John Kuthe wrote:
> On Saturday, December 29, 2018 at 5:10:15 PM UTC-6, dsi1 wrote:
> > On Saturday, December 29, 2018 at 12:57:20 PM UTC-10, GM wrote:
> > > https://fivethirtyeight.com/features...pYVpXTQVFac2Fk
> > >
> > >
> > > "Does CBD Really Do Anything?
> > >
> > > As marijuana is legalized in more and more states, the wellness world has whipped itself into a frenzy over a non-intoxicating cannabis derivative called cannabidiol. CBD products can be found on the internet and in health-food stores, wellness catalogs and even bookstores. (A bookstore in downtown Boulder, Colorado, displays a case of CBD products between the cash register and the stacks of new releases.) Celebrities like Gwyneth Paltrow, disgraced cyclist1 Floyd Landis and former Denver Broncos quarterback Jake Plummer are all touting CBD products, and according to Bon AppĂ©tit, CBD-infused lattes have become €śthe wellness worlds new favorite drink.€ť
> > >
> > > But, uh, what is it that CBD is supposed to do? I visited a cannabis dispensary in Boulder to find out what the hype was all about. After passing an ID check, I was introduced to a €śbudtender€ť who pointed me to an impressive array of CBD products €” tinctures, skin patches, drink powders, candies, salves, massage oil, lotions, €śsexy time personal intimacy oil€ť and even vaginal suppositories to treat menstrual cramps.
> > >
> > > Most of these products promised to relieve pain or otherwise enhance well-being, and none of it was cheap. (Prices started at about $30.) But I wanted to know: Does any of this stuff really work? After a deep dive into the scientific research, I learned that the answer was a big fat maybe.
> > >
> > > Although theres enticing evidence that good ol cannabis can ease chronic pain and possibly treat some medical conditions, whether CBD alone can deliver the same benefits remains an open question. What is clear, at this point, is that the marketing has gotten way ahead of the science.
> > >
> > > Cannabinoids are a class of compounds that interact with receptors throughout your body. CBD is just one of dozens of cannabinoids found in cannabis, including tetrahydrocannabinol (THC), which is the one responsible for marijuanas famous high. Medical cannabis is technically any cannabis product used for medicinal purposes, and these can contain THC or CBD or both, said Nick Jikomes, a neuroscientist at Leafly, a website that provides information about legal cannabis. €śA common mistake people make is to think that CBD is "the medical cannabinoid and THC is "the recreational cannabinoid.€ť Thats inaccurate, he said, because THC is a potent anti-inflammatory and can be helpful for pain.
> > >
> > > What makes CBD so appealing is that its non-intoxicating, so it wont get you high, though it €śis technically psychoactive, because it can influence things like anxiety,€ť Jikomes said. Although much of the marketing blitz around CBD centers on the fact that you can take it without getting stoned, there isnt much research looking at the effects of CBD when used in isolation, with a couple of exceptions. One is the use of CBD to treat seizures: CBD is the active ingredient in the only cannabis product that the Food and Drug Administration has signed off on €” a drug called Epidiolex, which is approved for treating two rare forms of epilepsy. Animal models and a few human studies suggest that CBD can help with anxiety, but those are the only conditions with much research on CBD in isolation.
> > >
> > > Last year, the National Academies of Sciences, Engineering and Medicine released a nearly 500-page report on the health effects of cannabis and cannabinoids. A committee of 16 experts from a variety of scientific and medical fields analyzed the available evidence €” more than 10,000 scientific abstracts in all. Because so few studies examine the effects of CBD on its own, the panel did not issue any findings about CBD specifically, but it did reach some conclusions about cannabis and cannabinoids more generally. The researchers determined that there is €śconclusive or substantial evidence€ť supporting the use of cannabis or cannabinoids for chronic pain in adults, multiple sclerosis-related spasticity (a kind of stiffness and muscle spasms), and chemotherapy-induced nausea and vomiting. The committee also found €śmoderate€ť evidence that cannabis or cannabinoids can reduce sleep disturbances in people with obstructive sleep apnea, fibromyalgia, chronic pain and multiple sclerosis, as well as €ślimited€ť evidence that these substances can improve symptoms of Tourettes syndrome, increase appetite and stem weight loss in people with HIV/AIDs, and improve symptoms of PTSD and anxiety.
> > >
> > > Donald Abrams was a member of the committee that reviewed the evidence that went into producing the report, and he said that the studies they reviewed overwhelmingly used pharmaceutically available preparations that contain THC, including dronabinol, nabilone and the whole-plant extract spray nabiximols, which contains equal parts CBD and THC. Its impossible to know whether the benefits of cannabis can also be obtained from CBD alone, Abrams said, because CBD is just one of 400 chemicals present in the plant. So far, CBD in isolation has been studied in only a handful of randomized, placebo-controlled trials (considered the gold standard of evidence in medical research), and the evidence remains sparse.
> > >
> > > Still, as the saying goes, absence of evidence isnt necessarily evidence of absence, and theres a reason we dont have a ton of solid research on CBDs yet €” €śto study it, we need a good source, €ť said Ziva Cooper, who is an associate professor at Columbia University and was on the National Academies committee. CBD is hard to get because its still technically a Schedule I drug, which limits its availability, Cooper said.
> > >
> > > Cooper recently got funding from the National Institutes of Health for a study looking at cannabinoids €” including CBD in isolation €” as a substitute for opioids, and numerous other clinical trials of CBD are underway. It will be several years before results are available, but these studies should help clarify both what benefits the substance may provide and any side effects it may come with. Most of the adverse effects so far associated with cannabis, such as impairments in short-term memory, coordination and judgment,2 come from products that contain THC as well as CBD, Cooper said, but we need to do more studies to find out for sure whether CBD has fewer risks. Studies are also needed to identify the best way to administer and dose CBD. €śI get emails from people asking me what dose of CBD to use, and the truth is, we really dont know,€ť Cooper said.
> > >
> > > In the meantime, some physicians are forging ahead €” and cashing in. Joe Cohen is a doctor at Holos Health, a medical marijuana clinic in Boulder. I asked him what CBD is good for, and he read me a long list of conditions: pain, inflammation, nausea, vomiting, intestinal cramping, anxiety, psychosis, muscle spasms, hyperactive immune systems, nervous system degeneration, elevated blood sugar and more. He also claimed that CBD has anti-cancer properties and can regenerate brain cells and reduce the brains levels of amyloid beta €” a kind of protein thats been linked to Alzheimers disease. I asked for references, noting that most of these werent listed in the Academies report or a similar review published in the Journal of the American Medical Association. €śI think you just have to Google search it,€ť he said. Its true that a preliminary study found hints that cannabinoids might reduce beta amyloid proteins in human brain cells, but the study was done in cells grown in a lab, not in people. As for cancer, the FDA sent warning letters last year to four companies that were selling products that claimed to €śprevent, diagnose, treat or cure€ť cancer.
> > >
> > > Those warning letters aside, theres not a lot of federal oversight right now over the claims being made or the products that are being sold. Cohen warned against buying CBD products online, because €śtheres a lot of scams out there.€ť Yet his clinic sells CBD, and he admits, €śI say "Dont buy online, but ours is worth doing, because we know what were doing. We ship all over.€ť
> > >
> > > Right now, theres a good chance that you dont really know what youre getting from any source. Testing and labeling rules vary by state, but many states that allow legal cannabis also require some kind of testing to verify that the THC and CBD levels listed on the label are accurate. However, this testing is controversial, and results can vary widely between labs, Jikomes said. A study published in March found measurable variations in test results, with some labs consistently reporting higher or lower levels of cannabinoids than others. There are no guarantees that the label accurately reflects whats in the product. For a 2015 study published in JAMA, researchers tested 75 products purchased in San Francisco, Los Angeles and Seattle and found that only 17 percent were accurately labeled. More than half of the products contained significantly lower levels of cannabinoids than the label promised, and some of them contained only negligible amounts of the compounds. €śWe need to come up with ways to confidently verify the composition of cannabis products and make this information available to consumers,€ť Jikomes said.
> > >
> > > €śAll these people are making claims,€ť Abrams said, but right now, theres little verification. €śIts the Wild West..."
> > >
> > > </>
> >
> > I think that CBD will work about as well as a lot of products sold for improved health and well-being. The only thing that matters is that people believe that it works.
>
> No, it's far more than that! These medicinal majical plants that SOME chose to illegalize have been with mankind for as long as mankind has existed and were LEGAL and used both responsibly and sometiomes irresponsibly. Cannabis was actually like the third most commonly prescribed medicine from MDs in 1920 in the U.S.!
>
And here was the *most* - prescribed "medicine" of the 20's:
QUOTE: "Historians speculate that Charles R. Walgreen, of Walgreens fame, expanded from 20 stores to a staggering 525 during the 1920s thanks to medicinal alcohol sales. (Walgreen attributed the pharmaceutical empires massive expansion to the introduction of milkshakes at its stores.) [Greg M: LOL...!!!]
https://www.atlasobscura.com/article...es-prohibition
The Lucrative Business of Prescribing Booze During Prohibition
Those looking to self-medicate could score at the doctors office.
BY PAULA MEJIA NOVEMBER 15, 2017
"On December 13, 1931, a car zipping along Fifth Avenue in New York City rammed into Winston Churchill. Churchill, in town to give a lecture at the Brooklyn Academy of Music, had looked to his right instead of his left while crossing the street (a habit€”traffic in England came from the left).. The accident cut Churchills nose and forehead, bruised his chest, and left him with a sprained shoulder. €śI do not understand why I was not broken like an egg-shell or squashed like a gooseberry,€ť he later wrote.
The press described the injuries as minor, but for months following the accident, Churchill privately battled depression and pleurisy, a condition that causes sharp chest pains. And Churchill, a prodigious drinker on a lecture circuit in Prohibition-era America, couldnt exactly guzzle the pain away. Buying alcohol was illegal€”until he got a doctors note. His physician, Dr. Otto C. Pickhardt, wrote that €śthe post-accident [recovery] of Hon. Winston S. Churchill necessitates the use of alcoholic spirits especially at meal times.€ť Specifically, Churchill required a €śnaturally indefinite€ť quantity of booze.
While its unclear how Pickhardt swung Churchills indefinite amount of booze, he wasnt the sole doctor to dole out alcohol during this dry era. Thousands of doctors, veterinarians, pharmacists, and dentists held permits authorizing them to prescribe select quantities of rye whiskey, scotch, and gin for a bevy of conditions including cancer, anxiety, and depression. According to Daniel Okrent, author of Last Call: The Rise and Fall of Prohibition, some 15,000 doctors applied for permits during the first six months of Prohibition, which began in 1920 and lasted through 1933. Yet due to a lack of federal oversight, pharmacists and physicians easily turned what was meant as a merciful concession into a lucrative loophole. By prescribing access to pharmacies stocked like liquor stores, it allowed them to become wealthy by selling a way out of Prohibition.
Prescribing alcohol during Prohibition wasnt pure corruption€”alcohols alleged medicinal uses have been traced as far back as ancient China, Rome, Egypt, and Greece. One 17th century-era recipe from Great Britain advised melding two pints of wine, along with sage and rue, to concoct an €śexcellent drink against the plague.€ť Dozens of 19th century-era physicians believed that alcohol prevented infectious diseases, cholera and fever, and that it spurred internal, €śvital powers€ť that kickstarted the healing process.
Initially, many doctors joined the coalition of preachers, former abolitionists, and suffragists pushing Prohibition. In 1916, the authors of The Pharmacopeia of the United States of America took two liquors, brandy and whiskey, off the list of scientifically approved medicines. And in 1917, the American Medical Association voted to advocate for prohibition. In their statement, they wrote that €śthe use of alcohol is detrimental to the human economy and €¦ its use in therapeutics as a tonic or stimulant or for food has no scientific value.€ť
In 1919, Congress passed the Eighteenth Amendment, which banned the sale, manufacture, and transportation of alcohol. Prohibition went into full effect on January 16, 1920, and agents wasted no time in dramatically seizing alcohol. Agents in New York City poured barrels worth of beer down the drain, while Bostons pedestrians walked foot-deep in smashed glass and liquid.
Still, when the nation went dry, doctors found themselves among the select few who could still legally access and distribute alcohol. The accompanying National Prohibition Act (also known as the Volstead Act) allowed clergymen to use wine for sacramental services and farmers to possess up to 200 gallons of preserved fruit. Doctors, meanwhile, could apply for licenses that gave them the ability to write scripts for medicinal booze. Patients could then ask for the drink of their choice at pharmacies€”not unlike going to a marijuana dispensary with a doctors note today.
Congress did write safeguards into the law. It dictated that patients couldnt obtain more than a pint of €śspirituous liquor€ť every ten days, and that prescriptions couldnt be filled more than once. Prohibitionists successfully pushed for even more restrictions, too. The 1921 Willis-Campbell Act (colloquially known as the Emergency Beer Bill) banned prescriptions of beer. It also lowered the cap on alcohol per prescription (from a pint to a half-pint) and limited physicians to 100 prescriptions every 90 days. Following the bills passage, doctors typically wrote a script every ten days for a half pint of alcohol.
Yet as The Washington Post notes, enforcement in the early years practically didnt exist, and by 1921, dozens of physicians and pharmacists (who filled the orders) had gotten hip to the laws money-making potential. Some watered down alcohol, while others doled out heavy-handed prescriptions. During Prohibitions first year, doctors prescribed an estimated eight million gallons of medicinal alcohol€”or, 64 million pints. Doctors got away with prescribing more than the legal limit due to loopholes and lax enforcement. The Willis-Campbell Act tightened the rules, but, by still recognizing doctors ability to use alcohol as medicine, left loopholes open. Doctors could issue looser prescriptions by showing (as in cases like Churchills) €śthat for some extraordinary reason a larger amount is necessary.€ť
From there, doctors had their work cut out for them. While physicians technically had to supply the government with their patient list, it didnt require them to be specific about treatments. Which is why one Providence, Rhode Island, physician merely listed the catch-all term for a physical weakness, €śdebility,€ť on his ledger to justify pints of rye. And they could get away with it, partially because they vastly outnumbered the government agents who kept tabs on them. According to the Post, only one agent existed per 300 physicians in New York City. Nearly 700 new, New York City drugstores registered between 1921 and 1922, and the Board of Pharmacy didnt have the resources to investigate if they were legit.. So the 64,000 physicians given liquor-prescribing permits from 1920 to 1926 didnt have much to worry about. A mere 170 physicians per year, on average, had their licenses revoked.
Given the low risk, many druggists and physicians started price-gouging patients. As Okrent writes, physicians prescription power during Prohibition became a way for them to line their pockets. The number of licensed pharmacists tripled in New York, and its not hard to see why. Obtaining a permit to fill prescriptions didnt take much effort, and they could charge extortionately. In Bootleggers and Beer Barons of the Prohibition Era, J. Anne Funderburg writes that mere weeks after Prohibition came into effect, Brooklyn pharmacists charged $12 for a pint of whiskey€”over $150 by todays standards.
While the medical community debated alcohols alleged medicinal uses, many physicians all but encouraged people to drink. One anecdote in Okrents book recounts a Detroit physician who encouraged patient to €śtake three ounces every hour for stimulant until stimulated.€ť Physicians wrote an estimated 11 million prescriptions a year throughout the 1920s, and Prohibition Commissioner John F. Kramer even cited one doctor who wrote 475 prescriptions for whiskey in one day.
It wasnt tough for people to write€”and fill€”counterfeit subscriptions at pharmacies, either. Naturally, bootleggers bought prescription forms from crooked doctors and mounted widespread scams. In 1931, 400 pharmacists and 1,000 doctors were caught in a scam where doctors sold signed prescription forms to bootleggers. Just 12 doctors and 13 pharmacists were indicted, and the ones charged faced a one-time $50 fine.
Selling alcohol through drugstores became so much of a lucrative open secret that its name-checked in works such as The Great Gatsby. Historians speculate that Charles R. Walgreen, of Walgreens fame, expanded from 20 stores to a staggering 525 during the 1920s thanks to medicinal alcohol sales. (Walgreen attributed the pharmaceutical empires massive expansion to the introduction of milkshakes at its stores.) According to Okrent, its also how distilleries in middle America, particularly in Kentucky, kept the lights on during Prohibition.
Medicinal alcohol wasnt exactly affordable, meaning that the loophole was a luxury reserved for wealthier Americans. Prescriptions ran patients three dollars€”the equivalent to $40 today€”and another three or four dollars to fill them. Authorities curiously allowed French champagne to be imported for medicinal use, which upper-crust Americans took advantage of: Imports skyrocketed by 332 percent in 1920. Industrious Americans decided to make alcohol for themselves, too, using corn syrup to make millions of gallons of moonshine supplied to drinking clubs and speakeasies. More adventurous patrons clandestinely ducked into speakeasies, with the understood risk that the mystery booze might contain industrial alcohol used in medical supplies.
Prohibition ended with the ratification of the 21st Amendment in 1933, and so did the era when a doctors note could get you hooch at the pharmacy. Yet Prohibition didnt do what it intended, which was to stop drinking. As Oxford University Press notes, alcohol enthusiasts drank more hard liquor during Prohibition than before, and spirits accounted for a staggering 75 percent of all alcoholic beverages consumed in the United States. (Ironically, alcohol consumption pre-Prohibition had been gravitating towards beer.) The era unwittingly became the foundation of contemporary American drinking culture, giving birth to libations including mixed drinks, bathtub gin, and moonshine. Some might say thats just what the doctor ordered..."
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