Published in full on BeyondTHC.com.
Bonni Goldstein, MD, flew into San Jose yesterday to address some 120 serious, devoted, desperate, courageous parents on the subject of “CBD and Pediatric Epilepsy.” Goldstein is 40-something and could be Bette Midler’s body double (or vice versa). The seminar was held at the Embassy Suites hotel in Milpitas, and was organized by Realm of Caring California, a foundation associated with the Stanley Brothers of Colorado. An extract from the Stanleys’ CBD-rich plant provided dramatic seizure relief to a little girl named Charlotte Figi, whose improvement was reported to the world by Dr. Sanjay Gupta on CNN last summer. The strain was dubbed “Charlotte’s Web.” Many of the parents who came to hear Goldstein are on a waiting list to get oil made from Realm of Caring plants being grown by Ray Mirzabegian, who also spoke.
Goldstein is the medical director of Canna-Centers, a chain of clinics. She had previously given seminars in concert with Realm of Caring in Santa Monica and Irvine. “There’s a lot on the internet that’s opinion,” she said, “I’m here to give you the facts.”
Over the course of an hour she explained, thoroughly and clearly, what is known about Cannabis as medicine. She touched all the bases: China, India, Egypt—thousands of years of documented medical use. Dr. William Brooke O’Shaughnessy’s in India in 1840, confirming that Cannabis extracts could alleviate symptoms—including seizures—for which Western Medicine had no treatment. The Israeli scientists in the 1960s working out the structure of THC and CBD, and assuming CBD was inactive because it wasn’t psychoactive.
A slide illustrated the similarity of THC, a molecule made by the Cannabis plant, and anandamide, a molecule made in the body that activates the same receptor. Receptors developed so neurons can respond to chemicals made by the body (plant cannabinoids coincidentally effective).
A synthetic cannabinoid, radioactively labelled, revealed where cannabinoid receptors are concentrated in the brain. Areas of the brain where ECB receptors are concentrated are involved with pain, memory, learning, anxiety, motor coordination, appetite, nausea and vomiting, pleasure and reward. The successful search for endocannabinoids “began the big push into cannabinoid research and therapeutics.” CBD and THC “are natural to your body.” Endocannabinoids are involved in numerous physiological processes; Goldstein listed five that have been identified to date in humans (anandamide, 2-arachidonoylglycerol (2-AG), Noladin ether, virodhamine, and N-arachidonoyldopamine).
Terpenoids, the essential oils in the plant, give off aromas and have anti-anxiety, anti-inflammatory and many other medicinal effects including, Flavonoids have anti-inflammatory and anti-oxidant properties. “All these compounds working together create an ‘entourage effect…’ I’m in favor of the whole plant. By pulling things out of it we may be losing some of the synergies. It will be great to do studies comparing whole plant extracts to single compounds.”
Most of the Cannabis plants in California have been crossed and hybridized. “Sativa” and “Indica” refer to the morphology of the plant. The resinous trichomes make Cannabigerolic Acid. Enzymes determine whether the CBGA will be transformed into CBD or THC. Strains like Charlotte’s Web, ACDC and Cannatonic have been bred to contain high levels of CBD and lower levels of THC.
How often have we heard, “More research is needed,” from those who would prefer to see no change in policies that should be informed by science? From climate denial to cannabis prohibition, the demand for absolute scientific certainty is a call for inaction. It begs the question: When is there “enough” research? How about not enough to eliminate all uncertainties, but enough to recommend medical treatment or change policy?
Cannabis and its derivatives have been documented for anti-epileptic effects since 1881. Today, the promise of cannabidiol (CBD) as an anti-epileptic treatment is prompting people to move to states that have safe access to medicinal products containing this compound.
A third of patients still do not find effective methods for preventing seizures. A recent Canadian study has demonstrated synergy between the anti-seizure activity of THC and CBD.
“David,” a 10 year old boy, had his first seizure at 2 months of age. The convulsions were photosensitive generalized tonic-clonic seizures that occurred 1-4 times each day. These events were occurring daily, even though he was being treated with two anti-seizure medications – lamotrigine (Lamictal) and valproic acid. But they had already tried carbamazepine, phenobarbital, zonisamide and levetiracetam (Keppra) without success.