Medical Cannabis Update: Recent Research Discussed in the Latest Healer Webinar

On December 11, 2024, Dustin Sulak, DO, founder of Healer, a cannabis education and product resource, hosted a two-hour webinar discussing several recent research studies involving medical cannabis. As Dr. Sulak explained, the monthly webinars are meant for audiences of all backgrounds, and discuss scientific literature being published on the many compounds of cannabis as they relate to health. This month’s webinar discussed studies on diabetic neuropathy, chronic pain, hemp product safety, CBN for sleep, and Parkinson’s disease, and featured guest speaker molecular biologist Kevin Spelman, PhD.

The first study, “Efficacy and safety of transdermal medical cannabis (THC:CBD: CBN formula) to treat painful diabetic peripheral neuropathy of the lower extremities,” was published in Medical Cannabis and Cannabinoids in November 2024. “The pathophysiology is nerve inflammation and dysfunction that's caused by chronic high blood glucose, hyperglycemia,” Dr. Sulak explained. “CB1 and CB2 receptors are relevant in neuropathy, including this type of peripheral neuropathy, because they've been known to influence or modulate pain signaling, inflammation and neuroprotection, meaning the health of the nerves, the ability to repair and survive despite these challenges.” This Phase III, randomized, double-blind, placebo-controlled clinical trial was conducted in Thailand between December 2022 and March of 2023 and involved 100 participants. The participants applied a topical cannabis oil (or placebo) once per day with the number of drops varying based on pain level. Dr. Sulak explained details about the ratio of cannabinoids in the oil, the effects on pain, and the limitations of the study.

The next study discussed was an observational study conducted in Australia. “Changes in Pain and Mental Health Symptoms Associated with Prescribed Medicinal Cannabis Use: A One-Year Longitudinal Study,” was published in October 2024 in Pain and Palliative Care Pharmacotherapy. All 96 patients had been prescribed cannabis from their doctor and were invited to complete a survey. Data was collected at baseline, three, six, and 12 months. Dr. Sulak discussed the effects on pain, sleep and distress, and change in medication use, and the possible causes for the perceived loss of efficacy over time.

Kevin Spelman presented the third study, “Postmarketing Surveillance of Full Spectrum Hemp Extract CBD Products: Reported Adverse Events and Serious Adverse Events,” was published in September 2024 in Drugs – Real World Outcomes. Dr. Spelman co-authored this study and provided a summary of the study, which focused on full spectrum hemp extract products manufactured by Charlotte’s Web. He discussed adverse event grading, dose range, results, limitations of the study, and where more data was needed. “Postmarketing surveillance has changed FDA rules,” Dr. Spelman stated. “The FDA has used postmarketing surveillance to really tie down adverse event, because in clinical trials, the adverse events you get aren't necessarily always fully reported.”

The next study, “A sleepy cannabis constituent: cannabinol and its active metabolite influence sleep architecture in rats,” was published in Neuropsychopharmacology in November 2024. Dr. Sulak highlighted that the study noted, “those claiming that CBN improves sleep often refer to a study conducted almost 50 years ago, which showed CBN prolonged phenobarbital induced sleep time in rats.” He then explained the setup of the tests done on the rats, the dosing, measurements taken, effects on REM and non-REM sleep, comparisons to sleep medications, plus a comparison to the results in the repeated CBN metabolites study, and finally, the new information on CBN and sleep the study provided.

The last study discussed in the webinar, “Impaired Gait, Postural Instability, and Rigidity in Relation to CB1 Receptor Availability in Parkinson's Disease,” was published in October 2024 in Movement Disorders. Dr. Sulak provided detailed background information on CB1 receptors in the brain and the types of Parkinson’s disease. In this study, brain images of 15 participants were analyzed by a neurologist to measure CB1 availability. Dr. Sulak discussed the correlations between the symptoms – gait, postural instability, rigidity, tremor, and bradykinesia – and CB1 availability. He then discussed the conclusions: “So what does this mean? Out of everyone with Parkinson's, certain people are going to be more likely to have lower levels of CB1 in their brain compared to others, and we may be able to differentiate that based on their severity of the symptoms that they present with. That might inform the strategy. So this supports the observation that cannabis impacts Parkinson's disease symptoms differently.”

The second part of the webinar offered attendees time to ask questions live. Topics included lack of effects felt after THC dosing, and impacts of cannabis on eye health.