Established in the dawn of the new millennium in 2000, the University of California Center for Medicinal Cannabis Research (UC CMCR) has steadfastly been at the forefront of pioneering and advancing both scientific exploration and policy research related to the potential therapeutic benefits and limitations of cannabis and its derivatives, known as cannabinoids. The Center’s commitment to this field of study was born out of the vision to unlock the potential inherent in medicinal cannabis, with a steadfast focus on the rigorous scientific study of cannabis’s efficacy and safety for therapeutic purposes. This distinguished institution’s work has received robust backing from the California State Legislature, lending it credibility and underscoring its importance in the sphere of medicinal cannabis research. With such authoritative support, the UC CMCR has been able to blaze a remarkable trail in the realm of cannabis-based therapy. It notably orchestrated the first therapeutic research studies using smoked cannabis in a span of twenty years, thereby breaking new ground in the field and setting precedent for future studies. Beyond just conducting preliminary studies, the CMCR has successfully concluded crucial research that has proven instrumental in unveiling the short-term efficacy of cannabis in treating conditions such as neuropathic pain and spasticity – a muscular control disorder. The research conducted by the Center has shed light on the potential of cannabis as a therapeutic tool and has provided invaluable insights that have redefined the understanding of cannabis’s role in medicine. The Center’s work isn’t confined to just research; it is also actively engaged in maintaining a dynamic research agenda. A testament to their commitment to the field, the Center keeps its research interests evolving with the times and the emerging trends in medicinal cannabis research, thereby ensuring its continuous relevance and influence in the field. Over the course of its existence, the UC Center for Medicinal Cannabis Research has forged numerous fruitful collaborations with crucial Federal and State agencies. These strategic partnerships have not only increased the spectrum of the Center’s influence but have also played a profound role in shaping policy and legislation concerning medicinal cannabis. It is through these collaborative efforts that the Center has been able to significantly influence policy and ignite change in the field of medicinal cannabis research. Today, the UC CMCR stands tall as a national beacon in the field of medicinal cannabis research. It continues to light the path for other researchers and institutions, providing a shining example of dedication to scientific rigor, collaboration, and impactful policy influence. The Center’s work doesn’t just benefit the scientific community; it also has vital implications for healthcare providers, policymakers, and patients, making it a critical player in the modern landscape of medicinal cannabis. It is without a doubt that the UC Center for Medicinal Cannabis Research will continue to shape and drive the future of cannabis research in the years to come.

Research Accomplished

The California State Legislature generously provided funding that was judiciously utilized to address specific areas that showed immense potential for producing beneficial effects of cannabis. These areas were carefully identified and delineated based on recommendations made by esteemed national bodies like the National Academy of Sciences and the Institute of Medicine Report from 1999. Additionally, the Workshop on the Medical Utility of Marijuana, an initiative by the National Institutes of Health in 1997, also provided valuable inputs on the therapeutic benefits of cannabis that required further exploration. The focus on these particular areas of research was not arbitrary, but instead was strategically driven by the insights and guidance of the Center for Medicinal Cannabis Research (CMCR) Scientific Advisory Board (SRB). The SRB is an independent body composed of internationally recognized subject matter experts, who are at the forefront of medical cannabis research. Their expertise and extensive knowledge in the field served as an invaluable resource in directing the research efforts towards the most promising areas. Following a rigorous review process conducted by the SRB, the CMCR embarked on a groundbreaking journey to conduct the first set of clinical trials of smoked cannabis as a therapeutic agent in over two decades. This was a significant milestone, marking a long-overdue return to research on the medical applications of cannabis. The primary areas of focus for these trials were conditions such as neuropathic pain and spasticity, which previous reports suggested could be positively impacted by the use of cannabis. Neuropathic pain, a complex, chronic pain state generally accompanied by tissue injury, and spasticity, a condition where certain muscles are continuously contracted causing stiffness or tightness of the muscles that may interfere with normal movements, were chosen as the core focus areas for these trials based on the potential that cannabis showed for providing relief in these medical conditions. These clinical trials initiated by the CMCR, therefore, represented a significant step towards harnessing the potential therapeutic benefits of cannabis, a natural plant compound that has been used by humans for its medicinal properties for thousands of years. The funding provided by the California State Legislature played an instrumental role in making this possible, showing a commitment to advancing our understanding of cannabis and its potential role in modern medicine. The outcomes of these studies could potentially revolutionize the treatment options for patients suffering from conditions such as neuropathic pain and spasticity, opening up new avenues for effective and possibly more tolerable treatment modalities.

The studies funded by the Center for Medicinal Cannabis Research (CMCR) were conducted across five University of California (UC) campuses – San Diego, Irvine, Los Angeles, San Francisco, and Davis. Moreover, some of these studies were also carried out in the region of San Mateo. Various branches of the University of California have been renowned for their groundbreaking research, and this foray into the field of medicinal cannabis is no exception. The primary focus of these studies was to examine the analgesic efficacy of cannabis. The research was performed on multiple experimental models of neuropathic pain. Neuropathic pain, a complex, chronic pain condition, usually occurs when issues develop in the way the nervous system perceives and transmits pain signals. This pain can have diverse etiology, originating from various causes and conditions such as nerve damage or dysfunction. The UC campuses and San Mateo also conducted specific studies to understand how cannabis impacts neuropathic pain related to HIV and diabetes. As these are chronic diseases with long-term effects, the neuropathic pain associated with them often becomes increasingly difficult to manage with conventional treatment methods. Thus, exploring the potential of cannabis in providing relief in such cases became a focal point of research. Additionally, the CMCR-funded studies evaluated the efficacy of cannabis in treating spasticity in multiple sclerosis (MS). MS is a potentially disabling disease of the brain and spinal cord (central nervous system) where the immune system attacks the protective sheath (myelin) covering the nerve fibers, causing communication problems between the brain and the rest of the body. Spasticity, a symptom of MS, refers to feelings of stiffness and a wide range of involuntary muscle spasms. The struggle to manage spasticity often impacts the quality of life for people with MS, justifying the need for exploring alternative treatments like cannabis. It’s important to mention that all these studies were designed as short-term trials, typically involving acute administration of cannabis over a brief period of a few days. This was done to ensure the results could be analyzed and interpreted within a manageable timeframe, and any immediate side effects or reactions could be noted and studied in detail. The findings from these studies underwent rigorous scrutiny and were reviewed by experts in the field and published in peer-reviewed scientific journals. These are publications that use a panel of other scientists and researchers to ensure the studies’ accuracy and reliability before they are published. This process helps maintain the integrity of the research and ensures that only high-quality, accurate information is disseminated to the public. The results of these studies demonstrated significant convergence, meaning that there was a consistent finding across multiple studies. Specifically, the treatment with cannabis showed a significant improvement in the symptoms being studied. This was particularly noticeable in participants who had not achieved relief from traditional treatments, signifying the potential for cannabis to fill a critical gap in the management of neuropathic pain and spasticity in multiple sclerosis. This potential makes it a promising avenue for future research and development in the field of medicinal cannabis.

For a listing of current, as well as past studies, please click here.

Education and Dissemination of Information Related to Cannabis and Cannabinoids
A key component of the mission statement of the Center for Medicinal Cannabis Research (CMCR) involves not just the research and exploration of cannabis and cannabinoids, but also a deep commitment to extensive education and the dynamic dissemination of this information. This is done in a timely manner while ensuring that the material disseminated is supported by substantial evidence. This is an essential part of the CMCR’s quest to drive awareness and understanding about the therapeutic benefits and potential of cannabis, its derivatives, and synthetic compounds, collectively referred to as cannabinoids. CMCR recognizes the utmost need for professionals across different fields – healthcare providers, researchers, educators, policymakers, and more – to be equipped with the latest, scientifically supported information about the medicinal use of cannabis. This allows these professionals to make informed decisions, offer the best possible advice, and develop policies that take into account the most recent and reliable findings in the field of medicinal cannabis research. Aside from professionals, the CMCR also believes in the importance of educating the general public about cannabis and its potential medical uses. Misconceptions and stigma about cannabis use are still prevalent in today’s society, despite the growing body of research pointing to its potential benefits. By providing factual, evidence-based information, CMCR hopes to dispel these myths and promote a more informed understanding of the role cannabinoids can play in health and well-being. The CMCR is not only focused on the present. There is a keen interest in fostering the careers of promising individuals who represent the future in the field of basic and clinical medicinal cannabis research. This is a critical aspect of the CMCR’s mission, as the future of medicinal cannabis exploration largely depends on the next generation of dedicated and knowledgeable scientists. These future professionals will be tasked with developing a deeper and more nuanced understanding of cannabis’s potential benefits, risks, and therapeutic applications. They will also further study the complex interactions between cannabis, cannabinoids, and various aspects of health, including physical, mental, and social well-being. They will also delve into how cannabis use can influence social and behavioral functioning. This research will extend the knowledge base, enabling the CMCR and others to provide even more robust, evidence-based information to professionals and the public. In essence, through its commitment to education, information dissemination, and fostering future talent, the CMCR is unceasingly committed to advancing the understanding of cannabis and its potential medicinal benefits. It strives to ensure that this understanding is based on solid evidence, is widely accessible, and ultimately contributes to the overall enhancement of public health and societal function.

To this end we engage in a broad range of activities:

Scientific publications
Public media, including print, radio and television dissemination
Educational events, including the CMCR symposia series as well as presentations at various national and international symposia and scientific meetings
Training. We will be establishing a pilot program (CMCR Graduate Scholars Program) to support graduate students and postdoctoral scholars with an interest in cannabinoid science, and facilitate their work with CMCR investigators.

Therapeutic Response of Cannabidiol in Rheumatoid Arthritis
INVESTIGATOR: Veena Ranganath, MD

STUDY LOCATION: University of California, Los Angeles

PROJECT TITLE: Therapeutic Response of Cannabidiol in Rheumatoid Arthritis

FUNDING SOURCE: Center for Medicinal Cannabis Research

PROJECT TYPE: Clinical Study

STATUS: Active (Enrolling)

ABSTRACT:

Rheumatoid Arthritis (RA) is a rare autoimmune destructive arthritic disease, where patients suffer from joint pain, joint deformity, stiffness, swelling, fatigue, impaired function, and decreased quality of life. Presently, there is no cure for RA and up to 70% of RA patients are not in remission. An estimated 64 million Americans have tried cannabidiol (CBD) per 2019 Consumer Reports national survey, where 24% are taking CBD for joint pain. Preclinical data suggests a therapeutic pain effect through anti-inflammatory pathways. However, there are few studies in rheumatic diseases evaluating cannabis-related therapeutic agents, let alone CBD without delta-9-tetrahydrocannabinol (THC). Only one clinical trial with THC+CBD in RA exists with encouraging results, suggesting improvement in pain and RA disease activity. This was a short duration, non-blinded, low dose trial using nabixomol. It is unclear if the therapeutic effects were due the THC, CBD, or combination. In addition, the results were vague in discerning if nabixomol improved pain only, joint inflammation, or both.

We propose to randomize 45 RA patients on stable RA therapy with moderate to severe disease activity and evidence of musculoskeletal ultrasound (MSUS) joint inflammation, to either placebo, CBD 200mg BID, or CBD 400mg BID for 12 weeks. We hypothesize that relative to baseline, CBD will dose-dependently improve RA joint inflammation as measured by disease activity score (DAS28, a validated clinical RA outcome) and MSUS. In addition, we will evaluate if there are any biologic effects of CBD through cytokine array and immune cell sub-types. Lastly, we will evaluate for treatment emergent adverse events and tolerability during the course of the trial.

The overall goal of this proof-of-principle proposal is to examine the efficacy and safety of CBD treatment as adjunctive to the medical management of RA patients with moderate to severe disease activity. Our proposal has added value due to our expertise in musculoskeletal ultrasound as a supplementary endpoint beyond the DAS28. The results of this study will inform a future larger clinical trial to apprise the public and physicians on whether CBD truly reduces RA synovial inflammation and provide evidence-based CBD dosing.

The Role of Cannabidiol (CBD) in Regulating Meal Time Anxiety in Anorexia Nervosa
INVESTIGATORS: Guido Frank, MD

STUDY LOCATION: University of California, San Diego

PROJECT TITLE: The Role of Cannabidiol (CBD) in Regulating Meal Time Anxiety in Anorexia Nervosa: Safety, Tolerability and Pharmacokinetics

FUNDING SOURCE: Center for Medicinal Cannabis Research

PROJECT TYPE: Clinical Study

STATUS: Active (Enrolling)

ABSTRACT:

Because there are no proven treatments that normalize core symptoms in adult anorexia nervosa (AN), a disorder with high chronicity and mortality, many individuals seek out alternative approaches to care. Recent evidence has suggested that exaggerated anxiety and diminished reward or motivation to eat play a key role in causing AN symptoms and poor outcome. The endocannabinoid system is involved in the regulation of many central and peripheral functions, including appetite, food intake, and energy balance and data suggest that eating disorders are associated with alterations of the endocannabinoid system. Prior attempts to target the endocannabinoid system in AN have focused on CB1 receptor agonists like tetrahydrocannabinol (THC) that can increase anxiety. As states have legalized cannabis, THC and cannabidiol (CBD) products are being used by patients with AN. CBD is of interest given the possibility that this drug might reduce anxiety. However, there is inconsistent evidence on CBD’s impact on appetite, which is highly relevant in treatment of AN. This project would be the first study to utilize pure, synthesized CBD to investigate the safety, tolerability, and pharmacokinetics in adult patients with AN. We propose a placebo-controlled, randomized, double-blind, pilot study, to evaluate and compare the acute and maintenance pharmacological effects of CBD at various doses compared to placebo in adult patients with AN. Our primary aim is to characterize CBD’s pharmacokinetic and safety profile in patients with AN as well as the clinical effect of CBD on 1) anxiety; 2) on AN symptoms, and 3) on restrictive eating behavior using a test meal. Knowing the safety concerns of CBD has immediate implications on clinical treatment, including effects on weight restoration, and if well tolerated and shown to have the potential to alleviate anxiety, CBD would be an important treatment to further investigate in a clinical trial.

The Effects of Cannabidiol (CBD) on Symptoms of Severe Autism
INVESTIGATOR: Doris Trauner, MD
STUDY LOCATION: University of California, San Diego

PROJECT TITLE: The Effects of Cannabidiol (CBD) on Symptoms of Severe Autism

FUNDING SOURCE: Wholistic Research and Education Foundation

PROJECT TYPE: Clinical Study

STATUS: Active (Enrollment Complete)

ABSTRACT:

This clinical trial is examing if and how cannabidiol (CBD), a chemical found in the cannabis plant, provides therapeutic benefit to children with severe autism spectrum disorder (ASD). The trial is funded by a grant from the Ray and Tye Noorda Foundation in partnership with and based on recommendations from the Wholistic Research and Education Foundation.

ASD affects an estimated one in 68 children in the United States, primarily boys. CBD is a major chemical compound found in cannabis. It does not produce the “highness” caused by THC but interacts with the body’s endocannabinoid system; a network that regulates diverse physiological and cognitive processes.

The goals of the study are to determine 1) if CBD is safe and tolerable and whether it helps with the symptoms of ASD; 2) whether and how CBD alters neurotransmitters and/or improves brain connectivity; and 3) whether biomarkers of neuro-inflammation, also associated with ASD, are altered by CBD.

The clinical trial consists of 30 children, ages eight to 12 years, with a confirmed diagnosis of moderate to severe autism. They must be free of other neurological conditions, such as epilepsy, and in general good health.

In the first phase of the study, half the children receive an oral dose of CBD and half placebo. In the second phase, the groups are switched and the half who originally received CBD receives placebo, while the initial placebo group receives CBD. Investigators are blinded to which children are receiving which treatment until after all of the testing is completed at the end of the study.

For more information about the CMCR, click here.

For additional details about the study please visit ClinicalTrials.gov or submit our Study Interest Survey.

Therapeutic Efficacy of Cannabis and Cannabinoids in Prescription Opioid Abuse and Addiction
INVESTIGATOR: Michael Taffe, PhD

STUDY LOCATION: University of California, San Diego

PROJECT TITLE: Therapeutic Efficacy of Cannabis and Cannabinoids in Prescription Opioid Abuse and Addiction

FUNDING SOURCE: Center for Medicinal Cannabis Research

PROJECT TYPE: Pre-Clinical Study

STATUS: Active

ABSTRACT:

The non-medical abuse of opioids is a significant global health problem. In the United States, approximately 2 million people have a prescription opioid-related abuse disorder, which may increase the likelihood of later non-prescription opioid use and prescription opioid-related overdose deaths. Clinical and epidemiological evidence suggest that cannabis may attenuate harms associated with opioid use and that the opioid-sparing effects of cannabinoids may alter the rewarding effects of opioids. Using a new method for delivery of drugs to rats via e-cigarette technology, this study will determine if inhalation of crude cannabis extract, delta-9-tetrahydrocannabinol (THC) or cannabidiol (CBD) will decrease oxycodone self-administration behavior and attenuate withdrawal­ mediated effects in opioid-dependent subjects. The goals of this project will be achieved through the following aims: (1) determine the effects of acute or repeated cannabis extract, THC or CBD treatment on prescription oxycodone self-administration behavior and (2) elucidate mechanisms by which cannabis extract, THC or CBD modulate brain stress-reward function associated with opioid intoxication and withdrawal. We hypothesize that cannabis and cannabinoid treatment via inhalation will attenuate oxycodone abuse- and withdrawal-induced behaviors, and that cannabinoids will have neuroprotective effects on stress-reward signaling mechanisms. Overall, this proposal will elucidate the therapeutic effects of cannabis and cannabinoids on the behavioral and molecular outcomes of prescription oxycodone addiction and dependence.

Engaging the endocannabinoid system with cannabidiol to reduce anxiety reactivity
INVESTIGATOR: Charles Taylor, PhD

STUDY LOCATION: University of California, San Diego

PROJECT TITLE: Engaging the Endocannabinoid System with Cannabidiol to Reduce Anxiety Reactivity: A Randomized Controlled Trial in Social Anxiety Disorder

FUNDING SOURCE: NIH

PROJECT TYPE: Clinical Study

STATUS: Enrolling

ABSTRACT: Cannabis-based products are commonly used by the public to self-manage symptoms of anxiety; however, people are making decisions about what type of product to use (e.g., CBD, THC), and in what doses, in the absence of rigorous empirical data. Cannabidiol (CBD) is a non-intoxicating phytocannabinoid that has shown promise – based on animal and single dose findings in humans – as a natural therapeutic for anxiety and stress-related disorders. These conditions are common, disabling, and for which first-line pharmacological and psychosocial treatments fail 50% of patients. Although initial evidence suggests that CBD has anxiolytic properties, the dose-dependent biological and behavioral effects have not been characterized in clinically anxious samples. No studies, to our knowledge, have compared different CBD doses within the same clinical sample, nor have putative biological targets (e.g., endocannabinoid function) been measured alongside anxiety reactivity or symptom measures. This limited knowledge has impeded the translation of single dose findings to chronic dosing randomized clinical trials in anxiety populations. The proposed two-phase, milestone-driven project intends to address this gap by advancing knowledge about the mechanisms and therapeutic potential of CBD for anxiety. We will test the causal role of endocannabinoid-mediated anxiety reactivity in reducing clinical symptoms and impairment in patients diagnosed with social anxiety disorder (SAD). The R61 phase project will evaluate the dose-dependent effects of CBD on blood plasma levels of anandamide (an endogenous cannabinoid that has been shown to regulate stress responses; primary biological signature) and anxiety reactivity to a social stress task (secondary target) in a sub-acute (4-day) dosing study (i.e., when steady state CBD levels have been reached). Aim 1 will test the hypothesis that CBD increases anandamide levels and decreases anxiety reactivity compared to placebo. Aim 2 will determine which dose (300 or 900 mg/d) of CBD produces a greater effect on anandamide and anxiety reactivity. If CBD is found to be superior to placebo in elevating plasma anandamide levels and reducing anxiety reactivity, the R33 phase project will attempt to replicate the R61 project findings (Aim 1; sub-acute dosing study) and examine whether changes in anandamide and anxiety responses are associated with clinical improvement (i.e., reduction in anxiety symptoms and impairment; Aim 2) following an 8-week double-blind, randomized, placebo-controlled trial of CBD (dose informed by the R61 project) in subjects diagnosed with SAD. Secondary clinical outcomes will be change in functional interference, and co-occurring symptoms of depression and general anxiety. Positive findings will support a larger confirmatory efficacy trial to further evaluate the therapeutic potential of CBD for anxiety disorders. Regardless of study outcomes, important information will be gained about the role of CBD in modulating endocannabinoid-mediated anxiety outcomes, which will pave the way for future research on cannabinoids and anxiety.

If interested, please fill out this brief pre-screen to determine your initial eligibility! If the pre-screen shows that you are initially eligible for our research study, please be sure to follow the instructions listed to provide your contact information.

For further information call (858) 534-6407 or email [email protected]

Efficacy of inhaled cannabis versus placebo for the acute treatment of migraine
INVESTIGATOR: Nathaniel Schuster, MD

STUDY LOCATION: University of California, San Diego

PROJECT TITLE: A Randomized, Double-Blind, Placebo-Controlled Trial of Vaporized Cannabis for the Acute Treatment of Migraine

FUNDING SOURCE: Migraine Research Foundation

PROJECT TYPE: Clinical Study

STATUS: Active

ABSTRACT: This study is funded by the Migraine Research Foundation. People with migraine will treat 4 distinct migraines with vaporized cannabis with either ~0% THC and CBD (placebo), ~5% THC, ~12% CBD, or ~5% THC with ~12% CBD. The purpose is to determine the effect of THC and CBD on acute migraine with regards to pain freedom and pain relief, most bothersome symptom, and on its individual associated features (photophobia, photophobia and nausea).

The Effects of THC on Glucose Metabolism and Endothelial Function in Subjects with Type 2 Diabetes
INVESTIGATOR: Jeremy Pettus, MD

STUDY LOCATION: University of California, San Diego

PROJECT TITLE: The Effects of THC on Glucose Metabolism and Endothelial Function in Subjects with Type 2 Diabetes

FUNDING SOURCE: Center for Medicinal Cannabis Research

PROJECT TYPE: Clinical Study

STATUS: Active

ABSTRACT:

Delta-9 tetrahydrocannabinol (THC) use is becoming increasingly common amongst patients with type 2 diabetes (T2D). Indeed, a recent national survey showed a dramatic 340% rise in cannabis use among individuals with T2D. In parallel, the incidence of T2D is increasing at an alarming rate. However, data regarding THC use in T2D are frequently contradictory. For example, epidemiologic data suggest an inverse cannabis-T2D association, however animal studies suggest cannabis increases hyperphagia, obesity, and insulin resistance. Additionally, data on how cannabis affects cardiovascular disease risk is limited with studies either finding a protective or deleterious effect on inflammation, endothelial function (EF), and other markers of CVD risk. Thus, how THC affects glucose metabolism and CVD risk in T2D is not known. We seek to address this gap in knowledge by conducting the first prospective, randomized, placebo-controlled, clinical trial comparing cannabis whole plant material (4% THC) versus placebo cannabis (THC extracted) obtained from the NIDA Drug Supply Program in subjects with T2D.

This study will address two specific aims. Aim 1: Determine the effects of THC on glucose metabolism. We hypothesize that THC will improve insulin sensitivity measured as peripheral glucose disposal during an insulin clamp. Aim 2: Determine the effects of THC on inflammation and EF. We hypothesize that THC impairs EF via proinflammatory mediators. To test our hypothesis, 30 subjects with T2D will be randomized to either THC or placebo, administered twice daily via vaporization (Mighty Medic Vaporizer, Storz-Bickel, Tuttlingen, Germany). After 2 weeks of treatment, subjects will undergo a hyperinsulinemic-euglycemic clamp, OGTT, and indirect calorimetry to quantify insulin sensitivity, insulin secretion, glucose metabolism and energy expenditure respectively (Aim 1). Subjects will also undergo assessments to quantify micro- and macrovascular EF and inflammatory milieu as measured by reactive hyperemia peripheral arterial tonometry, flow mediated dilation, and peripheral blood inflammatory profile respectively. Patients will then crossover into the alternative treatment arm and all procedures will be repeated after 2 weeks. With both cannabis use and the prevalence of T2D rising, it is now a public health imperative to understand how THC affects metabolism and markers of CVD risk. The results of this study will help shape recommendations for THC use in patients with T2D.

Analgesic, appetite-stimulating, and subjective effects of cannabigerol administered alone and in combination with delta-9-tetrahydrocannabinol
INVESTIGATOR: Ziva Cooper, PhD

STUDY LOCATION: University of California, Los Angeles

PROJECT TITLE: Analgesic, appetite-stimulating, and subjective effects of cannabigerol administered alone and in combination with delta-9-tetrahydrocannabinol

FUNDING SOURCE: Center for Medicinal Cannabis Research

PROJECT TYPE: Clinical Study

STATUS: Active (Enrolling)

ABSTRACT:

Chronic pain is a significant public health burden for which there are few effective treatments lacking adverse effects that limit their long-term use. Anorexia frequently co-occurs with pain; severity of appetite impairment is positively associated with pain intensity. Delta-9-tetrahydrocannabinol (THC), the primary psychoactive component of cannabis, holds promise as a therapeutic candidate to treat chronic pain.

THC and has also been established as a therapeutic for anorexia associated with Acquired Immunodeficiency Syndrome (AIDS) and is used to stimulate appetite associated with other disorders. However, THC’s analgesic and orexigenic effects can be accompanied by intoxication, abuse liability, and cognitive disruption limiting its clinical utility. Cannabigerol (CBG) is a minor cannabinoid that, in laboratory animals, lacks the psychoactive side effects of THC. Preclinical studies point to CBG’s potential pain-relieving and appetite stimulating effects but these findings have yet to be translated to humans. It has been hypothesized that minor cannabinoids, like CBG, may interact synergistically with THC to enhance therapeutic outcomes while reducing negative psychoactive effects. Specifically, CBG may increase the analgesic and appetite stimulating effects of low, minimally intoxicating, doses of THC, and/or reduce adverse consequences of higher THC doses. Understanding if CBG has analgesic and appetite-stimulating properties alone or in combination with THC is fundamental to developing novel cannabinoid-based therapeutics for these indications. At a time when pharmacotherapeutic strategies to decrease reliance on opioids for pain relief are desperately needed and novel orexigenic agents are warranted, probing the analgesic and appetite stimulating effects of CBG and its potential THC-sparing effects is of significant interest. The proposed double-blind, placebo-controlled study will be the first to assess the dose-dependent analgesic, appetite-stimulating, and adverse effects of CBG alone and in combination with THC in volunteers. Analysis of plasma THC, THC metabolites, and CBG will determine the degree to which effects observed under CBG-THC dose combinations are due to a pharmacokinetic interaction. The objectives of this study address a central mission of the Center for Medicinal Cannabis Research. Study findings will be essential in understanding the clinical potential of CBG alone and in conjunction with THC for pain management and anorexia.

Cannabidiol for Sedative/Hypnotic-sparing Management of Insomnia in Adults
INVESTIGATORS: Mariana Cherner, PhD

STUDY LOCATION: University of California, San Diego

PROJECT TITLE: Cannabidiol for Sedative/Hypnotic-sparing Management of Insomnia in Adults

FUNDING SOURCE: Center for Medicinal Cannabis Research

PROJECT TYPE: Clinical Study

STATUS: Active (Enrolling)

ABSTRACT:

It is estimated that up to a third US adults suffer from sleep problems, which are in turn associated with sub-optimal, and sometimes compromised, daily functioning. Sedative and hypnotic medications constitute the main pharmacologic treatment for insomnia, but they are habit-forming and associated with adverse next-day “hangover” effects, including impaired driving and risk of falls. Sedative/hypnotics are also increasingly being linked to longer-term neurocognitive deficits. Therefore, a substitute medication with low abuse potential and a benign cognitive profile would be highly desirable. As the endocannabinoid system is involved in regulation of circadian rhythm, exogenous cannabinoids may have therapeutic potential in the area of sleep. A few studies not specifically targeting insomnia indicate that CBD use may result in sedation. However, objective scientific evidence is lacking with regard benefits, detrimental effects, or effective dose. We propose a randomized, double-blind placebo-controlled phase II study to examine the noninferiority and efficacious dose range of CBD in managing symptoms of insomnia compared to sedative/hypnotic medication. We will measure sleep outcomes objectively using wrist-worn actigraphy as well as by self-report via real-time ecological momentary assessment and traditional questionnaires. We will also compare objective next-morning neuropsychological performance. Positive study results will provide support for the use of CBD as a potential sedative/hypnotic-sparing treatment for insomnia.

Cannabis Use and the Endocannabinoid System in Bipolar Disorder
INVESTIGATORS: William Perry, Ph.D. & Jared Young, Ph.D
STUDY LOCATION: University of California, San Diego

PROJECT TITLE: Cannabis Use and the Endocannabinoid System in Bipolar Disorder

PROJECT TYPE: Clinical Study

STATUS: Active

ABSTRACT:

This study will look at the impact of chronic cannabis use as well as the effects of acute administration of the principal constituents of cannabis on cognition and brain levels of endogenous cannabinoids and the neurotransmitter dopamine.

Cannabis use is highly prevalent in people with Bipolar Disorder (BD) and likely results in significant cognitive and behavioral disturbance in a population already vulnerable to cognitive deficits. Parallel studies in rodent models of BD will enhance the understanding of the neurobiology of cannabis use from acute, chronic, and withdrawal perspectives, and may ultimately lead to novel treatment targets.

The Center for Medicinal Cannabis Research (CMCR) was established at the University of California, San Diego in 2000, thanks to the vision of then Senator John Vasconcellos and the leadership of then-University of California President Richard Atkinson. CMCR was initially funded with a $3 million annual allocation from the State of California, under the mandate of the California State Legislature. The primary objective was to conduct high-quality scientific studies intended to ascertain the safety and efficacy of cannabis and cannabis compounds for treating medical conditions. From 2000 to 2010, researchers at CMCR conducted several studies on the potential medical benefits of cannabis. These included investigations into its efficacy in treating neuropathic pain associated with HIV/AIDS, multiple sclerosis, diabetes, and spinal cord injury, in addition to research into cannabis’s potential to alleviate spasticity and other symptoms related to various neurological conditions. In 2010, the state funding ended, but the CMCR continued its research activities using the remaining balance of the initial state funding, as well as federal grants and other sources of funding. During this period, the CMCR expanded its scope to include research into the potential risks associated with cannabis use, in addition to its potential benefits. Over the course of its history, the CMCR has made significant contributions to our understanding of the potential therapeutic applications of cannabis. Its research has provided strong evidence for the efficacy of cannabis in treating chronic neuropathic pain and has also shed light on potential adverse effects of long-term cannabis use, such as cognitive impairment and an increased risk of addiction. In recent years, the CMCR has expanded its research efforts to include studies on the potential therapeutic effects of cannabidiol (CBD), a non-psychoactive compound found in cannabis, as well as the potential benefits of cannabis for treating additional conditions such as autism and post-traumatic stress disorder. Despite the numerous challenges associated with conducting research on a Schedule I drug, the CMCR has been at the forefront of advancing the science of medicinal cannabis and continues to contribute to our understanding of its potential benefits and risks.

You might be interested in exploring more about the University of California – Center for Medicinal Cannabis Research, which has been a pioneer in scientific exploration and policy research related to the therapeutic benefits and limitations of cannabis and cannabinoids. Speaking of cannabis, you might be interested in learning more about its potential benefits for treating conditions such as autism and post-traumatic stress disorder. To delve deeper into these topics, you can check out the Cannabis and Autism Spectrum articles on Wikipedia.