Daily Dose Q&A

2025-12-03

Multiple Sclerosis (MS) is a qualifying condition for participation in many state medical cannabis programs. What are the symptoms MS patients hope to treat by consuming cannabinoid-based products? What are the common side effects they encounter?

According to a survey of MS patients in Canada, self-medication with THC-containing cannabinoids appears to be widespread among patients with multiple sclerosis. Target symptoms typically include sleep disturbances, pain, and spasticity, with the most commonly reported side effects being drowsiness, emotional flattening, and difficulty concentrating.

Sanatarossa, So, Smyth, Gustavsen, Tsuyuki. Medical Cannabis Use in Canadians with Multiple Sclerosis. Multiple Sclerosis.Jan 27, 2022.

2025-12-02

Some patients with Parkinson's Disease (PD) consume cannabinoid-based products. What PD symptoms seem to be ameliorated by cannabinoids?

"The reported self-use of cannabinoids in patients with Parkinson's disease (PD) ranges from 8.3 to 37%. Cannabinoids are used to improve motor symptoms, such as tremor, bradykinesia, rigidity, levodopa-induced dyskinesia and freezing as well as non-motor symptoms such as pain, anxiety or sleep disorders. The inhalative use of THC-containing cannabinoids seems to be preferred by patients. In addition to improving symptoms, taking cannabinoids can also reduce the dosage of the prescribed anti-parkinsonian medication. However, many patients also stopped self-medication with cannabinoids due to ineffectiveness. Side effects include dry mouth, dizziness, and cognitive changes."

Hidding, U., Mainka, T. & Buhmann, C. Therapeutic use of medical Cannabis in neurological diseases: a clinical update. J Neural Transm(2023). https://doi.org/10.1007/s00702-023-02719-1

2025-12-01

Is cannabidiol (CBD) metabolized or excreted without being metabolized?

CBD is extensively metabolized in the liver by the cytochrome P450 enzymes CYP3A4 and CYP2C19. Of importance, approximately 60% of all prescribed medications are metabolized through CYP3A4, so there is a high potential for drug:drug interactions; drugs that induce or suppress CYP3A4 may affect the serum concentrations of CBD and CBD metabolites.

Balachandran P, Elsohly M, Hill KP. Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review. J Gen Intern Med . 2021 Jan 29; doi: 10.1007/s11606-020-06504-8. Epub ahead of print. PMID: 33515191.

2025-11-25

CBD oil products may be sold as full spectrum, broad spectrum, CBD isolate and whole plant CBD. What is the difference among the four types?

Full spectrum CBD extract contains CBD and other cannabinoids (including up to 0.3% THC), terpenes, and essential oils. Unlike full spectrum CBD, broad spectrum CBD does not contain THC, but it does contain the other components found in full spectrum CBD. CBD isolate is CBD in its molecular form, and is typically sold as 99+% pure. Whole plant CBD is similar to, but not the same as full spectrum CBD. Whole plant and full spectrum CBD contain a variety of cannabinoids; however, whole plant CBD will also contain fats, waxes, and other fibrous materials.

Norton M. To CBD or not to CBD?: What Pharmacists need to know. Pharmacy Today. AUG O1,2020; VOLUME 26, ISSUE 8: P41-55.

2025-11-24

Do oral mucosal spray cannabinoid-based medicines (CBMs) have the same bioavailability as ingested CBMs?

No. The administration of CBMs via oromucosal sprays (sublingual) avoids first-pass metabolism (although some of the product is swallowed) and therefore sublingual administration has a higher bioavailability than ingested formulations.

Current Psychiatry. 2021 May;20(5):21-23, 28-33 | doi:10.12788/cp.0121, and MD Raphael J. Leo Raymond M. St. Marie. "Cannabinoid-Based Medications for Pain." MDedge Psychiatry, 3 May 2021,