Dr. Ethan Russo, MD, is a board-certified neurologist, psychopharmacology researcher, and Medical Director of PHYTECS, a biotechnology company researching and developing innovative approaches targeting the human endocannabinoid system. Previously, from 2003 to 2014, he served as Senior Medical Advisor and study physician to GW Pharmaceuticals for three Phase III clinical trials of Sativex! for alleviation of cancer pain unresponsive to optimized opioid treatment and studies of Epidiolex! for intractable epilepsy. He has held faculty appointments in Pharmaceutical Sciences at the University of Montana, in Medicine at the University of Washington, and a visiting Professor, Chinese Academy of Sciences. He is a past President of the International Cannabinoid Research Society and former Chairman of the International Association for Cannabinoid Medicines. He serves on the Scientific Advisory Board for the American Botanical Council. He is the author of numerous books, book chapters, and articles on Cannabis, ethnobotany, and herbal medicine. His research interests have included correlations of historical uses of Cannabis with modern pharmacological mechanisms, phytopharmaceutical treatment of migraine and chronic pain, and phytocannabinoid/terpenoid/serotonergic/vanilloid interactions.
Cannabis, or marijuana, has been used for centuries for both symptomatic and prophylactic treatment of migraine. It was highly esteemed as a headache remedy by the most prominent physicians of the age between 1874 and 1942, remaining part of the Western pharmacopoeia for this indication even into the mid-twentieth century. Current ethnobotanical and anecdotal references continue to refer to its efficacy for this malady, while biochemical studies of THC and anandamide have provided a scientific basis for such treatment. The author believes that controlled clinical trials of Cannabis in acute migraine treatment are warranted.
The Role of Cannabis and Cannabinoids in Pain Management (2001)- Pain management : a practical guide for clinicians
The herb cannabis is derived from the Old World species Cannabis sativa L. Cannabis indica and C. ruderalis may also merit species status. Cannabis has a history as an analgesic agent that spans at least 4000 years, including a century of usage in mainstream Western medicine. Qual- ity control issues, and ultimately political fiat eliminated this agent from the modern pharmacopoeia, but it is now resurgent. The reasons lie in the remarkable pharmacolog- ical properties of the herb and new scientific research that reveals the inextricable link that cannabinoids possess with our own internal biochemistry. In essence, the can- nabinoids form a system in parallel with that of the endog- enous opioids in modulating pain. More important, can- nabis and its endogenous and synthetic counterparts may be uniquely effective in pain syndromes in which opiates and other analgesics fail.
Chronic Cannabis Use (2002)
Description: Chronic Cannabis Use in the Compassionate Investigational New Drug Program: An Examination of Benefits and Adverse Effects of Legal Clinical Cannabis – Ethan B. Russo, M.D. et. al.
SUMMARY. Cannabis has an ancient tradition of usage as a medicine in obstetrics and gynecology. This study presents that history in the literature to the present era, compares it to current ethnobotanical, clinical and epide- miological reports, and examines it in light of modern developments in cannabinoid research.
Description: Cannabis has been employed in human medicine for more than 4000 years. In the last century, political prohibition led to its disappearance from the conventional pharmacopoeia, but this trend is reversing due to the broad acceptance and application of this forbidden medicine by patients with chronic and intractable disorders inadequately treated by available therapeutics. This study addresses the “road back” for cannabis medicines, and reacceptance as prescription products.
Can this Concept Explain Therapeutic Benefits of Cannabis in Migraine, Fibromyalgia, Irritable Bowel Syndrome and other Treatment-Resistant Conditions?
This study examines the current knowledge of physiological and clinical effects of tetrahydrocannabinol (THC) and cannabidiol (CBD) and presents a rationale for their combination in pharmaceutical preparations. Cannabinoid and vanilloid receptor effects as well as non-receptor mechanisms are explored, such as the capability of THC and CBD to act as anti-inflammatory substances independent of cyclo-oxygenase (COX) in
Description: Cannabis, Pain, and Sleep: Lessons from Therapeutic Clinical Trials of Sativex, a Cannabis-Based Medicine by Ethan B. Russo*a)b), Geoffrey W. Guya), and Philip J. Robsona) a) GW Pharmaceuticals, Porton Down Science Park, Salisbury, Wiltshire SP4OJQ, U.K. b) GW Pharmaceuticals, 20402 81st Avenue SW, Vashon, WA 98070, USA
Description: This study surveys the history of cannabis, its genetics and preparations. A review of cannabis usage in Ancient Egypt will serve as an archetype, while examining first mentions from various Old World cultures and their pertinence for contemporary scientific investigation.
Description: This article reviews recent research on cannabinoid analgesia via the endocannabinoid system and non-receptor mechanisms, as well as randomized clinical trials employing cannabinoids in pain treatment. Tetrahydrocannabinol (THC, Marinol®) and nabilone (Cesamet®) are currently approved in the United States and other countries, but not for pain indications. Other synthetic cannabinoids, such as ajulemic acid, are in development
Description: Phytochemical and genetic analyses of ancient cannabis from Central Asia
The Yanghai Tombs near Turpan, Xinjiang-Uighur Autonomous Region, China have recently been exca- vated to reveal the 2700-year-old grave of a Caucasoid shaman whose accoutrements included a large cache of cannabis, superbly preserved by climatic and burial conditions.
Tetrahydrocannabinol (THC) has been the primary focus of cannabis research since 1964, when Raphael Mechoulam isolated and synthesized it. More recently, the synergistic contributions of cannabidiol to cannabis pharmacology and analgesia have been scientifically demonstrated.
Role of Cannabinoids in Pain Management (2013)
• Cannabinoids are pharmacological agents of endog- enous (endocannabinoids), botanical (phytocan- nabinoids), or synthetic origin.
• Cannabinoids alleviate pain through a variety of receptor and non-receptor mechanisms including direct analgesic and anti-inflammatory effects, modulatory actions on neurotransmitters, and inter- actions with endogenous and administered opioids.
• Cannabinoid agents are currently available in various countries for pain treatment, and even cannabinoids of botanical origin may be approvable by FDA, although this is distinctly unlikely for smoked cannabis.
• An impressive body of literature supports cannabinoid analgesia, and recently, this has been supplemented by an increasing number of phase I–III clinical trials.
Although cannabis is primarily viewed by the public as a recreational drug or agent of abuse, its medical application spans recorded history.1,2 Evolution has yielded a cannabis plant that produces a family of some 100 chemicals called phytocannabinoids (“plant cannabinoids”), many of which have distinct and valuable therapeutic effects.3,4
The Cannabis sativa Versus Cannabis indica Debate (2016)
An Interview with Ethan Russo, MD
Cannabis and Cannabinoid Research (Dr. Daniele
Piomelli: CCR): I would like to start with a few questions that should not be too contentious. First off, what is the geographic origin of the Cannabis plant?
Dr. Russo: Cannabis originated in Central Asia and perhaps the Himalayan foothills. There are converging lines of evidence, including a center of biological diversity there, and biochemical data that support this. There is no trace of its presence in the Western Hemisphere before the 16th century
Cannabis Pharmacology: The Usual Suspects and a Few Promising Leads (2017)
Ethan B. Russo*,1, Jahan Marcu†
Mammals and plants are exposed to cannabinoids and related com- pounds that notably modulate their growth and physiology. The human spe- cies in the Old World grew up around the >70 million-year-old cannabis plant, giving us a natural affinity to cannabinoids (Clarke & Merlin, 2012). This plant has been documented as a provider of food, clothing, textiles, and medicine for millennia. For thousands of years, the plant has been associated with relieving symptoms of disease and has demonstrated numerous thera- peutic properties (Russo, 2007, 2011).
Cannabis consumers have always maintained that different types (strains, or chemical varieties, chemovars) produce distinct effects, whether this be with respect to their psychoac- tivity or to their therapeutic attributes. Strains are often designated as sativa, indica, or a hybrid. These labels are quite misleading as applied in the marketplace, however.
Cannabis has been employed medicinally throughout history, but its recent legal prohibition, biochemical complexity and variability, quality control issues, previous dearth of appropriately powered randomised con- trolled trials, and lack of pertinent education have conspired to leave clinicians in the dark as to how to advise patients pursuing such treatment. With the advent of pharmaceutical cannabis-based medicines (Sativex/na- biximols and Epidiolex), and liberalisation of access in certain nations, this ignorance of cannabis pharmacology and therapeutics has become untenable. In this article, the authors endeavour to present concise data on can- nabis pharmacology related to tetrahydrocannabinol (THC), cannabidiol (CBD) et al., methods of administration (smoking, vaporisation, oral), and dosing recommendations.
The topic of Cannabis curries controversy in every sphere of influence, whether politics,pharmacology, applied therapeutics or even botanical taxonomy. Debate as to the speciation of Cannabis, or a lack thereof, has swirled for more than 250 years. Because
all Cannabis types are eminently capable of cross-breeding to produce fertile progeny,it is unlikely that any clear winner will emerge between the “lumpers” vs. “splitters” in this taxonomical debate.
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