Name: A Peer-reviewed Medical Marijuana Course
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Author Bio

The COVID epidemic has accelerated research of the immune system’s integrated response to viral diseases. This 30-minute video sponsored by the American Osteopathic Association discusses cannabinoids’ impact on optimal immune function. It is presented by physician author, Jeffrey S. Block, MD – founder and principal partner of an independent professional consultancy providing client organizations with advanced scientific guidance. Dr. Block’s industry-wide expertise provides insight by translating the evolving science’s objective evidence-based data into clinical applications.

About the Author

Jeffrey Sherwood Block, M.D. . is a Board-certified physician anesthesiologist and adjunct Professor at the University of Miami Miller School of Medicine. Additionally, he is a highly awarded horticulturist and certified Master Gardener educator with the University of Florida’s UF/IFAS Extension Program. Dr. Block’s textbook chapter “Endocannabinoid Receptors and Medical Cannabis” (Advanced Therapeutics in Pain Medicine – CRC Press 2020) is a sentinel work on integrated pain management. Block served as the Florida Medical Association’s “Designated Expert on Botanical Medicines” authoring mandated physician education; and in 2014 was appointed by Florida’s Surgeon General to determine the rules for Florida’s first cannabis law. His consultancy’s demonstrated insight and responsible leadership are valued by both allied professionals and new industries seeking knowledge of future uses for Cannabinoid medicines.

Contact: DocBlock@NurturingNature.com
Website: https://nurturingnature.com

Cannabinoids and Adaptive Immuno-Modulation References

E.V. Berdyshev, 2000. Cannabinoid receptors and the regulation of immune response. Chemistry and Physics of Lipids 108 (2000) 169–190; www.elsevier.com/locate/chemphyslip

Biles, Mary 2019. Cannabis and the Immune System – A Complex Balancing Act. Project CBD (May 8, 2019).

Block, Jeffrey S., 2019. Endogenous Cannabinoid Receptors and Medical Cannabis. (pre-publication chapter) Advanced Therapeutics in Pain Medicine, January 2021. CRC Press.

Cabral, Guy A., Rogers, Thomas J., and Lichtman, Aron H., 2015. Turning Over a New Leaf: Cannabinoid and Endocannabinoid Modulation of Immune Function. J Neuroimmune Pharmacol. 2015; 10(2): 193–203. Published online 2015 Jun 9. doi: 10.1007/s11481-015-9615-z

Centers for Disease Control and Prevention. CDC Urges Clinicians to Report Possible Cases of Unexplained Vaping-associated Pulmonary Illness to their State/Local Health Department. Clinician Outreach and Communication Activity. 2019. Published August 14, 2019.

Hernández-Cervantes R., Méndez-Díaz M., Prospéro-García Ó., and Morales-Montor J. 2017. Immunoregulatory Role of Cannabinoids during Infectious Disease. Neuroimmunomodulation 2017;24:183–199.

Klein TW (2005) Cannabinoid-based drugs as anti-inflammatory therapeutics. Nat Rev Immunol 5, 400–411.

Li et al. 2019, Cell 176, 459-467.

James M. Nichols and Barbara L.F. Kaplan, 2020. Immune Responses Regulated by Cannabidiol. Cannabis and Cannabinoid Research, Vol. 5, No. 1

National Academies of Science, Engineering and Medicine. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Washington, DC: The National Academies Press; 2017.

Pacher P, Kunos G. Modulating the endocannabinoid system in human health and disease–successes and failures. FEBS J. 2013;280(9):1918-1943.

Shmerlig, Robert H., MD, 2015. Senior Faculty Editor. First, Do No Harm. Harvard Health Publishing.

Siddappa N. Byrareddy, Mahesh Mohan, 2020. SARS-CoV2 induced respiratory distress: Can cannabinoids be added to anti-viral therapies to reduce lung inflammation? Brain, Behavior, and Immunity 87 (2020) 120–121.

References

Perioperative Considerations for the Patients Utilizing Cannabinoid-based Medicines and Products

References:

Alexander JC, Joshi GP. A Review of the Anesthetic Implications of Marijuana Use. Proc (Bayl Univ Med Cent). Jul2019;32(3):364–371.
American Osteopathic Association. (2019, April 15). Regular Cannabis Users Require Up To 220% Higher Dosage for Sedation in Medical Procedures: Physicians Concerned Over Possible Rise in Adverse Side Effects. ScienceDaily. www.sciencedaily.com/releases/2019/04/190415172147.htm
DeFilippis EM, Bajaj NS, Singh A, Malloy R, Givertz MM, Blankstein R, Bhatt DL, Vaduganathan M. Marijuana Use in Patients With Cardiovascular Disease
JACC Review Topic of the Week. JACC. Jan2020;75(3):320-332.
Flisberg P, Paech MJ, Shah T, et al. Induction Dose of Propofol in Patients Using Cannabis. Eur J Anaesthesiol. 2009;26:192.
Goel A, McGuinness B, Jivraj NK, Wijeysundera DN, Mittleman MA, Bateman BT, Clarke H, Kotra LP, Ladha KS; Cannabis Use Disorder and Perioperative Outcomes in Major Elective Surgeries: A Retrospective Cohort Analysis. Anesthesiology 2020 Apr;132(4):625-635.
Horvath C, Bowman Dalley C, Grass N, Tola, DH. Marijuana Use in the Anesthetized Patient: History, Pharmacology, and Anesthetic Considerations. AANA Journal Dec 2019 Vol. 87, No. 6.
Ladha KS et al. The Impact of Perioperative Cannabis Use: A Narrative Scoping Review. Cannabis Cannabinoid Res. 2019 Dec 6;4(4):219-230.
McCallum RW, Soykan I, Sridhar KR, Ricci DA, Lange RC, Plankey MW. Delta-9-tetrahydrocannabinol Delays the Gastric Emptying of Solid Food in Humans: a Double-blind, Randomized Study. Aliment Pharm Ther. 1999;13(1):77-80. doi:10.1046/j.1365-2036.1999.00441
Tapley P, Kellett S. Cannabis-based Medicines and the Perioperative Physician. Perioper Med 8, 19 (2019). https://doi.org/10.1186/s13741-019-0127-x
Touil N, Lavand’homme P. Cannabis Hyperalgesia-A Phenomenon Underestimated in the Peri-operative Period? Eur J of Anaes: Sept 2019. Vol 36. Issue 9. p 623-624

References

What is the endocannabinoid system?

Atakan, Z. “Cannabis, a complex plant: different compounds and different effects on individuals.” Therapeutic advances in psychopharmacology 2012; 2(6): 241-54
Battista, Natalia; Meccariello, Rosaria; Cobellis, Gilda; Fasano, Silvia; Di Tommaso, Monia; Pirazzi, Valentina; Konje, Justin C; Pierantoni, Riccardo;Maccarrone, Mauro The role of endocannabinoids in gonadal function and fertility along the evolutionary axis. Molecular and Cellular Endocrin. Vol 355, issue 1, May 2012;1-14
Bellocchio L, Cervino C, Pasquali R, Pagotto U. (June 2008). The endocannabinoid system and energy metabolism. J. Neuroendocrinol. 20 (6): 850–7. doi:10.1111/j.1365-2826.2008.01728.x. PMID 18601709
Cottone E, Pomatto V, Bovolin P. Role of the Endocannabinoid System in the Central Regulation of Nonmammalian Vertebrate Reproduction. Int J Endocrinol. 2013: 941237.
Di Marzo V. The endocannabinoid system: its general strategy of action, tools for its pharmacological manipulation and potential therapeutic exploitation. Pharmacological Research. 2009; 60(2):77–84.
Maccarrone M, Gasperi V, Catani MV, Diep TA, Dainese E, Hansen HS, Avigliano L. The endocannabinoid system and its relevance for nutrition. Annu Rev Nutr 2010 08/21;30(1545-4312; 0199-9885):423-40.
Mackie K, Stella N. Cannabinoid receptors and endocannabinoids: evidence for new players. AAPS J. 2006;8(2):E298-306.
Serrano A, Parsons LH. Endocannabinoid influence in drug reinforcement, dependence and addiction-related behaviors. Pharmacol Ther. 2011;132(3):215-41.

What are the components of the endocannabinoid system?

Atakan, Z. “Cannabis, a complex plant: different compounds and different effects on individuals.” Therapeutic advances in psychopharmacology 2012; 2(6): 241-54.
Di Marzo V and De Petrocellis L. Endocannabinoids as regulators of transient receptor potential (TRP) channels: A further opportunity to develop new endocannabinoid-based therapeutic drugs. Curr Med Chem, 2010; 17(14): 1430-49.
Mackie K, Stella N. Cannabinoid receptors and endocannabinoids: evidence for new players. AAPS J. 2006;8(2):E298-306.

What are the two most well studied endocannabinoids?

Di Marzo V and De Petrocellis L. Endocannabinoids as regulators of transient receptor potential (TRP) channels: A further opportunity to develop new endocannabinoid-based therapeutic drugs. Curr Med Chem, 2010; 17(14): 1430-49.
Freund TF, Katona I, and Piomelli D. Role of endogenous cannabinoids in synaptic signaling. Physiol Rev, 2003; 83(3): 1017-66.
Hillard CJ, Manna S, Greenberg MJ, DiCamelli R, Ross RA, Stevenson LA, Murphy V, Pertwee RG, and Campbell WB. Synthesis and characterization of potent and selective agonists of the neuronal cannabinoid receptor (CB1). J Pharmacol Exp Ther, 1999; 289(3): 1427-33.

What are the receptors of the endocannabinoid system?

Atakan, Z. “Cannabis, a complex plant: different compounds and different effects on individuals.” Therapeutic advances in psychopharmacology 2012; 2(6): 241-54.
Di Marzo V and De Petrocellis L. Endocannabinoids as regulators of transient receptor potential (TRP) channels: A further opportunity to develop new endocannabinoid-based therapeutic drugs. Curr Med Chem, 2010; 17(14): 1430-49.

Describe cannabinoid receptor -1.

Aggarwal SK. Cannabinergic pain medicine: A concise clinical primer and survey of randomized-controlled trial results. Clin J Pain 2012 02/23;29(1536-5409; 0749-8047; 2):162-71.
Atakan, Z. “Cannabis, a complex plant: different compounds and different effects on individuals.” Therapeutic advances in psychopharmacology 2012; 2(6): 241-54.
Burns HD, Van Laere K, Sanabria-Bohorquez S, et al. [18F]MK-9470, a positron emission tomography (PET) tracer for in vivo human PET brain imaging of the cannabinoid-1 receptor. Proc Natl Acad Sci USA. 2007;104:9800–9805.
Freund TF, Katona I, and Piomelli D. Role of endogenous cannabinoids in synaptic signaling. Physiol Rev, 2003; 83(3): 1017-66.
Howlett AC, Blume LC, Dalton GD. CB(1) cannabinoid receptors and their associated proteins. Curr Med Chem. 2010;17(14):1382-93.
Ibrahim BM, Abdel-Rahman AA. Cannabinoid receptor 1 signaling in cardiovascular regulating nuclei in the brainstem: A review. J Adv Res. 2013;5(2):137-45.
Mackie K. Cannabinoid receptors: where they are and what they do. J Neuroendocrinol, 2008; 20 Suppl 1: 10-4.
Manzanares J, Julian M, Carrascosa A. Role of the cannabinoid system in pain control and therapeutic implications for the management of acute and chronic pain episodes. Curr Neuropharmacol. 2006;4(3):239-57.
Kruk-Slomka M, Dzik A, Budzynska B, Biala G. Endocannabinoid System: the Direct and Indirect Involvement in the Memory and Learning Processes-a Short Review. Mol Neurobiol. 2016;54(10):8332-8347.
Serrano A, Parsons LH. Endocannabinoid influence in drug reinforcement, dependence and addiction-related behaviors. Pharmacol Ther. 2011;132(3):215-41.

Describe cannabinoid receptor -2.

Guillot A, Hamdaoui N, Bizy A, Zoltani K, Souktani R, Zafrani ES, Mallat A, Lotersztajn S, and Lafdil F. Cannabinoid receptor 2 counteracts interleukin-17-induced immune and fibrogenic responses in mouse liver. Hepatology, 2014; 59(1): 296-306.
Maresz K, Carrier EJ, Ponomarev ED, Hillard CJ, and Dittel BN. Modulation of the cannabinoid CB2 receptor in microglial cells in response to inflammatory stimuli. J Neurochem, 2005; 95(2): 437-45.
Maresz K, Pryce G, Ponomarev ED, Marsicano G, Croxford JL, Shriver LP, Ledent C, Cheng X, Carrier EJ, Mann MK, Giovannoni G, Pertwee RG, Yamamura T, Buckley NE, Hillard CJ, Lutz B, Baker D, and Dittel BN. Direct suppression of CNS autoimmune inflammation via the cannabinoid receptor CB1 on neurons and CB2 on autoreactive T cells. Nat Med, 2007; 13(4): 492-7.
Pacher P, Kunos G. Modulating the endocannabinoid system in human health and disease–successes and failures. The FEBS journal 2013; 280:1918-43.

Respiratory depression is associated with the overdose of opioids or benzodiazepines. Is respiratory depression associated with the overdose of cannabinoids?

Herkenham M, Lynn AB, Little MD, et al. Cannabinoid receptor localization in brain. Proc Natl Acad Sci USA. 1990; 87:1932–1936.

What are phytocannabinoids?

Atakan Z. “Cannabis, a complex plant: different compounds and different effects on individuals.” Therapeutic advances in psychopharmacology 2012; 2(6): 241-54
ElSohly, M. A. and W. Gul. 2014. Handbook of cannabis (Chapter 2). Oxford, UK: Oxford University Press: P.20.
Mehmedic Z, Chandra S, Slade D, et al. Potency trends of Δ9-THC and other cannabinoids in confiscated cannabis preparations from 1993 to 2008. J Forensic Sci. 2010;55(5):1209-1217.

The terms cannabis, marijuana and hemp are often used interchangeably; however, the terms actually have different meanings. What is cannabis? What is marijuana? What is hemp? Is the hemp plant a cannabis plant?

Agriculture Improvement Act of 2018, HR2, Subtitle G-Hemp Production, Sec. 297A (Definitions) (2018). https://www.congress.gov/bill/115th-congress/house-bill/2/text?format=txt Accessed 1/2/19.
Fortenbery TR, Bennett M. Opportunities for Commercial Hemp Production. Review of Agricultural Economics, 2004, 26 (1), 97–117.
Hazekamp A, Fischedick JT. Cannabis–from cultivar to chemovar. Drug Testing and Analysis, 2012; 4 (special issue): 660-7.
Kane B. Medical Marijuana: the continuing story. Ann Intern Med.2001; 134(12):1159-1162
Pollio A. The Name of Cannabis: A Short Guide for Non-botanists. Cannabis Cannabinoid Res. 2016;1(1):234-238.

What are terpenes (terpenoids)?

Russo EB. Taming THC:potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. Br J of Pharmacolo. 2011;163(7):1344-1364. doi:10.1111/j.1476-5381.2011.01238.

Briefly describe the health effects of delta-9-tetrahydrocannabinol.

ElSohly, M. A. and W. Gul. 2014. Handbook of cannabis (Chapter 2). Oxford, UK: Oxford University Press: P.20.

In 2017, the National Academies of Sciences, Engineering and Medicine(NASEM) published the Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Did the results of the research indicate that cannabis-based products are effective?

National Academies of Sciences, Engineering, and Medicine. 2017. The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. Washington, DC: The National Academies Press. doi: 10.17226/24625.

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