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Meds Cannabis and ADHD


Vapor Accessory Addict
Staff member


“Cannabinoids in attention-deficit/hyperactivity disorder: A randomised-controlled trial,” by R.E. Cooper and colleagues at Kings College London has been e-published in European Neuropsychopharmacology.

“Adults with ADHD may represent a subgroup of individuals who experience a reduction of symptoms and no cognitive impairments following cannabinoid use,” the abstract concludes. “While not definitive, this study provides preliminary evidence supporting the self-medication theory of cannabis use in ADHD.” (Thanks to Joe. D. Golstrich, MD, for forwarding.)

The trial by Cooper et al was conducted with Sativex, GW’s Oromucosal Spray, which contains a 50-5o mix of THC and CBD. The peer-reviewed results confer credibility on the thousands of cannabis users who say the herb helps them focus, and on physicians who approve use of cannabis in treating ADHD. This is a good example of how GW Pharmaceuticals continues to advance the medical marijuana movement.

Recently, activists have denounced GW for lobbying state legislatures to pass bills that would make Epidiolex —GW’s almost-pure-CBD anticonvulsant— immediately available if and when the FDA shifts it from Schedule 1. (FDA approval for Epidiolex could come any day now. And no, I don’t own stock in the company.)

The activists fear that their legislators will cite the availability of Epidiolex to continue a ban on other CBD formulations. Wrath has been directed at GW —a more vulnerable target than the Prohibitionist legislators. The sad brouhaha was first publicized by Leafly. David Bienenstock, writing a follow-up piece for Vice, asked me for a comment and then didn’t use it. Here it is, a little dusty from the cutting room floor:

The oddest thing about the Leafly exposé is the image of GW Pharmaceuticals trying to sneak something over on us, hiring lobbyists “on the low down.” Geoffrey W. Guy, MD, is a pharmaceutical entrepreneur and has never pretended to be anything else. His stated plan has always been to seek approval from the regulatory authorities —the Home Office in the UK, the FDA in the US—for GW’s cannabis-based medicines. He laid it all out in 1998 at the International Cannabinoid Research Society meeting, and I reported on it in detail in Synapse (the UCSF weekly). Guy got the go-ahead to cultivate cannabis and produce medicine by convincing the Home Office that a compound in the plant called cannabidiol had medicinal effects of its own and could negate the psychoactivity of THC, and that cannabinoids could be ingested by means other than smoking.

The first issue of O’Shaughnessy’s (Summer 2003) includes a piece describing GW’s progress and so does every issue since. It was GW providing plant extracts to scientists that broke the NIDA monopoly on cannabinoid research. My first goal for Project CBD was to bring US physicians and growers up to speed on what GW had learned.

When I filled my wife in just now she said, “Do these people know that without Geoffrey Guy there would be no CBD?” The woman tends to exaggerate, but her aim is true.
In a report for O’Shaughnessy’s on the 2004 meeting of the International Cannabinoid Research Society, a renowned scientist writing as “Dr. X” was struck by “All the posters on CBD! What a difference a decade makes. I presented a poster about CBD in 1994 and mine was the only mention of CBD at the conference. In 2004 we heard a dozen. The difference between 1994 and 2004? GW Pharmaceuticals sparking the interest and supplying the drug to researchers.”

O’S also published “The Pharmaceuticalization of Marijuana” by Lester Grinspoon, warning that GW’s pursuit of FDA approval would complicate the political movement against Prohibition. “The Ballad of Grinspoon and Guy” laments the tension between the two approaches.

Doctors in the Society of Cannabis Clinicians —doctors who believe their patients— have known all along that cannabis can alleviate symptoms of ADHD. Drs. Tom O’Connell and Claudia Jensen were among the first to publicize this application.
Cannabinoid and Terpenoid Doses are Associated with Adult ADHD Status of Medical Cannabis Patients

By Jeffrey Y. Hergenrather, M.D., Joshua Aviram, Ph.D., Yelena Vysotski, B.Sc., Salvatore Campisi-Pinto, Ph.D., Gil M. Lewitus, Ph.D., and David Meiri, Ph.D.

The aim of this cross-sectional questionnaire-based study was to identify associations between the doses of cannabinoids and terpenes administered, and symptoms of attention deficit hyperactivity disorder (ADHD).

Participants were adult patients licensed for medical cannabis (MC) treatment who also reported a diagnosis of ADHD by a physician. Data on demographics, ADHD, sleep, and anxiety were collected using self-report questionnaires. Data collected on MC treatment included administration route, cultivator, cultivar name, and monthly dose. Comparison statistics were used to evaluate differences in reported parameters between low (20-30 g, n=18) and high (40-70 g, n=35) MC monthly dose and low adult ADHD self-report scale (ASRS, 0-5) score (i.e. ≤3.17 score, n=30) or high ASRS score (i.e. ≥3.18 score, n=29) subgroups.

From the 59 patients that answered the questionnaire, MC chemovar could be calculated for 27 (45%) of them. The high MC monthly dose group consumed higher levels of most phyto-cannabinoids and terpenes, but that was not the case for all of the cannabis components. The high dose consumers and the ones with lower ASRS score reported a higher occurrence of stopping all ADHD medications. Moreover, there was an association between lower ASRS score subgroup and lower anxiety scores. In addition, we found an association between lower ASRS score and consumption of high doses of cannabinol (CBN), but not with Δ-9-tetrahydrocannabinol (THC).

These findings reveal that the higher-dose consumption of MC components (phyto-cannabinoids and terpenes) is associated with ADHD medication reduction. In addition, high dosage of CBN was associated with a lower ASRS score. However, more studies are needed in order to fully understand if cannabis and its constituents can be used for management of ADHD.

Citation: Hergenrather JY, Aviram J, Vysotski Y, Campisi-Pinto S., Lewitus GM, Meiri D. “Cannabinoid and Terpenoid Doses are Associated with Adult ADHD Status of Medical Cannabis Patients.” Rambam Maimonides Med J. 2020 Jan 30;11(1). doi: 10.5041/RMMJ.10384

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