1. An Introduction to Cannabinoid-Based Therapeutics &
Cannabinoid Deficiency Syndrome (CDS)
Presented by: Rob Streisfeld, NMD
NYANP - ANNUAL CONFERENCE
October 2, 2016

2. CANNABIS
Food, Herb, or Drug?

3. Concentration Vs Micro-dosing
FACTORS TO CONSIDER
Raw Vs Heated
Concentration Vs Micro-dosing
Mechanism of Delivery
Related Condition (s)
Nomenclature
Terpene Profiles

4. The EndoCannabinoid System
Cannabis Receptors Identified in 1990
First EndoCannabinoid Identified in Anandamide “Bliss”
Found in nearly all animals
Receptors found in the brain are stimulated by exercise, and have been shown to help mediate emotions, consolidate memory and coordinate movement.

5. DEA SAYS NO MEDICAL VALUE ?
Oct. 7, US Government Receives Cannabinoids Patent
The US Department of Health and Human Services receives a patent (US 6,630,507 B1) for the therapeutic use of "cannabinoids as antioxidants and neuroprotectants."
The abstract says in part: "Cannabinoids have been found to have antioxidant properties... The cannabinoids are found to have particular application as neuroprotectants… in the treatment of neurodegenerative diseases such as Alzheimer's disease..."
US patent 6,630,507 B1 , Oct. 3, 2007

6. National Institute of Drug Abuse admits Cannabis has Medicinal Benefits
The Use of WHOLE PLANT Extract of Cannabis may help the body kill certain types of Cancer cells and reduce the size of others.
In combination with radiation, a study using mice suggested that radiation is more effective with Cannabis, than without.
*Curious to compare effectiveness of Cannabis without Radiation

7. The DEA refuses to re-schedule Cannabis:
Still SCHEDULE 1!?!
AUGUST 11, 2016
The DEA refuses to re-schedule Cannabis:
"There is no evidence that there is a consensus among qualified experts that marijuana is safe and effective for use in treating a specific, recognized disorder," the report added.
"At this time," the DEA concluded, "the known risks of marijuana use have not been shown to be outweighed by specific benefits in well-controlled clinical trials that scientifically evaluate safety and efficacy."

8. Addressing Cannabis in the Clinic

9. Packer and Kunos Review, FEBS J. 2013 May;280(9):1918-43

10. Cannabis: Clinical Implications
Key to Preventative Medicine? “It protects your DNA from being damaged and slows down the aging process.” - Dr Michelle Ross (neuroscientist)
Can you use too much Cannabis? “High doses down regulate a system, so by taking high doses of THC — which binds very potently to the CB1 receptor — we could be down-regulating the endocannabinoid system.” Michelle Sexton, ND

11. Physiology Impacted by Cannabis
An Incomplete List
Anxiety, Appetite, Blood Pressure, Bone Formation
Cerebral Blood Flow, Digestive system,
Emesis & nausea, Immune System, Inflammation,
Memory, Mood, Movement
Stress

12. the effects of Cannabis/cannabinoids.
Scientists are now conducting numerous clinical trials and preclinical studies into
the effects of Cannabis/cannabinoids.
These studies include but are not limited to: 
• Autoimmune diseases, including HIV and AIDS, multiple
sclerosis and Alzheimer's disease
• Inflammation
• Pain
• Seizures
• Substance use disorders
• Mental disorders
Also: PTSD, Endocrine disorders (diabetes), TBI & CTE as it
pertains to sports/athletics

14. CANNBINOIDS - DETAILED

15. C A N B I O D S
….(Just a few)
Credit: Nature’s Root

16. THC & THCA
THC isolated can have unpleasant psychoactive effects. Tempered and augmented by terpenes and other cannabinoids, psycho-activity is more effective as well as noticeable more enjoyable.
THCA has significant clinical applications while being non-psychoactive. (Anti-nausea, Anti-epileptic, Anti-inflammatory, etc.)
THC activates CB1 & CB2 receptors, leading to apoptosis of cancer cells. (Apoptosis vs Necrosis)

18. Medical Genomics & Cannabis
Variation and Nomenclature of the Plant
Personalized Cannabis-based Therapeutics
Genetic Anomalies/ Identifiers in Clinical Treatment

20. Cannabinoid Deficiency Syndrome
Underlying Cause of Dis-Ease?
Single Cannabinoid or Entourage?
Potential Impact from Birth
Anandamide and a “Runner’s High”

21. Cannabis Deficiency & Some Common Conditions
Migraine, fibromyalgia, IBS and related conditions display common clinical, biochemical and pathophysiological patterns that suggest an underlying clinical endocannabinoid deficiency that may be suitably treated with cannabinoid medicines.
Russo, EB. Neuro Endocrinol Lett Apr;29(2):

22. Cannabis & Metabolism Cannabis For Weight Loss?
Major Cannabinoids have been shown to impact
Cytochrome P450 Enzymes *Drug Interactions Possible
Cannabis For Weight Loss?
THC: Small amounts stimulates appetite while high consumption may down regulate CB1 receptors, decreasing appetite.
THCV: Increases Metabolism in Fat Cells

23. Marijuana (Cannabis) Use Disorder?
Marijuana or cannabis use disorder is classified in DSM-5 in different categories (mild, moderate, or severe) depending on how many symptoms are present.
Unfortunately too often used by Allopathic Model after years of being told that Cannabis is an illicit drug with no medical value
The Conundrums:
“More Research Needed” &
“Stoner” stigma

24. Recommending Cannabis
SATIVA vs INDICA
Concentration & Ratios
1) high THC content / low CBD concentration;
2) high THC concentration / high CBD content;
3) low THC / high CBD content.

25. Terpenes
Over 120 different types of Terpenes, in varying amounts, have been identified in cannabis depending on the individual strain.
Credit: 420College.org

26. Cannabis Education Charts Commonly
found in Medical Marijuana Dispensaries

27. Forms & Functions Smoking Vaporizing
Edibles/ Dietary Inclusion (including juicing)
“Dabs” and other Concentrates
Tinctures
Topical
Suppositories

28. Dosing “Guidelines” ORAL DOSING 0.05mg/kg/day – 30mg/kg/day
(e.g. 3mg -1,700mg daily for average adult)
Dr Dustin Sulak, DO is one of the most effective and experienced Cannabis clinicians in the U.S
18,000 plus total patients
Go to HEALER.COM for more information

29. Fungus, Yeast, & Mold… Oh My!!
Cannabis & Mycotoxins
Fungus, Yeast, & Mold… Oh My!!
Third party microbial testing has become a regulatory requirement in the medical and recreational Cannabis markets, yet knowledge of the Cannabis microbiome is limited.
Mycotoxins produced by fungi include:
Aflatoxins Citrinin Patulin
Ochratoxins FusariumToxins
It is important to know the quality of the medicine, just like the with the food you eat and supplements you take

30. Pesticides Are Not the Only Concern with Cannabis Crops
Chemical contaminants commonly used during Cannabis production include:
INSECTICIDES:
Miticides
Abamectin
Imidacloprid
Bifenazate
Etc.
FUNGICIDES:
Myclobutanil
Plant Growth Regulators
Daminozide
Paclobutrazol

31. Tx Pearls
Effects of smoked marijuana occur within minutes and can last 1 to 3 hours.
Effects from marijuana consumed in foods or beverages appear later, usually in 30 minutes to 1 hour but can last up to 4
Due the the relationship of THC and CBD, the use of Cannabidiol may “antidote” overconsumption of THC.
Different cannabis cultivars or cannabinoid ratios can cause opposite responses in the same individual
Regular users demonstrate less psychotomimetic, perceptual
altering, amnestic, and endocrine effects. (D'Souza et al., 2008).

32. Review of Cannabis Medications
Epidiolex
Sativex
Dronabinol/Marinol
and more…
Synthetic Vs Natural
Whole Plant Vs Isolate

33. LATEST RESEARCH REVIEW ON: (Time Permitting.. Links will be provided)
Cannabis & Pediatrics
Cannabis & Cancer
Cannabis & Pain

34. THANK YOU!!