-associated spasticity. Summary/UNASSIGNED:to treat multiple clinical conditions, but more preclinical, and clinical studies and clinical trials, which follow regulatory guidelines, are needed to formally recommend CBD and other cannabinoids as medicines.
PMID: 36093358
ISSN: 2196-2952
CID: 5336102

Cannabis/Cannabinoids for Treating COVID-19 Associated Neuropsychiatric Complications

Khalsa, Jag H; Maggirwar, Sanjay B; Bunt, Greg
COVID-19 epidemic has resulted in devastating mortality and morbidity consisting of socioeconomic and health effects that have included respiratory/pulmonary, cardiovascular, mental health and neurological consequences such as anxiety, depression, and substance use. Several effective vaccines have been developed and extensive efforts are underway to develop therapeutics to treat COVID-19. Cannabis and/or its product-cannabidiol (CBD) are being advertised for the treatment of COVID-19 associated mental/neurological complications and substance use disorders. However, research reviewed shows that there is insufficient data from clinical studies to support the use of cannabis or CBD for the treatment of COVID-19 associated mental health and neurological complications. Additional basic and clinical research is suggested to develop cannabis or cannabidiol for the treatment of mental health problems associated with coronavirus infection and or substance use disorders. In the meantime, it is important that the addiction physician/psychiatrist must caution while prescribing or recommending cannabis or CBD for treating such clinical indications. Research shows that currently there is no clinical evidence to support the use of cannabis or any of its compounds including CBD for treating any of the neuropsychiatric complications of COVID-19. Thus, it is important that the addiction physicians/psychiatrists caution their patients from using cannabis or cannabis products for treating any such complications.
PMID: 34655372
ISSN: 1557-1904
CID: 5068122

COVID-19 and Cannabidiol (CBD)

Khalsa, Jag H; Bunt, Greg; Maggirwar, Sanjay B; Kottilil, Shyam
COVID-19 pandemic has resulted in devastating mortality and morbidity consisting of socioeconomic and health effects that have included respiratory/pulmonary, cardiovascular, mental health and neurological consequences such as anxiety, depression, and substance use. Extensive efforts are underway to develop preventive vaccines and therapeutics such as remdesivir, dexamethasone, convalescent plasma, and others to treat COVID-19 but many report residual mental health problems after recovery. Cannabis products such as cannabidiol (CBD) are being advertised for the treatment of COVID-19 associated mental health problems and substance use disorders. This commentary will briefly clear the myth that CBD can ameliorate a wide range of COVID-19 associated health effects including anxiety, depression, or any substance use disorder, and show that there is a clear lack of sufficient unbiased clinical evidence from well-designed double-blind, placebo-controlled clinical trials to prove the antianxiety or antidepression therapeutic properties of CBD and support its wide use as medicine to treat COVID-19- associated mental health conditions or substance use disorders. Finally, we suggest that addiction physicians must play an important role in dealing with their patients requesting CBD prescription for treating any of these conditions.
PMID: 33323690
ISSN: 1935-3227
CID: 5043372

Cannabis-Induced Hypodopaminergic Anhedonia and Cognitive Decline in Humans: Embracing Putative Induction of Dopamine Homeostasis

Blum, Kenneth; Khalsa, Jag; Cadet, Jean Lud; Baron, David; Bowirrat, Abdalla; Boyett, Brent; Lott, Lisa; Brewer, Raymond; Gondré-Lewis, Marjorie; Bunt, Gregory; Kazmi, Shan; Gold, Mark S
Over years, the regular use of cannabis has substantially increased among young adults, as indicated by the rise in cannabis use disorder (CUD), with an estimated prevalence of 8. 3% in the United States. Research shows that exposure to cannabis is associated with hypodopaminergic anhedonia (depression), cognitive decline, poor memory, inattention, impaired learning performance, reduced dopamine brain response-associated emotionality, and increased addiction severity in young adults. The addiction medicine community is increasing concern because of the high content of delta-9-tetrahydrocannabinol (THC) currently found in oral and vaping cannabis products, the cognitive effects of cannabis may become more pronounced in young adults who use these cannabis products. Preliminary research suggests that it is possible to induce 'dopamine homeostasis,' that is, restore dopamine function with dopamine upregulation with the proposed compound and normalize behavior in chronic cannabis users with cannabis-induced hypodopaminergic anhedonia (depression) and cognitive decline. This psychological, neurobiological, anatomical, genetic, and epigenetic research also could provide evidence to use for the development of an appropriate policy regarding the decriminalization of cannabis for recreational use.
PMID: 33868044
ISSN: 1664-0640
CID: 4875732

Therapeutic Communities for Addictions: Essential Elements, Cultural, and Current Issues

Chapter by: De Leon, George; Perfas, Fernando B; Joseph, Aloysius; Bunt, Gregory
in: Textbook of addiction treatment : international perspectives by el-Guebaly, Nady; Carra, Giuseppe; Galanter, Marc [Eds]
Mailand : Springer, 2015
pp. 1033-1047
ISBN: 9788847053236
CID: 1448932

Social Therapies and Treatment Settings: An Introduction

Chapter by: Bunt, Gregory; Mohamed, Mahmood Nazar
in: Textbook of addiction treatment : international perspectives by el-Guebaly, Nady; Carra, Giuseppe; Galanter, Marc [Eds]
Mailand : Springer, 2015
pp. 1031-1032
ISBN: 9788847053236
CID: 1448922


Bunt, G; Galanter, M; el-Guebaly, NA
ISSN: 1464-3502
CID: 1881152

The therapeutic community for the adolescent substance abuser

Chapter by: Bunt, Gregory C; Stanick, Virginia A
in: Clinical handbook of adolescent addiction by Rosner, Richard [Eds]
Chichester, West Sussex ; Hoboken, NJ : Wiley-Blackwell, 2013
pp. 390-404
ISBN: 0470972343
CID: 844872

An exploratory study of spiritual orientation and adaptation to therapeutic community treatment

Dermatis, Helen; James, Tina; Galanter, Marc; Bunt, Gregory
The purpose of this study was to determine the extent to which spiritual orientation was associated with adaptation to therapeutic community treatment. Spiritual orientation was assessed by the Spirituality Self-Rating Scale, a measure consistent with the conceptualization of spirituality typically reflected in Alcoholics Anonymous members' views. Spiritual orientation was positively correlated with acceptance of therapeutic community principles and clinical progress. Further assessment of spirituality related characteristics and their relation to treatment outcomes is important in informing the design of interventions aimed at improving progress in the therapeutic community, particularly those aspects involving the relative value of integrating the 12-Step group approach in therapeutic community programs
PMID: 20635280
ISSN: 1545-0848
CID: 111388

Spiritual Orientation among Adolescents in a Drug-Free Residential Therapeutic Community

Solhkhah, R; Galanter, M; Dermatis, H; Daly, J; Bunt, G
Clinically, the treatment of substance abuse has relied on the Twelve Steps model, which is heavily focused on issues of spirituality. Adolescents may have cognitive and developmental issues that preclude them from taking advantage of the Alcoholics Anonymous (AA) model. To this end, we examined the spiritual orientation and spiritual behaviors among adolescent substance abusers in a drug-free residential therapeutic community (TC). One hundred and eighty-six adolescent clients of a drug-free residential therapeutic community were given a self-report questionnaire about their substance abuse and attitudes toward spirituality. The adolescents had a mean Spiritual Orientation Score of 21.48, reflecting a significantly lower level of spiritual orientation than adults in a similar setting. Also, adolescents who were heavy marijuana users were less spiritual than those adolescents who used marijuana less. Spirituality and affiliation with religious institutions may be considered a protective factor because they represent more conventional beliefs and attitudes and indicate a stronger social bond to conventional society
ISSN: 1067-828x
CID: 97885