2022 Project Narratives and Anticipated Impacts
Cannabinoid use in young adults with Crohn’s Disease
Naueen Chaudhry, MD
Assistant Professor
College of Medicine
University of Florida
College-aged patients with Inflammatory Bowel Disease (IBD) are a vulnerable population with unique needs during their transition from their home town to college with changes in their support system, medical care and new academic and social challenges. In this project, we are using a mixed methods approach to study how college-aged students will differ in their attitudes and cannabinoid use patterns than an older cohort, and hence may also experience different outcomes.
Emerging adults, although physically developed, remain in an emotional, cerebral and psychological developmental phase during this crucial part of their life. A sharp increase in Marijuana use has been reported in this age group. Our study, with the additional layer of qualitative data will provide valuable insights into the patterns and outcomes of marijuana use in young college-aged adults with Crohn’s Disease.
Quantitative assessment of complex drug-drug interaction networks involving medical cannabis products in special populations
Rodrigo Cristofoletti, PhD
Assistant Professor
College of Pharmacy
University of Florida
Patients receiving medical cannabis are likely to be taking other concomitant drugs and thus, risks related to Drug-Drug Interactions (DDIs) should be carefully assessed. An emerging body of evidence from in vitro studies has predicted inhibitory effects of cannabinoids on several drug metabolizing enzymes. However, clinical studies designed to assess DDIs involving major cannabinoids are scarce in the literature, which is partially due to the small number of approved cannabinoid products by the Food and Drug Administration, the high costs associated with performance of confirmatory clinical DDI trials, and legal and ethical issues surrounding medical cannabis use. We will apply modern in silico modeling techniques to estimate DDI risks related to cannabinoids.
Qualifying conditions to get access to medical cannabis in Florida include cancer, epilepsy, glaucoma, positive status for human immunodeficiency virus, Crohn’s disease, and many others. What these conditions and disorders have in common is both their chronicity and the lack of fully effective therapeutics to treat them. Thus, multiple medications are frequently prescribed concurrently (i.e. polypharmacy), and many of these agents will continue to be used concomitantly with medical cannabis. Such practices pose unknown risks for potential DDIs. Our research project aims to identify and mitigate the risks of DDIs involving medical cannabis in complex patients meeting.
Event-Level Changes in Psychiatric and Physical Symptoms Following Medicinal Cannabis Use in Older Adults
Robert Dvorak, PhD
Assistant Professor
Dept. of Psychology
University of Central Florida
Little is known about the immediate effects of medical cannabis use on clinical symptoms in real time. This study will examine the changes in both physical and mental health symptoms after medical cannabis use in older adults. Participants will use their mobile phones to report on symptoms throughout the day to determine the magnitude of changes in symptoms from pre- to post- medical cannabis use.
Polypharmacy is a significant issue in older adults. This places them at risk for a cascade of side effects. Results from the current study will provide guidance on symptoms that are, or are not, amenable to medical cannabis use, and help guide prescription recommendations for providers to reduce polypharmacy related issues.
Long-term Molecular, Metabolic and Behavioral Consequences of Perinatal Exposure to Cannabidiol (CBD) – A Safety and Efficacy Study
Debra Fadool, PhD
Professor
Dept. of Biological Sciences
Florida State University
Cannabidiol (CBD) is a non-psychoactive ingredient of cannabis that has demonstrated changes in anxiety, chronic pain, sleep, and prevention of substance abuse in mouse and human subjects. We want to understand the effects of perinatally-administered CBD in mice in terms of offspring health, growth, and pup/dam interactions. We have designed experiments that will monitor long-term health consequences of fetal-exposed pups once raised to adults that will measure glucose metabolism, energy homeostasis, and memory and attention behaviors, and whether modifications in gene expression are associated with long-term metabolic or psychiatric changes.
Individuals seek CBD during pregnancy to reduce stress, nausea, and anxiety but the impact of CBD on cognitive development and long-term health/mental health consequences is not known. Cannabis products cross placental membranes to enter fetal circulation, in fact, postpartum sampling of umbilical cords in women have indicated higher cannabis use than reported by survey – upwards to 22% for pregnant mothers in the USA. Our study will examine health outcomes of offspring exposed to CBD in utero, where we will examine how gestational exposure produces molecular changes in brain-region specific gene transcription that may increase obsessive-compulsive behavior and decrease long-term memory as adults.
Evaluation of immunomodulatory effects of chronic medicinal marijuana use and its routes of administration (smoking versus vaping) on the cerebral metabolism, morphology, dopamine (via neuromelanin MRI), and neural circuits of the whole-brain, and pain in young adults living with- and without-HIV
Varan Govind, PhD
Associate Professor
University of Miami
More than 50% of HIV-positive individuals use marijuana for alleviating the adverse effects of HIV infection and its medication. Inhalation is the most widely used consumption method for marijuana products and these are available in many forms or formulations such as joints, blunts, vape oil cartridges, and other forms. The beneficial and harmful compounds in these marijuana-based products vary widely across the cannabis plant strains and the parts thereof used, forms/formulations used, routes of administration, and intake durations. Consequently, marijuana users experience conflicting or mixed health outcomes. This study proposes to evaluate the effects of chronic marijuana use and routes of its administration on the brain, inflammation, immune function, pain, and behavioral functionsin HIV+ individuals.
People living with HIV use medical or recreational marijuana for alleviating adverse effects of HIV infection and its medication such as neuropathic pain, anxiety, depression, and cognitive dysfunction among many others. Specifically, this proposal will evaluate effects of chronic marijuana use and its routes of administration on the brain, systemic inflammation, immune activation, neuropathic pain, and behavioral measures in HIV-positive individuals. We anticipate that this study will provide preliminary data for assessing the impact of the form, dose and route of cannabis administration on the systemic inflammation and immune activation, brain metabolism and tissue structure, and interactions between the systemic and central nervous system (CNS) measures. This will form an important first step for designing cannabis-based systematic interventional studies to ameliorate specific conditions in HIV-positive individuals.
A translational animal model to study neurobehavioral consequences of THC and oxycodone polysubstance use
Lori Knackstedt, PhD
Associate Professor
Dept. of Psychology
University of Florida
In our proposed research we will use a rodent model of sequential oxycodone and cannabis intake to investigate the effects of opioid-cannabis polysubstance use on opioid-seeking, anxiety and the potential effects of the route of cannabis administration (inhaled smoke or ingested “edibles”) on these measures.
The ability of cannabis to influence opioid intake has not yet been assessed in either humans or animals, and thus the use of experimental animals to do so will have the advantage of careful control of drug availability, route of administration and the timing of seeking and anxiety assessments. This work will potentially impact policy regarding the use of medical marijuana for the treatment of opioid use disorder, as is currently legal in several U.S. states.
Randomized, Controlled Cross-over comparison of Cannabidiol to Oral Opioid for Postoperative Photorefractive Keratectomy Pain control
Walter Steigleman, MD
Associate Professor
Dept. of Opthamology
University of Florida
Photorefractive keratectomy (PRK) is a refractive eye surgery like LASIK with excellent outcomes and long-term stability. However, PRK involves longer healing and more pain than LASIK often requiring treatment such as oral opioid medications to control. A substantial fraction of patients who develop addiction to opioid medications started with a legitimate prescription for postoperative pain. In this study, we will evaluate if an oral CBD product can offer similar pain relief to current standard therapy with an opioid medication.
The impact of our study will inform the ophthalmology community about cannabidiol influence on postoperative PRK pain control. If we find similar efficacy, we should be able to reduce future opioid use for this surgery. This will be among this first reported studies evaluating CBD for eye/ocular pain.
Effects of cannaboidiol on resting state EEG and neuropathic pain severity in people with spinal cord injury
Eva Widerstrom-Noga, PhD
Professor
School of Medicine
University of Miami
Although some individuals with spinal cord injury (SCI) who experience neuropathic pain report beneficial effects of marijuana, there is limited research regarding the analgesic impact of Cannabidiol (CBD) after SCI. Endocannabinoid receptors are common in areas of the brain that are involved in the pain experience and therefore it is likely that CBD modulates brain activity. However, the effect of CBD on neuropathic pain symptoms and its relationship with brain electrocortical activity in people with SCI is incompletely known. We will investigate the analgesic effects of a single CBD dose and associated brain changes using electroencephalography.
As far as we know, no studies have examined changes in neuropathic pain symptoms and resting state electrocortical activity following oral full-spectrum CBD oil administration. This study will provide important information regarding if a single CBD dose produces analgesic effects in those who experience neuropathic pain after their SCI and if these are associated with electrical changes in the brain. This study will serve as a basis for a larger, high-quality clinical trial to evaluate the effects of long-term CBD treatments in people who experience neuropathic pain after their SCI.