Posts by Daniel Whitelocke, M.D.

Dr. Daniel's Take on Cannabis

Terpenes and Cannabis: What Medical Marijuana Patients Should Know

by June 8, 2020

Some of our patients at AR MMJ Cards have asked about the difference between terpenes and cannabinoids.  We wanted to walk through the definition of terpenes, why they are important, how they interact with the brain and olfactory system, and a review of selected terpenes/strains. A close appreciation of the powerful value of terpenes is essential to even the casual cannabis connoisseur to unlock the most from your medication. We will delve into how cannabinoids act as a sensory catalyst in the central nervous system by starting a cascade of actions that amplify terpenes action even further. One can quickly glean how terpene genetics can have an enormous impact on the potential that medical cannabis has to offer.

What Are Terpenes?

Since plants are limited in their physical range, they give off chemical clues to the aromatic rewards that they offer. These chemical clues are called terpenes. They are the essential oils behind the intoxicating olfactory allure that draws in a diverse array of species to cannabis. Terpenes ignite the fire of our most primal instincts long before our consciousness is aware of it. Found in cannabis trichomes, terpenes comprise the largest group of components in fragrant essential oils secreted by plants. These pheromones are the economic driver behind the billion-dollar industry of essential oils.

Over 100 different terpenes have been identified in the cannabis plant, and every strain tends toward a unique terpene type and composition. Terpenes may play a key role in differentiating the effects of various cannabis strains. Some terpenes might promote relaxation and stress-relief, while others potentially promote focus and acuity.

Terpenes are further classified based on the number of isoprene units (C5H8) in the molecule. Monoterpenes like linalool and limonene are both monoterpenes (one terpene unit or two isoprene units).  β-caryophyllene and humulene are both known as sesquiterpenes with three isoprene units. Carotenoids, which are also components of the visual system, are tetraterpenes composed of eight isoprene units.

The development of terpenes in cannabis began for adaptive purposes: to repel predators and lure pollinators. They shape the attributes that contribute to the overall composition of a strain, adding a dimension to each one’s “personality.”

Why Are Terpenes So Important?

Think of this: cannabinoids are colorless, odorless and tasteless. As far as the external senses go, cannabinoids are, in fact, quite bland and boring. Cannabinoids act as a blank canvas that give terpenes the freedom to bring cannabis its unique variety of color, depth, and texture. Not only do terpenes equip each cultivar of cannabis with its own unique color and flavor, terpenes influence the character of a multitude of effects elicited by cannabis, especially the nature of the euphoric effects.

Consider the scenario of two cannabis strains otherwise equal in their cannabinoid profiles with say, 15% THC and 7% CBD, but one strain being primarily of a beta-caryophyllene heavy profile and the other with a linalool heavy profile. Although these strains might look alike from their cannabinoid profiles, their effects would be vastly different due to their terpene profiles. We can quickly glean that terpenes are the actual stars of the show doing the heavy lifting. Cannabinoids simply provide the scaffolding framework for terpenes to follow the path of least resistance to their receptors.  Natures synergistic chemokinetics are busy at work forming each unique chemical identity that gives rise to the architecture of the entourage effect.

The diverse chemical milieu reflected by the wide variety of cannabis cultivars and chemotypes is the chemical fingerprint of cannabis.

How Do Terpenes Interact with the Olfactory System?  How Does It Relate to Our Attraction to Natural Scents?

People are naturally drawn to scents. Our olfactory system is vastly unique amongst the cranial nerves. It has direct connections to the emotional center in the brain known as the limbic system residing in the hippocampus and amygdala. The amygdala forms the main hub for a broad spectrum of emotional processes and the hippocampus is largely responsible for consolidating new memories. Its monosynaptic structure means that the sensory nerves in your nostrils synapse directly onto the brain via the first cranial nerve.

The sense of smell is the most preserved of our primitive instincts and holds untold clues into our most profound realms of existence. Deep in the most primordial of our instincts, we are drawn to certain terpenes for reasons we may not consciously understand. The concept is quite similar to the mechanism of déjà vu, where one feels a sense of familiarity that can be quite profound or even unsettling. In other words, there is consciousness of an event or emotional memory without there being an actual memory to tie it to. The reason for this deep emotional reaction to scents lies in the functional anatomic design of the olfactory nervous system.

Terpenes are the sweetly intoxicating perfume of nature that soothes the mind and body. In fact, they act directly on brain cells to modulate their activity. The therapeutic effect of scent is increased thru combustion because terpenes are aerosolized at higher temperatures as these oils vaporize. However, the soothing effect of terpenes occur even in the absence of combustion. Take a walk in a coniferous forest and your psyche will quickly begin to drink in the invigorating effect of focused optimism elicited by bathing the senses in pinene. Combusting terpenes elicits a more robust and rapid effect by releasing a densely concentrated dose of concentrated terpene-rich vapor immediately into the olfactory bulb where it sends synapses to the vital components of the limbic system, the amygdala and hippocampus. We can even see how these terpenes in cannabis can play a vital role in addressing diseases in which parts of the amygdala and hippocampus can be affected by pathology. Cannabis has been highly touted for its efficacy in alleviating symptoms associated with conditions symptomatic for emotion-associated memory impairment such as anxiety, depression and Alzheimer’s disease (AD), etc.

How Do Terpenes Contribute to the Entourage Effect with Cannabinoids?

The entourage effect simply means that cannabinoids such as THC and CBD, along with the hundreds of other compounds, along with the terpenes, are meant to work together in concert to have an effect that is greater than the sum of their parts. The diverse combinations of terpenoids are what afford cannabis with the chameleon-like quality of mimicking a wide array of flavors and olfactory textures. Terpenes add layers of olfactory texture to marijuana’s natural sensual allure. Consider the mechanism of Delta THC acting on the CB1 receptor. This binding opens up the door for terpenes to exert their effects; compound this with the notion that the entire underlying effect is to amplify our sense of perception.

The entourage effect decoded…This idea is that many different terpenes are interacting with many different cannabinoids and the that the sum of the combined effects is greater than the total of the individual parts acting separately. In other words, these interactions modulate and potentiate each other based on the specific relative combinations of concentrations.

As said, cannabis contains some 100 known terpenes, all of which produce their own effects. Combined with the cannabinoids and other terpenes, the future of cannabis may just be in the cultivation of strains rich in certain terpenes and cannabinoids to create strains tailored to produce certain effects. Because terpenes shape the character of the type of euphoria we feel when we use cannabis, the wide array of terpenoid combinations allow the casual connoisseur to indulge in the seductive medley of hints and notes. 

What Are the Major Terpenes in Cannabis?  How Do they Differ?  Which Strains Are High in a Specific Terpene?

Myrcene: This is the Indica/Sativa Checkpoint

Myrcene is responsible for giving marijuana its distinctive aroma. Myrcene can also be found in wild thyme, mangoes, lemongrass, cardamom, and hops and thus has a musky, earthy scent. The majority of commercial cannabis strains are myrcene dominant, meaning the most abundant terpene in their chemical profile is myrcene. β-myrcene comprises 29.4% to 65.8%  of the essential oil composition of the fragrance of Cannabis sativa.

Also found in mangoes, myrcene has relaxing properties as well as anti-inflammatory properties. Strains that are high in myrcene are Skunk XL, White Widow, and Special Kush. 

Myrcene has a boiling point between 331 to 334 °F, so even people who vaporize their bud at lower temperatures should be able to consistently feel the relaxing, sedating effects. Anything over .5 % myrcene is considered an Indica. Myrcene, for example, is found in many relaxing cannabis strains like Blue Dream and Granddaddy Purple

Beta-Caryophyllene: The one terpene that acts like a cannabinoid

This terpene, which has a spicy, woody, peppery scent, is also found in black pepper and cinnamon. Studies indicate that this one small terpene is capable of performing the big job of treating anxiety, depression, and inflammation. Caryophyllene is found in such strains as Super Silver Haze, Skywalker, and Rock Star.

β Caryophyllene is the only terpene known to interact with the body’s endocannabinoid system as if it was a cannabinoid using the CB2 receptor, which has anti-anxiety effects and anti-inflammatory properties.

Alpha-Pinene: Great for Alzheimer’s pt, Memory impairment, Anti-inflammatory

Pinene is the most common terpene in the natural world (but not in marijuana; myrcene is the most common terpene in marijuana). It is responsible for the bronchodilation effects of cannabis. It can also act as a stimulant and an AChE inhibitor. It’s also found in rosemary and basil and has a wide variety of positive effects, including pain relief, inflammation and anxiety. 

Found in two varieties, alpha, which is responsible for that wonderful pine aroma, and beta, which has a scent like rosemary, dill, or parsley. Pinene is a strong bronchodilator, but also has strong anti-inflammatory and antiseptic effects that have been used for centuries in herbal medicines.  

Pinene, found in sage and conifers, has been shown to aid in alertness and memory retention. α-Pinene in particular is thought to reduce the memory deficits commonly reported as a side-effect of THC consumption. It likely demonstrates this activity due to its action as an acetylcholinesterase inhibitor, a class of compounds which are known to aid memory and increase alertness.

α-Pinene contributes significantly to many of the varied, distinct, and unique odor profiles of the multitude of marijuana strains, varieties and cultivars.  α-Pinene is rapidly absorbed across lung blood vessels and exerts great anti-inflammatory and antimicrobial effects, as well as having some activity as an ACE inhibitor (controls blood pressure).

Keep in mind that pinene-dominant strains are uncommon (meaning it’s rarely the most abundant terpene in a strain), but it’s commonly seen as the second most abundant terpene in a strain’s terpene composition. Pinene can be found in strains like Strawberry Cough and Blue Dream, Big Smooth, Snoop’s Dream, and Critical mass.

Potential therapeutic value: Treatment of asthmapaininflammationulcersanxietycancer

Limonene: Second most abundant terpene in cannabis

Limonene may not be present in all cannabis strains but has powerful anti-fungal and antibacterial properties. Its great smell means that it is a common additive in household cleaning and cosmetic products. Limonene can also help to relieve stress and enhance mood. 

Limonene smells citrusy and is found in — you guessed it — citrus! It also vaporizes low, at 350 °F, and is associated with anti-anxiety effects, along with some anti-depressant effects. It’s also used for its anti-inflammation properties. It’s the second most abundant terpene found in cannabis; limonene can also be found in various citrus fruits and is responsible for the citrusy smell. Limonene can also help to bust stress and enhance mood.

Strains high in Limonene include Sour Diesel and OG Kush as well as Super Lemon Haze. 

Linalool: Calming; can balance out the anxious side effect of THC

Linalool has a wonderful, floral scent and is found in lavender. It’s also been known to have anti-depressant properties, and if you’ve ever turned to a lavender-scented candle or bath to relax — a strain high in linalool would also do the trick! Linalool can help to balance out the anxious side effect sometimes produced by THC and this makes it an ideal terpene for the treatment of anxiety.

Potential therapeutic value: Treatment of anxietydepressioninsomniapaininflammation, and neurodegenerative disease

Linalool is present in strains like Special Kush, Amnesia Haze, and OG Shark, Kosher Kush.

Humulene: May actually help to DECREASE appetite

Known for its herbal aroma, Humulene has aromas of hops with woody and earthy scents. Strains that contain humulene may actually help to decrease appetite, counter to the popular notion that weed always gives you the munchies. Found in hops, cloves, coriander, and basil, humulene vaporizes at 222ºF (106ºC) and has shown anti-inflammatory and antibacterial properties in research.  

Potential therapeutic value: Anti-inflammatory

Strains which contain humulene include Liberty Haze, Gelato, Girl Scout Cookies, and Sour Diesel. 

Terpinolene: Uplifting ACTIVE strains

About 1 in ten strains is terpinolene dominant. Terpinolene is also found in lilacs, nutmeg, and cumin. The scents are piney, floral, and herbal.  It vaporizes at 122ºF (50­ºC) and its ocimene is beautiful, sweet, earthy, citrusy aroma, which is why it is frequently used in perfumes.

Potential therapeutic value: Antiviral, anti-fungal, antiseptic, decongestant, antibacterial

Terpinolene is commonly found in uplifting, active strains like Jack Herer and Ghost Train Haze, and Chernobyl.

Terpenes and Timmy: Case Report

Take Timmy for example. At his junior prom 20 years ago Timmy, the gentleman, was returning from the restroom with a fresh cocktail made with illicitly obtained bottom shelf grain alcohol. Timmy was already intoxicated by the prospect of social lubricant compensating for the gulf in beauty between his pimple faced self and Fiona, a 5’1” blonde with short hair wearing a white dress with stunningly high heels. Distracted in thought, Timmy tripped over his last step and spilled the entire drink on the front of her dress, drowning her buxom in purple stuff screwdriver that had a mild whiff of sour urine. Stunned by the embarrassment, she instinctively delivered a violently accurate left foot to the right testicle of Timmy, dropping him to his knees. The pubescent mob howled in brace-faced laughter as Timmy lay in the fetal position clutching his groin, soaked in a puddle of dollar store purple drink.

He struggled for years to get his confidence back in the dating life but eventually he was able to attract/convince a wife and successfully procreate with her. So, all good in that department. Although several years have passed, the intrusive thoughts about the experience still haunt him and he still has very hurt feelings about the whole incident.

Timmy now sweats profusely before social work functions and hyperventilates terribly around short haired blonde women in heels. To find solace in situations like this, Timmy drops a couple of Mimosa terpene oil under his tongue before he smokes a small joint of a piney, citrusy variety of cannabis to calm his nerves. This way, those memories don’t control his thoughts on the outcomes of things. The binding of these specific terpenes doesn’t negate the memory, they just reduce the impact of negative emotional intrusion in dictating the emotional outcome of current events.

Final Thoughts….

All fun aside folks, terpenes are really magic stuff that oftentimes can get lost in the mix. It’s really a big subject that I think I can only tackle the tip of the iceberg for now. Certainly look for more to come…terpenes are certainly going to make a loud noise in the cannabis world.

The Source In Bentonville, AR – Dispensary Review

by May 18, 2020

About Dispensary The Source

“The Source is the premier medical cannabis destination in Arkansas. We offer deli style flower service with over 50 strains available, as well as a selection of edibles, concentrates, topicals and cannabis accessories.”

Address: 406 Razorback Dr, Bentonville, AR 72712

Phone# (479) 330-9333

Hours:

Monday9AM–6PM
Tuesday9AM–6PM
Wednesday9AM–6PM
Thursday9AM–6PM
Friday9AM–6PM
Saturday9AM–6PM
Sunday10AM–6PM

AR MMJ CARD RATING & REVIEW ⭐⭐

The regrettable thing about the Source is that they are in the best possible location, but the quality of product, purchasing experience and timeliness are just not there.

Product Storage Score:⭐

Ideally, a dispensary will store their marijuana flower in a dimly lit, cool (not cold) environment, with minimal exposure to air.

Deli-style dispensaries in general will be unlikely to receive a high product storage score from AR MMJ Cards, because it’s the worst possible way to store your product, from a scientific standpoint.

As many MMJ users know, the terpenes in Medical marijuana are largely responsible for your high. However, terpenes are very delicate, and easily degraded by heat and light. Once MMJ flower has been prepared for use, the best thing for the longevity of the product at that point, is to seal it in an air-tight container and store it away from heat and light.

At The Source in Bentonville, their product is stored in large, clear glass jars on high shelves near the light. 

Every time the jar is opened for someone to smell, or for the attendant to measure out your bud, that cannabis flower is being oxidized. i.e. deteriorating, and becoming less effective at all of it’s functions. Every time that jar gets opened, and every minute it sits there next to the light, the CBN is increasing.

“CBN, No Beuno” says Dr. Daniel. “That’s the measure of the oxidative age of the flower. You could get mimosa from a place with good product storage, and mimosa from a place with deli-style storage, you could be getting two completely different experience because the CBN is so much higher in the deli-style product storage method.”

Deli-style storage is the fastest way to destroy the terpenes in your product.

Pricing Score :⭐⭐⭐⭐⭐

The Source has excellent product prices in a range that serve everyone. Also, due to their ability to measure on demand, they can sell in small increments like portions of a gram. This can be important if you’ve only got a couple extra bucks and you don’t want to have to pull out another $20.

Wait & Staff Score :⭐⭐

The wait is a huge problem. This dispensary is in an excellent location, so they are often packed, and due to nothing being pre-measured, the line takes a very long time to progress.

The first time I visited was in February 2020 and I arrived about 10 minutes after they opened. There was one other person there, who went in before me, and I waited in the waiting area for 17 minutes before being allowed back. The young man I spoke to was polite, and as helpful as he could be, but didn’t know a lot about the bud.

My second visit was a few weeks later, and I made the mistake of going in the middle of the afternoon. The place was packed and I waited over an hour and a half to get in. I generally time how long the wait is the first few times, but I was there so long, I ended up talking on the phone after the first hour or so, and lost track of the time after that.

By the time I got in there, the staff had clearly had a long day, and seemed annoyed at seeing another person there to purchase product. I actually wanted to ask some questions about what they had and perhaps try something new, but not wanting to be a bother, I just picked something I knew and purchased a little less.

All in all, the buying experience is just sub par in comparison with the environments some of the other dispensaries have created.

REQUIRED: AR MMJ CERTIFICATION

Before purchasing cannabis from a medical marijuana dispensary, like This One, Arkansas patients must first qualify for a medical marijuana certification; AR MMJ Cards can provide qualified patients with the state-required recommendation to complete this process.

CALL ARMMJ CARDS: (479) 308-5000


Get Your Certification Started

See Our List Of Arkansas Medical Marijuana Dispensaries

Leave Your Own Review Of This Dispensary Below

Alzheimer’s Disease and Cannabis

by May 15, 2020
Cannabis for alzheimers

According to the Mayo Clinic, “Alzheimer’s disease is a progressive disorder that causes brain cells to waste away (degenerate) and die. Alzheimer’s disease is the most common cause of dementia — a continuous decline in thinking, behavioral and social skills that disrupts a person’s ability to function independently.”  Alzheimer’s Disease not only impacts the patient, but also those around.  

At AR MMJ Cards, some of our patients are in the early stages of this disorder.  We wanted to lay the groundwork for how the intrinsic pharmacology of cannabis medicines counteract the neuroinflammatory process characterizing Alzheimer’s Disease (AD). Starting with a brief history, we delve into the science behind the disease process and how cannabis may hold immense promise AD patients. This installment closes up with guidelines on dosing, methods of ingestion, and which cannabis strains may be most helpful in dealing with symptoms associated with AD.

History of Cannabis Use for Alzheimer’s:

As far back as 1890, Sir John Russell Reynolds, MD, Physician to Queen Victoria, published his findings on cannabinoid treatment on dementia patients. He describes patients wandering and fidgety at night or what Sir Reynolds referred to as sundowning – that is, until they were given a small dose of Cannabis Indica at bedtime. Through Sir Reynold’s research and testing, he determined that cannabis decreased the effect of sun-downing. 

“I have found nothing comparable in utility to a moderate dose of Indian hemp given at bedtime. It has been absolutely effective for months and indeed years, without any increase in the dose.” – Sir Reynolds

Pathophysiology of Alzheimer’s Disease:

AD usually begins by attacking the brain’s hippocampus, which is a critical brain region for memory processing. The 3 hallmark characteristics of the Alzheimer’s brain include:

 

  • The buildup of amyloid-ß (Aß) plaques
  • Tangles of fibers inside brain cells called neurofibrillary tangles
  • The activation of support cells in the brain called microglia

Over time, neurofibrillary tangles from degenerated axons (the long projections from nerves that transmit electrical impulses) form webs. These dense misfolded webs form at the junction of nerves called synapses, thus preventing communication from one nerve to another. In this manner, there is a functional decrease in the amount of available Acetylcholine, the neurotransmitter that is chronically deficient in Alzheimer’s dementia. This forms the basis of nerve degeneration driving the clinically observable manifestations seen in Alzheimer’s dementia including recent memory dysfunction, executive dysfunction, disruption in sleep/wake patterns, personality changes, depression, and irritability.

The Science Behind Cannabinoid Action on the Alzheimer’s Patient:

The increase in endocannabinoid tone in Alzheimer’s patients reflects the adaptive homeostatic response to nerve inflammation.  This leads to improvements in neuroinflammation, oxidative stress, neurogenesis, and cerebral blood flow.  Cannabinoids exert a multiplicity of actions to modulate neuronal dysfunction. Central to this adaptive process is the critical presence of CB2 receptors on microglia. These vital support cells act as scavengers for the nervous system and clear out inflammatory debris. CB2 receptor activation on microglial cells initiates a cascade of events that potentiates beta amyloid removal as well as reducing nerve inflammation. Please note carefully the concept of cannabis medicines restoring cellular balance by mitigating oxidative stress will be revisited again ad nauseum as this mechanism is central to to the concept of cannabinoid rescue.

  • Activated CB1 receptors on the surface of microglial cells decrease harmful inflammatory glutamate release from nerve cells. This is the mechanism underlying MMJ’s beneficial effect on Alzheimer’s dementia
  • CB1 receptor activation also inhibits acetylcholine esterase, the enzyme responsible for breakdown of acetylcholine. Inactivation of this degrading enzyme increases the amount of Acetylcholine available at the nerve endings (synapses).  Ironically, the same mechanism is employed by pharmaceutical drugs used to increase acetylcholine concentration in the nerve terminals of the central nervous system of Alzheimer’s patients.
  • Anandamide and 2-Acyl glycerol (2-AG) are increased in affected areas of the brain, as well as their metabolizing enzymes – Fatty acid amino hydrolase (FAAH) and monoacyl glycerol lipase (MAGL).

How Cannabis Can Help Alzheimer’s Patients

The pathophysiology and science of Alzheimer’s leads to devastating effects on patient’s orientation including person, place, and time. As a result, they are easily confused by familiar places and even distrust family members close to them. Caregivers also suffer miserably with combative patients who oftentimes have other comorbid conditions (one or more diseases or conditions that occur with another condition in the same person at the same time) that complicate management. Visual and hearing loss also contribute to disorientation and resultant mood disorders. In addition, sundowning can be particularly frightening for patients. Because there are deficits in recent memory once the sun goes down, patients can’t discern whether the day has just finished or is just beginning:

  • Imagine your anger when being denied morning coffee by stranger claiming to be their grown child
  • You go to grab your car keys, but are told you don’t drive
  • You want to take your dog for a walk, but are told you don’t have a dog
  • Everyone telling you what to do is just annoying and undignifying

The disconnect lies in that AD patients have conscious awareness that memories exist, they just can’t access them. This maddening scenario for the patient and caregivers spins into a vicious cycle of constant apprehension and confusion.  To alleviate some of these feelings, there are Alzheimer symptoms that may respond to low dose cannabis including: sleep problems, paranoia, anxiety, pain, poor appetite, and weight loss.

Cannabis Studies, Dosing, and Strains for Alzheimer’s Patients:

  • A 2016 study published in Journal of Alzheimer’s Disease looked at nursing home patients with Alzheimer’s dementia who had THC oil added to their current meds[1,2].  All patients reported improvements in sleep, agitation, irritability, and caregiver distress. 
  • Check out this YouTube video on cannabis and an Alzheimer’s patient – the video is taken by a son of his mom before and after cannabis dosing.
  • Preliminary studies in rodents show the ideal response at a one to one (1:1) THC to CBD ratio in terms of reducing harmful Alzheimer’s amyloid plaque. 
  • Maximal dampening of neuroinflammation is achieved with the following dosing schedule for Alzheimer’s patients:
    • 2.5 milligrams THC at bedtime and 1.5 milligrams at breakfast and lunch 
    • The target dose is 5 milligrams THC two to three times daily 
    • Balloon vaporizers are the favored delivery method for elderly Alzheimer’s patients. Smoking is not recommended for these patients due to fire hazard – Vaporizing balloons are a better option
  • Great care must be exercised with the administration to the demented elderly. They are at greater risk for injury with falls. Oral forms are excellent for these patients, but attention must be paid to not make cannabis inaccessible, so they don’t mistake it as a snack.

This clinic suggests that patients or caregivers look for cannabis strains with high myrcene and linalool content for their sedative properties and THC synergy.  Myrcene enables the cannabinoids to transfer from the blood to the brain more quickly and linalool promotes relaxation.  These strains include high CBD varieties like ACDC and are great options for neuroprotective properties. Other viable cannabis options are Purple Urkle, Granddaddy Purple, and Bubba Kush.  

Cannabis can help Alzheimer’s patients with symptoms, but results are dependent on the patient and their bodies.  If you need help determining if cannabis may be right for you or a family member, please visit www.armmjcards.com.  

Additional References:

1.) Shelef, A., Barak, Y., Berger, U., Paleacu, D., Tadger, S., Plopsky, I., & Baruch, Y. (2016). Safety and Efficacy of Medical Cannabis Oil for Behavioral and Psychological Symptoms of Dementia: An-Open Label, Add-On, Pilot Study. Journal of Alzheimers Disease51(1), 15–19. doi: 10.3233/jad-150915  

2.) Woodward, M. R., Harper, D. G., Stolyar, A., Forester, B. P., & Ellison, J. M. (2014). Dronabinol for the Treatment of Agitation and Aggressive Behavior in Acutely Hospitalized Severely Demented Patients with Noncognitive Behavioral Symptoms. The American Journal of Geriatric Psychiatry22(4), 415–419. doi: 10.1016/j.jagp.2012.11.022

The ReLeaf Center In Bentonville, AR – Dispensary Review

by May 4, 2020

About Dispensary The ReLeaf Center

“As the premier destination for medical cannabis dispensary products and services, it is the mission of ReLeaf Center to provide patients access to high quality, affordable alternative solutions to meet the needs of all of their qualifying conditions”

Address: 9400 E McNelly Rd, Bentonville, AR 72712

Phone# (479) 488-2071

Hours:

Monday9AM–6PM
Tuesday9AM–6PM
Wednesday9AM–6PM
Thursday9AM–6PM
Friday9AM–6PM
Saturday9AM–6PM
Sunday10AM–6PM

 

AR MMJ CARD RATING & REVIEW ⭐⭐⭐⭐⭐

There are a few great dispensaries in Northwest Arkansas, but The ReLeaf Center takes the cake. Although it’s a bit of a drive to get there, the friendly staff, reasonable prices, and incredible selection makes it worth the trip. The ReLeaf Center is true to it’s name. From the moment you arrive to the moment you leave, you feel relieved. Everyone smiles, the atmosphere is pleasant, and the staff learns your name and asks you how you are doing. Above all their superior product storage practices, and routine discounted-sales of aged products, makes us rest assured in our decision to crown ReLeaf as AR MMJ Cards’ favorite dispensary in Northwest Arkansas. You will never get an inferior product or experience at The ReLeaf Center.

Product Storage Score:⭐⭐⭐⭐⭐

Ideally, a dispensary will store their marijuana flower in a dimly lit, cool (not cold) environment, with minimal exposure to air. ReLeaf storage checks all of those boxes. The lighting inside the entire dispensary is dim, and the temperature is moderately cool. 

The buds that live in glass containers, are stored in dark bins, which protect them from light. Their product is stored in individual containers, which means it is not exposed to air from the time it is packaged to the time you purchase it.

All of these measures serve to protect the terpenes and tricomes on the plant. That’s just the scientific way of saying it protects your high. When you hear about “old bud,” that’s referring to bud with deteriorated terpenes. 

Naturally weed will age, even when kept in ideal conditions, and ReLeaf runs specials to clear out all of their products that are beginning to get old. This is key, because you know you can ALWAYS get good quality from a dispensary with that sort of practice.

Pricing Score :⭐⭐⭐⭐

ReLeaf prices are good considering the amount, but they rarely sell in increments less than an eighth. If you only have a couple bucks to pick up a gram or so, you probably won’t be able to find anything at ReLeaf.

However, if you are fine with buying an eighth or more at once, The ReLeaf Center has strains in different “tier levels,” tier prices ranging from $25 to $55 an eighth for cannabis flower. 

There seems to be a choice for everyone, though. If you like edibles, wax, vapes, of even shake (which a lot of places don’t have), there is a variety of options in a wide range of prices.

Wait & Staff Score :⭐⭐⭐⭐⭐

Even when there is a line a ReLeaf there is never a wait. They are adequately staffed, and thus can get people in and out really quickly.

True to its name, The ReLeaf Center has created a buying experience that is pleasant and relaxing. I’ve met three of their security guards, each of whom was kind and helpful. The staff generally remembers your name after your second or third visit, and they are extremely helpful if you want to change it up or ask any kind of questions

The buying experience is positive whether it’s your first or hundredth time. Once you arrive, a smiling face greets you. Once you enter a smiling face asks how you are doing and welcomes you back. You never feel rushed to make a decision, or like they’re trying to get you out quickly. 

Once you’ve concluded your time, they wish you a nice day, and you pass a line of smiling employees on your way out. Not only are they never understaffed, but every one of their staff members is kind, helpful, and leaves you feeling positive. The environment of this dispensary is second to none.

REQUIRED: AR MMJ CERTIFICATION

Before purchasing cannabis from a medical marijuana dispensary, like This One, Arkansas patients must first qualify for a medical marijuana certification; AR MMJ Cards can provide qualified patients with the state-required recommendation to complete this process.

CALL ARMMJ CARDS: (479) 308-5000


Get Your Certification Started

See Our List Of Arkansas Medical Marijuana Dispensaries

Leave Your Own Review Of This Dispensary Below

Cannabinoid Therapy for Arthritis

by April 3, 2020

Arthritis is the leading cause of disability in the United States, affecting over 27 million adults nationwide. The economic, personal, and societal impact is staggering, with the CDC reporting yearly arthritis-attributable medical care costs and earning losses at $303.5 billion

How does arthritis occur and what are the symptoms?

Arthritis involves a diverse group of processes and commonly results in inflammation within one or more joints. The two most common forms of arthritis are osteoarthritis and rheumatoid arthritis, with other forms being autoimmune, infectious, cancerous, or traumatic.

The most encountered form of arthritis is osteoarthritis, which is essentially a degenerative disease of the joint space that occurs with normal wear and tear over time. Weight-bearing joints in the knees and hips are most affected, but osteoarthritis can affect many joints including those in the hands, feet, and spine. The inflammatory pathology of osteoarthritis is driven by a powerful cytokine called interleukin 1a. This interleukin driven (ignore the Klingon warship names here) degenerative erosion of ligaments ultimately leads to the destruction of the bone cells underlying the articular cartilage of the joint where bones meet. Patients suffering from osteoarthritis typically present with symptomatic complaints of pain, inflammation, stiffness, and crepitus (otherwise known as crackling, creaky joints). 

Rheumatoid arthritis, on the other hand, is an auto-immune process in which the body’s own antibodies mistakenly attack the synovial cells that form the inner tissue lining of the joint. This systemic inflammatory disorder is largely driven by interleukin 6 and affects many organs, leading to painful, deformed joints. Patients often report symptoms of early morning stiffness of hands, feet, and the spinal column in the neck.

How does the pathology of arthritis occur?

As cells that form cartilage (chondrocytes) and line the joint (synoviocytes) become damaged, a distress signal is sent to the innate immune system via chemical messengers called cytokines and chemokines. In response, a variety of pro-inflammatory cell types are recruited to the damaged site as part of the normal response to insult in an attempt to limit joint damage and initiate repair, but this adaptive response becomes harmful when inflammation can’t be shut off. As arthritis progresses, the body’s regenerative capacity can’t keep pace with the rate of cellular destruction. A vicious cascade of events ensues, resulting in swelling of the joint and collagen degradation, and the damage to the bony matrix surrounding the joint forms a fibrotic scar.

How does endocannabinoid rescue work for arthritis?

Recall that the entire endocannabinoid system functions to maintain equilibrium, or the body’s natural balance.In other words, the ECS is a ubiquitous biochemical surge protector that evolved to restore natural equilibrium at the cellular level when systems are perturbed.  The cannabinoid entourage of anti-inflammatory and pain reducing compounds interacts with the ECS at this crucial checkpoint to short-circuit this vicious cascade of events.  Specifically, CBD induces the change in chemical signal from a cell-toxic pro-inflammatory signal, to cell growth and survival signal.  

Chondrocytes, the cells that build cartilage, are richly endowed with CB2 cannabinoid receptors. As inflammation progresses, more CB2 receptors are recruited to the surface of the damaged cell, thereby increasing the rate of cannabidiol (CBD) binding and exerting its effects. When CBD binds with these receptors, a reversal of the pro-inflammatory sequence occurs. Cells stop recruiting to the area, swelling goes down, and redness subsides. The body then begins the process of clearing out the inflammatory debris and restoring elasticity to the joint.  

The cannabinoid anti-inflammatory “switch” blocks the effects of prostaglandins driving the pro-inflammatory pathway. This is a very important point to remember because commonly available NSAIDs (advil, ibuprofen, naproxen, aspirin, etc.) and steroids target this exact same pathway. However, all NSAIDs, acetaminophen, and steroids come at the expense of their own toxicity and side effect profile. They can have deleterious effects on the stomach and kidneys in the case of NSAIDs, and toxic liver effects for acetaminophen, which is the leading cause of ED overdose. Steroids also come with their own long list of side effects that can limit their effectiveness.

Emerging scientific cannabis literature.

Cannabis medicines have been shown to reduce joint damage by 70% in chronic arthritis. In addition, cannabinoid medicines address the pain sensation processing known as nociception. Mouse and rat models have shown CBD to be effective at blocking the progression of osteo and rheumatoid arthritis at an optimal dose of 25 mg/kg. That works out to a dose of about 2 grams per day for a 70 kg (154 pound) person. CBD directly modulates the immune system by reducing harmful chemicals tnf-a and ifn-gamma that recruit cells like neutrophils and macrophages that damage the joint. In addition to turning off the destructive pro-inflammatory signals, CBD actually recruits regenerative stem cells (mesenchymal cells) to migrate to the site of injury and differentiate into chondrocytes to rebuild joint tissues. John McPartland summed it up succinctly, “The forces of embryogenesis become the forces of healing after birth.”

Why is it important to talk to your doctor about medical marijuana?

The mainstay of any medical intervention is to treat the underlying cause of symptoms and not just the symptoms of a pathologic process, all while minimizing side effects of treatment. Cannabis can effectively treat the inflammatory and pain symptoms of arthritis, although it is important to note that it does not always address the root cause. Differentiating the exact forms of arthritis is essential, and requires medical training and institute appropriate and timely intervention. For example, some forms of arthritis, like gouty arthritis (gout), are caused by microscopic crystals precipitating in the joint space. This means that gout is effectively treated with targeted medications that lower uric acid levels rather than with cannabidiols. In addition, some joint pains are caused by an infectious agent. These are medical emergencies and require immediate joint drainage and antibiotic therapy to avert permanent damage. 

The take home point is that a trained physician can recognize these different entities and take appropriate action to limit joint damage and maximize symptom relief. Cannabis medicines can be a powerful tool in a patient’s armamentarium if used correctly.

How can ARMMJCards help?

At ARMMJCards, we do far more than certify patients for MMJ cards. We educate patients on how to effectively incorporate cannabis medicines into their comprehensive treatment plan. To learn more or see how you can qualify, visit us here or call 479-308-500.

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CBD vs THC, Which is Right for Me?

by January 1, 2020

With the explosion of cannabis products into the mainstream, this topic couldn’t be hotter. Although cannabis has hundreds of identified cannabinoids compounds, Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are present in the highest concentrations and account for the bulk of beneficial physiologic properties that can be attributed to cannabis plants.

These two compounds have important differences for users, so having the right information about them and what they do is crucial to becoming a more informed patient and making healthier decisions.

THC vs CBD: Psychoactive effects

The most striking difference between these two are the psychoactive effects. THC administration results in an unmistakable euphoric “high” whereas CBD does not have overt psychoactive properties. For this reason, some users might seek out one or the other at a particular time or setting. 

CBD has a much more marked effect on peripheral nerves and produces a more marked effect of a body relaxation due to it’s soothing anti-inflammatory properties.

For example, long haul truck drivers might not want to risk using THC for legal and safety reasons, but still might desire the beneficial effects of cannabinoids. In this case, CBD would be a more logical choice.

CBD can help safely promote relaxation and sooth hyperactive nerves, without impairing one’s judgement. 

On the other hand, a home-bound patient who might have anxiety and pain issues may benefit more greatly from the euphoric distraction provided by THC compounds.

Research has shown the the highest yield medicinal cannabis strains contain a balanced of both THC and CBD.

The decision on which to use primarily depends on the patient’s comfort level with feeling the euphoric “high” associated with THC administration.

What are Cannabinoids?

Simply put, cannabinoids are compounds that interact with the endocannabinoid system. Cannabinoids can either by synthesized by the body (yes, really) and are thus called ENDOcannabinoids. The two best characterized of endocannabinoids are Anandamide and 2-Acylglycerol, or 2-AG for short. These compounds are made in the body and have similar structures to cannabinoids made in plants. The phytocannabinoids synthesized in plants bind to the same receptors in the body as the endocannabinoids and are degraded by the same enzymes.

This opens up another huge topic of the endocannabinoid system which we will delve into as a recurring theme on future blogs. In short, this system is present in humans and other mammals and has evolved over thousands of years to restore homeostasis, or natural balance, to our physiologic systems when we are encountered with stimuli that perturb our natural balance. As a matter of fact, the endocannabinoid system is a collective of hormones, receptors, and enzymes with active sites in the brain, digestive system, immune cells, reproductive systems, pain sensory nerves, emotional centers, sleep and wakefulness sites, and memory to name a few. With such far reaching functions, it is clear to see why people are so interested in cannabis products making a resurgence as medicine.

Cannabinoids are the lipophilic, fat soluble substances that interact with the receptors of the cannabinoid system. It is only after binding to their specific receptor that cannabinoid compounds exert their effects. Once bound to their cannabinoid receptors, known as the CB1 and CB2 receptors,  a cascade of reactions follow within the target cell that result in the release of neurotransmitters or hormone that further medicate and/or amplify the effects of cannabinoids.

THC vs CBD: A closer look at the chemistry

On first look, Tetrahydrocannabinol and Cannabidiol seem almost identical. They share a common chemical formula and have an equivalent molecular weight. Looking at their chemical structure looks almost identical even to the untrained non-chemist. But upon closer look at the THC compound, you can notice a cyclic structure with an Oxygen atom sandwiched in between two carbon atoms in what is called an Ether bond. This enables THC to sit comfortable in its receptor like a lock and key and exert its effects.

On the other hand, Cannabidiol has opened up that ring structure and you notice a hydroxyl group (-OH) at the end where the oxygen was formerly bound on each side by carbon atoms. Now the structure has two -OH groups and is therefore called a -Diol. This means that this structure cannot sit comfortably in the same receptor as THC because of its nonpermissive shape. In fact, when CBD comes into contact with the CB1 receptor, it actually restricts binding of THC to the active site of tis receptor. This modulation of THC’s activity by CBD receptor binding is called Allosteric inhibition.

THC vs. CBD: Legal status

At the time of this writing, products containing higher than 0.3% THC are still considered illegal on a federal level in the United States as a schedule I drug. CBD based products with less than 0.3% THC are not psychoactive and are completely legal for consumption in all US States and do not require a Medical Marijuana Card in order to get CBD from a retailer. On the other hand, in states that have a medical marijuana program, patients can still obtain medical marijuana with appropriate physician certification and licensure by that state despite marijuana’s status as a federally illegal drug. This means that if patients abide by the rules of their respective state’s medical marijuana program, they will not be subject to criminal prosecution by local and state authorities. The Rohrabacher-Farr Amendment of 2014 prohibits the Justice Department from spending funds to interfere with the implementation of state medical cannabis laws. 

THC vs. CBD: Will I pass a drug test?

Patients taking THC containing products should be advised that use will likely result in a positive test on a most employment-based drug screens. Most drug tests will not show positive for most CBD based products that are below the 0.3% threshold but certain high sensitivity tests might show positive. Pure CBD isolates contain no THC, but CBD products labeled as “Full Spectrum” contain the full entourage of cannabinoids and it is possible to show positive for THC despite not having psychoactive effects. For the most part, however, users can rest assured that most products marketed as CBD that are below 0.3% THC will not test positive for THC.

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