The elderly are the fastest growing population of cannabis users. But how do hospice workers feel about their patients using cannabis? A recent survey by pharmacists at the University of Maryland asked palliative care practitioners about their opinions on cannabis use among hospice patients. Over 90% of workers support the use of cannabis, but most physicians did not recommend cannabis to their patients. This may be due to a lack of knowledge about safe use of cannabis — over 80% of respondents wanted standardized protocols on the use of cannabis in palliative care.

Robert Randall was the first U.S. citizen to legally access cannabis based on medical necessity since the start of prohibition. He and his wife, Alice O’Leary Randall, sued the government because THC-rich cannabis was the only effective medicine for his glaucoma.

Phytocannabinoids consistently confuse scientists because of the multiplicity of their actions. CBD, for example, binds to a handful of neurotransmitter receptors, as well as hormone receptors, ion channels, and a variety of enzymes. Receptors without a known endogenous ligand are called “orphan” receptors. GPR18 is involved in ocular-pressure (and hence glaucoma treatment) as well as cardiovascular function.

Plant cannabinoids, such as cannabidiol (CBD) and tetrahydriocannabinol (THC), interact in interesting ways with endocannabinoids.

It’s increasingly recognized that the runner’s high, which used to be attributed to endorphins, is conferred partly by endocannabinoids in the brain. In response to the stress of exercise, the brain produces anandamide, “the bliss chemical” which provides that feeling of elation along with pain reduction and health benefits. A collaboration between researchers in Wisconsin and at Iowa State University has sought to understand this phenomenon in women suffering from depression.

CBD is clearly a useful medicine in the treatment of some types of epilepsy, yet patients are faced with dilemmas when they must decide which product to use, how to incorporate it with other medications, and how to begin dosing. Isolate CBD products have the advantage of being standardized, although they suffer from numerous limitations. There is plentiful evidence that orally ingesting high doses of pure CBD reduces pediatric seizures.

Many prohibitionist arguments are being flipped on their heads. CBD’s anti-anxiety effects have replaced much of the reefer madness mentality. Rather than causing lung cancer, marijuana appears to have anti-cancer activity, if anything. And in spite of the gateway theory, whereby casual cannabis use supposedly escalates to heroin, we find that cannabis helps to treat pain and reduce opiate use. An animal study out of the Scripps Research Institute reaffirms that THC generally reduces the addictiveness of opioids.