#i really do hope it's good but the JW comparison is a bit....

[pharmacyforthemasses]

Marijuana and Medications

Marijuana refers to the parts of the Cannabis plant that are smoked or consumed in edibles. This plant contains 483 substances, some of which are psychoactive (cause changes in the brain). Sixty-five of these substances are called “cannabinoids” because when they get into your body, they bind to these molecules called “cannabinoid receptors” which then triggers a cascade of other biochemical reactions in the body. The most potently psychoactive compound in marijuana is a cannabinoid called tetrahydrocannabinol, or THC. Another prominent cannabinoid is cannabidiol, or CBD.

Marijuana has been classified by the Drug Enforcement Agency (DEA) as a schedule 1 narcotic. This classification means that according to the federal government, marijuana is a highly addictive drug with no medical usage whatsoever. For comparison, methamphetamine is a schedule 2 narcotic. So is cocaine. The classification of marijuana as a schedule 1 substance is, well, ridiculous, but also problematic because since the government says it has no medical use, it’s really hard to do controlled studies to determine if it DOES have a medical use. So good, hard evidence about the efficacy of marijuana and its derivatives for various health complaints is lacking.

As a recreational drug, marijuana causes feelings of being “high” or stoned, changes in perception (how the world looks/sounds/smells etc), increased appetite, and an elevated mood. Adverse effects include paranoia, red eyes, short term memory loss, and loss of motor skills.

Is marijuana safe? Well, that depends on what you mean. Marijuana is almost impossible to overdose on. That said, it does cause loss of motor skills that can lead to accidents including motor vehicle accidents. Smoking marijuana carries many of the same risks as smoking cigarettes. High THC strains of marijuana have also been linked to new cases of psychosis. It’s true that no one has ever died of a marijuana overdose, but that doesn’t mean it’s completely safe. It is also possible to develop a psychological dependence on marijuana, though physical addiction is much less common.

As a medication, marijuana or its derivatives have been cited as effective for everything from chemotherapy induced nausea and vomiting to pain relief to depression and anxiety. Dronabinol, a synthetic form of THC, is FDA approved to treat HIV-associated anorexia and chemo-induced nausea and vomiting, so natural THC probably has similar effects..

One of the biggest questions facing the medical community is, how effective is marijuana for pain relief? Well, that’s not a simple answer. Hill et al. [1] published a review in 2017 of studies that looked at marijuana as a treatment for pain. In general, studies have shown that marijuana can alleviate pain, especially chronic pain, but the pain relief isn’t caused by a simple dose-response mechanism (higher doses don’t lead to greater pain relief). Anecdotally, I’ve had patients swear that marijuana has worked for them when nothing else touched their pain. I’ve had patients tell me that marijuana gave them their lives back. I’ve also had patients tell me that marijuana did nothing for them. I’m hoping with more states decriminalizing marijuana, we’ll start to see some robust research coming out so we can start figuring out how marijuana actually works.

Because research about marijuana is lacking, we don’t have a lot of good information about drugs that interact with marijuana. We do have a few theories though.

Remember those CYP enzymes I was talking about in an earlier post? Here’s a quick review. CYP enzymes are molecules in the body, predominantly the liver, that cause chemical reactions to occur. Most of these chemical reactions help your body eliminate drugs from your body, though some of the chemical reactions also activate drugs in your body. There are a ton of CYP enzymes, and they’re all named with a combination of letters and numbers to tell them apart.

THC is metabolized (broken down) by CYP2C9 and CYP3A4. Some medications can “turn off” a CYP enzyme, which prevents it from working to eliminate THC from the body. If CYP2C9 or CYP3A4 is turned off, then they can’t metabolize THC, which could lead to THC building up in the body and causing toxicity. Drugs that turn off CYP2C9 include amiodarone, cimetidine, cotrimoxazole, metronidazole, fluoxetine, fluvoxamine, fluconazole, and voriconazole. Drugs that turn off CYP3A4 include clarithromycin, erythromycin, cyclosporine, verapamil, itraconazole, voriconazole, and boceprevir.

It gets more complicated. It turns out that THC and CBD have the ability to affect CYP enzymes, too. Except they don’t turn CYP enzymes off, they RAMP IT UP. Specifically, CYP1A2. THC and CBD put CYP1A2 into overdrive, so any drugs metabolized by that enzyme get metabolized FASTER, leading to patients not getting enough exposure to the medication for it to work. Drugs that could get metabolized too quickly include theophylline and chlorpromazine [2].

One final thing concerning drug interactions. Patients should be cautious using marijuana if they’re using other drugs that have similar effects. You can expect interactions between marijuana and drugs with sympathomimetic activity (tachycardia, hypertension), central nervous system depressants (drowsiness), and drugs with anticholinergic effects (tachycardia, drowsiness). For example, diphenhydramine (Benadryl) causes drowsiness. Using marijuana and Benadryl together can cause more drowsiness than either would cause alone. Side effects can stack up.

I hope this was at least a little bit helpful. If you have any questions, feel free to shoot me a message or an ask. I’m more than happy to break things down or explain concepts further.

1.    Hill KP, Palastro MD, Johnson B, Ditre JW. Cannabis and Pain: A Clinical Review. Cannabis Cannabinoid Res. 2017;2(1):96–104. Published 2017 May 1. doi:10.1089/can.2017.0017

2.    https://www.pharmacytimes.com/publications/issue/2014/december2014/drug-interactions-with-marijuana

[yourrainycollectorhologram-blog]

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"illinois mutual insurance

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car insurance. jw

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""After buying a used car, could I drive it right away without auto insurance?""

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Car insurance cost in CA?

I just moved to Los Angeles county from Massachusetts. I have a 2002 Mercedes c230 that I brought with me. I used to pay $850/yr. for full coverage on it in MA. I have been looking around and getting quotes online for $900+ for 6 months here! I am a 25 yr old single, and I also have a perfect driving record. Is all insurance rediculously priced here?, or am i just looking in the wrong place? ( I've looked at GEICO, progressive, other nationwide online companys) thanks for any help.""

I want some cheap car insurance...?

Who offers really cheap car insurance? It doesn't matter what it covers as long as it keeps me legal.

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illinois mutual insurance

Help! Accident on motorcycle with no insurance.?

I was recently involved in an accident on my motorcycle with a Hertz rental car. I purchased the bike 9 days before the accident and was planning on adding the motorcycle to my car insurance policy. No one was hurt in the accident but a police report was filled out at the request of the rental company. I was wondering if insurance companies possibly have some kind of grace period for accidents a certain number of days before the policy is added, or if need be, transferred to the motorcycle. The rear bumper of the rental car was dented and the right rear lights were damaged. My motorcycle is fine. I live in California.""

Best home Insurance in Texas?

I'm a first time homer buyer and I'm about to gets quotes for home insurance and I was wondering what are some of the best and affordable companies to go with????

Has you health insurance premium cost gone up or down?

Individuals buying health insurance on their own will see their premiums tumble next year in New York State as changes under the federal health care law take effect, Gov. Andrew M. Cuomo announced on Wednesday. State insurance regulators say they have approved rates for 2014 that are at least 50 percent lower on average than those currently available in New York. Beginning in October, individuals in New York City who now pay $1,000 a month or more for coverage will be able to shop for health insurance for as little as $308 monthly. With federal subsidies, the cost will be even lower. Supporters of the new health care law, the Affordable Care Act, credited the drop in rates to the online purchasing exchanges the law created, which they say are spurring competition among insurers that are anticipating an influx of new customers. The law requires that an exchange be started in every state.""

Cheapest car insurance? I am talking less than $70 bucks a month. I have seen maybe 60 bucks a month lowest?

Only answer this question with exact information of a company that can go cheaper than 70 bucks a month as that is the lowest I have been able to find.

Medical Health Insurance Florida: Affordable Options?

Are there affordable choices for medical health insurance in Florida? I run a small business with just a few employees. I am having difficultly finding options I can afford.

Do Car Insurance rates go up when being rear ended?

I was rear ended and it was NOT my fault. I live in California and have State Farm. Will my rates go up?

""If I am under my wife's health insurance plan, do i need to get my own insurance under Obamacare?""

Currently, my kids and I are under my wife's health insurance plan. I heard that if we stay under her plans, we will be penalized once this Obamacare goes into effect.""

Auto Insurance Question?

well I want to buy an E36 BMW M3 (1996-1999) in couple of months, but i want to know that how can i get an insurance quote from other insurance companies. My moms insurance name is Access, but i want to get quotes from different companies to see which one is the cheapest. the problem is that, i don't have the car yet and there are questions that the website asks that i can't say it because i don't have enough info about the car, and i can't bother the sellers if im not going to buy the car yet. so how do you think i can get an insurance quote online when i don't have the car yet. sorry if the question sounds confusing""

Should an average person buy a life insurance?

Should an average person buy a life insurance?

About how much does motorcycle insurance cost?

and is it more than car?...about...

What is the difference between farmer's insurance and state farm?

I'm confuse. and what is the best insurance company.

Mandated Health Insurance is different from Mandated Auto Insurance how?

The Supreme Court will be deciding if the government can force us to buy health insurance from a private corporation. The government forces us to buy auto liability insurance from a private corporation. I am at a loss to see the difference.

Paying 10k a year for car insurance?

with a great driving record for 3 cars total is that even possible to charge that much. I have been told that if I move to Illinois it will cost that much.

Will obstruction of plate show up on car insurance?

I got a ticket for obstruction of plate this morning and I was wondering whether this will show up as a record on the insurance. I would rather pay it off myself because I don't want my parents to find out. Also, will it increase the rates? I read somewhere that no proof of insurance can increase rates, but I got a ticket for that awhile ago, it didn't affect anything.""

What are the best health insurance companies with the best plans that covers everything?

Hello, I am in the State of Pennsylvania which is USA. What are the best health insurance companies with the best plans. I'm not happy with free, but people tell me I can't afford plans, and I still do it anyway. I looked at BlueCross. Well, both Highmark, Capital. Capital said they had a Senior PPO plan. I believe that's the name. They have a once year dental plan, but it doesn't cover anything else for the dental. They do have that plan for medical, vision, prescriptions, and the such. What companies, and what plan from that particular company would cover everything, but affordable? I am 29 years of age. I'll be 30 in January. I'm not qualify senior. I do have benefits coming for disabled Medicare of a disabled deceased record.""

Need a quick answer on car insurance?

My first question is, if your car is hit and the other insurance company admits fault - aren't they supposed to come meet YOU to assess damages? Secondly, is an insurance company allowed to deny you whats owed after already admitting fault and after already getting an estimate from a body shop? How do I prevent them from low balling me?""

Can you pay car insurance monthly without extra charges?

Most car insurers charge a direct debit fee up to 30% APR if you pay monthly - are there any free ones (or at least cheaper ones)?

Short term car insurance in US?

I am an Indian Resident and will be travelling to US for a period of 1-2 months. Am getting a good offer on a car rental but the insurance cost is very high (almost $20/day). Is there any way to get short term car insurance in US to cover a rental car for a period of 1-2 Months and pay around $150-$200/Month?

Adding 18 year old non-owner to car insurance.?

I am now 18 years old but have not yet gotten my driver's license because of the rate increase before I turned 18. I have had my learner's permit for 3 years and have a perfect driving record (no tickets or accidents). I do not own a car right now. So, I need to know if A) I need to be added to my parent's policy in order to drive their car once I get my license, and B) if so, how much more will the insurance be? I live in Florida.""

Help with insurance terms?

Hi, i am having trouble working out what my insurance guy is telling me... what is a premium, and how often is it payed, and what is excess, and how often is it payed? what should i be asking and checking for? Thanks""

Question about car insurance...?

im trying to figure out if im being ripped off by my parents. i pay $200 every month for car insurance because that's what my parents tell me it is. I got one speeding ticket for going 14 mph over the limit and in 2 minor accidents. no damage to either cars. my question is am i being ripped off? I told some people that i pay that much and they said there is no way your insurance could be that high. help me out please?

Insurance Company?

Does anyone know personally about the celtic health insurance. is it a good insurance company? I am needing insurance and I recently found the celtic health insurance company, and Humana. what do yall know about these?""

Car insurance - Can anyone help?

We have company cars and Ive just told my manager that I would rather go in my car than the company car in this weather. She has just told me that its okay if I use my car because if I did have an accident, the company would claim on their insurance. How true is this? As she has lied to me before so i dont trust her. She told me that i could claim expenses and then once i put the form in, she said i couldnt so anything she says i dont believe.""

How much would insurance cost for this motorcycle?

Hey guys I know you can't give me a direct quote or anything like that, but if you had to guess or anybody who you knew had one it would be pretty cool. Im 17 now turning 18, I have my own insurance and I've been driving for a year without an incident so my rates are about to go down. Its a 2013 r1, what would the price range be per month?""

Will my insurance be through the roof?

I am 16 years of age, and I own a '85 2.8L V6 Fiero GT. It's of course 2 door and a sports car. I have the title and plates all ready in my name. I was wondering before I go to get insurance Monday, do you guys think it will be expensive for me? My mother is adding me as a second driver and sadly I am not carrying a B average for that discount. I tried getting some quotes from Progressive it was 650 and Nationwide it was 800, and my mother uses Nationwide. I am not sure if I did the quote correctly though because it shouldnt be that much! Please any helpful idea's or thoughts! Thanks.""

illinois mutual insurance

illinois mutual insurance

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