Getting More Bhang for Your Buck: Cannabis in India


3 minute read
Originally posted here: https://mcgill.ca/oss/article/health/getting-more-bhang-your-buck-cannabis-india

As of October 18th, 2019, edible (and drinkable) cannabis became legal in Canada. And yet, almost 5 months later, legal cannabis stores have remarkably little selection. The SQDC (Quebec’s cannabis retailer) only started stocking cannabis beverages one week ago and only offers three types of tea and one type of seltzer. All things considered, it doesn’t seem like drinkable cannabis will be replacing Canadian’s joints, oils, pills or vapes any time soon.

If we look elsewhere however, the story of cannabis drinks couldn’t be more different.

According to the 2017 World Drug Report from the United Nations Office on Drugs and Crime, two of the top 10 cities that consume the most cannabis in the world are in India: New Delhi and Mumbai. The trick here is that much of the cannabis consumed isn’t smoked, but rather drunk in a drink called “bhang”.

Bhang looks somewhat like a shamrock shake or a green smoothie, but tastes (I’m told) of spices and herbs like saffron, fennel, garam masala and more. Strictly speaking, the term bhang refers to a paste made by steeping finely ground cannabis leaves (not buds) in hot milk. This paste can then be eaten on its own or used to create drinks or snacks like pakoras. However, the most popular preparation by far involves adding more milk, rosewater, sugar, nuts and other ingredients to the paste to create a refreshingly cool drink. This drink is often referred to as bhang but is more correctly named according to what ingredients are used, as a bhang thandaibhang lassi or other.

Bhang is especially common during Hindu festivals, in particular Holi, the two-day Festival of Spring, which turns the streets into a sea of colour with coloured paint and water pistols. Cannabis has a rich history in sacred Hindu texts and is named as one of the five sacred plants in the Atharva Veda. The Hindu god Shiva has long been associated with cannabis, and is said to have used bhang for meditative and healing purposes, and is even known as the Lord of Bhang. Cannabis has been used in Ayurvedic medicine to treat conditions ranging from skin disorders to anxiety.

Despite India’s rich cannabis-history, marijuana is actually illegal in the country. Bhang manages to maintain its huge consumption rates due to a legal loophole. It is against Indian law to possess hashish and ganja, but not the leaves of the cannabis plant, which is what bhang is made from. Incidentally, despite its illegality, hashish (made from the resin of the cannabis plant and commonly mixed with tobacco before smoking) is much more popular in India than in North America, while marijuana (the dried buds of the cannabis plant) is much less popular.

Interestingly, cannabis of all preparations was legal in India until 1961, when the Single Convention on Narcotic Drugs moved cannabis to the hard drug category. Prior to this, cannabis consumption had been seen as an inherent part of the religious and social customs of India. Even the colonial British rulers concluded, after commissioning the Indian Hemp Drugs Commission Report of 1894, that “to forbid or even seriously to restrict the use of so gracious an herb as cannabis would cause widespread suffering and annoyance.”

Today any flowering top (called ganja) and separated resin (called charas) from the cannabis plant remains illegal in India, although that is clearly not limiting citizen’s ability to imbibe in THC and CBD. So long as only the leaves of the cannabis plant are consumed, Indians are within their legal rights. As to what happens to the flowering buds once the leaves are removed, well, perhaps I’ll save that for the Indian government to worry about.

Is hard water dangerous to drink?

3 minute read
Originally posted here: https://mcgill.ca/oss/article/health-you-asked/you-asked-hard-water-dangerous-drink

What is Hard Water?

Hard water is water containing high concentrations of dissolved minerals, usually calcium or magnesium carbonates (CaCO­or MgCO3), chlorides (CaCl2or MgCl2) or sulphates (CaSO4or MgSO4). The hardness of water depends on its source. Groundwater that has been in contact with porous rocks containing deposits of minerals like limestone or dolomite will be very hard, while water from glaciers or flowing through igneous rocks is much softer.

The hardness of water is determined by the milligrams of calcium carbonateper litre and is reported it in parts-per-million (ppm). In general, water with less than 60 ppm can be considered soft, water with 60-120 ppm moderately hard, and water with greater than 120 ppm hard. For reference, Montreal’s water is typically around 116 ppm, or moderately hard, and sea water’s hardness is approximately 6,630 ppm since it contains many dissolved salts (depending on the sea, of course).

Hard water can interfere with the action of soaps and detergents and can result in deposits of calcium carbonate, calcium sulphate and magnesium hydroxide (Mg(OH)2) inside pipes and boilers, causing lower water flows and making for less efficient heating. The ions in hard water can also corrode metal pipes through galvanic corrosion. Water softening filters can circumvent these problems through the use of ion-exchange resins that replace calcium and magnesium ions with sodium and potassium ions. But if one consumes water with higher-than-average concentrations of calcium and magnesium. Is that OK?

The Health Effects of Hard Water

Studies have generally found hard water to have positive effects on the health of its drinkers. Several studies have reported that calcium and magnesium in drinking water have a dose-dependent protective effect when it comes to cardiovascular disease. There is also some evidence that calcium and magnesium in drinking water may help protect against gastric, colon, rectal cancer, and pancreatic cancer, and that magnesium may help protect against esophageal and ovarian cancer. Hard water may also serve a protective role against atherosclerosis in children and teens.

Some studies have shown a relationship between the mineral content of water and eczema or dermatitis in children. However, a 2011 study from the University of Nottingham involving 336 children aged 6 months to 16 years with eczema put that relationship to the test. The researchers installed water softening units in half of the participants’ homes and monitored the children’s eczema over a period of 3 months. Using a standard scoring system, the group that received softened water showed a 20% improvement, while the group that continued with hard water showed a 22% improvement, making it unlikely that hard water is contributing to worsening eczema symptoms.

Likewise, while some studies have shown correlations between water hardness and kidney stone formation, the majority of studies have found no such relationship.

It is estimated that individuals living in hard water areas who drink 2 litres of water a day ingest about 52 mg of magnesium from their water. Considering the daily recommended intake of magnesium is 420 mg, water can account for about 12% of that.

Individuals with type 2 diabetes often experience hypomagnesemia (low magnesium) as insulin regulation requires magnesium to function. In these people, the extra intake of magnesium through drinking water could be beneficial. The heightened magnesium concentration in hard water can also benefit people experiencing chronic constipation, as magnesium salts act as laxatives. One study noted that vegetables cooked in hard water often show an increase in their calcium concentration, as opposed to the decrease seen when they’re cooked in soft water.

It is fairly difficult for humans with healthy kidneys to experience hypercalcemia (too much calcium), as any excess calcium is excreted through the kidneys. Similarly, hypermagnesemia is fairly rare, and usually just results in short episodes of diarrhea.

The Physical Effects of Hard Water

There are, however, some non-medical reasons hard water isn’t always preferable. Hard water can appear cloudy if the solubility of mineral salts is exceeded. Furthermore, if the calcium concentration surpasses 100 ppm, the water will taste “funny.” Neither of these presents a risk, but consumers prefer a “clean” appearance and taste.

Basically, while hard water can be hard on appliances and pipes, it is not hard on the body, and can actually give the daily intake of calcium and magnesium a nice little boost.

How Do You Like Your Salmon?

4 minute read
Originally posted here: https://mcgill.ca/oss/article/health-nutrition/how-do-you-your-salmon

If you’re not particularly salmon savvy you may be under the impression that “salmon” is an individual species of fish, like how a black bear is an individual species of bear. That, however, is not true of our fishy friends. In fact, there are two main divisions of salmon: Atlantic and Pacific.

Atlantic salmon are big fish found in the northern Atlantic Ocean weighing 8-12 pounds when fully grown. Their meat is known to taste very mild and is generally cheaper than other types of salmon, due to the fact that nearly all of the Atlantic salmon commercially available today is farmed.

Climate change, human colonization, habitat destruction, and overfishing have decimated the wild populations of Atlantic salmon that were once abundant throughout the northern Atlantic. Lake Ontario was once home to this fish, but by 1900 the population was completely extinct. While there are still wild Atlantic Salmon alive and swimming, their capture is strictly regulated, hence the need for fish farms to fill this void.

What about Pacific salmon? Well, its name is a misnomer, since there isn’t one species of fish called Pacific salmon, but rather seven different species of salmon who live in the pacific: Sockeye, Chinook, masu (found mainly near East Asia), pink, Coho and Chum. While the Pacific salmons have suffered population losses due to humans and climate change, their numbers haven’t been decimated to the extent of the Atlantic salmon, so, wild-caught Pacific salmons are still commercially available.

Chinook (also called King) salmon are the largest of the Pacific salmons, weighing between 20 and 135 pounds. They’re known for being fatty, making them of value to chefs, and also quite pricey, due to their general rarity amongst fish. If you’re after something a little cheaper but still fat-filled, the Coho might be for you. At roughly 20 pounds in size, it is often cooked whole. Your low-fat salmon options include the lesser-known Chum or pink salmons, both quite small and low in fat, as well as the well-known, medium-sized, and bright pink Sockeye.

Whichever type of salmon you choose to eat though, you’ll want to find out where it was caught and whether it was farm-raised or wild-caught. Not for culinary purposes, since at least one study found that farmed salmon was as acceptable to eaters as wild salmon, but rather for health ones.

Quite a few studies have examined the levels of contaminants like PCBs (polychlorinated biphenyls), PBDEs (polybrominated diphenylethers), PAHs (polycyclic aromatic hydrocarbons) and mercury, and the results have not been confidence inspiring.

2001 study found that farmed salmon showed higher levels of PCBs, PBDEs, DLCs (dioxin-like compounds) and other chlorine-containing pesticides that pose significant health risks to humans. Similarly, a 2004 study found high levels of organochlorine contaminants in farmed fish and found that farmed salmon originating in Europe had much higher contaminant concentrations than salmon originating in North America or Chile.

The contaminants seem to get into the salmon through their food. Commercially available salmon feeds are extremely high in contaminants like PCBs and PBDEs, likely due to being made from small fish who themselves harbour high concentrations of contamination.

Interestingly enough, mercury, the contaminant we are used to hearing about in fish, is not an issue for either wild or farmed salmon. One study found that there’s less mercury in B.C. raised salmon than other foods like eggs, honey or vegetables.

Several studies have found that as few as one meal per month of farmed Atlantic salmon can expose the eater to contaminant levels that exceed those set by governing bodies like the World Health Organization. To reach a similar level of contamination by eating wild-caught salmon alone would take more than 4-16 meals per month. You can see a representative chart of this data (based on the United States Environmental Protections Agency’s guidelines) below.

(source: http://www.ncbi.nlm.nih.gov/pubmed/14716013)

Fish farms can also have devastating environmental consequences due to antibiotic use, waste accumulation, disease spread, escaped fish and more. These effects are bad not only for the surrounding oceans but for the fish too. Infections like sea lice can cause fish extreme pain or even kill them, and the genetic disorders common in farmed fish like curved spines or malformed jaws can severely harm their welfare.

So, what does this all mean for those who feed on fish?

You should keep in mind the potential risks of eating farm-raised salmon while grocery shopping and remember that you can minimize your exposure to these contaminants by choosing salmon that is either wild-caught or farm-raised in North America whenever possible.

If you’re eating salmon mainly for the omega-3 fatty acids, I have some good news and some bad news. The good news is that there are several non-meat sources of omega-3s, such as flax, chia, and hemp seeds, flaxseed oil, and eggs. The bad news is that many of the supposed health benefits of omega-3s have been largely overblown. Our own Dr. Christopher Labos has writtenabout omega-3’s ineffectiveness in preventing cardiovascular events and quite a few Cochrane reviews have found no benefits from fish oil for many conditions including ulcerative colitisasthmaCrohn’s diseaseallergies in children and dementia.

Is Algaecal a Marine Mineral Miracle or Just Another Overhyped Health Product?

7 minute read
Originally posted here: https://mcgill.ca/oss/article/health-you-asked/algaecal-marine-mineral-miracle-or-just-another-overhyped-health-product-2

Every supplement makes flashy claims, but the ones made by AlgaeCal, that it is “the only calcium supplement that increases bone density” is particularly bold. You see, while every other calcium supplement currently on the market can, at best, decrease the rate of loss of bone density, AlgaeCal claims to be able to fully tip the scales in the other direction and make your bones denser with time. So, are the makers of AlgaeCal lying, or is it truly a miracle marine mineral? Does it represent a breakthrough in the way that we treat osteoporosis? Let’s look at the science.

Why do I care how dense my bones are?

Put simply, because bones that are less dense break more easily, and no one likes broken bones.

As we live our day-to-day lives our bones receive micro-damage. To combat this, our bones are in a constant state of remodelling. So constant in fact that up to 10% of our bones may be in the remodelling process at any one time. This remodelling has two main parts: bone resorption, and bone formation. Most of the time these two processes exist in equilibrium, but as we age this equilibrium can shift (for a wide variety of very complicated reasons). The result is osteoporosis. It affects roughly 10% of Canadians aged 40 or older and is characterized by weak and brittle bones that break in situations healthy bones would not, like when bending over to pick something up.

We can put a number on this loss of bone strength by looking at bone mineral (a calcium-containing compound that makes up 70% of the mass of a human bone called carbonated hydroxyapatite) since it is responsible for most of a bone’s strength. The bone mineral density (BMD) is a good predictor of fracture risks and can be easily and painlessly measured using a DEXA test.

As aside: What is a DEXA test?
DEXA stands for dual-energy X-ray absorptiometry, a non-invasive procedure that involves lying on a table for several minutes while two X-ray beams are aimed at your hip, spine, wrist or other bone. As for how this allows doctors to measure your BMD, I’ll let Osteoporosis Canada explain: “Think of the light shining through the curtains of your home on a sunny day. The amount of light that reaches your eye depends on the thickness of the curtains. If your curtains are very thick, very little sunlight passes through them. If, however, you replace them with a thinner fabric, the light coming through to you will increase substantially. Similarly, a bone densitometer uses a detector to measure the transmission of small amounts of X-rays (light) through your bones. The amount of light that passes through the bone is measured, thus providing a radiologist with a picture that indicates how dense (thick or thin) your bones are.”

How well do the existing calcium supplements work?

AlgaeCal costs more than 100 times as much as normal calcium supplements, so it must work much, much better right? Well, to answer that we first have to look at how well traditional calcium supplements work.

A 2007 meta-analysis published in The Lancet found, looked at both studies using fractures or BMD as their endpoint, and found that calcium supplementation was associated with a 12% risk reduction in all fracture types, and a 0.54% reduction in the rate of BMD loss in the hip and a 1.19% in the spine.

Basically, calcium supplements can help mitigate the decrease in BMD and increase in fracture risk that come with osteoporosis.

An aside: Why do we sometimes use fractures and sometimes use bone mineral density as our outcome?
The main negative outcome of osteoporosis is bone fractures. So, when we’re testing treatments for osteoporosis, we would ideally use fractures as our endpoint. Basically, that means that we would test if patients receiving a particular treatment suffer fewer fractures to see if that treatment works. This, however, can be difficult to do. If researchers run studies on osteoporosis treatments only lasting a few years, they may get artificially skewed numbers, as patients could experience no fractures during the study, but suffer one days after it ends, or they could experience two fractures during the study period but never another. Hypothetically, researchers could monitor osteoporotic patients from the time they’re diagnosed with osteoporosis to the time of their death, but the logistics of funding and operating an over-30-year-long study would be monumental. So, our options are to either run studies over only a few years using fractures as an endpoint but with a large number of participants to help account for the inconsistencies or to use bone mineral density as a surrogate clinical endpoint.

While some studies have found that calcium supplementation is not effective unless given with vitamin D, the Lancet meta-analysis found no statistical difference between the risk reductions offered by calcium alone versus calcium + vitamin D. Vitamin D only affected the fracture risk if the patient was deficient in it, and a similar effect was seen with calcium. Essentially, if you’re vitamin D or calcium deficient, it could be affecting your body’s ability to create new bones, but if you’re not, taking a vitamin D supplement likely won’t help you avoid broken bones, and taking calcium supplements will only help a bit.

How is AlgaeCal different from traditional calcium supplements?

What is it about AlgaeCal that allows it to do what other calcium supplements cannot? Well, what is AlgaeCal?

As you may have gathered from the name, AlgaeCal is made from algae. Specifically, a red algae found in the waters near Brazil, South Africa and New South Wales in Australia. The AlgaeCal website explains that the balls of algae are harvested by hand, sun-dried and then milled into a powder. It states that it is “pure whole food,” even though it is very literally not whole but ground up and that AlgaeCal contains “Nutrients. Not Chemicals.” I hate to be the one to tell them, but calcium, the selling point of their supplement, is so much of a chemical that it’s even on the periodic table of the elements!

The website states that AlgaeCal Plus naturally contains “all 13 essential bone supporting minerals: calcium, magnesium, boron, copper, manganese, silicon, nickel, selenium, strontium, phosphorus, potassium, vanadium, and zinc”, as well as vitamins D3 and K2. Unfortunately, they only provide values for six of these minerals, making it impossible to know if the others are present in useful amounts.

Even for the minerals we know the amounts of, the research supporting their effects on BMD is a bit weak. This 2008 study found no relation between boron intake and BMD in the femur or lower spine, and this 2000 studyfound that low vitamin K2 intake was not associated with low BMD.

So, if these minerals don’t matter, is the calcium in AlgaeCal somehow different than traditional calcium supplements?

Well, it claims to contain “pre-digested” or “plant-digested” calcium. Unsure what this meant, even having studied science for many years, I reached out to the company and asked. Unfortunately, their answer didn’t really explain much: “In regards to pre-digested, the algae itself absorbs all 13 bone-building minerals and pre-digests them for you.” I guess what they mean by pre-digested is just one of the great mysteries of the universe, like dark matter and why it’s impossible to eat only one potato chip.

Anyways, whatever pre-digested means, all that really matters is the bioavailability of the calcium or the amount that is absorbed through your digestive tract and into your bloodstream.

Calcium in conventional calcium supplements (or “rock-based” calcium, as AlgaeCal calls it) can be in a variety of salts, which, according to a 2000 review have bioavailabilities ranging from 23-37%. So, this is the number to beat for AlgaeCal.

Too bad we have no idea what the bioavailability of AlgaeCal actually is! While a clinical trial to answer that question was started in 2009 and finished in 2010, no data from it was ever published. Perhaps because it didn’t show the results that AlgaeCal wanted it to.

Nonetheless, the AlgaeCal website claims that there are 4 studies that support their product’s effectiveness. So, let’s take a look at those.

The studies of AlgaeCal

The first one published looked at AlgaeCal’s effects on human bone cells. The researchers treated human osteoblast cells with either AlgaeCal, calcium carbonate or calcium citrate, and found that AlgaeCal-treated cells showed statistically better function than the cells treated with the other calcium compounds. But there are two problems with this study. First, results in Petri dishes rarely translate directly to humans. Second, this study was funded, at least in part, by AlgaeCal. A conflict of interest that throws all of these results into question.

The next two studies (12), both done in 2011, were thankfully done in humans. They compared several “bone-health plans” (see image below) implemented in 176 participants and found that any of the plans were associated with increases in BMD. Not just that they slowed losses but that they increased bone mineral density!

Unfortunately, a few aspects of the designs of these studies prevent us from trusting their results. They weren’t blinded in any fashion, which means the results could be extremely biased, and they were not placebo-controlled. Oh, and also the lead scientist, Dr. Gilbert Kaats, is the CEO of Integrative Health Technologies inc., a company that has invested in AlgaeCal, and funded one of the studies! That’s a conflict of interest if I’ve ever seen one.

The last study on their site, from 2016, is also headed by Dr. Kaats, and funded via a grant provided by AlgaeCal themselves. Like the others, it wasn’t placebo-controlled or blinded in any fashion and, like the others, it showed increases of BMD over a 7-year period.

If we could trust these results, that is to say, if these results were replicated in a double-blind, placebo-controlled study that wasn’t funded by AlgaeCal or led by someone with a conflict of interest, it would be incredible. If we truly could increase the BMD of those with osteoporosis, not just slow their losses, it would literally revolutionize how doctors treat these patients. But when something seems too good to be true, it usually is.

It’s certainly true that new drugs or treatments are sometimes discovered that revolutionize medicine. A quick look at ganciclovir or penicillin proves that. But it doesn’t happen often, and before we start considering AlgaeCal revolutionary, we need an independently performed study.

So, while we don’t know if AlgaeCal is a pseudoscientific product, it sure does market itself like one. Ever since I first googled this product, I have been inundated with ads for AlgaeCal on every platform from Twitter to Buzzfeed. Now, aggressive marketing doesn’t necessarily mean a product isn’t evidence-based. However, when I’ve previously looked into the science behind products that forcefully target me with ads (like BioSilAllerpet or Skinny Magic) the evidence has not been in their favour.

As of right now, it’s hard to say whether AlgaeCal works or not. All we can really say is that there’s no good evidence that it does. Also, it’s expensive. At $2.17 CAD per day, you would save quite a bit of money by instead buying a traditional calcium supplement and throw in a vitamin D supplement too, for $0.14 per day.

You’re probably storing leftovers wrong (especially if it’s rice)

3 minute read
Originally posted here: https://mcgill.ca/oss/article/did-you-know-health/youre-probably-storing-leftovers-wrong-especially-if-you-eat-rice

If, like me, you aim to cook dinners that provide both your next day’s lunch as well as a freezer portion to be thawed at some future date, you may want to stop. At least with rice.

Uncooked rice can contain spores of Bacillus cereus, a bacterium that can cause two different types of food poisoning. The first type is characterized by vomiting (and thus is called the emetic form). It results from consuming a toxin produced by the bacteria while they’re growing in your food and has a short incubation time of 1-5 hours. The second is characterized by diarrhea (and is non-surprisingly called the diarrhoeal form). It results from a toxin that is produced in your small intestine as the bacteria grow there and has a longer incubation time of 6-15 hours.

The two forms are commonly associated with different types of foods. The diarrhoeal form has been linked with foodstuff like soupsmeatvegetablesand milk products including formula. The emetic form comes from a more limited list of culprits, as it’s mostly associated with starchy foods that have been improperly stored like rice, pasta, pastries or sauces.

But what does “improperly stored” actually mean?

If a raw food is contaminated with B. cereus (as much rice is) and then cooked, some spores will remain in the cooked product (unless you’re in the habit of heating your rice to above 100 ˚C for extended periods of time). These spores, If left standing in temperatures between 10 ˚C and 50 ˚C, such as on your stove or countertop, find themselves in their ideal environment (wet and warm) to germinate, grow and produce the toxin that will make you sick.

It doesn’t take long for the spores to reproduce either. A colony of B. cereuscan double in size within 20 minutes if kept at 30˚C. The routine reheating of your food will not help to deactivate the toxin or kill the bacteria. Since this bacteria and its toxin are so resistant to heat your only hope of dodging food poisoning is to avoid allowing the bacteria to germinate.

To sidestep a nasty bout of illness caused by B. cereus you should aim to eat your food as soon as possible after it is cooked. If you can’t do that, then hot foods should be kept above 60˚C and cold foods, below 5˚C. Meats and vegetables should be cooked to an internal temperature of 60˚C and kept there for at least 15 seconds. Frozen foods should ideally be thawed in the fridge or as a part of the cooking process.

If storing leftovers for later, they should be rapidly cooled in the fridge as fast as possible (according to the NHS, within 1 hour is best). You should avoid storing hot leftovers in deep dishes or stacking containers together, as it will cause the food to cool slower. When reheating leftovers make sure they reach an internal temperature of at least 74˚C and don’t keep them for more than seven days, even in the fridge.

When dealing with high-risk ingredients (like rice, grains and other starchy foods) it’s best to not keep leftovers at all. But if you do, try not to keep them for more than one day, and never reheat them more than once. Even freezingdoesn’t kill bacteria but rather just stops them from multiplying, so, by all means, freeze your leftover curry, but make fresh rice when it’s time to eat it again.

Considering the amount of improperly stored rice I now know I’ve eaten it seems almost a miracle that I haven’t gotten sick yet. Then again, food poisoning with B. cereus is often confused with the 24-hour flu, so I may have already paid for my mistakes without even knowing it.

Let’s all learn from my mistakes and start storing our leftovers properly.

Kratom- Potential Opioid Saviour?

4 minute read
Originally posted here: https://mcgill.ca/oss/article/health-general-science/kratom-potential-opioid-saviour

Kratom is rapidly becoming a choice recreational drug, but there’s a good chance you’ve never heard of this substance, which can cause sedative effects like morphine at high doses as well as stimulating effects, like caffeine or methamphetamine at low doses. This drug is not new, though regulations concerning it are (at least in North America), and not everyone is pleased about them.

Mitragyna speciosa, commonly known as kratom or ketum, is a tropical evergreen found in Southeast Asia. Its leaves are chewed fresh, or dried, powdered and put into capsules, extracts, slurries or drinks. A user feels the affects about 30 minutes after taking the drug, and they last roughly 6 hours, though the dosage and timings are highly strain dependent. The leaves contain several active compounds, most notably mitragynine and 7-hydroxymitragynine which act as alkaloid opioids. An alkaloid is any molecule that contains nitrogen, and has a biological effect. In these chemicals’ cases, that biological effect is achieved through acting as μ-opioid receptor agonists. These molecules bind to, and activate the opioid specific receptors, much like other opioids such as morphine, codeine or fentanyl. 7-Hydroxymitragynine has a potency equal to 17 times that of morphine, and as well as the molecules mentioned, kratom contains about 25 other alkaloids, each which will affect the body in some way.

Unlike these other opioids however, kratom remains largely unregulated in most of the world. Here in Canada it’s possible to purchase kratom in bulk online, though illegal to advertise it for consumption. While America has had a slightly more complicated relationship to the drug, as of October 2016 the DEA has rescinded its August 2016 move to place mitragynine and 7-hydroxymitragynine on the schedule 1 drug list. Around the world policies vary country to country- unregulated in most African countries, but regulated in Sweden, the UK, Australia and Denmark. Kratom remains entirely illegal in Thailand, where it’s been a controlled substance since 1943. Prior to this regulation, kratom leaves were often chewed fresh to achieve a small stimulation similar to that of coffee.

It’s worth exploring why public outcries to banning kratom have been so fierce, especially when the regulation of other opioids has been met with favourable responses. There is a distinct lack of studies performed on kratom and its effects, and it seems that most studies that were performed conclude by pointing out how it`s too difficult to draw conclusions based on so few studies. The DEA and other law enforcement agencies point to the questionable purity levels of kratom products, the potential for abuse and how leaving drugs unregulated leaves them in reach of young adults. Of concern is the fact that kratom is not detected on standard drug tests, its low cost, its wide availability online, and like any drug, its potential to be cut with dangerous chemicals. Considering the fentanyl crisis currently sweeping BC, a fear of opioids makes sense, but whether the concern is warranted remains to be seen.

While kratom is itself addictive, with even the user guide sites for it instructing users to not take more than 1 or 2 doses a week, there is growing evidence that it could serve as a stepping stone for opioid addicts on the path to getting clean. Studies have shown that kratom may be effective to wean addicts off their opioids of choice. When kratom is fermented, an additional bio-active chemical is produced- mitragynine pseudoindoxyl. This substance has been the subject of much scientific excitement, as it has been shown to be an antagonist for the delta opioid receptor, a process which has been correlated with reduced withdrawal symptoms, and reduced morphine tolerance. The withdrawal symptoms of kratom, which include anxiety, restlessness, tremor, sweating and cravings for the substance, are generally considered to be milder than the withdrawal symptoms of other opioids, though longer lasting.

Studies have shown that tolerance to kratom is not built over time as it is with other opioids. This, combined with its potential to lessen withdrawal symptoms, while still providing the painkiller effects that most patients take opioids for, makes me really look forward to the kratom research that will take place in the near future. It undeniably has potential that warrants study, but at present it is far too soon to start referring addicts to Madam Kratom’s online emporium. The toxicity of kratom has not been properly studied, nor has its interactions with other drugs (legal or otherwise), its long term effects, or even really, its short term effects. While the promise is present the science is not, and it would be truly foolish to rush to the kratom bandwagon without knowing how it will affect most major organs, amongst other things.

7 Up: Originally an Antidepressant

1 minute read
Originally posted: https://mcgill.ca/oss/article/did-you-know-history/7-was-originally-antidepressant

When 7 Up was originally placed on the market (In 1929), it was named Bib-Label Lithiated Lemon-Lime Soda- a much less catchy, though more descriptive name. The ‘lithiated’ in the name came from the soda’s ingredient lithium citrate, a compound used to treat patients with mental health problems like bipolar disorder, depression or mania. 

The soda went through a name change to 7 Up Lithiated Lemon Soda, before finally settling on just 7 Up, and a formula with no added lithium. The 7 in the name has no confirmed source, but several theories about its origin. Some soda fans claim that it is derived from the 7 ingredients used in the original recipe, others from the soda having a pH of 7 (which is not true), and others think that the 7 originates from the lithium in the original formula, as this element has an atomic mass of ~7.

Is Himalayan Pink Salt Better For You?

3 minute read
Originally posted here: https://mcgill.ca/oss/article/health-and-nutrition-quackery-you-asked/himalayan-pink-salt

We were asked what to make of the many claims circulating about Himalayan pink salt, whether there is any truth to the ideas that this salt will help respiratory illnesses, increase bodily hydration or strengthen bones. There are a lot of claims about Himalayan salt, but let’s start with its origin. 

Himalayan salt is mined primarily at the Khewra Salt Mine in Punjab, Pakistan, and is a result of ancient seas being covered by lava. All the water evaporated, the fish died, but the salt remained, covered by rock. Thus, technically, Himalayan salt is a sea salt, even though it’s mined like rock salt, as it is the result of ocean deposits.

The main claims about Himalayan salt speak to the various ways it is good for you due to its superior mineral content when compared to sea or table salt. While it’s true that table salt is often baked and treated such that all minerals except sodium chloride are removed, most sea salt is left untreated and also contains minerals. Pink salt enthusiasts claim that Himalayan salt has a lower sodium chloride composition than sea salt, meaning it has higher amounts of other minerals like sulphate, magnesium, calcium, potassium, bicarbonate, bromide, borate, strontium, and fluoride.

The actual percentages in Himalayan salt depend on what article you read. This article claims 85.62% sodium chloride and 14.38% other trace minerals, whereas this article claims 87% sodium chloride and 13% other trace minerals. In truth, the number is closer to to the high end, with sodium chloride content being 95-97%, leaving 3-5% composition for other minerals. It’s true that minerals are found in higher abundance in Himalayan salt, but when you factor in how little salt you tend to eat in a day (at least salt you directly add to your cooking or meals) the difference is unnoticeable. In the quantities consumed, minute differences in composition between sea, table and Himalayan salt just don’t matter.

Now to address the many other claims beyond increased mineral consumption. In truth, many of the claims have merit, but almost all of them are the same no matter the kind of salt consumed, and certainly, all of them have been exaggerated. Articles claim that Himalayan salt will ‘create an electrolyte balance’, which is true, but so will sea salt, or even Gatorade. As for the claims that Himalayan salt will lower your blood pressure, that is quite the opposite of reality.

Outside of consuming Himalayan salt, there is some belief that inhaling diffused salt, or bathing in salt baths can be beneficial. There is limited evidence that salt inhalation may help certain conditions, largely due to the intrinsic drying properties of salts. For those suffering from conditions in which bronchial secretions are increased like pleural effusion or COPD can benefit from salt drying these secretions. For those without chronic lung problems, however, halotherapy isnon-effective, and can even aggravate asthma.

In the end, there’s no more health benefit to Himalayan salt than there is to any salt, and in general, salt poses much more of a risk than a reward to our health. By all means, however, continue to use pink Himalayan salt, it’s no worse than sea salt and much prettier! 

Woofer Madness: Cannabis, Companion Animals and What Legalization Means for Your Pets

7 minute read
Image created by Ada McVean
Originally posted here: https://mcgill.ca/oss/article/health/woofer-madness-cannabis-companion-animals-and-what-legalization-means-your-pets

Take-home message:
– THC is very dangerous to most companion animals
– Medical cannabis has only a few uses in humans, and even fewer in animals
– Cannabis, hemp or CBD treats, food or supplements are not approved or regulated by Health Canada. They are illegal and could be quite dangerous for your pets.

While medical marijuana has been available to varying degrees for decades, with recreational marijuana legalized this week in Canada, discussions about what (if anything) cannabis can treat seem to be at an all-time high (see what I did there?)

Discussions of treating medical problems with cannabis are not limited to humans. If cannabis may benefit humans, it may similarity benefit companion animals like dogs or cats. Considering that some of the major ailments cannabis is touted to treat are prime concerns for pet owners (anxiety, arthritis, pain) it makes sense for pet owners to be curious about cannabis.

Cannabis can be very dangerous for pets

When discussing cannabis and companion animals, it’s important to define a few terms.

Tetrahydrocannabinol or THC is the main psychoactive component of cannabis. As most pet owners aren’t interested in getting their furry friends high, the vast majority of pet-marketed cannabis products are free, or almost free, from THC. Which is good, because THC is quite dangerous for animals.

Since it’s difficult to study cannabis (due to it’s soon-to-expire illegal nature) we lack recent numbers on the dose based effects of THC in dogs. Early studies report intoxication effects in dogs with doses between0.25 and 0.5 mg/kg of body weight. If your average German Shepard is about 30 kg, they would show THC’s effects after ingesting 7.5 – 15 mg, or about a 10th of your average “special” brownie.

Though cannabis intoxication and adverse effects have been reported in other animals like catshorses and ferrets, it’s much more common in dogs. Why? Because dogs like to eat. As Dr Sarah Silcox, the President of the Canadian Association of Veterinary Cannabinoid Medicine explained to me, “edibles, in particular, are very attractive to dogs, and if left within reach of pets, will often be gobbled up quickly.”

Cases of cannabis toxicity in pets have been increasing in States where legalization has occurred. We can expect much the same trend here in Canada. It really can’t be said enough that vigilance is crucial in keeping your pets safe.

While it’s not likely that pets will die from cannabis exposure (through smoke or edibles) there can still be serious effects, especially if left untreated. Fluffy and Rover probably won’t get a kick out of the intoxicating effects of cannabis, given that they can’t understand what’s happening. Pets may experience significant anxiety, agitation or lethargy. Smoke of any kind can cause respiratory distress and potentially lung cancer to pets who inhale it regularly, due to the polyaromatic hydrocarbons created during incomplete combustion. Cats in particular are at risk of developing malignant lymphomas when exposed to secondhand cigarette smoke, a risk that may transfer to other types of smoke. .

So what’s with all the cannabis products for pets then?

Pet treats, foods and supplements in general feature no THC. They instead contain a different cannabinoid found in cannabis: cannabidiol or CBD. CBD is not toxic to animals like THC, and it does not cause the same psychoactive effects.

CBD products for pets are marketed for their pain relievingcalminganti-inflammatorysleep-aiding and anti-nausea effects. But do they work?

We basically don’t know.

This study of 16 dogs with osteoarthritis showed a significant decrease in pain after treatment with CBD oil, but similar studies, or studies looking at cannabis to treat other conditions are seriously lacking.

Dr Silcox mentioned many anecdotes of positive effects of CBD products on pets, and this survey have found that that well over half of all owners polled who have used cannabis products on their pets felt it helped. But anecdotes are never evidence enough. We need good, large, controlled studies to properly evaluate the potential benefits and risks of cannabis products on cats, dogs and other pets.

We can be cautiously hopeful that cannabis could eventually be used in veterinary medicine to treat similar conditions for which it’s showing promise in human trials. The problem is, the list of those conditions is short.

There’s good evidence that cannabis can treat nausea as a side effect of chemotherapy (something dogs do experience), as well as help manage multiple sclerosis (which bears some similarities to the canine disease degenerative myelopathy)

For pain treatment however, the evidence for cannabis hasn’t looked wonderful. This 2015 review found evidence for use of low dose cannabis for neuropathic pain, but not for other pain. This 2018 Cochrane review states that the use of cannabis for “chronic neuropathic pain might be outweighed by their potential harms.”

The outlook for cannabis in treating other conditions like anxiety, non-chemotherapy induced nausea or glaucoma is equally dim: “For most conditions (example anxiety), cannabinoid evidence is sparse (at best), low quality and non-convincing.” Despite claims to the otherwise, there isn’t any convincing evidence of cannabis’ ability to cure cancer either.

I have three main concerns with regards to cannabis and animals. First, with legalization, there will be more cannabis in homes, which means more cannabis in a position to be eaten by pets. In states where legalization has passed cases of cannabis toxicity in pets have increased. There’s no reason to expect a different trend in Canada, something that worries me.

Second, as Dr Silcox wrote, there is a “concern that that pet owners will attempt to medicate their pets with cannabis products and without appropriate guidance, put their pets at risk of adverse effects.” When we give our pets, children or ourselves any medication we first check dosage information, but the problem is that it isn’t available in any well researched, accurate or well-defined way for most species.

Third, pet owners may use cannabis in lieu of other evidence-based treatments, putting their pets at risk or hurting their quality of life. We don’t really know what cannabis can or should be used for in animals, but that hasn’t stopped many owners from using it for things like pain, anxiety management and diabetes management. My fear, simply put, is that owners will choose cannabis over NSAIDS, over other pain killers, over insulin, and even over euthanasia. I hope that no animals are suffering as a result of receiving cannabis as an alternative treatment to conventional veterinary medicine, but my fear is that it’s already happening and will begin to happen more with legalization.

Whether they work or not, they’re illegal and unregulated.

Until October 17th, 2018 all products containing plant-derived cannabinoids (which includes THC and CBD) fall under the Controlled Drugs and Substances Act. But even after the 17th, it isn’t open season for cannabis products. The new Cannabis Act will regulate the approval and sales of cannabis products, meaning that anything sold legally will need to be approved by Health Canada.

Health Canada currently has no products approved for veterinary or animal use. So CBD and cannabis products currently have, as Dr Silcox explains, “no regulatory oversight to ensure their quality, safety, or effectiveness. While they are marketed to treat a range of ailments, these health claims are unsubstantiated by Health Canada, the products are not approved, and as such, are not compliant with Canadian law.”

Now, that could soon change. With legalization around the corner, studies on cannabis and its effects are about to become a lot more feasible. With more evidence we will be able to hash out which CBD claims have merit, and which are baseless.

With entire conferences being held on veterinary use of cannabis we can hopefully expect some answers soon. In the meantime, a few things remain really important.

  1. Knowing the signs of excess cannabis exposure in your pets.
  1. Being open and honest with your veterinarians in regard to your pets cannabis exposure, and your use of CBD supplements with them.
  2. Storing all cannabis (in smokable or edible forms) in non-pet accessible places
  3. Eliminating your pet’s exposure to secondhand smoke

You might enjoy the feeling of being high, but Spot will not. Keep the joint to yourself and feed him a dog biscuit instead.