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Wednesday 17 April 2019

Cannabis and Anxiety

 

 
'Among medical cannabis consumers, 41% indicated having anxiety disorders. Anxiolytics — a class of drug used for the treatment of anxiety — are often associated with a potential range of undesirable side effects including confusion, drowsiness, nausea, memory problems, constipation, or muscle weakness. Cannabis has shown viability as a substitute for some prescription anxiolytics, and cannabis consumers appear open to trying it as such.

Among consumers reporting some anxiety disorder, 54% said that they had used cannabis to replace “some” or “all” of their prescription medications. Additionally, a majority (51%) of medical cannabis patients said that among their primary reasons to either reduce or transition from using prescription drugs was to utilize a more natural treatment option.'
 
-  New Frontier Data 
 
 
'485. Judging from the replies of several witnesses, the immediate effect of the moderate use of any of the hemp drugs on the habitual consumer is refreshing and stimulating, and alleviates fatigue, giving rise to pleasurable sensations all over the nervous system, so that the consumer is "at peace with everybody"—in a grand waking dream. He is able to concentrate his thoughts on one subject: it affords him pleasure, vigour, ready wit, capacity for hard work, and sharpness for business; it has a quieting effect on the nervous system, and removes restlessness and induces forgetfulness of mental troubles; all sorts of grotesque ideas rapidly pass through the mind, with a tendency to talk; it brightens the eyes, and, like a good cigar, gives content; the man feels jolly, sings songs, and tells good stories; it causes bravery in the brave and cowardice in the timid, and, like alcohol, brings out the real character of the man.'
 
 - Indian Hemp Drugs Commission, 1895
 
 
Anxiety is a condition that affects most people in the world at some point. In some people, it can be debilitating, as chronic anxiety can lead to further diseases of body and mind, such as hypertension, depression, etc. Often the demands of the daily life in today's world, with its increasing uncertainties and competition for resources, give rise to multiple occasions when an individual feels anxious or stressed. This is not isolated to particular geographies or age groups, but is seen almost everywhere that the modern human lives. I dare say that even plants, other animals and life forms, in general, are given to more anxious times these days than in the past, given the stress on the planet. There may be remote tribes in deep forests who are relatively unaffected by it, as they continue to live in nature, but this will also surely change as modern humans impact even the remotest places on earth.
 
Anxiety is one of the leading medical conditions for which a person is eligible for cannabis as a medication in many US states. Thousands of people now are prescribed medical cannabis by their physicians, based on which a person is eligible for quantities of cannabis as flower, bud or concentrates that they can procure from the nearest cannabis dispensary. The extent of usage is evidence that more and more people are increasingly turning towards cannabis as a remedy for anxiety, in preference to benzodiazepines, sedatives and other pharmaceutical drugs. Cannabis has been found to be suitable for treating anxiety in animals as well.
 
There is some opposition to cannabis for the treatment of anxiety, with cases reported where it is stated that cannabis has caused anxiety in some individuals. I have personally come across a couple of instances, where persons who consumed cannabis underwent bouts of panic and anxiety. In both instances, however, this happened only when they consumed cannabis for the first time, and the unfamiliarity of the experience may have contributed to the anxiety. These persons are now seasoned cannabis users with the initial experience of anxiety long forgotten.

Compared to the few instances of anxiety in inexperienced cannabis users, if we look at their synthetic substitutes that are widely prescribed the world over for the treatment of anxiety, it is truly worrisome. Benzodiazepines, the most common medication for the treatment of anxiety, and its precursor, barbiturates, have been found to be highly problematic medications but their usage continues to across the world. A recent study stated that 'Although overdose receives less attention as a benzodiazepine-related adverse event, benzodiazepines are the second-most common medication class involved in pharmaceutical overdose deaths, and overdose deaths that involve benzodiazepines increased more than 6-fold from 1996 through 2014. More than 75% of benzodiazepine-related deaths involve opioids, and evidence continues to accumulate that use of benzodiazepines is associated with increased risk of opioid-related overdose and mortality.'  In addition to the risk of fatal overdose in combination with other pharmaceutical drugs, there is also the risk of addiction, self-injury, depression and suicide that has been increasingly reported. Regarding barbiturates, the precursors that benzodiazepines replaced, William S Burroughs wrote in his book Junk, as follows - ''Barbiturates are more dangerous than junk [opioids] because a user of barbiturates - eight or more capsules per day - gets the horrors when he is cut off barbiturates, and he is subject to epileptic fits with frequent head injury from flopping around on concrete floors. He is most likely to find himself cut off in a place where the floors are concrete." New Frontier Data reports that  - "Anxiolytics — a class of drug used for the treatment of anxiety — are often associated with a potential range of undesirable side effects including confusion, drowsiness, nausea, memory problems, constipation, or muscle weakness."
 
Cannabis has been described in many historic medical texts as a treatment for anxiety, and before worldwide prohibition anxiety may have been one of the main reasons for its extensive usage. In his note on references to the hemp plant occurring in Sanskrit and Hindi literature, to the Indian Hemp Drugs Commission of 1894-95, Mr. G. A. Grierson, C.I.E., Magistrate and Collector, Howrah, says, 'The Rajavallabha, a materia medica, by Narayanadasa kaviraja, but which is quoted in the Çabdakalpadruma, and is believed to be ancient, has the following:— Çakra-'çanam tu tiksno-'snam moha-krit kustha-naçanam | Bala-medha-'gni-krit-çlesma- -dosa-hari rasayanam || Jata mandara-manthanaj jala-nidhaup iyusa-rupap ura|  Trailokye vijaya-prade 'ti vijaya çri-devaraja-priya || Lokanam hita-kamyayak siti-tale-praptan araihk amada|  Sarva-"t anka-vinaça-harsa-jananiy aihs evitas arvada. || "Indra's food (i.e., ganja) is acid, produces infatuation, and destroys leprosy. It creates vital energy, the mental powers, and internal heat, corrects irregularities of the phlegmatic humour, and is an elixir vitæ. It was originally produced, like nectar, from the ocean by the churning with Mount Mandara,2 and inasmuch as it gives victory in the three worlds, it, the delight of the king of the gods, is called vijaya, the victorious. This desire-fulfilling drug was obtained by men on the earth, through desire for the welfare of all people. To those who regularly use it it begets joy and destroys every anxiety." The Indian Hemp Drugs Commission states in its summary on medical uses of cannabis in 19th century India that '472. There are a few other effects of a beneficial character which are referred to by certain witnesses. They are, however, of a less important character and less generally contemplated than those which have been already considered. Thus the drugs are said to be used sometimes to prevent insomnia and to relieve anxiety, as the consumer of alcohol sometimes takes a "night cap before going to bed" or a glass of wine when he is of heavy heart. The drugs are said to be cheering in their effects, and to be prized by many on this account. An interesting illustration of this may perhaps be found in the popular belief existing in many parts that these drugs protect against cholera and other epidemic diseases. One very intelligent witness, who has seen much of this use, explains it as due to the stimulating and inspiriting nature of the drugs.'  In its summary on the immediate effects of cannabis usage, the Commission states that '485. Judging from the replies of several witnesses, the immediate effect of the moderate use of any of the hemp drugs on the habitual consumer is refreshing and stimulating, and alleviates fatigue, giving rise to pleasurable sensations all over the nervous system, so that the consumer is "at peace with everybody"—in a grand waking dream. He is able to concentrate his thoughts on one subject: it affords him pleasure, vigour, ready wit, capacity for hard work, and sharpness for business; it has a quieting effect on the nervous system, and removes restlessness and induces forgetfulness of mental troubles; all sorts of grotesque ideas rapidly pass through the mind, with a tendency to talk; it brightens the eyes, and, like a good cigar, gives content; the man feels jolly, sings songs, and tells good stories; it causes bravery in the brave and cowardice in the timid, and, like alcohol, brings out the real character of the man.'  Mr. W. H. Grimley, Commissioner of Chota Nagpur, says in his evidence to the Hemp Commission that , 'As an alleviator of sorrow and anxiety, a black-care-dispeller, a death-scarer, and devil-driver, it is held in high repute.' Assistant Surgeon Bosonto Kumar Sen, says, 'They produce sound sleep and relieve pain and anxiety.'  Azher Hossein, Hospital Assistant, Gauhati, says, 'Moderate dose appears to be harmless, for it keeps the mind temporarily cheerful and free from anxiety.' Rao Sahib Pranshankar, Brahmin, Inspector of Police, Detective Branch, Bombay, says, 'By way of forgetting pain, allaying fatigue, anxiety, etc., and keeping jolly all round.' Hospital Assistant Bhau Saccaram, Brahmin, Raipur Dispensary, Ahmedabad, says, 'They give temporary relief from anxiety or grief.'
 
Now, however, persons legally using cannabis for anxiety are a minute fraction of the people who could benefit from it globally. This fraction is essentially well to do Americans and Europeans who, you could say, have played a significant role in raising worldwide anxiety levels through their wars and, to top it all, through the prohibition of the very plant that they themselves now use as medication. The greater majority of the world, however, continues to face and handle anxiety without any legal access to the plant as of today. To worsen things, people who have been deprived access to the medicinal and safe cannabis, have now been provided by the state with dangerous synthetic pharmaceuticals, including benzodiazepines and barbiturates. Vulnerable young and elderly persons are prescribed these medications and alarming numbers of patients are succumbing as a result of this, vastly unacknowledged, fact. And the world is only getting more anxious. 

Related articles

The following list of articles taken from various media speak about the above subject. Words in italics are the thoughts of yours truly at the time of reading the article. 
 
Patients with generalized anxiety disorder (GAD) exhibit sustained improvements in their symptoms following the use of cannabis products, according to data published in the journal Neuropsychopharmacology Reports.

British investigators assessed the safety and efficacy of plant-derived cannabis products (either oils, flower, or a combination of both) in over 300 patients enrolled in the UK Medical Cannabis Registry. Cohort participants possessed a doctor’s authorization to access cannabis products. (Since 2018, specialists have been permitted to prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.) Authors assessed the efficacy of cannabis at one, three, six, and 12 months.

Consistent with prior studies, cannabis treatment was associated with persistent improvements in patients’ anxiety, sleep, and health-related quality of life. Patients presenting with severe baseline anxiety were most likely to experience a clinically significant improvement in anxiety symptoms at 12?months.

Researchers concluded: “The findings from this cohort study demonstrate that treatment with CBMPs [cannabis-based medicinal products] is associated with statistically significant improvements across anxiety-, sleep-, and HRQoL-specific PROMs [patients-reported outcome measures] after 12?months in patients with GAD. … Results also indicated CBMPs were well tolerated throughout the study. … Patients were prescribed either oils, dried flower, or a combination of both, and this study identified no difference in outcomes at 12?months between treatment groups.”

https://norml.org/news/2024/01/18/analysis-cannabis-products-provide-sustained-improvements-in-patients-with-generalized-anxiety-disorder/


A team of Australian investigators assessed the safety and efficacy of oral cannabinoid formulations (either tinctures of capsules) containing various ratios of THC and CBD in 198 patients with anxiety disorders. The median doses consumed by study participants were 50.0 mg/day for CBD and 4.4 mg/day for THC. (Australian law permits physicians to authorize cannabis products to patients unresponsive to conventional prescription treatments.)

Researchers reported, “The total participant sample reported significantly improved anxiety, depression, fatigue, and ability to take part in social roles and activities.”

Among the subset of subjects diagnosed specifically with post-traumatic stress, cannabis therapy similarly “improved anxiety, depression, fatigue, and social abilities,” with CBD-dominant formulations exhibiting the greatest efficacy.

https://norml.org/news/2023/08/10/study-plant-derived-cannabinoids-effective-for-anxiety-post-traumatic-stress/
 
 
 
What is it about marijuana that causes fear in people who don't use it? Is it the fear that they will lose control over the empires that they have built based on threats, manipulation and force? Is it the fear that individuals all over the world may become free to choose to take control over their means of medication, recreation and livelihood? Is it the fear that contented, healthy and peaceful individuals cannot be exploited and manipulated easily and so are dangerous to today's systems? Is it the fear that marijuana will make the individual more conscious of what is happening in the world and she will not quietly accept the status quo? Is it the fear of losing one's self-control and letting one's most deepest madness take over sometimes? Is it the fear of being labelled a non-conformist, insane or a criminal and ridiculed by society? Is it the fear of losing all your possessions in this world? Is it the fear of death? Is it the fear of the unknown, the void, the great spirit of the universe? If you examine your fears closely, you will probably realise that these things are bound to happen anyway...the plant may in fact help you handle your fears better...

Updated Oct 08, 2022 12:25:53pm



'Results: Medicinal cannabis use was associated with lower self-reported depression, but not anxiety, at baseline. Medicinal cannabis users also reported superior sleep, quality of life, and less pain on average. Initiation of medicinal cannabis during the follow-up period was associated with significantly decreased anxiety and depressive symptoms, an effect that was not observed in Controls that never initiated cannabis use.

Conclusions: Medicinal cannabis use may reduce anxiety and depressive symptoms in clinically anxious and depressed populations. Future placebo-controlled studies are necessary to replicate these findings and to determine the route of administration, dose, and product formulation characteristics to optimize clinical outcomes.'

https://www.frontiersin.org/articles/10.3389/fpsyt.2021.729800/full


'Methods: We present the case of a 20-year-old male with treatment-resistant stuttering, who markedly improved after treatment with medicinal cannabis.

Results: Besides improved speech fluency as assessed by several phoniatric tests, we observed remission of (social) anxiety, improved mood, and reduced stress, resulting in an overall improvement of quality of life after cannabis therapy. The patient, in addition, reported improved attention, concentration, and sleep, increased self-confidence, and better social life. No side effects occurred. Over a time period of more than a year, treatment was equally effective. In an interview, the patient describes his personal view and the influence of cannabis-based treatment on his life.

Conclusions: Medicinal cannabis could be effective in treatment of refractory stuttering, but these preliminary data have to be confirmed in controlled studies.'

https://www.liebertpub.com/doi/10.1089/can.2021.0060


'Among medical cannabis consumers, 41% indicated having anxiety disorders. Anxiolytics — a class of drug used for the treatment of anxiety — are often associated with a potential range of undesirable side effects including confusion, drowsiness, nausea, memory problems, constipation, or muscle weakness. Cannabis has shown viability as a substitute for some prescription anxiolytics, and cannabis consumers appear open to trying it as such.

Among consumers reporting some anxiety disorder, 54% said that they had used cannabis to replace “some” or “all” of their prescription medications. Additionally, a majority (51%) of medical cannabis patients said that among their primary reasons to either reduce or transition from using prescription drugs was to utilize a more natural treatment option.'

https://newfrontierdata.com/cannabis-insights/medical-cannabis-use-rising-among-u-s-consumers-with-anxiety-disorders/


'Besides locomotor and anxiety-like behaviors, dopaminergic molecular parameters were quantified in both prefrontal cortex and ventral striatum. Regarding molecular levels, CBD modulated at basal levels the dopaminergic targets (D1R, D2R, DAT, and TH) in the assessed brain areas, preventing AMPH relapse and decreasing anxiety-like behavior per se and in AMPH-CPP animals. The current findings give evidence about CBD-induced AMPH-relapse prevention, which may be linked to dopaminergic mesocorticolimbic system modulation. Although future and clinical studies are needed, our outcomes show that CBD may be a useful alternative to prevent AMPH relapse.'

https://www.sciencedirect.com/science/article/abs/pii/S0924977X21001966


'Coronavirus disease-19 (COVID-19)-related anxiety and post-traumatic stress symptoms (PTSS) or post-traumatic stress disorder (PTSD) are likely to be a significant long-term issue emerging from the current pandemic. We hypothesize that cannabidiol (CBD), a chemical isolated from Cannabis sativa with reported anxiolytic properties, could be a therapeutic option for the treatment of COVID-19-related anxiety disorders. In the global over-the-counter CBD market, anxiety, stress, depression, and sleep disorders are consistently the top reasons people use CBD. In small randomized controlled clinical trials, CBD (300–800 mg) reduces anxiety in healthy volunteers, patients with social anxiety disorder, those at clinical high risk of psychosis, in patients with Parkinson's disease, and in individuals with heroin use disorder. Observational studies and case reports support these findings, extending to patients with anxiety and sleep disorders, Crohn's disease, depression, and in PTSD. Larger ongoing trials in this area continue to add to this evidence base with relevant patient cohorts, sample sizes, and clinical end-points.'

https://www.liebertpub.com/doi/10.1089/can.2020.0102
 
 
'Analysts affiliated with CB2 Insights, a chain of medical cannabis evaluation clinics operating throughout the United States, assessed data from over 61,000 patients seeking medical cannabis evaluations in 12 states over a 17-month period (November 2018 to March 2020).

Patients seeking medical cannabis authorizations were most likely to report their primarily condition to be related to chronic pain (39 percent), followed by anxiety (14 percent) and post-traumatic stress (8 percent). Patients also frequently reported suffering from comorbid conditions for which they sought relief, including insomnia and depression.'

https://norml.org/news/2021/02/11/analysis-medical-cannabis-most-commonly-recommended-for-treating-chronic-pain-conditions

 
'A decrease in distress-related symptoms was reported by subjects over 95 percent of the time following their use of herbal cannabis. Researchers reported, “On average, respondents recorded a maximum symptom intensity reduction of 4.33 points for agitation/irritability, 3.47 points for anxiety, and 3.98 for stress on an 11-point visual analog scale.”

Authors reported that higher THC levels were most closely associated with reductions in distress-related symptoms. By contrast, “CBD levels were generally not associated with changes in symptom intensity levels.”

They concluded: “The findings suggest the majority of patients in our sample experienced relief from distress-related symptoms following consumption of Cannabis flower, and that among product characteristics, higher THC levels were the strongest predictors of relief.”'

https://norml.org/news/2021/02/04/study-cannabis-inhalation-associated-with-reduction-in-distress-related-symptoms


'A team of international investigators from France, Germany, Italy, and the Netherlands assessed the relationship between adults’ access to low-THC (below 0.6 percent THC) cannabis and prescription drug sales in 106 Italian provinces over a two-year period.

They reported, “[L]ocal availability of light cannabis [low-THC, CBD-based products] led to a significant decrease in the number of dispensed boxes of anxiolytics by approximately 11.5 percent, a reduction of dispensed sedatives by 10 percent and a reduction of dispensed anti-psychotics by 4.8 percent.”

Researchers also identified less significant reductions in the use of anti-epileptic medications, anti-depressants, opioids, and migraine drugs.'

https://norml.org/news/2020/09/17/availability-of-low-thc-cannabis-products-associated-with-reduced-use-of-prescription-anxiolytics-sedatives


'Results
At low doses, THC can enhance the extinction rate and reduce anxiety responses. Both effects involve the activation of cannabinoid type-1 receptors in discrete components of the corticolimbic circuitry, which could couterbalance the low “endocannabinoid tonus” reported in PTSD patients. The advantage of associating CBD with THC to attenuate anxiety while minimizing the potential psychotic or anxiogenic effect produced by high doses of THC has been reported. The effects of THC either alone or combined with CBD on aversive memory reconsolidation, however, are still unknown.

Conclusions
Current evidence from healthy humans and PTSD patients supports the THC value to suppress anxiety and aversive memory expression without producing significant adverse effects if used in low doses or when associated with CBD. Future studies are guaranteed to address open questions related to their dose ratios, administration routes, pharmacokinetic interactions, sex-dependent differences, and prolonged efficacy'

https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02813-8


'Current users and PU [past users] took MC [Medical Cannabis] to address pain (65.30%), spasms (63.30%), sleeplessness (32.70%), and anxiety (24.00%), and 63.30% reported it offered “great relief” from symptoms. Participants reported that MC is more effective and carries fewer side effects than prescription medications.

Conclusions
Medicinal cannabis is an effective and well-tolerated treatment for a number of SCI[Spinal Cord injury]-related symptoms.'
https://www.nature.com/articles/s41394-019-0208-6


'Results
Cannabis use was consistently two to three times higher among those with high anxiety compared to those with some or no anxiety and was higher in states with RML [Recreational Marijuana Legalization] compared to MML [Medical Marijuana Legalization] or no MML/RML. Cannabis use has increased over time among those with and without anxiety overall, in MML states, and in states without MML/RML; with a faster increase in cannabis use among those with high anxiety compared to lower anxiety in states with MML.

Conclusions
Cannabis use is increasing among American adults overall, yet is disproportionately common among Americans with anxiety especially among those residing in states where cannabis has been legalized.'
https://www.sciencedirect.com/science/article/abs/pii/S0376871620303288


'And no matter the outcome, the study will do little to curb people selling CBD products. If the pudding does do something, CBD oil brands will have a paper to add to their marketing arsenal. If the special puddling doesn’t do anything for people with chronic pain, it will be easy to ignore; manufacturers can easily word claims about products’ benefits vaguely enough to avoid out-and-out false advertising. But more importantly, once something is in the public imagination as being useful, it’s hard to oust it. CBD has benefited from early studies that suggest legitimate uses from pain management to anxiety to insomnia. It doesn’t matter much that these are typically small, and often in rodents. There’s also the simple fact that it comes from marijuana; that it would do something positive seems logical, in the same way that buying face creams boasting antioxidants seems logical, even though they may only wind up being present in trace amounts. One only really has to note that a product has CBD in order to sell it. '
https://slate.com/technology/2019/09/unfortunately-the-cbd-horse-is-pretty-definitively-out-of-the-barn-so-to-speak.html

 
'The report's author concluded: "[T]his case demonstrates how the patient was able to significantly benefit from the introduction of medical cannabis into her mental health intervention for the treatment of vertigo and a generalized anxiety disorder. In this case, the benefits for the 88-year-old patient using medical cannabis as a treatment in the both the short term and longer-term far outweighed the potential risks that may require consideration for children or adolescents."'
https://norml.org/news/2020/04/23/case-report-88-year-old-patient-reports-cannabis-improves-symptoms-of-anxiety-vertigo


'“The evidence described in the present systematic review indicates that CBD is a promising adjunct therapy for the treatment of cocaine dependence due to its effect on cocaine consumption, brain reward, anxiety, related contextual memories, neuroadaptations and hepatic protection as well as its anticonvulsant effect and safety,” the study authors concluded.

“The clinical administration of CBD leads to a reduction in the self-administration of cocaine and, consequently, the amount of the drug consumed. Moreover, the reward induced by cocaine is blunted by CBD treatment.”'
https://www.marijuanamoment.net/cbd-is-a-promising-therapy-in-treating-cocaine-misuse-meta-study-finds/


'Long-term use of BZRAs [Benzodiazepine receptor agonist] (> four weeks) in older adults should be avoided for most indications because of their minimal efficacy and risk of harm. Older adults have increased sensitivity to BZRAs and decreased ability to metabolize some longer-acting agents, such as diazepam. All BZRAs increase the risk of cognitive impairment, delirium, falls, fractures, hospitalizations, and motor vehicle crashes. Alternative management strategies for insomnia, anxiety disorders, and the behavioural and psychological symptoms of dementia (also known as responsive behaviours) are recommended. BRZAs have minimal efficacy for anxiety, insomnia, or responsive behaviours related to dementia. This is coupled with concerns about their associated adverse effects. These drugs commonly appear on lists of medications to avoid in the care of older patients'
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7067147/


This also implies reduced use of opioids, benzodiazepines and analgesics...key factors in increased fatalities among men in recent years in the US..

'Among those who acknowledged using cannabis for medical purposes, 49 percent reported doing so to treat anxiety. Forty-seven percent of respondents said that they used cannabis for insomnia, 42 percent said that they did so to treat chronic pain, and 39 percent said that cannabis eased their depression.

Respondents most preferred method of cannabis ingestion was inhalation.

Women, more frequently than men, reported using cannabis to address symptoms of post-traumatic stress, insomnia, anxiety, and migraines. Men were more likely to report using cannabis as a mood stabilizer.'
https://norml.org/news/2020/04/30/survey-cannabis-often-used-to-mitigate-symptoms-of-anxiety-insomnia-and-chronic-pain


Fear is death. Fear of death is the greatest of all fears. Inject the fear of death into a healthy person and watch his body and mind wither away in the shortest time in front of your eyes. Most individuals fall ill as their stress levels break their immune systems from within. Inject the fear of death into a nation and watch it lose all its vitality and health in the shortest possible time. Once the fear has taken deep root and the individual or nation is weakened in body and mind, it is ready to be controlled for one's purposes, such as believing stories about threats from neighbors and taking up arms against them. Most wars have succeeded because individuals and nations have been made fearful enough to think that their lives are at risk if they do not take up arms. The belief that death can be avoided through pharmaceutical medication and wars is a typical conditioning of the weakened mind. Fight and overcome the fear of death in your mind and you will be healthy once again as an individual or a nation. Once the forces trying to inject their own fears into you realize that your mind is strong, they may be able to conquer their own fears...
May 2, 2020, 5:54 PM


'The INCB reported that in 2006, total global licit production of benzodiazepines amounted to at least 180 metric tonnes, 56 tonnes of which was diazepam. Italy (32 %), India (19 %), China (11 %) and Germany (10 %) were the leading manufacturers between 1997 and 2006.'
http://www.emcdda.europa.eu/publications/drug-profiles/benzodiazepines_en


'Benzodiazepines are widely used in medicine to treat anxiety and insomnia. Flunitrazepam (Rohypnol®) is the benzodiazepine most commonly linked by media reports to drug-facilitated sexual assaults, more commonly referred to as ‘date rape’. However, forensic toxicology shows that only a very small number of such assaults actually involve the use of flunitrazepam. A number of studies, cited in the EMCDDA Technical data sheet on Sexual assaults facilitated by drugs or alcohol (EMCDDA 2008), suggest that alcohol and other benzodiazepines are an underestimated problem in such cases.'
http://www.emcdda.europa.eu/publications/drug-profiles/benzodiazepines_en


'Thirty-three benzodiazepines were included in Schedule IV of the 1971 United Nations Convention on Psychotropic Substances in 1984 (Table 1). Midazolam (1990) and brotizolam (1995) were subsequently added to the Schedule. In 1995, flunitrazepam (CAS 1622-62-4) was transferred from Schedule IV to Schedule III because the International Narcotics Control Board (INCB) stated that it was one of the most misused benzodiazepines and because of its frequent diversion into the illicit market.

Phenazepam (fenazepam) (CAS 51753-57-2), which is used in medical practice in some countries outside of the European Union, is not scheduled in the 1971 United Nations Convention on Psychotropic Substances.'
http://www.emcdda.europa.eu/publications/drug-profiles/benzodiazepines_en


'Although benzodiazepines are much safer in overdose than their predecessors, the barbiturates, they can still cause problems in overdose. Taken alone, they rarely cause severe complications in overdose; statistics in England showed that benzodiazepines were responsible for 3.8% of all deaths by poisoning from a single drug. However, combining these drugs with alcohol, opiates or tricyclic antidepressants markedly raises the toxicity. The elderly are more sensitive to the side effects of benzodiazepines, and poisoning may even occur from their long-term use. The various benzodiazepines differ in their toxicity; temazepam appears most toxic in overdose and when used with other drugs.The symptoms of a benzodiazepine overdose may include; drowsiness, slurred speech, nystagmus, hypotension, ataxia, coma, respiratory depression, and cardiorespiratory arrest.

In the United States, benzodiazepines are Schedule IV drugs under the Federal Controlled Substances Act, even when not on the market (for example, nitrazepam and bromazepam).

The elderly are at an increased risk of both short- and long-term adverse effects, and as a result, all benzodiazepines are listed in the Beers List of inappropriate medications for older adults.'
https://en.wikipedia.org/wiki/Benzodiazepine


'Although overdose receives less attention as a benzodiazepine-related adverse event, benzodiazepines are the second-most common medication class involved in pharmaceutical overdose deaths, and overdose deaths that involve benzodiazepines increased more than 6-fold from 1996 through 2014. More than 75% of benzodiazepine-related deaths involve opioids, and evidence continues to accumulate that use of benzodiazepines is associated with increased risk of opioid-related overdose and mortality. Given that older adults experienced the largest absolute increases in opioid-related mortality between 2001 and 2016 and also experience the highest rates of coprescribing of opioids and benzodiazepines, benzodiazepine prescribing may be associated with increased opioid-related morbidity and mortality among older adults.'
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7125434/


Can the benzodiazipines please be substituted with cannabis and natural cannabis be legalized for people to access world wide?

'With regard to CBD's safety, they concluded: "[M]ost studies reported no adverse events with acute administration and mild to moderate adverse effects with chronic administration. In comparison to other drugs, a better side effect profile was presented.'
https://norml.org/news/2020/04/16/review-oral-use-of-cbd-reports-anxiolytic-and-anti-psychotic-activity-few-adverse-effects


'I certainly knew about anxiety. For any woman, just walking down a street can sometimes be an anxiety-inducing experience. It’s worse for a woman of color. Now picture a black trans woman and what she’s dealing with. Sometimes, knowing the kind of day that lies ahead, it’s almost impossible to just get out of bed, let alone walk down a street without fear due to the high rates of violence she faces. For me, cannabis made it possible.

For trans people, the hurdles of everyday life are often much higher, the barriers to basic needs are much wider, and the structural nature of discrimination and exclusion is much deeper. Shouldering that weight every single day results in debilitating stress, anxiety and depression.'
https://www.marijuanamoment.net/cannabis-is-critical-to-trans-health-and-self-care-sponsored-op-ed/


'Top Trump administration officials say drug overdose deaths are surging amid the coronavirus pandemic, driven by increased substance use due to anxiety, social isolation and depression.

 A White House drug policy office analysis shows an 11.4 percent year-over-year increase in fatalities for the first four months of 2020, confirming experts’ early fears that precautions like quarantines and lockdowns combined with economic uncertainty would exacerbate the addiction crisis'
https://www.politico.com/news/2020/06/29/pandemic-unleashes-a-spike-in-overdose-deaths-345183


'Pennsylvanians suffering from anxiety may soon be able to treat the disorder with medical marijuana.

The state Medical Marijuana Advisory Board on Friday voted to add anxiety and Tourette syndrome as conditions qualifying patients to buy medicinal cannabis at dispensaries across the state.'
https://www.mcall.com/business/healthcare/mc-biz-medical-marijuana-news-anxiety-tourettes-edibles-20190201-story.html


'Main Outcome Measures: Sleep and anxiety scores, using validated instruments, at baseline and after CBD treatment.

Results: The final sample consisted of 72 adults presenting with primary concerns of anxiety (n = 47) or poor sleep (n = 25). Anxiety scores decreased within the first month in 57 patients (79.2%) and remained decreased during the study duration. Sleep scores improved within the first month in 48 patients (66.7%) but fluctuated over time. In this chart review, CBD was well tolerated in all but 3 patients.

Conclusion: Cannabidiol may hold benefit for anxiety-related disorders. Controlled clinical studies are needed.'
http://www.thepermanentejournal.org/issues/2019/winter/6960-cannabis.html


'More importantly, the results get us closer to understanding how CBD interacts with neurons in entirely different ways than its well-known partner compound, THC – sidestepping drawbacks of affecting the endocannabinoid system in the process. And if these findings replicate in humans, we’re also closer to harnessing CBD’s potential to deliver non-addictive pain and anxiety relief, offering patients on highly addictive opioids and benzodiazepine anti-anxiety meds another way to go.'
https://www.forbes.com/sites/daviddisalvo/2018/10/29/study-cbd-may-provide-pain-and-anxiety-relief-in-different-ways-than-previously-thought/


'The study, published in the Brazilian Journal of Psychiatry, tested how CBD influences anxiety in a simulated public speaking setting, “a well-tested anxiety-inducing method.”'
https://www.marijuanamoment.net/marijuana-ingredient-reduces-anxiety-during-public-speaking-study-shows/


'According to a recent Cochrane review on the efficacy of cannabinoids in TS [Tourette syndrome], definite conclusions cannot be drawn, because longer trials including a larger number of patients are missing. Notwithstanding this appraisal, by many experts THC is recommended for the treatment of TS in adult patients, when first line treatments failed to improve the tics. In treatment resistant adult patients, therefore, treatment with THC should be taken into consideration.'
https://www.ncbi.nlm.nih.gov/pubmed/23187140/


'A key part of anxiety is fear, and the few human studies that have been conducted on cannabidiol have suggested that the compound dampens people's fear by changing the activity of certain brain regions, said Carl Stevenson, a co-author of the new review and a neuroscientist at the University of Nottingham in the United Kingdom.'
https://www.livescience.com/58353-marijuana-chemical-cannabidiol-could-help-fight-anxiety.html


'Unlike widely used anxiolytic and antidepressant drugs such as benzodiazepines and SSRIs, the acute administration of an anxiolytic dose of CBD does not appear to interfere with the sleep cycle of healthy volunteers. Future studies should address the effects of CBD on the sleep-wake cycle of patient populations as well as evaluate the chronic effects of CBD in larger samples of patients with sleep and neuropsychiatric disorders.'
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895650/



'Main Outcome Measures: Sleep and anxiety scores, using validated instruments, at baseline and after CBD treatment.

Results: The final sample consisted of 72 adults presenting with primary concerns of anxiety (n = 47) or poor sleep (n = 25). Anxiety scores decreased within the first month in 57 patients (79.2%) and remained decreased during the study duration. Sleep scores improved within the first month in 48 patients (66.7%) but fluctuated over time. In this chart review, CBD was well tolerated in all but 3 patients.

Conclusion: Cannabidiol may hold benefit for anxiety-related disorders. Controlled clinical studies are needed.'
http://www.thepermanentejournal.org/issues/2019/winter/6960-cannabis.html


'The researchers from the Minnesota Department of Health (MDH) and the Oncology Research Center at HealthPartners/Park Nicollet found that patients with cancer who enrolled in Minnesota’s medical cannabis program reported significant improvement in symptoms, including reduced anxiety, lack of appetite, depression, disturbed sleep, fatigue, nausea, pain and vomiting, within four months of starting the medication.

“It is encouraging to see this evidence that Minnesota’s medical cannabis program is helping cancer patients,” said Minnesota Health Commissioner Jan Malcolm. “In addition to helping people with qualifying conditions, the program was designed to help advance scientific understanding of the treatment potential of cannabis. These latest findings demonstrate that the program is making valuable contributions toward that goal as well.”'
https://content.govdelivery.com/accounts/MNMDH/bulletins/23cc6d0


'The most common conditions for which CBD was either discussed or recommended were pain management, anxiety, seizures and storm or fireworks phobias, according to the survey.'
https://www.marijuanamoment.net/veterinarians-want-marijuana-laws-loosened-for-pets-and-humans-survey-finds/


“I believe that advanced dementia patients with tremendous anxiety, restlessness, and pain will benefit,” he wrote. “Such patients are episodically distraught and become quickly angered and paranoid of staff trying to help them due to their confusion and inability to understand their circumstances.”'
http://www.startribune.com/alzheimer-s-added-to-minnesota-s-medical-marijuana-list/501803661/


'Opioid addiction, autism, general anxiety, chronic anxiety, depression and insomnia were selected Wednesday for more study as qualifying conditions for medical marijuana in Ohio.

A committee of the Ohio State Medical Board met in Columbus to select those conditions as Ohio prepares for the first sales of medical marijuana, perhaps as early as next week.'
https://www.cincinnati.com/story/news/2019/01/09/ohio-study-more-ailments-medical-marijuana/2529672002/


Can the benzodiazipines please be substituted with cannabis and natural cannabis be legalized for people to access world wide? 

'With regard to CBD's safety, they concluded: "[M]ost studies reported no adverse events with acute administration and mild to moderate adverse effects with chronic administration. In comparison to other drugs, a better side effect profile was presented.'
https://norml.org/news/2020/04/16/review-oral-use-of-cbd-reports-anxiolytic-and-anti-psychotic-activity-few-adverse-effects


“These include patients on chemotherapy with nausea and vomiting, glaucoma, asthma, anorexia and weight loss in AIDS, cancers, anorexia nervosa, chronic and neuropathic pain, multiple sclerosis, sleep disorders and some neuropsychiatric disorders” she outlined.'
https://jis.gov.jm/health-ministry-supports-conditional-use-of-cannabis-for-research-and-meidicinal-purposes/


'Cannabis improves sleep and recovery after an event, reduces anxiety and fear and aids the forgetting of negative events such as bad falls and so forth.'
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3717337/


'In conclusion, the experimental and clinical use of CBD, a compound that does not produce the typical subjective effects of marijuana induced by delta9-THC, has clearly shown anxiolytic, antiepileptic, and antipsychotic properties, among other effects. Since the 1970s, a number of scientific articles showing the potential therapeutic effects of CBD in different animal models of neuropsychiatric disorders and some clinical trials have been published. Recent investigations on the new effects of CBD and its synthetic analogs and on the comprehension of the mechanisms of action of this compounds as well as a better understanding of the endocannabinoid system have emerged.'
https://www.frontiersin.org/articles/10.3389/fimmu.2018.02009/full


'The top three reasons why consumers use cannabis are for relaxation (66%), stress relief (59%) and to reduce anxiety (53%). Nevertheless, small percentages use cannabis for a long list of reasons. including to improve their sleep, treat medical conditions, enjoy social experiences, and stimulate creativity.'
https://newfrontierdata.com/marijuana-insights/with-archetypes-cannabis-industry-meets-customers-in-the-open-market/
 
 
'The full scope of the dangerous interaction of chemicals is as yet little known, but disturbing findings now come regularly from scientific laboratories. Among this is the discovery that that the toxicity of an organic phosphate can be increased by a second agent that is not necessarily an insecticide. For example, one of the plasticizing agents may act even more dangerously than another insecticide to make malathion more dangerous. Again, this is because it inhibits the liver enzyme that would normally 'draw the teeth' of the poisonous insecticide.

What of other chemicals in the normal human environment? What, in particular, of drugs? A bare beginning has been made on this subject, but already it is known that some organic phosphates (parathion and malathion) increase the toxicity of some drugs used as muscle relaxants, and that several others (again including malathion) markedly increase the sleeping time of barbiturates.'
 - Silent Spring, Rachel Carson, 1962


'Morphine hits the backs of the legs first, the the back of the neck, a spreading wave of relaxation slackening the muscles away from the bones so that you seem to float without outlines, like lying in warm salt water. As this relaxing wave spread through my tissues, I experienced a strong feeling of fear. I had the feeling that some horrible image was just beyond the field of vision, moving, as I turned my head, so that I quite never saw it. I felt nauseous. I lay down and closed my eyes. A series of pictures passed, like watching a movie. A huge, neon-lighted cocktail bar that got larger and larger until streets, traffic, and street repairs were included in it; a waitress carrying a skull on a tray; stars in a clear sky. The physical impact of the fear of death; the shutting off of breath; the stopping of blood.' - Junky, William S Burroughs, 1977, originally published in 1953


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