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News Bites from CDA Knowledge Networks – 2020/05/27

CDA Oasis May 26, 2020

Managing a Loose Screw-Retained Implant Crown

CDA Oasis May 25, 2020

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Researchers are examining marijuana’s role in the relief of symptoms related to a number of disease and health concerns. The following are a few examples of published studies.

Crohn’s Disease

Anecdotally, people have reported marijuana as having a positive effect on Crohn’s disease symptoms. In one study (Naftali et al., 2013), the sample size was 21 patients (mean age 40 years ± 14 years; 13 men) with Crohn’s Disease Activity Index (CDAI) scores greater than 200/600 (disease severity) who had not responded to therapy with steroids, immunomodulators, or antitumor necrosis factor-alpha agents. Patients were assigned randomly to two groups, one given marijuana cigarettes containing 115 mg of THC twice daily and the other given cigarettes containing marijuana flowers from which the THC had been extracted. Disease activity and laboratory tests were assessed during 8 weeks of treatment and then 2 weeks thereafter. Complete remission (CDAI score < 150) was achieved by 5 of 11 subjects in the marijuana group (45%) and 1 of 10 in the placebo group (10%; p = 0.43). A clinical response (decrease in CDAI score of >100) was observed in 10 of 11 subjects in the marijuana cigarettes group (90%; from 330 ± 105 to 152 ± 109) and 4 of 10 in the placebo group (40%; from 373 ± 94 to 306 ± 143; p = 0.028).

Three patients in the marijuana group were weaned from steroid dependency. Subjects receiving marijuana cigarettes reported improved appetite and sleep, with no significant side effects. Although the primary end point of the study (induction of remission) was not achieved, a short course (8 weeks) of THC-rich marijuana produced significant clinical, steroid-free benefits in 10 of 11 people with active Crohn’s disease as compared with those who received placebo, without side effects. Although this study had a small sample, the attention given to the botanical detail of the study design is superior. The investigators acknowledged and accounted for the problem that medicinal marijuana and all plants contain various constituents in a mixture, making it difficult to measure the contribution of each one. They dealt with the standardization issue by choosing marijuana for the study from genetically identical plants grown from twigs of the same mother plant and in equal conditions. Plants were tested to verify an equal content of active ingredients. The investigators also standardized the machine-made cigarettes to contain equal weights of marijuana flowers (Naftali et al., 2013).

Nonalcoholic Fatty Liver Disease

A population-based, case-controlled correlational study tested the hypothesis that marijuana is associated with reduction in non-alcoholic fatty liver disease. The risk factors identified from more than 6 million patient records included age 40 to 60 years, being female, hyperlipidemia, hypertension, alcohol use, diabetes, metabolic syndrome, and being a non-Hispanic Caucasian person. The study found the hypothesis to be supported (Adejumo et al., 2017).

AIDS-Associated Anorexia

According to Lutge, Gray, and Siegfried (2013), the FDA approved dronabinol for the treatment of AIDS-associated anorexia using a study published in 1995 that at the time was the only study amenable to further analysis. The study, with a sample size of 139 (88 evaluable), found that participants administered dronabinol were twice as likely to gain 2 kg or more in body weight. The mean weight gain was 0.1 kg, as compared to a loss of 0.4 kg in the placebo group.

Sleep Disturbances

Sleep disturbances are prominent symptoms in individuals with substance use disorders. A self-report online survey of 248 people suggests that those who are “risky” marijuana and/or alcohol users are likely to report poor sleep quality rather than daytime sleepiness. Riskiness was determined by a score of lower than 6 for a 39-item instrument called the Marijuana Screening Inventory. Women typically have poorer sleep outcomes than men, as do people who use both alcohol and marijuana (Ogeil, Phillips, Rajaratnam, & Broadbear, 2015).

A study of 13 daily marijuana users, all men, examined the effects of around-the-clock dosing with oral THC on sleep latency and ability to fall asleep. The participants were given an escalating dose up to 120 mg on days 5 and 6. The overall amount of nighttime sleep decreased slightly during the study. Although other reports have suggested that people typically have somnolent side effects after receiving oral THC, this study suggests, although it had a very small number of participants, that people may become tolerant to the effects of THC through sustained use (Gorelick et al., 2013).

Rapid eye movement sleep behavior disorder (RBD), in which people act out their dreams, is considered a prodromal symptom of Parkinson’s disease (PD). Marijuana is being explored for its neuroprotective effects in RBD/PD. Four patients with RBD/PD were treated with CBD for 6 weeks. Three received 75 mg per day and one person 300 mg per day. All four subjects had a significant decrease in symptoms (Chagas et al., 2014).

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