Adulteration of cannabis with tobacco, calamus, and other cholinergic compounds

A shifting demographic of people admix cannabis with cholinergic agents, intent upon enhancing cannabimimetic effects or reducing adverse effects. Augmentation of cannabimimetic effects with tobacco (or nicotine) has been corroborated by in vitro mechanistic studies, animal behaviour studies, anecdotes from patients, and one clinical trial. The mechanism may be pharmacokinetic and pharmacodynamic. This trend of adultering cannabis with tobacco poses a problem because of the adverse effects of tobacco; solutions are suggested. The grey literature also reports admixtures of cannabis and calamus root, with the intent of reducing adverse effects of cannabis. At least one compound in calamus root (beta-asarone) blocks acetylcholinesterase (AChE). Contrary to expectations, AChE blockade diminishes cannabimimetic effects. Obviously more research needs to be done.

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