Ethan Russo, MD Certificate of Advanced Cannabis Pharmacology & Therapeutics

The basic functions of the Endocannabinoid System, ECS, were summarized in 1998 by Professor Di Marzo as,“relax, eat, sleep, forget and protect.” The ECS is an essential regulator of bodily function in its many facets. Dr. Russo will go into detail discussing the scientific discovery of the ECS and the scientific data of the importance of understanding the ECS. It is also shown in the journal article Physicians-in-training are not prepared to prescribe medical marijuana by Evanoff et al, 89.5% of residents and fellows graduating from American medical schools felt they were not at all prepared to prescribe medical marijuana, 35.3% felt not at all prepared to answer questions, and 84.9% reported receiving no education in medical school or residency on medical marijuana. The report further outlined only 9% of medical school curriculums included content on medical cannabis. These statistics have changed little since 2017.

The use of cannabis for medicinal purposes dates back thousands of years, with the first documented use occurring in ancient China around 2700 BCE, where it was utilized for various ailments, including pain relief and gastrointestinal issues. Throughout history, cannabis has been referenced in several ancient texts, including the Egyptian Ebers Papyrus and the writings of Greek physician Hippocrates. In the 19th century, cannabis gained popularity in Western medicine as a treatment for conditions such as headaches, insomnia, and muscle spasms. However, the rise of prohibition in the early 20th century led to a significant decline in its use. The latter half of the century saw a resurgence of interest in medical cannabis, particularly during the 1970s and 1980s, as researchers began to explore its therapeutic potential once again. This history highlights the cyclical nature of cannabis use in medicine and sets the foundation for ongoing policy discussions about its legality and therapeutic applications.

Medical cannabis is often defined as cannabis prescribed by a healthcare professional for the treatment of specific medical conditions. Additionally, nomenclature surrounding cannabis can vary significantly based on legal, cultural, and scientific contexts, necessitating clarity in communication about its use. Understanding the terminology surrounding medical cannabis is essential for discussing its historical and contemporary relevance in medicine and policy. Dr. Russo will discuss biases on the cannabis species controversy. Piomelli D, Russo EB 2016. The Cannabis sativa Versus Cannabis indica Debate: An Interview with Ethan Russo, MD. Cannabis Cannabinoid Res 1(1):44-6.

In addition, Dr Russo will define the 3 varieties of cannabinoids; Phytocannabinoids (Pate 1994): terpenophenolic 21-C compounds found in the genus Cannabis (e.g., THC, CBD) Endocannabinoids (Di Marzo 1998): natural endogenous compounds binding cannabinoid receptors (e.g., anandamide) whose functions are:  “relax, eat, sleep, forget and protect” Synthetic cannabinoids (e.g., ajulemic acid) that also affect cannabinoid receptors. Dr Russo will outline an Ideal Cannabis Classification Scheme and discuss plant morphology, cannabinoid content and terpenoids.

Ireland has a rich history of medical research that includes contributions to the understanding of cannabis and its therapeutic properties. Dr Russo will present his History of Cannabis as Medicine: Nineteenth Century Irish Physicians and Correlations of their Observations to Modern Research

In the late 19th and early 20th centuries, Irish researchers such as Dr. William Brooke O’Shaughnessy conducted some of the earliest scientific studies on cannabis, highlighting its potential use for a wide range of conditions, including epilepsy, pain management, and muscle spasms. O’Shaughnessy described cannabis botanically, reviewed its literary history in East and West, drew upon the knowledge of Ayurvedic healers as the basis for his therapeutic experiments, first in test animals, and then in patients. Furthermore, Irish proponents of cannabis research emphasized its application for rare diagnoses, showcasing its potential versatility in treating complex health issues. Dr. Russo will also discuss modern day Irish contributors such as: Bill (Will) Devane,  Saoirse O’Sullivan, and David Finn.

The cannabis plant, belonging to the Cannabaceae family, is known for its unique properties and diverse uses. It is typically classified into three primary species: Cannabis sativa, Cannabis indica, and Cannabis ruderalis, each exhibiting distinct characteristics in terms of growth patterns, cannabinoid profiles, and effects. Over millennia, cannabis has been cultivated for various purposes, including medicinal, recreational, and industrial applications. As societal perspectives on cannabis continue to evolve, the plant has gained recognition for its potential therapeutic benefits, leading to increased research and interest in its chemical composition. Understanding the cannabis plant’s biology, cultivation methods, and historical significance is essential for exploring its medical applications and the ongoing development of cannabis-related policies.

Cannabis sativa (“cultivated cannabis”) is an ancient medicinal plant that has been prohibited in the USA since 1937. Dr. Russo will provide an introductory focus on its botany, uses and cultivation practices, all topics that will be recurrent with more in-depth treatment as the course progress. Dr. Russo will discuss Cannabis Typology (Ernest Small), Type I: high THC chemovars, Type II: mixed THC/CBD chemovars, Type III: CBD-predominant chemovars, Type IV: CBG-predominant chemovars,Type V: Zero cannabinoid chemovars, Type VI?: THCV-predominant chemovars and phytocannabinoids from Russo and Marcu 2017 Cannabis pharmacology:  The usual suspects and a few promising leads. In addition to Dr. Russo taking a “deep dive” into explaining the components of the Cannabis Plant, he will also discuss Cannabis Synergy: The Entourage Effect, Cannabis Chemovars, Chemical  Ecology of Phytocannabinoids, Terpenoids, Landraces, and will Outline the Ideal Cannabis Classification Scheme. This module will prove to be invaluable for those that want to understand the components of the Cannabis Plant.

CBD, or cannabidiol, is one of the most extensively researched cannabinoids derived from the cannabis plant. Research has shown that CBD may possess a wide range of therapeutic properties, including anti-inflammatory, analgesic, anxiolytic, and anticonvulsant effects. How does CBD work? Dr. Russo will discuss how CBD interacts with receptors, ION channels, enzymes, and transporters. In addition, focused coursework on “CBD Mechanism of Action: Receptors” such as Cannabinoid Receptors, Glycine Receptors, GABA Receptors, GPR55 Receptor, Serotonin Receptor, Peroxisome Proliferator-activated Receptors, Adenosine Receptors, Opioid Receptors to give students a high level of understanding, but in terms that everyone will understand. So what does this mean for patients and ailment focused treatments? Dr. Russo will discuss topical applications to key findings for ailments such as MS and Epilepsy to impact on bone fractures.

Dr. Russo’s good friend and associate, Raphael Mechoulam, is remembered and honored in this module. A personal tribute that will give students an unparalleled insight to “Rafi”.  Raphael Mechoulam often regarded as the “father of cannabis research,” made groundbreaking contributions to the field of cannabis science and medicine, significantly advancing our understanding of cannabinoids and their effects on the human body. In the early 1960s, was the first to isolate and identify tetrahydrocannabinol (THC), the psychoactive component of cannabis, as well as cannabidiol (CBD), which is known for its therapeutic properties. His pioneering work laid the foundation for the discovery of the endocannabinoid system, revealing how cannabinoids interact with receptors in the body to produce various physiological effects. Mechoulam’s research has provided invaluable insights into the potential medical applications of cannabis, particularly in areas such as pain management, epilepsy, and neuroprotection. Beyond his scientific achievements, he has played a crucial role in advocating for cannabis research and its integration into mainstream medicine, influencing policy discussions and promoting further exploration into the therapeutic benefits of cannabis. His legacy continues to inspire ongoing research and greater acceptance of cannabis as a legitimate medical treatment. Students will find this module not only educational, but enjoyable to hear about a great friendship between friends.

Delta-8-Tetrahydrocannabinol (Δ⁸-THC) ”Dealing” With An Emerging Public Health Issue. The focus of this presentation is to acquaint the learner with the science, history and controversy surrounding delta-8-THC, a naturally occurring compound found in cannabis in trace amounts, which has now infiltrated the market, particularly in the USA, through synthetic production from cannabidiol (CBD). Virtually no commercial preparations containing delta-8-THC are naturally derived, and quality control is severely lacking in the industry, leading to products that are almost invariably contaminated with by-product compounds with unknown toxicological risk, as well as the presence of residual solvents. ASTM. 2021. In 2021, ASTM published a white paper: Delta-8-tetrahydrocannabinol and the need to develop standards to protect safety of consumers. Some of the findings include:

“Some estimate the synthetic cannabinoid market to be $10 billion by 2025—”

“The process to derive Δ⁸-THC—is a synthetic process utilizing harsh and toxic chemicals that are not safe for human consumption.”

“They are in gummies, vaporizer cartridges, tinctures and more. Its rise is largely attributed to the oversupply of CBD—”

“—prices of both the biomass (hemp flower) and bulk CBD oil fell over 80% during 2019—”

“A common method to convert CBD to delta-8-THC was patented in 2001—. The result is an impure oil that needs further cleanup—”

“—can result in failed drug tests—Unknowing consumers can jeopardize their careers, custody battles and other scenarios where drug tests may be required—”

“Nearly anyone with access to the internet can find videos online showing how to synthesize Δ⁸-THC using acetic acid available in your kitchen, alluding to a simple process that is ridden with unintended consequences.”

Dr. Russo will outline the unknown but clear potential risks to consumers, based on scientific evidence. As the interest in delta-8 THC continues to grow, ongoing research and clearer policy frameworks will be vital to understand its implications for health and wellness.

“Cannabis is the single most versatile herbal remedy, and the most useful plant on Earth. No other single plant contains as wide a range of medically active herbal  constituents.”

– Dr. Ethan Russo

When utilizing medical cannabis, various intake methods and therapeutic strategies are employed to optimize its benefits. Patients can choose from several methods, including inhalation (smoking or vaporization), oral ingestion (edibles, capsules, and tinctures), sublingual administration (sprays or tinctures placed under the tongue), topical applications (creams, balms, and patches) and suppositories. Each method offers distinct absorption rates, onset times, and durations of effects, making the choice dependent on the patient’s specific needs. In addition to the discussion on how to medicate, testing, reading labels, and terpenes will be outlined in greater detail. The importance of patient harm mitigation such as strategies for edibles “start low, go slow” will also be outlined.

Dosing and titration are critical components in the effective use of medical cannabis, as individual responses to cannabinoids can vary significantly. Because cannabis products contain diverse concentrations of cannabinoids and terpenes, establishing an appropriate starting dose is essential for minimizing side effects and achieving therapeutic benefits. Many healthcare providers recommend a gradual titration approach, where patients start with a low dose and slowly increase it based on their response and tolerance. Dr Russo will use scientific data to discuss the “hazy” approach to dosing and titration. Studies such as Hazekamp et al. 2013. The medicinal use of cannabis and cannabinoids-An international survey on administration forms. J Psychoact Drugs 45(3):199-210 help provide learners with peer reviewed studies to support lessons. Legal implications are discussed, Standards for Cannabis Recommendation, to maintain compliance.

The history of cannabis prohibition and scheduling spans centuries, beginning with its mention in the Circa 200 CE Babylonian Talmud, which referenced cannabis and suggested it should not be grown alongside grapes, possibly indicating its inebriating effects. By the 13th century, cannabis—specifically hashish—was outlawed in Egypt by King Baybars, though the prohibition was largely ineffective. In 1484, Pope Innocent VII issued a Papal Bull condemning witchcraft, but notably did not mention cannabis. In the modern era, the 1894 Indian Hemp Drugs Commission report documented the widespread traditional use of cannabis
in India without significant harm. In 1922, Emily Murphy’s role as Canada’s first female justice contributed to the country’s eventual cannabis prohibition. The Panama Canal Zone Committee in 1925 found no evidence of withdrawal symptoms, emphasizing the lack of concern about addiction at the time. Despite opposition from figures like William C. Woodard of the AMA, who advised against prohibition, cannabis was federally criminalized in the US with the 1937 Marihuana Tax Act.
Subsequently, in 1941, cannabis preparations were removed from the US
Pharmacopoeia. The 1961 Single Convention Treaty of the United Nations
further categorized cannabis as forbidden, while allowing limited medical research. Throughout the late 1960s and early 1970s, various reports, including the 1969 Wootton Commission in the UK and the US Shafer Commission, debated medical use and prohibition, with the US’s Controlled Substances Act of 1970 placing cannabis in Schedule
I—indicating a high potential for abuse and no recognized medical value—pending further review. The Supreme Court’s 1972 ruling in United States vs. Timothy Leary invalidated the 1937 Marihuana Tax Act, amidst ongoing international and national debates that continue to shape cannabis policy today.

Cannabis use, while often beneficial for many medical conditions, can also lead to adverse events and undesirable effects, necessitating harm reduction strategies to ensure safe consumption. Common side effects include dizziness, fatigue, dry mouth, and cognitive impairment, particularly in individuals consuming high doses of THC. More serious risks exist for certain populations, including those with a history of mental health disorders or substance abuse, where cannabis use could exacerbate symptoms or lead to dependency. Harm reduction approaches focus on educating patients about responsible use, emphasizing the importance of starting with low doses and gradually titrating as needed to minimize negative effects. By providing clear guidelines and fostering open communication between healthcare providers and patients, harm reduction strategies aim to enhance the safety and efficacy of medical cannabis, ensuring that individuals can maximize its benefits while reducing potential risks to their health and well-being.

Dr. Ethan Russo has played a key role in educating both healthcare professionals and patients about Cannabinoid Hyperemesis Syndrome (CHS). Published 2021 in Cannabis and Cannabinoid Research Dr. Russo’s scientific study on Cannabinoid Hyperemesis Syndrome identifies genetic markers of Cannabinoid Hyperemesis Syndrome, a rare condition triggered by high-THC consumption.

CHS is a condition characterized by cyclic episodes of nausea and vomiting that some long-term cannabis users experience, often leading to significant discomfort and distress. Dr. Russo emphasizes the importance of recognizing this condition as a potential adverse effect of chronic cannabis use, particularly with high-THC products. By raising awareness of CHS, Dr. Russo aims to foster a more comprehensive understanding of cannabis’s effects, enabling healthcare professionals to provide informed guidance to patients. His contributions are vital in bridging the gap between cannabis use and its potential risks, thereby promoting safer consumption practices and more effective management of cannabis-related health issues.

Dr. Ethan Russo has been a key educator on the role of cannabis in pain management, particularly highlighting its potential as an opioid-sparing alternative in clinical settings. The facts. 2016 deaths from opioid overdose topped 64,000 in USA (NYT, 9/2/17), mostly fueled by fentanyl (540% increase in 3 years). The figure was 72,000 deaths in 2017, and has exceeded 100,00 more recently.2.5 million Americans have opioid use disorder (Hurd 2017)80 die each day from OD

80% start by misusing prescription opioids and there are 200 million opioid prescriptions/year written.  In this module, by integrating cannabis into pain management regimens, patients may experience reduced reliance on opioid medications, thus mitigating the risks associated with opioid use, such as addiction and overdose. Dr. Russo emphasizes that, through careful dosing and individualized treatment plans, medical cannabis can provide significant relief while minimizing side effects, ultimately contributing to a more balanced and safer approach to managing chronic pain conditions.

Dr. Ethan Russo has been instrumental in advancing the understanding of the relationship between cannabis and gut health, highlighting the potential therapeutic benefits of cannabinoids in managing gastrointestinal disorders. His research suggests that cannabinoids can interact with the endocannabinoid system present throughout the gut, potentially influencing various physiological processes such as inflammation, motility, and pain signaling. Cannabinoids like THC and CBD have shown promise in alleviating symptoms associated with conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and even appetite regulation in patients undergoing treatments like chemotherapy. In this module, Dr. Russo emphasizes the anti-inflammatory properties of cannabinoids, which may play a crucial role in addressing the underlying inflammation often seen in gut-related conditions. By advocating for further research into cannabis’s effects on gut health, Dr. Russo aims to provide healthcare providers and patients with evidence-based insights into how medical cannabis can serve as an adjunctive therapy, potentially improving quality of life for individuals struggling with various gastrointestinal issues.

Dr. Ethan Russo has been instrumental in advancing the understanding of the relationship between cannabis and gut health, highlighting the potential therapeutic benefits of cannabinoids in managing gastrointestinal disorders. His research suggests that cannabinoids can interact with the endocannabinoid system present throughout the gut, potentially influencing various physiological processes such as inflammation, motility, and pain signaling. Cannabinoids like THC and CBD have shown promise in alleviating symptoms associated with conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and even appetite regulation in patients undergoing treatments like chemotherapy. In this module, Dr. Russo emphasizes the anti-inflammatory properties of cannabinoids, which may play a crucial role in addressing the underlying inflammation often seen in gut-related conditions. By advocating for further research into cannabis’s effects on gut health, Dr. Russo aims to provide healthcare providers and patients with evidence-based insights into how medical cannabis can serve as an adjunctive therapy, potentially improving quality of life for individuals struggling with various gastrointestinal issues.

Dr. Ethan Russo has made significant contributions to the understanding of cannabis’s impact on liver health, exploring both its potential benefits and risks. Research indicates that cannabinoids, such as THC and CBD, may possess hepatoprotective properties that could aid in treating conditions like fatty liver disease and hepatitis by reducing inflammation and promoting cellular regeneration. Dr. Russo highlights how the endocannabinoid system plays a crucial role in liver metabolism and function, influencing processes such as lipid storage, glucose homeostasis, and the immune response. While his work underscores the therapeutic potential of cannabis for liver health, he also stresses the importance of balanced use, especially in patients with existing liver conditions, as high levels of THC could strain liver function in certain populations. By emphasizing the need for further clinical research into the relationship between cannabis and liver health, Dr. Russo advocates for a nuanced understanding of how cannabinoids can be utilized safely and effectively in medical treatments, ultimately aiming to improve health outcomes for patients with liver-related issues.

Dr. Ethan Russo has been a significant voice in exploring the potential benefits of cannabis in dermatology, particularly regarding its anti-inflammatory and therapeutic properties for various skin conditions. This module highlights the efficacy of cannabinoids, such as THC and CBD, in addressing issues like eczema, psoriasis, and acne, where inflammation plays a central role. Dr. Russo advocates for topical formulations of cannabis, which can provide localized relief without the psychoactive effects associated with systemic cannabis use. His contributions aim to expand the understanding of how cannabis can be integrated into dermatological treatments, offering a natural alternative for patients seeking relief from chronic skin ailments.

In this module, Dr. Russo discusses the importance of peer reviewed studies on cannabis as evidence-based medicine. It is important to discuss the potential about the therapeutic benefits and risks associated with cannabis use. With a growing body of scientific research demonstrating the efficacy of cannabinoids in treating various medical conditions, including chronic pain, epilepsy, and anxiety, education helps dispel misconceptions and stigma surrounding cannabis. By equipping healthcare professionals with knowledge about appropriate dosing, potential side effects, and drug interactions, patients can receive personalized, informed care. Additionally, fostering a better understanding among patients empowers them to make informed decisions regarding their treatment options, ultimately enhancing patient outcomes and promoting safe, responsible use of cannabis in clinical settings.

Dr. Ethan Russo has extensively studied the complexities of drug-drug interactions involving cannabis, recognizing that cannabinoid compounds can affect the metabolism of various medications and potentially alter their therapeutic efficacy. Cannabis components, particularly THC and CBD, are metabolized by cytochrome P450 enzymes in the liver, which are also responsible for processing many prescription medications. This overlapping metabolic pathway can lead to significant interactions; for example, CBD has been shown to inhibit certain enzymes, which may increase the plasma concentrations of concurrently administered drugs, resulting in heightened effects or adverse reactions. Dr. Russo emphasizes the importance of healthcare providers being aware of these interactions when prescribing cannabis alongside other medications, as they can affect the pharmacokinetics and pharmacodynamics of treatments for conditions ranging from epilepsy to pain management. By promoting a better understanding of cannabis’s potential interactions with other drugs, Dr. Russo advocates for integrated approaches to patient care that prioritize safety and individualized treatment strategies, ensuring that cannabis can be used effectively and responsibly in conjunction with other therapies.

The term “standard of care” with respect to cannabis refers to the expected level of specialized medical care that healthcare providers should offer when incorporating cannabis as a therapeutic option for patients. In this module, Dr. Russo,  discusses evidence-based practices, clinical guidelines, and recommendations informed by current research on the efficacy, safety, and appropriate usage of cannabis in treating certain medical conditions. This module also emphasizes the importance of patient education, informed consent, and ongoing monitoring of treatment progress. As cannabis becomes more widely accepted in the medical community, defining and adhering to a standard of care is crucial for ensuring that patients receive safe, effective, and personalized treatment options, ultimately fostering better health outcomes and promoting responsible use of cannabis in medical practice.

Dr. Russo’s research on cannabis and Alzheimer’s disease suggests that cannabinoids may offer neuroprotective effects that could mitigate neurodegeneration and reduce inflammation, both of which are critical factors in the progression of Alzheimer’s. Studies indicate that cannabis may also help alleviate common symptoms in Alzheimer’s patients, such as agitation, anxiety, and loss of appetite. However, while preliminary findings are promising, further rigorous clinical trials are necessary to establish definitive evidence of efficacy and safety in treating Alzheimer’s with cannabinoids.

Dr. Russo discusses the current, evidence-based research that suggests that cannabis may offer symptomatic relief for patients with Parkinson’s disease, particularly in managing symptoms such as tremors, rigidity, and dyskinesia. Studies indicate that cannabinoids, particularly CBD and THC, can modulate neurotransmitter systems involved in motor control and may possess neuroprotective properties that help mitigate neuronal damage. Cannabis holds promise in Parkinson disease, but clear guidelines cannot yet be advanced; different preparations may be necessary at different disease stages. One of Dr. Russo studies on Cannabis and Parkinson’s Russo, E. B. 2018. Cannabis Therapeutics and the Future of Neurology. Front Integrat Neurosci 12:1-11.

Dr. Russo’s insight provides valuable insights into the potential benefits of cannabis for managing multiple sclerosis (MS) symptoms, highlighting its effectiveness in alleviating spasticity, pain, and other neurologic symptoms associated with the condition. Evidence from clinical studies suggests that cannabinoids, particularly THC and CBD, can significantly reduce muscle spasms and improve overall quality of life for MS patients. Additionally, cannabis may help with neuropathic pain and sleep disturbances, which are commonly reported by those with MS. This module goes through research, treatment options and overall strategies to use cannabis with managing multiple sclerosis (MS).

Dr. Russo discusses the therapeutic potential of cannabis, particularly cannabidiol (CBD), in managing epilepsy, specifically in treatment-resistant forms such as Dravet syndrome and Lennox-Gastaut syndrome. This module details studies that indicate that CBD can significantly reduce seizure frequency and severity without the psychoactive effects linked to THC, making it an appealing option for patients, especially children, who suffer from refractory epilepsy. Dr. Russo emphasizes the importance of access to high-quality cannabis formulations and ongoing monitoring to ensure optimal treatment outcomes. While cannabis is not considered a first-line therapy for all epilepsy types, it represents a valuable alternative for those who have not achieved adequate control with conventional anti-seizure medications, as indicated by the growing body of evidence supporting its use.

Research suggests that cannabis may be an effective treatment for migraine management, with patients reporting a reduction in the frequency and severity of migraine attacks when using cannabinoids, particularly CBD and THC. This modules discussed studies that indicate that cannabis can help alleviate migraine pain and associated symptoms, such as nausea and sensitivity to light, by modulating pain pathways and reducing inflammation. Additionally, the anxiolytic properties of cannabis may contribute to overall stress reduction, which can be beneficial for individuals prone to migraine triggers.

Evidence-based cannabis medicine refers to the practice of using cannabis and its components—primarily cannabinoids like THC and CBD—guided by scientific research and clinical studies that demonstrate their therapeutic efficacy. This approach emphasizes the importance of understanding the mechanisms of action, appropriate dosing, and potential side effects associated with cannabis use. Evidence-based medicine relies on rigorous, peer-reviewed studies that assess the safety and effectiveness of cannabis for various medical conditions, such as chronic pain, epilepsy, multiple sclerosis, and anxiety disorders. Practitioners utilizing this framework prioritize individualized treatment plans, starting with low doses based on clinical guidelines and gradually adjusting as needed, while also considering patient feedback and ongoing research developments. This method ensures that cannabis is used responsibly and effectively within a clinical context, supporting better patient outcomes and minimizing risks.

In this module, Dr. Russo explores the potential of cannabis-based treatments for anxiety, schizophrenia, PTSD, and depression. His recent research on cannabigerol (CBG): Acute effects of cannabigerol on anxiety, stress, and mood: a double-blind, placebo-controlled, crossover, field trialsuggests it may help manage anxiety and stress without the intoxicating effects of THC. Dr. Russo highlights the importance of the entourage effect, where various cannabinoids and terpenes work together to enhance therapeutic benefits. He also discusses the complex relationship between cannabis and schizophrenia, emphasizing that while high-THC strains may increase psychosis risk in vulnerable individuals, cannabinoids like CBD could offer therapeutic benefits for managing symptoms. Additionally, Dr. Russo examines cannabis’s role in treating PTSD and depression. Research suggests that CBD may alleviate anxiety, nightmares, and sleep disturbances in PTSD, while also showing potential antidepressant-like effects by interacting with serotonin receptors and reducing inflammation.

Cannabis has a long history of use for women’s health, dating back centuries across various cultures for its therapeutic properties. Traditionally, women have utilized cannabis to manage a range of health issues, including menstrual pain, hormonal imbalances, and pregnancy-related symptoms such as nausea and anxiety. In ancient practices, cannabis was often employed as a remedy to alleviate menstrual cramps and discomfort due to its analgesic and anti-inflammatory effects. In his 2002 review, Ethan Russo explored the historical use of cannabis in obstetrics and gynecology, suggesting its potential as a safe and effective alternative for various conditions, including dysmenorrhea, hyperemesis gravidarum, and menopausal symptoms. Dr. Russo’s work compares historical usage with current ethnobotanical, clinical, and epidemiological reports, and considers modern developments in cannabinoid research. Dr. Russo concludes that “the long history of cannabis in women’s medicine supports further therapeutic investigation and application to a large variety of difficult clinical conditions”.

Throughout history, cannabis has played a significant role in pediatric medicine, with ethnobotanical data from around the world highlighting its various applications for children’s ailments. In many cultures, cannabis was utilized to treat conditions such as seizures, pain, and anxiety among children. From 1840 onward, cannabis became a mainstream medicine in Western countries, widely integrated into pharmaceutical practices for nearly a century. During this period, there were no significant safety concerns reported, and tolerance to higher doses of cannabis in younger children was well documented. However, the advent of international prohibition led to a decline in its use and research. Despite this, historical evidence suggests that cannabis had been a part of pediatric treatment regimens without notable adverse effects, underscoring the importance of revisiting its therapeutic potential in modern medicine.