Medical Cannabis and Cannabinoids最新文献

{"title":"Franjo Grotenhermen.","authors":"Franjo Grotenhermen","doi":"10.1159/000489141","DOIUrl":"https://doi.org/10.1159/000489141","url":null,"abstract":"","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"1 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2018-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000489141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arno Hazekamp.","authors":"Arno Hazekamp","doi":"10.1159/000489363","DOIUrl":"https://doi.org/10.1159/000489363","url":null,"abstract":"I often describe myself as a cannabis “myth buster”, helping to separate fact from fiction about cannabis. I recognize the promising medical potential of the plant, but do not see it as a miracle cure. The current growth of interest in medical cannabis will subside to more manageable proportions in years to come. We will learn when cannabis medicine works, and when it is smarter to choose other treatments, so that cannabis can find its proper place among other medicines. As a scientist, I believe in patient-inspired research: How we do studies is a job for trained scientists, but what we study can and should be inspired by what actual patients care about. It is the responsibility of researchers in this field to contribute to the education of consumers, physicians, and policymakers alike, for this is sorely lacking at present. Leaving cannabis education in the hands of commercial parties turns information into mere advertising. To better understand the healing effects of cannabis products, it is crucial to establish their efficacy over the course of time. Extensive clinical trials are necessary here, but this will take time. Meanwhile, there is much we can learn from simply asking current users a lot of smart questions. I therefore find well-designed surveys just as important as chemical tests done in a laboratory. For clinical trials to be meaningful, we need to establish commonly agreed measurements and standards – and these are virtually absent at present. Detailed chemical profiling of cannabis strains is necessary, along with a standard classification system, the accurate labelling of products such as cannabis oil, and a uniform system for capturing and analyzing patients’ views and experiences. This cannot happen so long as individual laboratories and scientists, within individual territories, continue to work in isolation from one another, each hoping to achieve a great breakthrough. Standardization in scientific methods is a crucial prerequisite for medicinal cannabis to succeed and for us to develop a common language for discussing its benefits and risks. Arno Hazekamp (1976, The Netherlands), independent consultant for cannabis R&D projects under the name Hazekamp Herbal Consulting.","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"1 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2018-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000489363","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Intricate Influence of the Placebo Effect on Medical Cannabis and Cannabinoids.","authors":"Jürg Gertsch","doi":"10.1159/000489291","DOIUrl":"10.1159/000489291","url":null,"abstract":"<p><p>The botanical drug cannabis flos (inflorescence of <i>Cannabis sativa</i> L.) has a unique popular status as being a potent recreational drug and bona fide universal remedy (panacea). Generally, cannabinoids exert therapeutic effects in a broad range of pathophysiologies related to inflammation, pain, metabolic and stress-related conditions in preclinical animal models. However, the translation of such data to humans still lacks an evidence-based foundation. Motivated by the booming cannabis manufacturing industry and the increasing worldwide self-therapy by patients, there are cumulative accounts about broad therapeutic effects of cannabis and legal cannabinoids like cannabidiol (CBD) beyond statistical evidence. The numerous affirming anecdotal reports by patients pose a challenge to physicians and legal authorities. Moreover, the lack of standardization of cannabis products and widely missing randomized double-blind placebo-controlled clinical trials largely hinder the scientific assessment of medical cannabis in humans. Given the recent insight that the endocannabinoid system is mediating, at least in part, a placebo effect, psychoactive cannabis and cannabinoids could exert complex neuropharmacological actions. As discussed in this commentary, the meaning response may play a role in the broad palliative and therapeutic effects of medical cannabis unprecedented by other phytopharmaceuticals.</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"1 1","pages":"60-64"},"PeriodicalIF":0.0,"publicationDate":"2018-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8489322/pdf/mca-0001-0060.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetics and Tolerability of Δ9-THC-Hemisuccinate in a Suppository Formulation as an Alternative to Capsules for the Systemic Delivery of Δ9-THC.","authors":"Mahmoud A ElSohly,&nbsp;Waseem Gul,&nbsp;Larry A Walker","doi":"10.1159/000489037","DOIUrl":"https://doi.org/10.1159/000489037","url":null,"abstract":"<p><p>The objectives of this study were: (1) to assess the safety, tolerability, and pharmacokinetics of ascending doses of Δ⁹-tetrahydrocannabinol-hemisuccinate (THC-HS) after rectal administration as suppositories in male volunteers; and (2) to compare the pharmacokinetics of oral administration of Δ⁹-tetrahydrocannabinol (Δ⁹-THC) with an equivalent amount of Δ⁹-THC delivered as THC-HS via the suppository formulation. In support of the pharmacokinetic evaluations, an analytical method was developed and validated for the determination of Δ⁹-THC and for its major circulating metabolites 11-hydroxy-Δ⁹-tetrahydrocannabinol (11-OH-THC) and 11-nor-Δ⁹-tetrahydrocannabinol-9-carboxylic acid (THC-COOH) in human plasma. Δ⁹-THC, 11-OH-THC, and THC-COOH were extracted from plasma using solid phase extraction and analyzed by liquid chromatography-tandem mass spectrometry. The limits of detection and quantitation for all 3 analytes were 0.25 and 0.5 ng/mL, respectively. The method was validated over the range of 0.5-25 ng/mL. This method was used to quantify Δ⁹-THC and any THC-HS as Δ⁹-THC due to the inclusion of a hydrolysis step as part of the extraction procedure. Therefore, Δ⁹-THC measured was the total THC (free Δ⁹-THC plus Δ⁹-THC derived from THC-HS). The assay was reproducible for the measurement of all 3 analytes, with a variability of 7.2, 13.7, and 8.3%, respectively, at the 1 ng/mL level. The method was then used to assess the pharmacokinetics of Δ⁹-THC and metabolites from the suppository dosage form in doses equivalent to 1.25, 2.5, 5, 10, and 20 mg Δ⁹-THC per suppository as THC-HS. Systemic exposure to Δ⁹-THC, administered as THC-HS suppository, increased broadly dose proportionally. Systemic exposure and C_{max (obs)} estimates for 11-OH-THC and THC-COOH generally increased subproportionally. The pharmacokinetic profiles of Δ⁹-THC and metabolites were also compared after oral administration of 10 mg Δ⁹-THC (as dronabinol capsules) and after administration of 10 mg equivalents of Δ⁹-THC as THC-HS in suppository form. Total systemic exposure to Δ⁹-THC was considerably higher following rectal administration of THC-HS than after oral administration. The Δ⁹-THC area under the plasma concentration versus time curve (AUC_(0-_∞₎) for THC-HS was 2.44-fold higher (90% confidence interval: 1.78, 3.35) than for the capsule administration.</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"1 1","pages":"44-53"},"PeriodicalIF":0.0,"publicationDate":"2018-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000489037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kirsten R. Müller-Vahl.","authors":"Kirsten R Müller-Vahl","doi":"10.1159/000489140","DOIUrl":"https://doi.org/10.1159/000489140","url":null,"abstract":"Medical cannabis has enormous therapeutic potential. However, it is not well understood at the moment, and clinicians need to find out more about how this potential can be unlocked. We are still at the start of a journey here. Endocannabinoids in the brain (endogenous lipidbased retrograde neurotransmitters) influence all other neurological systems. This modulating effect holds great therapeutic potential, for it offers the prospect of our one day being able to treat not just neurological conditions but also the psychiatric disorders that characteristically accompany them. It is common for patients with Parkinson disease, for example, to also suffer from depression, anxiety, and sleeplessness, but the discipline of neurology itself does not usually address these problems. Most psychiatric disorders are attributable to an underlying genetic dysfunction. In the case of Parkinson disease, we understand the nature of the dysfunction and are able to counter it with dopamine. I am convinced that a range of neurological disorders, both neurodegenerative and neurodevelopmental (like Tourette syndrome), may ultimately be traceable to endocannabinoid deficiency syndrome. We already know which genes are responsible for regulating the endocannabinoid system, and I believe that advances in genetics and genomics will provide the answers we are seeking within our lifetimes. My experience indicates that medical cannabis does not have an addictive effect when used under medical supervision. Of the two cannabinoids in therapeutic use today, cannabidiol (CBD) is not psychoactive, and I myself have encountered no instances of patients being treated with tetrahydrocannabinol (THC) showing signs of dependence. A defining characteristic of endocannabinoids is that they exist throughout the body and not just in the brain. This may help explain the phenomenon whereby medical cannabis appears to address a range of related symptoms simultaneously. To define the specific indications for which medical cannabis has unquestionable relevance, however, will call for extensive, high-quality clinical trials. The considerable body of small trials and case studies already in existence in this field offers many good starting points for designing such essential large-scale studies. Kirsten R. Müller-Vahl, Professor of Psychiatry, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School. Graduate of Hannover Medical School.","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"1 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2018-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000489140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Light Spectrum on the Morphology and Cannabinoid Content of Cannabis sativa L.","authors":"Gianmaria Magagnini,&nbsp;Gianpaolo Grassi,&nbsp;Stiina Kotiranta","doi":"10.1159/000489030","DOIUrl":"https://doi.org/10.1159/000489030","url":null,"abstract":"<p><p><i>Cannabis sativa</i> L. flowers are the main source of Δ-9-tetrahydrocannabinol (THC) used in medicine. One of the most important growth factors in cannabis cultivation is light; light quality, light intensity, and photoperiod play a big role in a successful growth protocol. The aim of the present study was to examine the effect of 3 different light sources on morphology and cannabinoid production. Cannabis clones were grown under 3 different light spectra, namely high-pressure sodium (HPS), AP673L (LED), and NS1 (LED). Light intensity was set to ∼450 µmol/m²/s measured from the canopy top. The photoperiod was 18L: 6D/21 days during the vegetative phase and 12L: 12D/46 days during the generative phase, respectively. At the end of the experiment, plant dry weight partition, plant height, and cannabinoid content (THC, cannabidiol [CBD], tetrahydrocannabivarin [THCV], cannabigerol [CBG]) were measured under different light treatments. The experiment was repeated twice. The 3 light treatments (HPS, NS1, AP673L) resulted in differences in cannabis plant morphology and in cannabinoid content, but not in total yield of cannabinoids. Plants under HPS treatment were taller and had more flower dry weight than those under treatments AP673L and NS1. Treatment NS1 had the highest CBG content. Treatments NS1 and AP673L had higher CBD and THC concentrations than the HPS treatment. Results were similar between experiments 1 and 2. Our results show that the plant morphology can be manipulated with the light spectrum. Furthermore, it is possible to affect the accumulation of different cannabinoids to increase the potential of medicinal grade cannabis. In conclusion, an optimized light spectrum improves the value and quality of cannabis. Current LED technology showed significant differences in growth habit and cannabinoid profile compared to the traditional HPS light source. Finally, no difference of flowering time was observed under different R:FR (i.e., the ratio between red and far-red light).</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"1 1","pages":"19-27"},"PeriodicalIF":0.0,"publicationDate":"2018-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000489030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human Pharmacokinetics and Adverse Effects of Pulmonary and Intravenous THC-CBD Formulations.","authors":"Pascale Meyer,&nbsp;Manuela Langos,&nbsp;Rudolf Brenneisen","doi":"10.1159/000489034","DOIUrl":"https://doi.org/10.1159/000489034","url":null,"abstract":"<p><strong>Background: </strong>Due to variable absorption and extensive first-pass metabolism, the bioavailability of oral delta-9-tetra-hydrocannabinol (THC) and cannabidiol (CBD) is low, and, therefore, alternative application forms are necessary.</p><p><strong>Methods: </strong>In an open-label, 2-period phase-1 study on 11 healthy volunteers, a combination of THC and CBD was compared by pulmonary (inh) and intravenous (iv) application. The liquid aerosol was produced by an in vitro validated pressurized metered-dose inhaler (pMDI) device, releasing 41-44% of the cannabinoid dose, enabling a dosage of 81 µg THC and 87 µg CBD per actuation. Three subjects (pilot trial, low-dose session) received 324 and 348 μg THC and CBD, respectively, and 8 subjects (main trial, high-dose session) received 648 and 696 µg THC and CBD, respectively. The addition of the local anesthetic lidocaine to the inh preparation should prevent airways irritation and coughing. The pharmacokinetic evaluation was based on plasma profiles acquired by gas chromatography-mass spectrometry. Adverse effects were monitored by visual analog scales and measuring vital functions.</p><p><strong>Results: </strong>After low inh doses, THC and CBD were not measurable in plasma longer than 20 and 40 min after administration, respectively. Therefore, only plasma levels resulting after high doses were further evaluated. After inh and iv administration, THC plasma peaks were observed 5 min post-drug, with THC peak concentrations ranging from 3 to 22 and from 13 to 40 ng/mL, respectively. CBD peaks were also measured 5 min after inh and iv administration, with concentrations ranging from 2 to 17 and from 14 to 26 ng/mL, respectively. The elimination half-lives were 7 and 11 min after inh and 22 and 24 min after iv administration for THC and CBD, respectively. The mean inh bioavailability (calculated vs. iv) was 55 ± 37 and 59 ± 47% for THC and CBD, respectively. Conjugated 11-carboxy-THC was the main THC metabolite. The nebulized aerosol was generally well tolerated with little or no coughing and only slight psychological adverse effects. These were more distinct after iv administration, especially irritations and hallucinations. Besides moderate tachycardia, the vital functions stayed unchanged.</p><p><strong>Conclusions: </strong>We conclude that a THC-CBD inh aerosol shows favorable pharmacokinetic properties, which are similar to those of an iv preparation. Adding a local anesthetic is recommended to prevent coughing, which decreases absorption. The negligible psychoactivity may be due to an anti-psychotic effect of CBD, the low THC dosage, and/or the decreased formation of the psychoactive metabolite 11- hydroxy-THC. Therefore, the inhalation via a pMDI is a viable, safe, and well-tolerated alternative to the oral administration.</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"1 1","pages":"36-43"},"PeriodicalIF":0.0,"publicationDate":"2018-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000489034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Cannabidiol and a Novel Cannabidiol Analog against Tactile Allodynia in a Murine Model of Cisplatin-Induced Neuropathy: Enhanced Effects of Sub-Analgesic Doses of Morphine.","authors":"Hannah Marie Harris,&nbsp;Waseem Gul,&nbsp;Mahmoud A ElSohly,&nbsp;Kenneth J Sufka","doi":"10.1159/000489077","DOIUrl":"https://doi.org/10.1159/000489077","url":null,"abstract":"<p><strong>Objective: </strong>This research examined whether a cannabidiol (CBD)-opioid pharmacotherapy could attenuate cisplatin-induced tactile allodynia.</p><p><strong>Methods: </strong>Mice (C57BL/6) were given 6 doses of 2.3 mg/kg cisplatin intraperitoneally (IP) on alternating days to induce tactile allodynia as quantified using an electric von Frey (eVF). Test groups in Experiment 1 received either vehicle, 0.1 or 2.5 mg/kg morphine, 1.0 or 2.0 CBD, or the 2 drugs in combination. Test groups in Experiment 2 received either vehicle, 0.1 or 2.5 mg/kg morphine, 1.0, 2.0, 3.0, or 4.0 mg/kg NB2111 (a long-acting CBD analogue), or the 2 drugs in combination. Drugs were administered IP 45 min before eVF assessment.</p><p><strong>Results: </strong>Cisplatin produced tactile allodynia that was attenuated by 2.5 mg/kg morphine. Both CBD and NB2111 produced dose-dependent attenuation of tactile allodynia. CBD and NB2111, given in combination with sub-analgesic doses of morphine, produced attenuation of tactile allodynia equivalent to 2.5 mg/kg morphine.</p><p><strong>Conclusions: </strong>While both CBD and NB2111, either alone or in combination with sub-analgesic doses of opioids, exhibited analgesic effects, NB2111 could be capable of superior analgesia over time by virtue of enhanced pharmacokinetics.</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"1 1","pages":"54-59"},"PeriodicalIF":0.0,"publicationDate":"2018-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000489077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of the Endocannabinoids Anandamide and 2-Arachidonoyl Glycerol with Gas Chromatography-Mass Spectrometry: Analytical and Preanalytical Challenges and Pitfalls.","authors":"Christian Lanz,&nbsp;Johan Mattsson,&nbsp;Felix Stickel,&nbsp;Jean-Francois Dufour,&nbsp;Rudolf Brenneisen","doi":"10.1159/000489032","DOIUrl":"https://doi.org/10.1159/000489032","url":null,"abstract":"<p><strong>Background: </strong>The endocannabinoids anandamide (<i>N</i>-arachidonoyl ethanolamide [AEA]) and 2-arachidonoyl glycerol (2-AG) are involved in the regulation of neuronal, immune, metabolic, vascular, and reproductory functions.</p><p><strong>Methods: </strong>The development and validation of an analytical method for the determination of AEA and 2-AG in human plasma based on liquid-liquid extraction and gas chromatography-mass spectrometry after silylation is described and (pre)-analytical pitfalls are identified.</p><p><strong>Results: </strong>In contrast to 2-AG, AEA was unstable in whole blood and increased by a factor of 2.3 within 3 h on ice. AEA was stable in plasma on ice for 4 h while 2-AG tended to decrease. Excellent stability at room/ambient temperature was found for both derivatized compounds over 45 h. Furthermore, 3 freeze-thaw cycles revealed a complex pattern: endogenous AEA was stable in plasma but slightly increased in spiked samples (+12.8%), while endogenous 2-AG concentrations increased by 51% and declined by 24% in spiked samples. A long-term study over 4 weeks at -80°C showed that low endogenous AEA and spiked 2-AG concentrations were stable. However, spiked AEA tended to increase (+19%) and endogenous 2-AG significantly increased by 50% after 2 weeks. Food intake 2 h before blood collection showed no effect on AEA concentrations, whereas 2-AG increased significantly by a factor of 3.</p><p><strong>Conclusions: </strong>Overall, limited in vitro and/or in vivo/ex vivo chemical stability of endocannabinoids has to be taken into account.</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"1 1","pages":"9-18"},"PeriodicalIF":0.0,"publicationDate":"2018-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000489032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial.","authors":"Rudolf Brenneisen","doi":"10.1159/000489029","DOIUrl":"https://doi.org/10.1159/000489029","url":null,"abstract":"After having been involved for more than 40 years in natural products research, for me Cannabis sativa still is the most fascinating plant in any respect, which is as multifaceted as the bee’s eye. No other plant is so unique and diverse, reflected for example by its millennial history as ethnobotanical plant, its complex phytochemistry with more than 500 identified constituents, its amazing polypharmacology, and its controversial reputation in the public, media, and politics, either as stigmatized dope head marijuana or as mystified panacea. Nowadays, the term “medical cannabis” is largely rehabilitated and, besides “medical cannabinoids”, officially well accepted in the scientific community as a label of many international conferences or title of the present new journal, and more and more also by regulatory authorities in Europe and elsewhere. This paradigm change can be explained by increasing preclinical and clinical data showing the potential of cannabis as phytopharmaceutical; however, not negating the fact that this plant still is the most abused illicit drug worldwide. The hits in PubMed are a mirror of exploding cannabis and cannabinoid research in the last 25 years compared to the 25 years before 1992: “cannabis” 12,894 (4,645), “cannabis + medicine” 3,378 (281), “tetrahydrocannabinol” 5,353 (2,990), “cannabidiol” 1,564 (373), and “cannabidiol + medicine” 502 (20). Even more striking are the number of references for “endocannabinoids”, 4,429 (8), and “endocannabinoid system”, 1,785 (0), discovered in the late 1980s and early 1990s, respectively. In this context, it has to be noted that Big Pharma nowadays prefers to invest money in the search for endocannabinoid modulators and less in the development of cannabis-based medicines. For decades, cannabidiol (CBD) was the main cannabinoid of fiber-type cannabis shaded by tetrahydrocannabinol and not often in the focus of pharmacologists. The increasing scientific interest in CBD during the last 25 years as the most promising candidate for clinical utilization can be explained by its lack of any cognitive and psychoactive actions and its plethora of effects. Today, for many patients, CBD means hope, despite very few convincing clinical studies, whereas recreational consumers classify CBD only as lifestyle drug or food supplement. These two controversial points of views are additionally triggered by media headlines emphasizing CBD to be a unique antiepileptic drug and aggressive marketing of CBD producers and suppliers. Whether the therapeutic use of cannabinoids in the form of pure substances or as complex cannabis-based medicines should be preferred is not always rationally debated, especially among patients (“God’s pharmacy”), Rudolf Brenneisen","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"1 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000489029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39539143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}