Hi there, everybody. Dr. B. is back to tickle your fancy, or kick you in the butt. Are you enjoying the bizarre times we are currently living through? Ever wonder if someone with Narcissistic Personality Disorder (NPD), could benefit from a hit of medical cannabis? If so, which strain/chemovar would be best? Don’t know? Well, unfortunately nobody does and reading some of the medical research going on, we never will.


Another good example of a wasted research opportunity (see my Blog 14) was recently published in the Journal of Palliative Medicine, with the title, “Benefit of Tetrahydrocannabinol versus Cannabidiol for Common Palliative Care Symptoms,” by David Casarett, et al. of Duke University.


In this article the authors try to determine if the THC:CBD ratio in vaporized cannabis flower is of influence in the palliative treatment of six symptoms: neuropathic pain, insomnia, anxiety symptoms, depressive symptoms, anorexia, and post-traumatic stress disorder (PTSD)-related flashbacks. A total of 2,431 patients participated using the Strainprint mobile app as the data source in this electronic record-based retrospective cohort study.


The study results showed response was associated with increased THC:CBD ratio for neuropathic pain, insomnia, and depressive symptoms. Increased THC:CBD ratio was not associated with a greater response of post-traumatic stress disorder (PTSD)-related flashbacks or anorexia. The response for anxiety symptoms was not significant, but showed an inverted U-shaped curve, with maximal benefit at a 1:1 ratio (50% THC).




“Wow,” you could say, “that looks interesting!” Well, yes, and no. If we were looking at extracts of mixtures of pure THC and CBD, this might help reveal some insight into their ratio relationship in regard to palliative care. However, we are dealing with cannabis flower of different strains and, as we have discussed in my previous blogs (Blog 2 and Blog 3), we all know that cannabis is a “pharmaceutical treasure trove” of more than 100 cannabinoids, and more than 200 terpenoids and flavonoids. These chemicals modulate each other, often synergistically. We know that just focusing on THC and CBD is like speaking a language without knowing most of the alphabet or sounds involved. A lot more is going on (see Blog 5). It is like the blind men examining the elephant: Your conclusion depends on which part of the elephant you are touching, but in reality you never get the complete picture.


As we have seen in my Blog 4 discussing the research done by Arno Hazekamp in The Netherlands, it is possible to analyze cannabis flower as complex chemovar with certain medicinal effects. It isn’t easy, but it is possible. Why wasn’t this done in the study under discussion? I do not know. Supposedly, Strainprint™ records all relevant information on the strains and a much more useful picture of real-world use and benefit could be generated. My guess is the researchers are a bit lazy and too eager to publish just for publishing’s sake.


Herbal medicine is a long lost art and continues to be looked down upon by the medical establishment. Yet with modern technology and analytical techniques we should start to realize that our understanding and use of herbs like cannabis is not backward or impossible. It is potentially an important addition to our therapeutic armamentarium. Let’s do it right though. Let us stop futzing around with cannabis. Embrace its complexity and do serious research with that in mind. It could potentially help millions of patients around the world. Maybe even someone with NPD.



Dr. B.