How did a year of education in marijuana lead the author to exercise more?
And since when did the FDA approve marijuana for brain cancer treatment? 


Follow The Medicine

Why I Treated My Concussion with High-CBD Marijuana

by John Rossiter

"I'm not a medical expert. We will obviously follow signs. We will follow medicine and if they determine (marijuana) could be a proper usage in any context, we will consider that. Our medical experts are not saying that right now." -NFL Commissioner Roger Goodell, USA Today, Jan 23, 2014


I hadn't been to a brunch in a long time. Since my concussion, I'd barely socialized at all. I winced when the coffee grinder kicked into action (I had to borrow some earplugs from my hosts) and if the conversation split in two, my brain struggled to maintain focus. But generally, I felt OK.

It turned out there was a sports doctor there, and the talk turned inevitably to concussions. I mentioned that I'd begun the process of getting a medical marijuana prescription. While THC (aka delta9-tetrahydrocannabinol) is the most famous cannabinoid in the marijuana plant (it's the one that gets you high), I'd heard about another one called cannabidiol (CBD), which acts as a neuroprotectant and anti-inflammatory agent–and doesn't get you high. I'd seen some studies, heard some rumours that concussed NFL players were using the stuff, and, propelled by a recent setback in my own condition, I was pretty convinced there was no reason not to pursue this rather benign treatment. Click to scroll through the gallery below:

Nowadays, it is possible to get medicinal marijuana strains with little to no THC. That means no psychoactive effects. No high.

The sports doctor at brunch seemed skeptical, and as my wife told me, "you can find anything you want to believe on the internet." I was bit concerned.

Then a few days later, my wife and I were sent a note from the Brunch Doctor. He strongly advised against the marijuana treatment, and referred us to a specific study. He also introduced us to Google Scholar (a common resource for those searching for peer-reviewed studies and academic papers). I hadn't heard of it before, but if you enter "concussion marijuana" in its search engine, two of the top five hits referred to a study called "Barriers to Recovery from Concussion," which stated quite clearly that "marijuana consumer/users had a far greater length of recovery time."

When my wife, who had been skeptical of the whole marijuana thing from the start, and I were done freaking out, she chided me for my gullibility. We agreed to set the marijuana treatment option to rest. I fully agreed.

But I was curious. Had I been duped? How had I got it so wrong? In today's age of information overload, how does anyone know what to believe?

I started looking more closely at the study the Brunch Doctor had discovered in Google Scholar. It was led by Dr. Teena Shetty, who is based out of New York's Hospital for Special Surgery, and while the study seemed unequivocal at first glance, when I looked a bit more closely, a few things jumped out at me. Here's an excerpt from the Design/Methods section:

Any patient between the ages 10 and 50 years that came in for a concussion was asked to complete a questionnaire regarding their activity during their recovery period. A total of 220 patients were asked to participate between November 2011 and May 2014 and 45 had completed it by this time.

Forty-five completed questionnaires? That's not a lot of data, and questionnaires are only good if there is a lot of data. One other thing caught my eye:

Disclosure: Dr. Teena has received personal compensation for activities with GE-NFL Medical Advisory Board. Dr. Teena has received research support from a GE-NFL Research Grant.

So it turns out that the doctor who led this study received money from General Electric and the NFL. In fact, both organizations boast about their exciting $60-million collaboration on their websites.

Here's an excerpt from the GE Report above:

Shetty is still seeking to enrol more people in the program. "I would like to have as much data to work with as possible," she says. 

There definitely is nothing wrong with being well-funded by powerful entities, but I was surprised to see a connection between a multi-year study with 45 completed questionnaires, and these billion dollar organizations. So I became more curious about Dr. Teena Shetty. Here's some stuff about her education from her biography:

Dr. Shetty is a Fulbright scholar who received her medical degree and bachelor’s degree with honors from Brown University. Additionally, she attended Oxford University and then later the University of Cambridge where she received her master of philosophy degree in medicine.

This is a bit more interesting:

Dr. Shetty is both the neurologist for the New York Mets and unaffiliated Neuro-Trauma Consultant for the New York Giants.

She was featured in the November 2011 issue of Marie Claire magazine presenting eight inspirational professional women in New York City, and seems to be something of a regular on Fox News:

Dr. Shetty is the go-to person when it comes to major networks doing stories on concussions and the NFL. In this interview with MSNBC, Dr. Shetty trumpets the work the NFL is doing regarding brain injuries:

The NFL has given a lot of financial help to research being done in this area... There's a lot of research being done on helmets.

It seemed weird to me that this well-connected, well-funded, data-seeking advocate for the NFL was presenting research with so little data, and that that was the research I was being referred to by other doctors.

At the same time, I began to look deeper into some of the articles discussing high-CBD marijuana as a treatment for concussions. These are the first that pop up:

I'll summarize the two main ideas these articles bring up.

First, they discuss the growing number of scientific studies showing the neuroprotective qualities of marijuana. Here's an excerpt from the Men's Journal article:

In 2000, researchers at Maryland's Laboratory of Cellular and Molecular Regulation found that cannabidiol (CBD)—had powerful protective effects against brain trauma, and was a more potent antioxidant than vitamins C or E. Antioxidants have been shown to nurture brain health and relieve brain injury by preventing inflammation. 

Second, the articles suggest that many current and former NFL players use high-CBD marijuana as a treatment. Here's an excerpt from the National Post article:

The NFL is reaching a critical point in navigating its tenuous relationship with what is recognized as the analgesic of choice for many of its players.

"It's not, let's go smoke a joint," retired NFL defensive lineman Marvin Washington said. "It's, what if you could take something that helps you heal faster from a concussion, that prevents your equilibrium from being off for two weeks and your eyesight for being off for four weeks?"

NFL players using marijuana to treat their concussions is interesting to me. Apart from essentially being a concussion factory, the NFL is a billion-dollar industry and these players are multimillionaires, with all the greatest, most modern sports medicine facilities and staff at their disposal.

And they're using high-CBD marijuana to treat their head injuries?

 The doctor featured in the Hollywood film 'Concussion' is also an advocate for marijuana

The doctor featured in the Hollywood film 'Concussion' is also an advocate for marijuana

Since the NFL has rightly been under the concussion microscope lately, a lot of people have been weighing in with their thoughts. Preeminent Harvard psychiatrist Lester Grinspoon wrote an open letter to the NFL.

 Read Harvard's Lester Grinspoon's full open letter

Read Harvard's Lester Grinspoon's full open letter

Here's an excerpt:

I think you, and the NFL, must go beyond simply following the medicine, and help lead the way by directly funding research to determine if cannabis—including preparations with no psychoactive effects, such as those with a high-cannabidiol (CBD) to tetrahydrocannabinol (THC) ratio—can indeed provide significant protection against the damage of repetitive concussions.

Already, many doctors and researchers believe that marijuana has incredibly powerful neuroprotective properties, an understanding based on both laboratory and clinical data.

Others also believe marijuana has incredibly powerful neuroprotective qualities. Below is a gallery showing a few more entities that believe in cannabinoids as neuroprotectants. GW Pharma (which trades on NASDAQ) and the U.S. Government registered their patents years ago. Dutch Gold developed specific protocols for concussed athletes using CBD.

Here is the key text from the U.S. Government patent:

The cannabinoids are found to have particular application as neuroprotectants, for example in limiting neurological damage following ischemic insults, such as stroke and trauma, or in the treatment of neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease and HIV dementia. Nonpsychoactive cannabinoids, such as cannabidiol, are particularly advantageous to use because they avoid toxicity that is encountered with psychoactive cannabinoids at high doses useful in the method of the present invention.

At the other end of the spectrum, here are just a few regular folks who found marijuana helpful for their concussions.

Here's an excerpt from Kate's blog:

The results have been fantastic. I would never have imagined that I would find relief in such an odd place. For the first time in almost 5 years, I'm sleeping well and mostly through the night. I even had a couple dreams here and there! Imagine, not dreaming for 5 years and never feeling rested. Either the sleep or the marijuana gives me positive results during the day too. My headache is dulled, my nausea is way reduced. I feel steadier and much more relaxed and rested. I don't have that jittery, restless feeling that I've been plagued with. My brain isn't so overworked and I can focus on the things that I'm trying to focus on.

So it seems that there's all sorts of people who are using high-CBD marijuana to treat concussions, from millionaire professional athletes to regular folks. Why is marijuana proving to be effective for these people? Why are all these companies and the U.S. Government registering cannabinoid patents? Maybe the answer lies in something I've barely even touched on yet–the science. 

While there have not been a lot of large clinical trials conducted–extremely expensive studies that only large corporations can afford to fund, and the only way that drugs can get approval–there have been lots of pre-clinical laboratory studies. In fact, I was completely overwhelmed by the amount of them. Even on a specific topic like brain injury, there are way more than I ever would have guessed. And thanks to Google Scholar, they're extremely easy to find. I can't show you them all, so let's take a look at–

The Top Ten Studies Saying Cannabinoids Are Good For Brain Injury

10.

Cannabidiol and Delta9-tetrahydrocannabinol Are Neuroprotective Antioxidants

From the Laboratory of Cellular and Molecular Regulation, National Institutes Of Mental Health, Bethesda, Maryland.

How's that for starting with a bang? CBD and THC are neuroprotective antioxidants?! Here's an excerpt:

Cannabidiol was more protective against glutamate neurotoxicity than either ascorbate or alpha-tocopherol, indicating it to be a potent antioxidant. These data also suggest that the naturally occurring, nonpsychotropic cannabinoid, cannabidiol, may be a potentially useful therapeutic agent for the treatment of oxidative neurological disorders such as cerebral ischemia.


9.

Cannabinoid Agonist Rescues Learning And Memory After Traumatic Brain Injury(TBI)

From Alberta Children's Hospital Research Institute, University of Calgary, Alberta

I wanted to start with a few simple catchy titles. THC is an example of a cannabinoid agonist. Here's an excerpt:

We speculate that for this current study, the cannabinoid agonist treatment may have preserved learning and memory in the TBI-treated animals by protecting the intact brain tissue that was not directly damaged by the primary injury, and that the “rescued” brain areas were then able to compensate for the lesioned areas. Alternatively, and/or in parallel, the cannabinoid receptor agonist treatment could also have limited cerebral edema and neuronal cell loss diffuse axonal damage, decreased pathological neuroinflammatory processes, or modulated metabolic processes that preserved neuronal tissues or functions.

Complicated stuff! These are biochemists, testing how specific brain receptors respond to specific chemical compounds. 

There are no questionnaires here!


8.

Endocannabinoids and Traumatic Brain Injury

From the Institute for Drug Research, Faculty of Medicine, The Hebrew University of Jerusalem, Israel

Once enough studies have been done, someone will do a summary study, summing up some of the existing studies. This one from 2011 focuses specifically on traumatic brain injury. In sections with titles such as "eCBs (endocannabinoids) as neuroprotectants in TBI – are they a ‘magic bullet’?" and "eCBs in neurogenesis," and "Is the eCB system a potential 'self-neuroprotective' entity?" the study examines in greater detail the previous research, referencing over a hundred other studies. 

Here's an excerpt:

The observation of these multifactorial events along with the pharmacological profile of the eCBs described above, led over the last decade to investigations, by us and others, of the neuroprotectant role of the eCB system after TBI (traumatic brain injury).


7.

Cannabinoids As Novel Anti-Inflammatory Drugs

From the Department of Pathology, Microbiology and Immunology, University of South Carolina

It turns out that cannabinoids are exceptional anti-inflammatory agents. This is another one of those summary studies linking to 130 other studies on the topic.

If you're surprised by all of the research saying cannabinoids are good for you, perhaps you have not heard of the endocannabinoid system. I certainly hadn't, and neither had any of my doctors. I don't know why this part of human biology is such a mystery, but an understanding of it is pretty crucial, so we need to take a little detour here.

I have to admit it feels weird to be introducing a major biological system to anybody. I'm not a doctor! How did it come to this? Maybe you don't want to hear about a major biological system from a handyman from Canada. I'd feel more comfortable presenting a couple more reputable sources to introduce you to the topic, such as this article from National Geographic, one of the best overviews of marijuana that I've come across. As well, this article from the New York Times discusses the endocannabinoid system using a recently discovered genetic connection between cannabinoids and anxiety. 

The endocannabinoid system is part of the central nervous system, and there are endocannabinoid receptors all throughout our body, though the majority of them are in the gut and the brain. To illustrate how involved this system is in our bodies, and the amount of research that has been done, I might refer you this summary study called The Endocannabinoid System as an Emerging Target of Pharmacotherapy. It contains over 1300 links to medical studies done in 9 main categories: diseases of energy metabolism, pain and inflammation, central nervous system disorders, cardiovascular and respiratory diseases, eye disorders, cancer, gastrointestinal disorders, musculoskeletal disorders, and reproductive functions.

It might be more appropriate to ask what isn't it involved in? Here's how Dr. Raphael Mechoulam (professor of Medicinal Chemistry at Hebrew University) describes it:

The endocannabinoid system acts essentially in just about every physiological system that people have looked into, so it appears to be a very central system. Actually, the cannabinoid receptors are found in higher concentrations than any other receptor in the brain, and they are found in very specific areas. They are not found all over, but rather in those places that one would expect them to be—such as areas that have to do with the coordination of movement, emotions, memory, reduction of pain, reward systems, and reproduction. So, I believe that this is a very central and essential system that works together and communicates with many other systems.

The only thing that can activate cannabinoid receptors are cannabinoids, be they those our body produces, those from a plant, or synthetic ones we've made in the lab. Before continuing with the top-ten list, let's quickly look at some studies that reflect how fundamental this system is.

Let's start at the beginning. We know marijuana has been used by chemotherapy patients for decades to increase their appetite. Well, it turns out that cannabinoids are in mother's milk, and appears to be pretty central to the suckling response:

Here's an excerpt from "The Endocannabinoid Receptor System in Pre- and Postnatal Life."

Recent research suggests that the endogenous cannabinoids (“endocannabinoids”) and their cannabinoid receptors have a major influence during pre- and postnatal development. First, high levels of the endocannaboid anandamide and cannabinoid receptors are present in the preimplantation embryo and in the uterus

Moreover, it's been well established that exercise is healthy. Well, we make cannabinoids when we exercise:

How many studies have been done on the endocannabinoid system or cannabinoids? Over 33,000, suggests the CBC's Michael Enright in this interview, and his guest, Dr. Mark Ware, Director of Clinical Research at the Alan Edwards Pain Management Unit at the McGill University Health Clinic, does not disagree. It is also worth mentioning that Dr. Ware describes the discovery of the endocannabinoid system as, "one of the biggest discoveries in neuroscience in the last twenty years."

A Google Scholar search of cannabinoids actually turns up over 60,000 hits. It's hard to narrow down tens of thousands of studies to a dozen, but I've selected a little gallery that showcases the variety of research being done. To create this gallery, I entered the term "cannabinoid" followed by a dozen different ailments (i.e. pain, PTSD, arthritis etc.) into Google Scholar, and picked one with a nice clear title. Click on an image below, and toggle left or right:

The common refrain throughout these studies is "positive results / worth more research." For example, from the study on endometriosis above:

We conclude from our data that cannabinoid agonists represent a promising approach in the treatment of DIE (deep infiltrating endometriosis)

With all of these positive results, this is an area of growing interest and research. Even in the United States, where marijuana is still a schedule 1 drug (meaning the DEA says it "has no currently accepted medicinal use" and has a "high potential for abuse") research forges ahead. This article talks about how the University of Alabama has launched one of North America's largest cannabidiol studies (UPDATE: Since I started writing this article, the first results have been announced. Click below)


6.

06tau.png

Tau Protein After Delta-9-tetrahydrocannabinol in a Human Neuroblastoma Cell Line

From the Department of Anatomy, College Of Human Medicine, Michigan State University

You may have noticed that this is complicated stuff. These are 21st-century biochemists using the most modern techniques and equipment to test how these specific cannabinoid receptors respond to being tickled by the one thing that can stimulate them–cannabinoids, be they produced by the body, a plant, or synthetically.

I've shown you some flashy study titles that are clearly on topic, but #6 is an example of a study that might not be clearly related until we examine it a bit closer. What is Tau? Here’s an excerpt from a Newsweek article, titled “Tau Could Be the Key to Monitoring Brain Damage from Concussions”:

Scientists know this much about tau: It’s a kind of protein, and it should not be floating around loose in your head. In a complex neurological system often likened to a railroad, tau proteins serve as the “ties” between the “tracks.” Essentially, when everything’s as it should be, tau proteins are what keep the nerve cells in your brain together, helping various areas of the brain communicate. The more tau knocked loose in the first 12 hours after a head injury, researchers have reported, the more likely something called the Extended Glasgow Outcome Scale may eventually veer away from a score of 8 (good recovery) and toward a score of 2 (vegetative state) or perhaps even 1 (death).

So tau floating around in the brain is bad, and this brings us back to study #6, which states that THC delivered shortly after impact reduces tau levels:

After 48-hr treatment, THC (10(-9) M) decreased 50 kD tau protein in the cytoplasmic (supernatant) fraction, and in the membrane (pellet) fraction the drug (10(-7) M) also decreased 50 kD tau protein.


5.

CB2 Cannabinoid Receptors Promote Neural Progenitor Proliferation via mTORC1 Signaling

From the Department of Biochemistry and Molecular Biology, School of Biology, Complutense University, Madrid, Spain

This is another complicated study. Of course, I had no idea what a progenitor cell was, or why I might want them to proliferate, so I looked it up. Here's how Wikipedia describes them:

Progenitor cells are found in adult organisms and they act as a repair system for the body. They replenish special cells, but also maintain the blood, skin and intestinal tissues.

It is not necessary to have a deep understanding of all the chemistry to see that these biochemists are describing positive benefits of cannabinoids, and the endocannabinoid system. 


4.

Effect of Marijuana Use on Outcomes in Traumatic Brain Injury

From The Harbor-UCLA Medical Center, Torrance, California

 

This study suggests that marijuana use aids in recovery from traumatic brain injury.

Why is it that this part of human biology remains so mysterious? Clearly the endocannabinoid system needs a better publicist. Who is going to go out and promote these studies?

Marijuana does not have the support of a pharmaceutical corporation behind it. The researchers behind this study spoke to Reuters:

Here's an excerpt:

“This data fits with previous data showing that (THC) may be neuroprotective,” Dr. David Plurad, one of the study's authors, said in a phone interview.

Experiments in animals have found that THC may protect the brain after injury, Plurad and his colleagues write in The American Surgeon. 

An article reporting on these studies might pop up briefly on ReutersThe Huffington Post, Men's World, or Time. But what happens then? Some pro-marijuana websites might try to promote them, but it's often easy to turn a deaf ear to these sites. The larger question is why don't my doctors know about the endocannabinoid system? Why, when I go to the library to investigate this fundamental biological system, do I encounter nothing but a bunch of confused librarians? Are the textbooks in my library that make no mention of this fundamental system the same ones that are being read at medical schools? Is that why one of my doctors reacted as though I had pulled out a bong when I asked her about it?

Does your doctor have an understanding of the endocannabinoid system?


3.

Cannabinoids Promote Embryonic and Adult Hippocampus Neurogenesis and Produce Anxiolytic and Antidepressant-like Effects

From the Neuropsychiatry Research Unit, Department of Psychiatry, University of Sasketchewan, The Department of Neurology, Xijing Hospital, China and The Department of Biomedical Sciences, University of Maryland, Baltimore

An Anxiolytic means it reduces anxiety, which is a common problem for people with brain injuries.

Here's an excerpt from this study:

In summary, since adult hippocampal neurogenesis is suppressed following chronic administration of opiates, alcohol, nicotine, and cocaine, the present study suggests that cannabinoids are the only illicit drug that can promote adult hippocampal neurogenesis following chronic administration.

Over and over, researchers have found the benefits of cannabinoids.

You'll notice that this study is a joint project between China, the United States, and Canada. Isn't that kind of nice? All these researchers united in their pro-cannabinoid voices, echoing all the other studies I've shown you here from Spain, and Israel, and all the other ones we haven't looked at. What is going on here? Are all these researchers just big Cheech and Chong fans, or is the endocannabinoid system simply the "central and essential system" that Dr. Mechoulam describes?

Marijuana was among the first, if not the first, plant harvested by humans, and it is well documented that humans have used marijuana as a medicine for millennia. Thousands of years ago legendary Chinese Herbalist Red Emporer Shen Nung was prescribing marijuana for many different ailments, from menstrual problems to gout, from rheumatism to senility. Could it be that now modern science is showing us precisely why people have been using marijuana as a medicine for so long?


2.

An Endogenous Cannabinoid (2-AG) Is Neuroprotective after Brain Injury

From the Department of Pharmacology, Medical Faculty, Hebrew University, Jerusalem, Israel

Though marijuana is illegal in Israel, the country has had a robust medical marijuana program since the 1990s, and it has emerged as a frontrunner in research and innovation. The program has over 20,000 patients, and this article from the Jerusalem Post breaks down a study on the program's effectiveness:

It says:

Most of the users reported in later interview that their pain, nausea, anxiety, appetite and general feeling had improved. Fewer then 1 in 10 stopped taking the drug after the first interview.

That is an impressive statistic! The study suggests that one of the reasons these patients prefer marijuana to their previous medications is because the side effects are much more mild. Compared to the gut-churning side-effects (literally) of other medications, the side-effects of marijuana, which include "dry mouth," "hunger," "fatigue," and "red eyes,"seem rather quaint. In this interview, "Israelis Are Eager to Share Their Expertise with a World That Has Been Slow to Legalize the Medical Use of Marijuana", Dr. Ruth Gallily, professor emeritus in immunology at the Hebrew University of Jerusalem, discusses how Cannabidiol's safety and lack of embrace by the broader medical community keeps her up at night. 

  "Cannabidiol is extremely non-toxic and it can be used very safely in order to improve disease symptoms," says Dr. Ruth Gallily. "If it's non-toxic and can improve (health), why not use it?"

"Cannabidiol is extremely non-toxic and it can be used very safely in order to improve disease symptoms," says Dr. Ruth Gallily. "If it's non-toxic and can improve (health), why not use it?"

All of this research and years of medical care have lead to many innovations. For example, an Israeli company was behind the research for these slow-release cannabinoid capsules:

israel-caps2.jpg

Indeed, all sorts of new ways of ingesting cannabinoids are being developed. GW Pharmaceuticals has developed Sativex, a spray:

Here's a small gallery showing a few more ways of getting cannabinoids into your bloodstream (with a few surprises in there!):

As we learn more, more specific protocols are being developed. It is amazing to see these studies are leading to different treatments. Let's look at a few of the studies on Glioblastoma, a rare and difficult-to-treat form of brain cancer, for example. Through studies like the following, we can see the evolution of sciences understanding of how cannabinoids are able to stop bad cells (i.e. cancerous or endometrial) from proliferating.

One can only assume that it was these types of studies above, that has lead to this–FDA approval for CBD treatment for glioblastoma! Great news! Why is it that this fact has never come up in the many articles regarding marijuana I have read? The gallery below shows three different organizations that got FDA approval to study Cannabidiol.

While we have seen already that certain organizations have developed concussion CBD protocol, as more research is done, specific protocols for those with brain injuries will almost certainly become more common.


1. 

Cannabinoids and Brain Injury: Therapeutic Implications

From Department of Pharmacology, Medical Faculty, Hebrew University, Jerusalem, Israel.

So here we are at #1. I have to admit that it might seem a little anti-climactic. There are no new revelations exactly in this study (at least, from the sections I'm able to comprehend)–it's just more of the same–"neuroprotective," etc., summarizing all the complex biochemistry it contains with this simple declaration:

We expect that within the next few years these mechanisms will be clarified and cannabinoid-based drugs for brain trauma will be introduced in the clinic.

I began this quest by looking into the background of an anti-marijuana study, questioning who was presenting this information, so it seems only fair that I do the same with these, let's call them "pro-marijuana" studies.

Here's some information regarding the education of Dr Raphael Mechoulam: He received his M.Sc. in biochemistry from the Hebrew University of Jerusalem (1952), and his Ph.D. at the Weizmann Institute, Reḥovot (1958), with a thesis on the chemistry of steroids. After postdoctoral studies at the Rockefeller Institute, New York (1959–60), he was on the scientific staff of the Weizmann Institute (1960–65), before moving to the Hebrew University of Jerusalem, where he became professor (1972) and Lionel Jacobson Professor of Medicinal Chemistry from 1975. He was rector (1979–82) and pro-rector (1983–85). In 1994 he was elected a member of the Israel Academy of Sciences.

  Dr. Mechoulam receives one of his many honorary degrees, this one from Complutense University in Madrid

Dr. Mechoulam receives one of his many honorary degrees, this one from Complutense University in Madrid

The list of honors from his biography is too long to fit here, so I'll just highlight a couple. He was among the first recipients of the European College of Neuropsychopharmacology Lifetime Achievement Award, and the National Institute on Drug Abuse presented him with the NIDA Discovery Award from the National Institutes of Health.

Google Scholar creates profiles for researchers whose names come up a lot. Dr. Shetty didn't have a page, but Mechoulam sure does. This screen grab from Dr. Mechoulam's google scholar page shows that his papers have been cited in other studies a whopping 39,416 times (and counting. NOTE: As I have been writing this article, this number has passed the 40,000 mark (now 43,000!). That is a lot. In fact, it is an incredible amount. As I said earlier, this is an area of growing interest.

 
 

Also note his h-index, which "estimates that after 20 years a 'successful scientist' will have an h-index of 20, an 'outstanding scientist' an h-index of 40, and a 'truly unique' individual an h-index of 60."

All the honours, citations and references are because Dr. Mechoulam has made several discoveries that have furthered our understanding of the world, as summarized in this article from businesswire.com:

In 1963 he elucidated the structure of cannabidiol (CBD), one of the most medically relevant compounds found in cannabis. Shortly thereafter, he isolated and elucidated the structure of the active component of cannabis, tetrahydrocannabinol (THC) in 1964. Almost 3 decades later, in 1992 and 1995, he isolated and identified the endogenous cannabinoids, anandamide and 2-AG, which together with specific receptors form the endocannabinoid system–a major endogenous biochemical system found in the brain and periphery that is involved in a wide range of physiological functions.

Professor Mechoulam is among the most honored and cited chemists living and working today and he believes cannabinoids will be used to treat brain injuries.

He is not alone. In this interesting article, Professor Mechoulam discusses how several major pharmaceutical companies already have marijuana programs:

Actually, most of the major U.S. companies have cannabinoid programs. I know that Smith, Kline & Beecham has one, and so does Pfizer and Merck. So, possibly the other companies are actually waiting for people to come on the market, so they won't be the first ones.

Everybody seems to agree on the benefits of cannabinoids, so what is delaying progress? Where are the large-scale clinical trials that could prove once and for all if marijuana is effective medicine? Here's a quote from the nasdaq.com article in the gallery below:

But for right now, Big Pharma appears to be throwing up roadblocks to stymie or delay development of prescription cannabinoid (CBD) medicines. It's not difficult to figure out why: to protect product franchises that could be cannibalized by marijuana-based medicines that might work better–and with fewer side effects–and not be addicting.

It seems like a funny system. The pharmaceutical companies on one hand delay and obstruct research regarding cannabinoids, and on the other hand are well prepared for its inevitable legality. And meanwhile, one department of the U.S. Government deems it a highly addictive drug with no medical benefits, and another acquires a patent for its use as a medicine, and yet another grants it legal status as a drug.

What really is striking, though, is the consensus. It really seems like everybody who looks into it is in agreement, from the doctors who research it, to the elite millionaire athletes who prefer it as a medicine, to the corporations who are just biding their time, to people who are uprooting their lives to live in states where it is legal, to the companies applying to the FDA for drug approval, and the FDA who approves it. For those currently unconvinced, I suspect when cannabinoids are inevitably legalized, Big Pharma will be there to tell you all about it. In fact, one can't help but wonder if marijuana was a compound that the pharmaceuticals could patent and make lots of money from, would it have gone through large clinical trials necessary for approval long ago?

Which brings us back to Dr. Shetty's study. Remember that one? The 45-questionnaire study by the GE-NFL funded scientist that sent me off looking at all this stuff? Well, as I sat with all these studies a bit, working on this article, I noticed another unusual thing about it, something that seemingly makes it unique from all the rest–it keeps changing.

Now don't get me wrong, while this is unique among what I looked at, it kind of makes sense. This is an ongoing study, which they update every once in a while. Great! More data! This is great timing for me. So, for the record, and the curious, but hardly essential viewing, here is a gallery of five vaguely differently worded abstracts of the same study, the latest updated in April 2016:

There are some funny little differences, but we only need to focus on one.

Remember that bold pronouncement that sent me on this information quest? That strong statement that "marijuana users had a far greater length of recovery time"?

Well, the newest version, makes no mention of marijuana. It has been eliminated as a line of questioning. I guess the questionnaire has been shortened–no more data on alcohol, cigarettes or marijuana. If you look at the updated study, you can't help but get the feeling that there isn't much to it. What is its purpose, I wonder?

But this is a study led by a doctor who was hand-picked by billion-dollar corporations, who felt that she was the researcher who should be funded to help find treatment for athletes' brain injuries.

Thanks to Google Scholar we can try to find out exactly what caught the eye of GE and the NFL as they searched desperately for a cure. Here's a gallery of all of the papers that Dr. Shetty was lead author of (that I could find, anyway), up to and including 2014, well after her association with the NFL began. Was it one of these that got them thinking that Dr. Shetty was the one to find a cure for the head trauma that is destroying the lives of NFL players, not to mention the public at large?

Anyway, when I said the study Brunch Doctor referred me to doesn't exist anymore, that is not quite right. Anyone who does a simple Google Scholar search for "marijuana concussions," as Brunch Doctor did, will be directed to earlier versions of the study that include marijuana as a "barrier to recovery" that live on, online. Look:

I can't help but feel a bit sorry for any doctor, or anyone one else, who searches for the terms "marijuana concussion," and doesn't dig any deeper. They will never learn of the work of Dr. Mechoulam, but instead are exposed to the no longer existent work of Dr. Shetty. 

Conclusion

  NFL Commissioner Roger Goodell (left) and GE CEO Jeff Immelt announce the winners of the $20 million "Head Health Challenge."

NFL Commissioner Roger Goodell (left) and GE CEO Jeff Immelt announce the winners of the $20 million "Head Health Challenge."

In 2014, NFL commissioner Goodell stood on stage next to General Electric CEO Jeffrey Immelt, and said: “We will follow medicine and if they determine (marijuana) could be a proper usage in any context, we will consider that. Our medical experts are not saying that right now.” 

One can't help but wonder if he was referring to the peculiar, shape-shifting study by Dr. Shetty. If not, what studies is he looking at, I wonder? I myself chose to follow the medicine of Professor Mechoulam and all those many other researchers from around the world whose papers I reference above. It seems clear that whether they come from some vigorous exercise, mother's milk, or from the marijuana plant, cannabinoids do many good in things in the body. 

With so much interest and research and data, and more varied methods of ingestion, specific protocol for brain injury and other ailments are on the horizon, if they are not here already. 

I myself have been thankful for this gentle drug. Though perhaps not for everyone, it has helped me in some fundamental ways. People with brain injuries often get medication for three main reasons: anxiety, depression, and sleep. When the brain is on tilt, it is easy to get overwhelmed. My CBD marijuana has helped me relax, reducing my anxiety and allowing me to sleep. I know now that if I go out for an over-stimulating brunch, for example, I can count on my marijuana, along with some meditation, to help calm my frazzled mind.

 Tilray are the first licensed medical cannabis producer in North America to be GMP certified in accordance with the European Medicines Agency’s good manufacturing practice (GMP) standards

Tilray are the first licensed medical cannabis producer in North America to be GMP certified in accordance with the European Medicines Agency’s good manufacturing practice (GMP) standards

Learning about my endocannabinoid system has helped me in other ways. I now use a CBD topical balm on my stiff ankles and feet every morning. It has also made it more clear why exercise is so important. So I now try to, in the parlance of these cannabinoid researchers, "activate my endocannabinoid system" through daily exercise. 

And, of course, it would have been impossible to work on this article without it.

Oh, one last thing. This study is interesting. It has over 84,000 completed questionnaires. Now that's a lot of data!


John Rossiter is a handyman and occasional fact-checker from Canada

A Note From Andy's Shave: The views expressed herein are those of the author alone. Also, Andy's Shave (and John) would like to make clear that John is not a doctor (or writer, or researcher, for that matter), and you should not take any medical advice from him.

 The author, as drawn by his daughter

The author, as drawn by his daughter