Insight’s from Healer’s November Webinar

On November 13, 2024, Dustin Sulak, DO, founder of Healer, a cannabis education and product resource, hosted a two-hour webinar discussing several recent research studies involving cannabis. As Dr. Sulak explained, the monthly webinars are designed to help attendees of all backgrounds stay up to date on clinically relevant studies and information published in scientific literature. This month’s webinar covered the effects of cannabis use during pregnancy, anxiety treated with CBD-dominant cannabis, cannabis tea, and PEA and melatonin for fibromyalgia.

The first part of the webinar covered several different studies, mostly focusing on cannabis use and pregnancy. Dr. Sulak discussed summaries from a 2017 report from the National Academies of Sciences, Engineering, and Medicine titled The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. The report’s conclusions addressed evidence of cannabis smoking and effects on the mother or the offspring, including anemia and lower birth weight, and also listed conditions that were not associated with cannabis use, including maternal diabetes. In summary, the report found limited evidence of direct harms to the mother from cannabis use during pregnancy, but acknowledged the need for more research, particularly studies that go beyond relying on self-reported cannabis use. Dr. Sulak noted, “At the time of this being published, just about all of the data about pregnancy and cannabis was dependent on maternal self-report. But the big problem with the quality of that data is it’s really just selecting for a subset of the cannabis users, the cannabis users that are willing to tell either a researcher or a medical professional that they’re using cannabis during pregnancy. And that could make a difference in the data.”

The first study discussed on cannabis use and pregnancy, Early Maternal Prenatal Cannabis Use and Child Developmental Delays, was published in October 2024 in JAMA Network Open. The study examined data from Kaiser Permanente Northern California from 2015 to 2019 from almost 120,000 pregnancies using screening questions and a urine toxicology test from, then later tracked diagnoses of speech and language disorders and global development delay up to 5.5 years. One finding Dr. Sulak noted was the discrepancies between self-reported data and the toxicology results, and the risk it poses for drawing inaccurate conclusions. The study found no association with maternal prenatal cannabis use and speech and language disorders in the offspring.

The next study, Maternal Prenatal Cannabis Use and Child Autism Spectrum Disorder, was published by the same authors and journal and used the same data set as the first study, but examined pregnancies and births from January 2011 to December 2019, and tracked autism diagnoses in the offspring up to age 12. From the study’s introduction, Dr. Sulak highlighted: “there’s growing perception that cannabis is a lower risk alternative to some prescription medications during pregnancy. There’s been survey studies of pregnant women who have indicated they think cannabis is safer than some pharmaceuticals. There’s also an association between maternal cannabis use and child autism spectrum disorders in one study. And then there’s three other studies that looked at it that did not find an association. So the preexisting data was a little mixed.” Ultimately, the study found no association with maternal prenatal cannabis use and autism.

The third study, Prenatal Cannabis Use and Offspring Attention Deficit Hyperactivity Disorder and Disruptive Behavior Disorders: A Retrospective Cohort Study, was published in October 2024 in Journal of Developmental & Behavioral Pediatrics. Similar to the first two studies in the webinar, this one was published by mostly the same authors and used the same data set to analyze data on diagnoses of attention deficit hyperactivity disorder (ADHD) and disruptive behavior disorders (DBD) up until age 11 from children born between 2011 and 2018 and. In this study, prenatal cannabis use was not associated with either ADHD or DBD.

In summarizing all three of these studies, Dr. Sulak stated: “Here we have huge cohorts, best quality data yet, but still not perfect data by far, but we see no association with ADHD, no association with disobedient disorder or autism spectrum disorder or developmental delay, speech disorder or motor delay. What we’re seeing is that some of the most dangerous outcomes for the offspring that people would be concerned about, and this puts us a little more at ease about them.” He also discussed reasons why a woman might use cannabis during a pregnancy, such as mitigating severe nausea or high levels of stress, plus what he suggests pregnant mothers should know on the potential risks and benefits of using cannabis. Dr. Sulak also briefly discussed findings from two studies on cannabis and lactation, specifically how much exposure to cannabinoids babies received from breast milk.

Next, Dr. Sulak discussed a study on cannabis and anxiety. Long-Term Treatment for Unspecified Anxiety Disorders with Cannabidiol: A Retrospective Case Series from Real-World Evidence in Colombia was published in September 2024 in Medical Cannabis and Cannabinoids. The study examined 24 patients at an integrative medicine clinic, who were given anxiety measures at baseline, after six months, and after 12 months, also with a CBD enriched sesame seed oil, twice daily, at 100 mg/ml CBD and 1.9 mg/ml THC. The doses were titrated based on therapeutic response. Dr. Sulak offered his interpretation of the results and adverse effects. “Here, 83% of people in this study were clinically relevant to baseline, and 30% or so clinically relevant after 12 months. The efficacy improved between six months and 12 months. That’s a pretty cool thing that I haven’t seen in another study with CBD and anxiety. Adverse effects were mild and transient.”

The fifth study, Tea Prepared from Dried Cannabis: What Do We Drink? was published in September 2024 in the Journal of Agricultural and Food Chemistry. Three types of cannabis flower were analyzed with 1g ground flower into 250 ml boiling water and boiled for an additional 10 minutes. The effect of an added 25 g of cream with 10% fat was also analyzed. The researchers analyzed 42 types of phytocannabinoids, 12 flavonoids, and more than 700 types of metabolites. Dr. Sulak discussed the significance of the genetics of the plants used in the study, and the results of the study, highlighting the increase in cannabinoid content – such as THCA – with the addition of cream, plus the potential therapeutic benefits of cannabis tea.

The final study, A Fixed Combination of Palmitoylethanolamide and Melatonin (PEATONIDE) for the Management of Pain, Sleep, and Disability in Patients with Fibromyalgia: A Pilot Study, focused on palmitoylethanolamide (PEA), which, as Dr. Sulak explained, is a an endocannabinoid that is available as a supplement and that works through the endocannabinoid system. “It’s not cannabis per se,” he added, “but we understand it because of cannabis, and it’s part of the bigger family of treatment options that interact with the endocannabinoid system.”

For the second hour of the webinar, attendees had the opportunity for a live Q&A session. Topics discussed included cannabis-based treatments for essential tremors and as a sleep aid.

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