Outside of the realm of beauty, the high ALA omega-3 and omega-6 content also makes hemp oil a perfect heart-healthy, nutrient-dense oil to cook with. Its smoke point is 330º (just above olive oil’s smoke point at 320º and below coconut oil’s at 350º) making it best for no or low heat cooking. When making a DIY salad dressing at home, try swapping your olive oil for hemp oil to get an extra dose of B vitamins, magnesium, and vitamin E. Delta-9-THC based monotherapy in fibromyalgia patients on experimentally induced pain, axon reflex flare, and pain relief.
Investigation of MS patients on Cannador revealed no major immune changes (Katona et al 2005), and similarly, none occurred with smoked cannabis in a short-term study of HIV patients (Abrams et al 2003). Hematological measures have been normal in all Sativex RCTs without clinical signs of immune dysfunction. Cognitive effects of cannabis have been reviewed (Russo et al 2002; Fride and Russo 2006), but less study has occurred in therapeutic contexts. Effects of chronic heavy recreational cannabis usage on memory abate without sequelae after a few weeks of abstinence (Pope et al 2001). While the Selective Reminding Test did not change significantly on Sativex, placebo patients displayed unexpected improvement.
It was also primarily developed as an anti-emetic in chemotherapy, and was recently re-approved for this indication in the USA. Prior case reports have noted analgesic effects in case reports in neuropathic pain (Notcutt et al 1997) and other pain disorders (Berlach et al 2006). An RCT of nabilone in 41 post-operative subjects actually documented exacerbation of pain scores after thrice daily dosing (Beaulieu 2006) (Table 1). An abstract of a study of 82 cancer patients on nabilone claimed improvement in pain levels after varying periods of follow-up compared to patients treated without this agent (Maida 2007).
On additional study, at 314 ng/ml cannabinoid concentration, Sativex and components produced no significant induction on human CYP450 (Stott et al 2007). Thus, Sativex should be safe to use in conjunction with other drugs metabolized via this pathway. Adverse effects of cannabinoids on immune function have been observed in experimental animals at doses 50–100 times the psychoactive level (Cabral 2001). In four patients using herbal cannabis therapeutically for over 20 years, no abnormalities were observed in leukocyte, CD4 or CD8 cell counts (Russo et al 2002).
Simultaneous and sensitive analysis of THC, 11-OH-THC, THC-COOH, CBD, and CBN by GC-MS in plasma after oral application of small doses of THC and cannabis extract. A multicenter dose-escalation study of the analgesic and adverse effects of an oral cannabis extract (Cannador) for postoperative pain management. Preliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis. The degree to which cannabinoid analgesics will be adopted into adjunctive pain management practices currently remains to be determined. No effects of THC extract, CBD extract or Sativex were observed in a study of effects on the hepatic cytochrome P450 complex (Stott et al 2005b).
Intoxication has remained a persistent issue in Marinol usage (Calhoun et al 1998), in contrast. While there have been no head-to-head comparative RCTs of Sativex with other cannabinoid agents, certain contrasts can be drawn. Sativex (Rog et al 2005) and Marinol (Svendsen et al 2004) have both been examined in treatment of central neuropathic pain in MS, with comparable results (Table 1). However, adverse events were comparable or greater with Marinol than with Sativex employing THC dosages some 2.5 times higher due to the presence of accompanying CBD (Russo 2006b; Russo and Guy 2006). Nabilone (Cesamet) (Figure 1), is a synthetic dimethylheptyl analogue of THC (British Medical Association 1997) that displays greater potency and prolonged half-life.
The degree to which a drug is reinforcing is determined partly by the by the rate of its delivery to the brain (Samaha and Robinson 2005). Sativex has effect onset in 15–40 minutes, peaking in a few hours, quite a bit slower than drugs of high abuse potential. It has been claimed that inclusion of CBD diminishes psychoactive effects of THC, and may lower potential drug abuse liability of the preparation (see Russo (2006b)) for discussion). Prior studies from Sativex clinical trials do not support the presence reinforcement or euphoria as problems in administration (Wade et cannabisoilt.com al 2006). Thus, it is now longer tenable to claim that psychoactive effects are a necessary prerequisite to symptom relief in the therapeutic setting with a standardized intermediate onset cannabis-based preparation.