“I used to scoff at cannabis/THC,” she said, referring to tetrahydrocannabinol, the main psychoactive compound present in cannabis.
As for the future, Courtney reassured fans that she is looking forward to helping others battling chronic and acute pain once she has restored her health. “Bear with me as I start to try and have a blast and help others every pain-free day. ” she said.
The former wife of Kurt Cobain, who maintains that she is still ‘100% sober’, admitted that she hasn’t always been a fan of the hemp-derived drug.
Courtney still dislikes ‘the weed feeling’ but insists this is different. “This isn’t that. It’s woman and nature supporting us. It’s magic,” she wrote.
However, she was able to take some major steps towards recovery when she ‘met the most empathetic wise pain management’ doctor. The practitioner, who remains unidentified, introduced Courtney to CBD oil – a natural remedy famous for its pain-relieving properties. The supplement is also commonly used for sleeping problems like insomnia, especially by those who’d prefer to avoid pharmaceutical medication.
It basically means we don’t have enough high-quality blood in our veins and arteries.
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This type of anemia is treated by identifying which nutrients are deficient and adding them to the diet either through food or in supplemental form.
Some of the Most Common Examples Include:
We’ll talk more about this later.
SPSS for Windows statistical package version 22 (SPSS Inc., Chicago, IL, United States) was used for all statistical analyses. The numerical data were expressed as means and standard deviations, and the categorical data were expressed as frequencies and percentages. Chi‐square test was used for categorical variables and independent samples t‐test was used to make comparisons between two groups to determine significant differences between groups. Linear variables of hematological parameters of the SG and CG were compared with student’s t‐test. In addition, neutrophil/platelet ratio and neutrophil/lymphocyte ratio were compared between two groups. A level of P<.05 indicated statistical significance.
Cannabis use disorders group (Synthetic Cannabinoid) (SG) with 40 patients (mean age: 28.55±7.08 years), and 40 healthy subjects group (CG) (mean age: 30.77±6.30 years) were included in the study. There was no statistically significant difference between groups in terms of age. Both groups consisted of 38 men and 2 women.
Cloned Enzyme Donor Immune Assay (CEDIA) was used as the immunoassay method during the analysis of the urine tests. Detected substrates consisted of amphetamine, benzodiazepine, barbiturate, opioids, 3,4‐metilenedioksi‐N‐metilamfetamin (MDMA), synthetic cannabinoids, THC, and buprenorphine for drugs consumption, and ethyl glucuronide for alcohol consumption.
At the first day of their hospitalization, EDTA blood samples (BD Vacutainer K2EDTA Plus plastic tubes; Becton Dickinson, Franklin Lakes, NJ, USA) were collected from each patient at the time of admission and hemogram parameters were measured using aperture‐impedance technology. Neutrophil/lymphocyte ratio (NLR) was calculated by rating neutrophil count to lymphocyte count (PLR), which was calculated by rating the count of lymphocyte to platelet count. Unsaturated iron‐binding capacity (UIBC) and total iron‐binding capacity (TIBC) were measured to understand iron levels for etiology of anemia diagnosis. The same procedure was applied for the control group. All hematological parameters of CG and SG groups were compared with each other.
Effects of synthetic cannabinoids on the central nervous system are similar to other cannabinoids.14, 15 In reference to these effects, cannabinoid ligands bind with specific G protein‐coupled receptors (CB1 receptor and the CB2 receptor) and activate the endocannabinoid system. Synthetic cannabinoids have potent agonism to cannabinoid receptors differentially from THC; thus, THC has partial agonism.12 CB1 receptors influence the central nervous system and cause thermoregulation disorders, psychotic episodes, memory disorders, antiemetic activity, appetite enhancer activity, anxiety, and stress relieving activities.16, 17 CB2 receptors were found in immune system such as thymus, tonsils, marginal zone of the spleen, B lymphocytes, T lymphocytes, macrophages, monocytes, natural killer (NK) cells, and polymorphonuclear cells. According to the earlier studies in the literature, cannabinoids appear to influence immune function, especially through CB2 receptors18, 19, such as inhibition of the functions of macrophage and macrophage‐like cells, suppression of B and T lymphocytes and cytolytic activity of NK cells, proliferation and maturation of cytotoxic T lymphocytes, affecting immune cells’ consolidation and chemotaxis, suppressing the antibody response in humans and animals, suppressing a variety of activities of T lymphocytes. It is well known that endocannabinoid‐anandamides have anti‐inflammatory effects but endocannabinoid 2‐Arachidonoylglycerol (2‐AG) shows agonist behavior against CB1 and CB2 receptors and it is speculated that it has pro‐inflammatory effects on immune function in contrast to anandamides20. So there are different hypotheses about the kind of effects of endocannabinoids on immune system.
There were statistically significant differences between the groups in terms of WBC , MCH , RDW , MCV , MPV , and NEU , LYM %, MONO % parameters (P<.05). MPW and LYM % were significantly lower in SG compared to CG . WBC , MCH , RDW , MCV , MPV , MONO , and NEU parameters were significantly higher in SG compared to CG (P<.05). UIBC and TIBC levels were significantly higher in SG compared to CG (P<.001). Although there was statistically significant difference between groups in terms of NLR , there was no significant difference for PLR values.
Erythrocyte series and serum iron profiles’ characteristics of SG and CG groups and inflammatory series and platelets’ characteristics of both groups are given in Tables 1 and and2 2 .
3.1. Sociodemographic attributes and clinical features of patients with cannabis use disorders
Over the last 20 years, there have been considerable researches involving the cannabinoids and its importance in regulating a variety of physiological and psychological processes such as pain, feeding behavior, lipid metabolism, pleasure sensation, and immune system.1, 2, 3 Cannabinoids are usually classified as endocannabinoids, phytocannabinoids, and synthetic cannabinoids.4 Synthetic cannabinoids are in the group of drugs called “new psychoactive substances” and these technically synthetic cannabinoid receptor agonists are designer drugs that mimic the psychoactive effects of cannabis.5, 6 They were synthesized in the 1970s, and most known and common synthetic cannabinoids were coded as JWH‐series (John W. Huffman), HU‐series (Hebrew University), and AM‐series (Alexandros Makriyannis). They were first marketed as legal cannabis alternatives in Europe in the early 2000s.7 Synthetic cannabinoids are synthesized in underhand laboratories and are usually in white color like salt, mixed with acetone, and then the mixture is sprayed on dried plant materials. They are generally used like marijuana by smoking and other inhalation ways (pipes, water pipes (bongs or hookahs), cigarettes (joints or reefers), or, most recently, in the paper from hollowed out cigars (blunts)).8, 9 The prevalence of use of synthetic cannabinoid is low in the large segment of the community (<1%), but it is higher among students, youngsters, and some special groups according to the drug tests.10 Synthetic cannabinoids are widely used in Turkey; however, there is no study for the epidemiologic data. It has both similar and different pharmacokinetic and pharmacodynamic mechanisms with the major active component of marijuana (Δ(9)‐tetrahydrocannabinol‐THC).11, 12 They have hundreds of chemical types, which are usually called K2, Spice, Bonsai, Jamaica etc.13
Platelets (PLTs) have major effects on homeostasis cascades, and they are also related to inflammatory events. MPV is a reflection of both pro‐inflammatory and prothrombotic conditions and it has been regarded as a prognostic marker of arterial and venous thrombosis.28 PLTs are highly activated when inflammatory mediators are released29 and the mean platelet volume (MPV) and platelet distribution width (PDW) are affected in patients with inflammatory and infectious disorders such as rheumatoid arthritis and ankylosing spondylitis.29, 30, 31, 32 According to literature, psychiatric disorders such as schizophrenia, unipolar depression, and bipolar disorder have abnormal (too low or too high) platelet counts and MPV parameters. For example, the mean number of platelets are lower in patients with schizophrenia and higher in patients with unipolar depression.33 According to the results of several studies in the literature, platelet activation is associated with an increased risk of other comorbidity.34, 35 Previous studies demonstrated endocannabinoids’ effects on platelet aggregation in blood and platelet shape change, secretion, and aggregation.36 Interactions between endothelial surface, platelets, and white blood cells during the inflammatory cascade may promote chronic illnesses and psychiatric disorders.37, 38 In addition, many psychiatric disorders are shown to have a strong relationship with the immune system.