OT - vaping - cbd's

[Ograx]

I’ve tried cbd to help with sleep and even at a higher dose I didn’t seem to get better or more sleep than normal. I’ve now been trying 300 mcg dose of melatonin which is either working awesomely or I have a nice placebo effect.

Just out of curiosity on the CBD did you try the oil or the water soluble? Did you vape it or was it tincture?

It was oil. I took it as drops. I'm in Canada so its easy to get and legal.

[babydinosnoreless]

I’ve tried cbd to help with sleep and even at a higher dose I didn’t seem to get better or more sleep than normal. I’ve now been trying 300 mcg dose of melatonin which is either working awesomely or I have a nice placebo effect.

Just out of curiosity on the CBD did you try the oil or the water soluble? Did you vape it or was it tincture?

It was oil. I took it as drops. I'm in Canada so its easy to get and legal.

Thanks. So many ways to take and it seems like everyone has a different experience.

[TropicalDiver]

I live in a state where everything is legal -- including both medical and recreational cannabis. So tons of choices around ratios (THC and CBD), delivery methods, and even extraction methods.

My rule of thumb: Look for potential bad things first.

Interactions
Because of how CBT (and THC) are processed, it can essentially occupy certain enzymes for a period of time. In some cases, that means the effective dosage for a given medication may be greater if you are using CBD than if you are not (additional research term: first pass effect). If the medication has a narrow therapeutic range, and the consequences of too high a level are bad, this would give me concern.

In many cases, this is not a big deal. There is no impact on the other medication, or the consequences of an elevated level are trivial. But take something like Xarelto -- the goal is to have enough of an anticoag effect to avoid clotting but not so much that you start bleeding. There are no real studies on this pairing so the medical advice I got was to avoid it as we do know they are processed by the same family of enzymes. (Retail pharmacist, compounding pharmacist, primary care -- all had the same advice and the same reasoning -- do not mix the two).

Delivery and Dosing
I want a delivery mechanism that avoids potential impacts (as much as possible). For me, that leaves out vaping and smoking. There is enough known about vaping to give me pause -- if there are other alternatives. And there are. Tinctures (sublingual) become a good option as do capsules (both systemic) and topical ointments (local?).

To be able to determine efficacy, I need to be able to develop a consistent dose that I can replicate.

There is some evidence that CBD is more impactful with some level of THC. But nobody knows how much. 20:1 (CBD being larger)? 10:1? 1:1? And in some states all that is available is stuff that has no THC content. The other thing is who (if anyone) is testing the strength of what you buy?

If I were doing this (and I am not saying what you should do), I would start with a small but known volume (and strength) of a good quality tincture. Either all CBD or 20:1. And see if it has an impact -- and then start adjusting. (Locally the best ones seem to have vegetable oil bases). But, your body and your choice.

Other
The research out there is mostly observational (and not all that much of that even). So it is a bit of the wild west. My personal guess is that CBD will turn out to be valuable for certain conditions in certain patients -- but who really knows.

But every other medication to deal with inflammation, mild pain, and the like has real downside risks. I am not health care provider -- as always you should consult your doctor and pharmacist about your particular case.

[palerider]

posted today: https://arstechnica.com/science/2019/08 ... c-says/#p3

[TropicalDiver]

I made some claims in the CPAP therapy and was asked to support my claims.

First, a hearty congrats for you -- however you did it. While it is an important feat, it is not an easy one! I hope others take encouragement in your story.

There is a natural and unavoidable regulatory tension between facilitating vaping access for cessation purposes and limiting vaping access for youth and teens. So, lets talk cessation.

We know that for those who are doing a more DIY attempt at cessation, the results using vape is better than other types of nicotine replacement therapy (NRT). At the end of one year, a quit rate of around 18% (vape) vs about 10% (other NRT). OTOH, the vape group is more likely to continue using vape than the other group is to use NRT.

But we also know that other approaches (typically involving both cognitive behavioral therapy and meds such as Chantix) can achieve quit rates well above either vaping or other NRT. So, pretty hard to say that vape is the most effective tool. OTOH, it is the most effective tool if you are not using options that require direct medical oversight.

Finally, harm reduction. There are at least two ways to think of this: group and individual. If you offer a group of 100 current smokers vaping, what is their longer term mortality and morbidity compared to a similar group of smokers that you offered NRT only? Because so many will continue to smoke in each group, there is no way you the control group will be worse by 100 times; they will be worse -- but by something less than double.

But to do a true harm reduction analysis for an individual who quits using vape, we would need to know the real risk of the tobacco control group plus the real risk of the vape group. And we simply don't know enough about vaping to know how those risks stack up. Yes, they are less than the smoking group. But how much less?

Is the heart attack (or stroke, or COPD, or lung cancer) risk for a person who smokes 100 times what it is for someone who vapes? That also seems very unlikely. Even if I use the figures you cite -- 95% (the report links back to another report which says that is a good way to communicate with patients) -- that would be a twenty-fold reduction in the relative risk from smoking vs the relative risk from vaping (a third way of thinking about harm reduction). Not 100 fold.

I agree with much of what you say but still think there is much unknown on the health impacts of vaping. And, again,congrats. I hope your story helps some here.

[Arlene1963]

posted today: https://arstechnica.com/science/2019/08 ... c-says/#p3

Thanks for that link, Palerider.

This is certainly alarming and I hope the CDC can quickly figure out what is suddenly causing this spike in serious respiratory illness in young adults who are vaping.
It is interesting that in all these years of vaping being around this is now happening in such a short time frame to this particular age group.
Here in Canada by comparison since 2015 only 14 adverse health reports related to vaping or e-cigs have been reported according to Health
Canada.https://globalnews.ca/news/5806783/resp ... th-health/

So yes, what exactly is going on?

[palerider]

It is interesting that in all these years of vaping being around this is now happening in such a short time frame to this particular age group.

That's not necessarily true.

What is possible is that problems people have been having are just now being recognized as being connected to vaping, and being reported, which is what happens anytime something new is identified.

Or not... that's just a possibility to consider.

[Dog Slobber]

posted today: https://arstechnica.com/science/2019/08 ... c-says/#p3

The recent outbreak of severe lung disease has been attributed to vaping and there are claims that the only common element is vaping. However there is problems with this conclusion:

Had the cause truly been vaping then this is what we would expect to see:
Cases reported would be a cross section of those who vape, young and old. This is impacting young people.
There would be trends that reflect length of use and heavy uses. There's not. It's a relatively new phenomenon.
The trends would not be localized and likely matching populations.

Instead, we are seeing a new, localized and clustered problem. Many of the articles mentioned THC, but a lot do not. There is a relatively new method of inhaling THC called dabbing that causes the exact same lung disease.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327978/

Vaping is the perfect vehicle for dabbing.

Dabbing also explains the clustering, recent outbursts, the fact that it is illegal explains why THC hasn't been connected to all the cases. Young people lie to the parents and doctors about illegal drug use.

https://www.usatoday.com/story/news/nat ... 081792001/

Here's a father who didn't know his son vaped. Vaping was attributed as the cause. When the content of his vaping gear was tested THC was detected.

• "Mojica said he had no idea that his son vaped, but he later found out that his son had begun vaping with friends a couple years ago, usually at parties. With steroids and aggressive management, doctors were able to save his life.
  
  “He nearly died on us that night. It was a horrible, horrible night," Mojica said. “If we could educate just one person to the dangers of vaping – or of smoking in general – and save a family from going through what we went through, that would be worth it.”
  
  When Pirzada sent out the patient's vape cartridge for testing, it came back with traces of THC, suggesting he had been vaping cannabis oil, a practice known as dabbing."

I expect that dabbing, the unsanitary street cartridges and juice containing THC and other unknown elements to eventually be the definitive cause, but vaping will continue to reported as the cause.

Anti-vaping articles has been click-bait for years.

[gv280z]

For the purpose of nighttime relaxation and drifting off to Lala Land on a nice fluffy cloud, I used to take Valerian Root. It has similar effect to Melatonin but a bit quicker and little more potent. I didn't upgrade or replace the VR with anything, and never felt like I needed it, just was kinda like drinking a glass of wine before bed.

[palerider]

Anti-vaping articles has been click-bait for years.

I thought that was relatively new... heck, vaping itself is relatively new.

I'm not arguing either way, just tossing new information into the information pot for others to consider.

[palerider]

For the purpose of nighttime relaxation and drifting off to Lala Land on a nice fluffy cloud, I used to take Valerian Root. It has similar effect to Melatonin but a bit quicker and little more potent. I didn't upgrade or replace the VR with anything, and never felt like I needed it, just was kinda like drinking a glass of wine before bed.

Relevance ?

[gv280z]

I thought this thread was asking about using cbd and vape together for the purpose of sleep aid. I'm aware that it's grown legs and gone into vaping in general and use to step down nicotine addiction, which was the original intent when E-Cigs 1st came out and then it became this whole other thing entirely for the cool kids to play with and all that.

[TropicalDiver]

The recent outbreak of severe lung disease has been attributed to vaping and there are claims that the only common element is vaping. However there is problems with this conclusion:

Had the cause truly been vaping then this is what we would expect to see:
Cases reported would be a cross section of those who vape, young and old. This is impacting young people.
There would be trends that reflect length of use and heavy uses. There's not. It's a relatively new phenomenon.
The trends would not be localized and likely matching populations.

IMHO, the only correct answer here is we don't understand the relationship. And I would suggest that your conclusions to the contrary likely suffer from confirmation bias.

Why might we see clustering of reporting within a younger group? Off the top of my head:
a) It could be medical -- for example the mortality rate during the flu pandemic was highest among the healthiest because of the immune reaction;
b) It could be reporting -- parents are more likely to drag their children off to the doctor than an adult might be inclined to visit a doctor;
c) Doctors might be more inclined to explore causation when the syndrome is unexplained and in children (versus an adult who says I got pneumonia);
d) Vaping could simply a proxy for some other (medically unrelated) risk behavior;
e) Perhaps this syndrome (if that what it turns out to be) happens more often in people who began with vaping rather than vaping after years of smoking;
f) Kids might be inclined to use different vaping delivery systems and products. This could be related to flavorings, who makes the product, extraction techniques, etc.

In terms of dabbing, hardly a new thing. And there are different methods of extraction (butane is rather dangerous while, IIRC, cold press CO2 requires expensive equipment). And not all vape oils would typically be viewed as high concentrate (which is a requirement to be dabbing). And concentrates and other oils are not illegal everywhere -- I live in a state (and you live in a country) with legal recreational. So, yes, there could be a link to using certain THC products. Or not. (See items a thru f above).

My view: While vaping is almost certainly less hazardous than cigarettes, that doesn't make it safe or benign. There is much research to be done to determine both the short and long term consequences of vaping. And up next in the marketplace is likely to be something called heated tobacco....

[Islandwoman]

Vaping is dumb if you have lungs. Why pay for air pollution.

[Dog Slobber]

IMHO, the only correct answer here is we don't understand the relationship. And I would suggest that your conclusions to the contrary likely suffer from confirmation bias.

Which is why my position has been you can't draw the conclusion that vaping is the cause. The media has concluded that the cause is vaping. I don't accept that conclusion, yet.

You seem to be accepting that the cause is vaping.

Respectfully, in the other topic an individual made some claims (rather absolute ones) about the dangers of vaping. Without out citing any sources.

I responded to those claims, I too didn't cite my sources. You gave the other individual a free pass, didn't ask them to provide any sources, but wanted me to support my claims.

I did.

Since then a few people have made claims about the dangers of vaping. But they're not being asked to support their claims.

Now we have a case where the overwhelming conclusion is an illness is caused by vaping. There are facts that are not explained by the evidence nor the conclusions. There is virtually no scrutiny being applied to the conclusion that vaping is the cause.

The overwhelming use of vaping is for non-cannabis use. Vaping as a delivery method for cannabis and substances is still small compared to nicotine.

Of the victims of this particular lung disease, THC users are vastly over-represented, those who haven't used THC are vastly under-represented.

THC dabbing better explains all the evidence thus far, but the overwhelming conclusion is vaping is the problem.