SweetSue's Class Notes

Green Flower Media: CannaMed 2018

Panel Notes:

Solving the Opioid Problem: The Latest Findings, Solutions & Future Directions

Running time:73min

Dustin Sulak, DO Ziva Cooper, MD Caroline MacCallum, MD Julia Arnsten, MD

At 45:02 Dr.Sulak mentions that he’s seeing a trend in his patient populations of women over the age of 70 taking large amounts of opioids. In his observation this population isn’t seeing the dramatic results with using cannabis to taper off the opioids.

It’s not across the board, but he believes it is a trend.
  • They’re feeling he effects of cannabis but NOT breaking their opioids in half to taper off.
  • They’re NOT getting the potentiation of the opioids when adding cannabis.
46:02 Ziva mentions that she’s seen the same tolerance in younger women who use only cannabis.

  • They build faster tolerances to the pain modulation effects of cannabis than their male counterparts will, in many cases.
  • You may have to experiment more with women to find the therapeutic dose, and it may be higher in THC.
  • Watch women closely for indications of cannabis-induced confusion or anxiety

    46:50 (Julia)There’s a wide distance between opiate use disorder and chronic pain. In some cases they overlap, but they’re different conditions.
48:08 We don’t have the data to say with confidence that cannabis can really be used for tapering off opioids.

  • Something has to occupy the opioid receptor when using cannabis instead, so what’s happening at the receptor level?
  • What’s happening between the opioid receptors and the eCBRs that allows cannabis to be useful for either treating opioid use disorder or for opiate withdrawal symptoms? We don’t know what’s going on at a cellular level.
48:34 Dustin suggests it may not be an agonist or antagonist, but may be an endogenous acyor occupying that receptor.

Dr. Sulak believes the framework necessary to follow as an example for cannabis therapies with opioids may be opioid use disorder with medicated-assisted treatment, coupling Canna meds with education on the drugs and the proper use with opioids.

It may be more productive to train the patients in medicated-assisted treatment with opioids and then introduce them to the regimen with cannabis.

58:43 80% Of addicted patients were originally prescribed opiates by their doctor.

59:22 Dr. Sulak believes it’s necessary to get another tool into the hands of doctors dealing with the addicted patients. What they have available now doesn’t work.

  • Educating clinicians about the use of cannabis as a medicine will go far to change the corse of this international problem.
59:40 Julia says we were duped by Perdue Pharma, but doctors still caused the epidemic, and it’s on doctors to clean it up.

Enhanced Recovery After Surgery (ERAS) is a movement in the surgical community to use anything other than opioids to counter pain.

  • i.e., use of ibuprofen, getting patients up and moving within an hour of surgery completion, and walking the hallways
1:00:26 Disreputable prescribers are now closing their doors, leaving their pain patients hanging with no supply. Those patients often turn to the streets.

  • These patients are at higher risk for overdose, since street drugs are often problematic.
  • Opioids are effective against pain and patients need them, whether for pain or because they’re addicted.
  • Julia believes doctors are doing their best to get the epidemic under control, but they can’t do it alone.
1:00:00 “Ziva.....You mention that your research subjects were able to use a lower dose of their opioid when they were smoking, I’m assuming THC-dominant cannabis. And Julia, you started to talk about some signaling interaction between the ECS and opioid receptors.

Ziva, could you maybe speculate a little bit on what may be going on in terms of a mechanism there?”
1:01:45 Ziva’s answer:

  • This was all THC, no CBD in the medicine was used in her study.
She checked to see if Naltrexone antagonized the analgesic effects of the cannabinoids, and it was clear this wasn’t directly MU opioid receptor mediated.
  • There appears to be some synergy to the signaling cascade downstream of the immediate activation of the opioid receptor when you combine the cannabinoids with opioids.
  • The mechanism hasn’t been worked out yet.
  • It’s important to understand this effect if we’re going to look at other cannabinoids or terpenes for opioid-sparing effect.
1:02:47 “Is there a ratio of cannabinoids for chronic pain?”


(Caroline) For inflammatory processes its best to start with CBD and the smallest amount of THC possible.

  • She recommends CBD oil for daytime and THC oil at night.
  • If someone’s not sleeping this is a great opportunity to use THC.
  • She finds many patients, finding sound sleep with THC, often choose to go drug-free during daytime hours.
  • For neurological pain she recommends 1:1.
  • She also recommends high THC oils, but most often 1:1.
1:04:02 Oils are great for long-acting, so she recommends three doses a day.

- Vaporization as a breakthrough administration pathway.
  • Migraines may need more THC.
Dr. Sulak has an opioid-tapering education package on Healer.com.

1:05:30 Dr. Sulak mentions the 2016 guidelines by the CDC that pain clinics should NOT be testing the urine of their patients for THC because the test results won’t drive clinical action.

FIND THIS FEDERAL DOCUMENT AND GET THE LINK TO JONES BEFORE HIS NEXT PHYSICAN VISIT.

Julia believes this goes back to the moralistic attitude of the physicians, who lose sight of the fact that they’re treating a disease. Instead they feel they’re going to influence people’s behavior and somehow make them different people.

  • She believes it’ll take advocacy to the people making those decisions, saying that they don’t make sense.
1:06:53 Opiate receptors are negatively, allosterically-modulated by CBD and THC. (FIND THIS Prof of Pot post)

  • No one on this panel had heard of this research.
Kratom has partial-agonist activity at the MU opioid receptor.
- Comes in two strengths.
  • Has a biphasic effect, energetic at low doses, sedating at higher doses.
  • Dr. Sulak has patients that got off opiates with a combo of cannabis and kratom. He believes there’s incredible therapeutic benefit to be gained from its use.
 
well, I don't know much, but, i use topical, oral, and vape/smoke.:yummy: Whenever I neglect any method for long, I have more pain and other symptoms of my RA and old injuries, break through! The whole enchilada for me, cbd,thc and terpines used by different delivery methods works best in my situation! I do get a bit stoned at times! Better than hurting, losing mobility or using big pharms poisons that helped less and had worse side effects! :smokin2:
 
Points of frustration

Points of frustration

  • Media owner SweetSue
  • Date added

Looking beyond my initial frustration....

Near the 38:00 point q&a begins.

First questioner:
First person (Dr. Jeff....?) to the mike is a N. California physican working with elderly patients in a residential homes with dementia patients who choose cannabis (or whose family members request this care). He outlined their treatment plan for agitated patients:

* 20 mg dose (10 mg THC:10 mg CBD), administered 2-3 times daily - morning, around 3 PM, bedtime dose.

* This dosing schedule will knock demented elderly patients down for a day or two, and then they get up less agitated, with reduced pain, fewer episodes of insomnia, among other benefits.

* Doses are adjusted up or down for each patient, as needed.

* Sometimes that dose gets up to 30 mg of each major cannabinoid for severely agitated patients.

* Families are reporting some improvements in cognition.

* Staff and families are happy with the changes this dosing strategy offers.


Second questioner:
Pointed out that there’s a Dr. Chow (sp?) at the University of S. Florida is working with a combination of THC, circumin, and melatonin as a treatment for Alzheimer’s.

* Her mother has Alzheimer’s, and they treat her with 3 daily doses of 11 mg CBD and 7 mg THC.

At 41:50 there’s mention of a 2017 study published in Nature Medicine (?) showing that THC injected into the brains of older animals improved memory.

* The questioner mentions a documentary titled “Prescribed Grass” (?) that I’d like to track down, about the senior population in Israel.

One of the panelists went right to ‘Do we need the psychoactive component to treat this? No, we don’t think so. Look to other components to use with CBD.’ (My paraphrase)

So what about the fact that THC and CBD work best together? What about the reality that the plant - before we perverted it through underground growing for a rev market - expressed as a high CBD? Do we simply ignore all of that because they’re afraid of THC? WTH?

Third questioner:
Curious if anyone at UCLA is working in collaboration with Dr. Bredison (sp?) on using the ECS to treat dementia with cannabinoids?

Shot down with a “We aren’t in collaboration.” :straightface:

Fourth questioner:
A Canadian physican treating patients of this population, among others.
* Their treatment plan is oils in the 4:1 CBD:THC range for agitated patients.

* They’re finding efficacy at this level and also have reduced their dependence on anti-psychotic meds.

* Sunnybrook released a study in Chicago (when?) on the efficacy of Nabilone to reduce responsive behavior in dementia patients.

Fifth questioner:
Dr. Gary Small (UCLA) made mention earlier in the discussion that they’ve autopsied the brains of people known to have used cannabis from a young age and the brains showed shrinkage later in life.

This questioner called him out on that, and he admitted that they had no idea whether there were contributing factors they couldn’t be aware of that would have also contributed to brain shrinkage.

Made me wonder how many of the general population of non-cannabis users would show the same results, if they looked.

Is this the study they use to tell us how dangerous cannabis is to our developing brains? Because if that’s the case, this is BULLSHIT!

Dr. Small explains that they recruited the study participants, asking for those who’d used cannabis from a young age.

As another panelist pointed out, the big problem now is “what we’re they using?” How strong was the THC content? How was it grown and processed? What particulates found their way into the flowers?

“How can you have a clinical outcome based on something you don’t know?”

Personal Opinion: The studies that came out of the U.S. were bogus, and are not good information to be used as guidance for any cannabis programs.

Sixth questioner:
The gentleman works for Dr. Mechoulam’s company creating cannabinoid medicines and inquired as to why Dr. Schubert was playing with synthetics instead of natural components?

The dr. explained again that it’s difficult to get funding for a drug you can’t patent.

Final questioner was Dr. Sulak asking how they can best keep themselves in touch with the clinical community to better structure the random trials to answer pertinent questions of dose and efficacy?

It’s sad to me that they still insist that cannabis be tried first in animal models. The human animal model has been using cannabis as a medicine for as far back as we find record. I think we can move a little faster past Petri dishes, mice and rats.
 
Source: medicalxpress.com

THC more important for therapeutic effects in cannabis than previously believed
February 26, 2019
University of New Mexico

thcmoreimpor.jpg


Researchers at The University of New Mexico recently solved a major gap in scientific literature by using mobile software technology to measure the real-time effects of actual cannabis-based products used by millions of people every day.

Contrary to popular media-reports and scientific dogma, the psychoactive chemical, tetrahydrocannabinol, or THC, showed the strongest correlation with therapeutic relief and far less evidence for the benefits of relying on the more socially acceptable chemical, cannabidiol, or CBD.

In a recent study titled "The Association between Cannabis Product Characteristics and Symptom Relief," published in the journal Scientific Reports, UNM researchers Sarah See Stith, assistant professor in the Department of Economics, and Jacob Miguel Vigil, associate professor in the Department of Psychology, found that THC and CBD contents were the most important factor for optimizing symptom relief for a wide variety of health conditions.

The findings were based on the largest database of real-time measurements of the effects of cannabis in the United States, collected with the ReleafApp, developed by co-authors Franco Brockelman, Keenan Keeling and Branden Hall.

Since its release in 2016, the commercially developed ReleafApp has been the only publicly available, incentive-free app for educating patients on how their type of product (e.g., flower or concentrate), combustion method, cannabis subspecies (indica, sativa, and hybrid), and major cannabinoid contents (THC and CBD) affect their symptom severity levels, essentially providing invaluable user feedback on their health status, medication choices, and the clinical outcomes of those choices as measured by symptom relief and side effects.

The study aimed to address the practical questions of knowing how fundamental characteristics of currently available and frequently used cannabis products, characteristics that often influence consumer choices, affect health symptom intensity levels. The average patient, across the roughly 20,000 measured user sessions and 27 measured symptom categories ranging from depression to seizure activity, showed an immediate symptom improvement of 3.5 points on a 0-10 scale. Dried flower was the most commonly used product and generally associated with greater symptom improvement than other types of products.

Cannabis is rapidly gaining popularity as a mid-level analgesic and promising substitute for prescription opioids and other classes of medications, which often carry undesirable side effects, dangerous drug interactions and risk of death. Presently, federal barriers restrict researchers from conducting cannabis administration studies in the U.S.

"We were able to fill the most significant absence in the previous medical literature, understanding the 'efficacy, dose, routes of administration, or side effects of commonly used and commercially available cannabis products in the United States,'" said Vigil, quoting from the recently released report from the National Academies of Sciences, Engineering, and Medicine, Committee on the Health Effects of Marijuana.

By studying products containing both THC and CBD, the authors were able to analyze the relative importance of these cannabinoids for symptom relief and side effect prevalence, advancing previous research examining either chemical in the absence of the other. One of the most striking patterns in the current results was that THC was generally associated with a more intense user experience, as measured by symptom relief and the prevalence of both positive and negative side effects.

"Despite the conventional wisdom, both in the popular press and much of the scientific community that only CBD has medical benefits while THC merely makes one high, our results suggest that THC may be more important than CBD in generating therapeutic benefits. In our study, CBD appears to have little effect at all, while THC generates measurable improvements in symptom relief. These findings justify the immediate de-scheduling of all types of cannabis, in addition to hemp, so that cannabis with THC can be more widely accessible for pharmaceutical use by the general public," said Vigil.

"More broadly understanding the relationship between product characteristics and patient outcomes is particularly important given the lack of medical guidance received by medical cannabis patients," said Stith. "Most receive only a referral for cannabis treatment from their healthcare provider with all other treatment advice coming from prior recreational experience, the internet, social interactions, and/or often minimally trained personnel working in dispensaries.

"This is very different from how patients receive treatment using conventional pharmaceuticals that come with clear dosing instructions and a standardized, uniform product," she added.

The authors caution that cannabis use does carry the risks of addiction and short-term impairments in cognitive and behavioral functioning, and may not be effective for everyone.

"However, I have seen many people use it as a primary medication for a full spectrum of health conditions as part of their broader desire to gain more control over their healthcare treatment," says Vigil, a perspective that seems to gaining momentum as cannabis appears to be re-emerging as one of the most widely used medications in the U.S.
 
Tennessee Tim said:
All the goodness from the plant! CBD alone, did not help me throw away my methotrexate and other Rx chemicals. :rollit:
Click to expand...

Absolutely! I get a little sick of hearing how CBD is “the medicine in cannabis.”

Alafornia linked me up to this link. What good neighbors we have. :laughtwo:


Endocannabinoid signaling mediates oxytocin-driven social reward

" Genetic or pharmacological interruption of anandamide degradation offsets the effects of oxytocin receptor blockade on both social place preference and cFos expression in the NAc. The results indicate that anandamide-mediated signaling at CB1 receptors, driven by oxytocin, controls social reward. Deficits in this signaling mechanism may contribute to social impairment in autism spectrum disorders and might offer an avenue to treat these conditions. "
 
If there's a vibration of sickness there's a corresponding vibration of health and wholeness. Healthy cells have a homeostatic vibratory rate. I grow more convinced by the day that joyful expectation is the vibration that heals.

My theory: When you carry joy forward into expectation you marry desire to belief. This is the critical step to radical remission and spontaneous healing. You reach the point that you believe, and your cells pick up the harmonic tones to match your expectation.

It works like that for all aspects of your life. What do you desire? How will it feel when it becomes a part of your experience? Hold that energetic fingerprint and wait for it.

I can understand why people think it's magical thinking. It's rational thinking outside the tidy box of pharmaceutical hell we put ourselves into, IMHO. I'm convinced enough to deliberately cultivate a default of joyful expectation. Works for me. :laughtwo:


Source: MIT Technology Review

Vibrating Cells Disclose Their Ailments
MIT researchers gauge the progress of malaria using a novel imaging technique.
by Michael Fitzgerald
Sep 9, 2008

Bridging physics, engineering, and microbiology, researchers at MIT have measured the frequency at which red blood cells vibrate and have shown that those frequencies reflect the health of the cells. The research could lead to better medical diagnostics.

Vibrant cells:MIT’s Michael Feld and Subra Suresh, with the aid of a technique developed in Feld’s lab, were able to image the vibrations of the membrane of a blood cell infected with the malaria parasite (top). Feld’s technique also provided images of the interior of the cells (bottom), allowing the researchers to correlate the cells’ vibrational frequencies with the progress of the disease.

The work was performed in collaboration between MIT physicist Michael Feld and Subra Suresh, dean of MIT’s school of engineering and a materials scientist. Feld heads MIT’s Laser Biomedical Research Center, which has developed an imaging technique that can create three-dimensional images of living cells. Suresh’s laboratory has conducted experiments to measure things like the stiffness of red blood cells infected by malaria parasites.

A red blood cell has electrical, chemical, and biological activity taking place inside it, which causes nanoscale vibrations at its surface. To measure the cells’ vibrational frequencies, the researchers combined Feld’s imaging technique with diffraction phase microscopy, in which a laser beam that passes through a cell rejoins a reference beam that does not, creating a distinctive interference pattern. To establish the connection between the cells’ vibration and their health, the researchers used Feld’s technique to create three-dimensional images of a malarial parasite inside a red blood cell. They also measured the levels of hemoglobin inside the cells during various stages of a malarial infection.

“This thing has never been done before,” says Ares Rosakis, professor of aeronautics and mechanical engineering at the California Institute of Technology. “Scaling down optical techniques to [the nanoscale] level is extremely challenging.” (Rosakis was not involved in the work, although one of his former graduate students was.)

Rosakis sees two uses for the new techniques. One is to improve computer models of cells, because Feld and Suresh’s measurements are so much more accurate than previous measurements. The other is better diagnostics. The U.S. Centers for Disease Control (CDC) note that the main test for malaria currently does not work for acute malaria: it can recognize the disease only after the fact. Eventually, a technique like Feld and Suresh’s could provide a way to detect malaria as it’s happening. “Think of the future of a doctor or even an untrained technician having [the technology] built inside a commercial microscope and … instantaneously getting a reading on the state of the disease,” Rosakis says.

Suresh notes that it was rare for mechanical engineers to work on cell biology, and rarer still to do it with physicists. But he and Feld “don’t need to leave the building” to collaborate, he says.

The two began working together about two and a half years ago, after Feld invited Suresh to give a talk about the work his lab was doing on malaria cells. After Suresh’s talk, the two decided to combine forces–and instruments–to measure the speed at which healthy and diseased red blood cells vibrate.

They chose malarial cells because of Suresh’s experience working with them, but it meant that Feld’s lab had to be refitted to meet the CDC’s Level 2 biosafety standards. That project was led by one of the researchers on Suresh’s team, Monica Diez-Silva, the only microbiologist in either group.

It takes 48 hours for a malarial invader to run through its life cycle, developing, reproducing, and being expelled from the cell. The researchers thus had to evaluate infected cells from each stage of that 48-hour process, at temperatures that simulated the fever and cooling that the human body experiences during a malarial infection.

Vibrating cell membranes move mere nanometers at a time, and those movements take place in microseconds–millionths of a second. To capture the data from the laser beam passing through the cells, the researchers used Feld’s imaging technique, which stitches multiple images together into a composite. The technique is a species of tomography, the principle that underlies computed-tomography (CT) scans.
Rosakis says that imaging with interference patterns is particularly challenging when looking at red blood cells, which are doughnut-shaped and fluid, constantly changing shape in all directions.

Suresh and Feld’s first set of experiments took almost eight months, including “weeks and weeks” to assemble the 3-D images of the parasites inside the cells. Then they decided to look at hemoglobin levels, which also took months. They spent almost six months writing up the results, which will be published in the Proceedings of the National Academy of Sciences this week.

Suresh says that the research should apply to any other type of living cells. He and Feld want to look at red blood cells with sickle anemia, and possibly cancer cells, although it will be more difficult to study cells that have a nucleus.

Suresh’s and Feld’s techniques can’t yet be used for diagnosing illnesses, but Suresh says that their work “makes the scientific foundation that you can measure” disease at the cellular level.



One more piece to the puzzle. :slide:
 
 
From a Forbes article reporting on the Releaf app.

Interestingly, the study conducted by the University of New Mexico seemed to confirm this, as it found cannabis proved to be more effective for severe symptoms that are treated by benzodiazepines or antidepressants, than it is for severe symptoms typically treated with opioids.

In other words, the researchers discovered cannabis is more effective for the treatment of mental symptoms like agitation, irritability, anxiety, depression, excessive appetite, insomnia, loss of appetite, nausea, gastrointestinal pain, stress and tremors, than it is in the treatment of physical ailments.
 
Interesting! So they're finding it's better as a replacement for everything except opioids.

Personally I would have taken out their comma between "antidepressants" and "than."
 
InTheShed said:
Interesting! So they're finding it's better as a replacement for everything except opioids.

Personally I would have taken out their comma between "antidepressants" and "than."
Click to expand...

In my world it suggests that they haven’t figured out how to find the minimum therapeutic dose. In most cases we think the dose is how much we can tolerate. Often that’s a far cry from the smaller amount that actually brings relief.

Terpenes, ratios, dose volumes and scheduling, when you eat and what you eat.... all the variables that come into play when you’re fine-tuning a regimen.

There’s so little practical guidance out there Shed.
 
Such variability is one of the things holding cannabis back from widespread recommendation by the medical community. I think I've mentioned it before, but repeatably is so important there.

Like Dr. Sulak, cannabis doctors might need to become a sub-specialty.
 
Source: Google.com, Neuroscience

Researchers found that THC reduces a person’s pain when compared to placebo. On a scale of zero to 100, before taking medication, on average participants rated their pain levels at 53. After taking THC oil, they rated their pain levels at an average of 35 compared to an average of 43 for those who were given the placebo.

In addition, the more pain relief a person experienced, the greater the reduction of connections between the areas of the brain involved in processing pain.

Researchers found that THC reduces a person’s pain when compared to placebo. NeuroscienceNews.com image is in the public domain.
“Interestingly, our results also show that the more connected the areas of the brain that process emotion and sensory prior to treatment, the greater the pain relief experienced when taking THC,” said Sharon. “Larger studies are needed to confirm our findings.”
 
SweetSue said:
"Interestingly, our results also show that the more connected the areas of the brain that process emotion and sensory prior to treatment, the greater the pain relief experienced when taking THC,” said Sharon. “Larger studies are needed to confirm our findings."
Click to expand...
I remember reading somewhere that cannabis diminishes the sensation of pain not by blocking the pain signals the way
pain-killers do, but by making us care less about it.
 
InTheShed said:
I remember reading somewhere that cannabis diminishes the sensation of pain not by blocking the pain signals the way
pain-killers do, but by making us care less about it.
Click to expand...

THC tamps down the perception at the site of injury, modulates the signal being transmitted to the brain, and dims the perception in the brain. It hits pain on many levels, including influencing the arrival of immune cells tasked with reducing inflammatory response.

My favorite way to describe it is it makes pain a quieter visitor, as though it sits pain off to the side so you can play with life again.
 
Doctor at pain clinic, going through all my paperwork, asked if I use cannabis. I said "Yes" and he replied, "That's good, very good". Now I'm just there for shots in my spine, I don't do opiates, which is what the pain clinic was set up to deal with full time. He's from India, and said he's been seeing so many folks taper off and quit needing the clinic. If there were a sub-set of cannabis trained doctors, he would qualify. In India cannabis is a sacred plant, Lord Shiva himself drinks bhang. They definitely aren't averse to using something so ayurvedic. It's a tough thing, we need some sort of standardization, but at the same time until 'science' has dissected and parsed all the components of grass there are so many folks suffering, mostly at the hands of Big Pharm Corp. Thank you Sue, you are so far ahead of the curve.
 
Well that’s really good to hear from the doctor.

Sometimes I wonder how much all this time and effort help Althegardener2, and then I remind myself that if I can keep it something that brings me joy it’s worth it.

Helping others discover what cannabis has to offer is the most fun I’ve had in years. I think I’ll stick with the exploration.

Every time I learn something new about cannabis or the ECS I realize how little I really know. It can be intimidating, if I let it be. :laughtwo:
 
Just found this “study” from 2017. Three volunteers apply a topical for three days and then tested negative. All this proved, IMHO, was that three days of application wouldn’t show up on their particular drug screening.

What about long-term use of a high-THC oil as a topical? I’m hoping to help a young man paralyzed from the sternum down find some relief from the internal pain pushing him to the edge of sanity. There are many others here I was also planning to give double-strength oil to that can’t fail a drug test or they’ll be dropped from pain management.

But at the moment I’m watching a video on Green Flower Media that suggests topicals applied to the areas where veins are close to the surface - for instance your wrists, the legs where veins come close to the surface, your palms, or the soles of your feet - might result in a positive test.

This is the first I’ve heard any canna professional say this. These areas she speaks of are the very places we advise you apply a topical if you’re attempting to hit deep pain that you can’t reach any other way.

WTF? :straightface:

Source

Original publication:
Forensic Science International
Volume 272, March 2017, Pages 68-71

Topical application of THC containing products is not able to cause positive cannabinoid finding in blood or urine.
Hess C, et al. Forensic Sci Int. 2017.

Abstract

A male driver was checked during a traffic stop. A blood sample was collected 35min later and contained 7.3ng/mL THC, 3.5ng/mL 11-hydroxy-THC and 44.6ng/mL 11-nor-9-carboxy-THC. The subject claimed to have used two commercially produced products topically that contained 1.7ng and 102ng THC per mg, respectively.

In an experiment, three volunteers (25, 26 and 34 years) applied both types of salves over a period of 3days every 2-4h. The application was extensive (50-100cm2).

Each volunteer applied the products to different parts of the body (neck, arm/leg and trunk, respectively). After the first application blood and urine samples of the participants were taken every 2-4h until 15h after the last application (overall n=10 urine and n=10 blood samples, respectively, for each participant).

All of these blood and urine samples were tested negative for THC, 11-hydroxy-THC and 11-nor-9-carboxy-THC by a GC-MS method (LoD (THC)=0.40ng/mL; LoD (11-hydroxy-THC)=0.28ng/mL; LoD (THC-COOH)=1.6ng/mL;. LoD (THC-COOH in urine)=1.2ng/mL).

According to our studies and further literature research on in vitro testing of transdermal uptake of THC, the exclusive application of (these two) topically applied products did not produce cannabinoid findings in blood or urine.
 
Excellent...source bookmarked.

:thanks: for the find!
 
I think I’ll post that in the study hall too.
 
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