By Lisa van de Geyn
March 28, 2019
Almost 180 million women around the world suffer from endometriosis, and those who use cannabis to help treat the painful related symptoms rave about the relief they feel. Not only do experts cite anecdotal reports from women of less physical discomfort, but also better sleep, less painful sex and emotional respite.
That’s great news, considering treatments for endometriosis—when the tissue lining the uterus grows in the ovaries, fallopian tubes and pelvis—is limited beyond over-the-counter pain medication, anti-inflammatories, sometimes hormone therapy and, worst-case scenario, surgery. Despite the encouraging self-reports, however, cannabis still isn’t considered a first line of defence for gynaecologists when it comes to writing prescriptions for patients.
One of the big reasons for this, suggests Antuanette Gomez, founder and CEO of Pleasure Peaks, a women’s sexual health and cannabis line based in Toronto, is there simply isn’t enough medical research on the benefits women say cannabis has on sexual health and endometriosis.
“Despite the statistics showing one in 10 women have the condition, and that endometriosis was one of the most googled medical terms of 2018, there’s not much other than anecdotal research in the sexual health world when it comes to cannabis.”
Gomez says her time working in a chronic pain clinic introduced her to a surprising number of patients who dealt with sexual health issues, including pain during intercourse, polycystic ovarian syndrome and endometriosis. “These women were referred and had pre-existing prescriptions that weren’t working. Ninety-five percent weren’t using cannabis, but because it’s effective in relieving nerve pain in people with multiple sclerosis, we suggested it could ease symptoms of endometriosis, which causes nerve pain in vaginal lining,” Gomez says.
Almost 180 million women around the world suffer from endometriosis.
One patient, she reports, was given a cannabis-coconut-oil infusion, and the results were game-changing. “She was able to have sex with her partner again, and that’s huge for a woman with endometriosis,” Gomez notes.
Dr. Kevin Rod, a family physician with a focused practice in chronic pain, as well as medical director of the Toronto Poly Clinic, says medical cannabis doesn’t just help ease the symptoms of chronic pelvic pain (including nausea, painful periods and gastrointestinal issues), it allows doctors to treat the patient as a whole and improves several aspects of health and wellness.
“The inflammation and pain caused by endometriosis affects stress, irritability and the ability to relax, sleep, cope and self-manage,” Dr. Rod says. “In my experience, when cannabis is used appropriately, seven out of 10 patients report a significant improvement.”
What’s on the horizon for endometriosis research?
While research on endometriosis has been limited, there’s new hope in the works for healthcare providers and patients—Strainprint Technologies Ltd., along with Israeli researchers, are prepping to roll out the first clinical study using cannabis to treat endometriosis. It will focus on identifying the cannabinoids, flavonoids and terpenes that offer women the most pain relief.
“We don’t yet know which formulations, amounts and modes work best, but based on the patients’ assessments of their pain, quality of sleep, stress and other symptoms, we can choose treatments that we believe will best help,” says Dr. Rod. “The key here is to ensure we start low and go slow,” he adds.
Gomez expects it will probably be three years or so until cannabis is the go-to for physicians. In the meantime, she’s launching a lubricant later this year that, she suggests will also be helpful for pain relief.
Dr. Rod, who has studied cannabis and pain in about 5,000 patients over the last five years, maintains that more resources and study results are needed, but there’s recently been a big shift in the attitudes of patients and doctors. “There’s an honest discussion going on now. More patients are willing to talk about cannabis and don’t feel as guilty or awkward as they did just two years ago,” he says. “More physicians and women will be receptive to cannabis treating this kind of pain when meaningful results are found.”
Thursday, 01 November 2018
Belmont, MA: Cannabis use is associated with an alleviation of clinical symptoms in patients with bipolar disorder, and does not negatively impact cognitive performance, according to clinical trial data published in the journal PLoS One.
Investigators with Harvard Medical School, Tufts University, and McLean Hospital in Massachusetts assessed the impact of marijuana use on mood symptomology and cognitive function in patients with bipolar disorder.
Authors reported that marijuana use was associated with lower scores of anger, tension, and depression, as well as higher levels of vigor in BPD patients. Subjects who used marijuana also showed no significant differences in cognitive performance compared to BPD subjects who abstained from the plant. The study is the first clinical trial to assess the impact of cannabis on both mood and neuropsychological performance in BPD patients.
Researchers concluded, “The current study highlights preliminary evidence that patients with BPD who regularly smoked marijuana reported at least short-term clinical symptom alleviation following marijuana use, indicating potential mood-stabilizing properties of marijuana in at least a subset of patients with BPD.”
For more information, contact Paul Armentano, NORML Deputy Director, at: firstname.lastname@example.org. Full text of the study, “A pilot investigation of the impact of bipolar disorder and marijuana use on cognitive function and mood,” appears in PLoS One.
Israeli researchers presented a study at the European Gastroenterology Conference this week that showed a regimen of cannabis oil made a significant improvement on the symptoms of Crohn’s Disease, Heathline reports.
Crohn’s Disease is an inflammatory bowel condition that can affect any part of the gastrointestinal tract, though most commonly it affects the small intestine. It leads to fever, abdominal pain, rectal bleeding, and bloody diarrhea. Sufferers of Crohn’s Disease are also at increased risk for bowel cancer.
In the study, 65 percent of patients given cannabis oil containing 15 percent CBD and 4 percent THC for two months were able to maintain remission of the condition, while only 35 percent of those given a placebo stayed in remission. Study participants given cannabis oil also reported a significant improvement in their quality of life over those with the placebo.
In an unexpected turn, checks for bowel inflammation via endoscope and chemical tests for markers of inflammation showed no difference in actual inflammation in the bowel compared to placebo. This means the mechanism that leads to cannabis oil’s effectiveness at treating Crohn’s is not fully understood and is probably not as simple as the anti-inflammatory properties of cannabis. Crohn’s Disease itself is still not very well understood, which further compounds the confusion.
Researchers said that, ultimately, no matter what the specifics of the chemical effect are, cannabis is favored as a treatment for Crohn’s simply because of the relief it provides. Cannabis is also safer than other traditional treatments for Crohn’s, such as corticosteroids or antibiotics.
More research is needed, though cannabis’ excellent safety profile and pain-relieving powers make it an easy choice for the treatment of Crohn’s.
We may finally know why marijuana helps people with chronic gut problems
And it could have implications for other inflammation, too.
By Kat Eschner August 14, 2018
Many people with IBD say cannabis relieves their symptoms, but no one ever really knew why—until now.
As John Mayer tells us (and tells us, and tells us), your body is a wonderland. When it comes to microbial life, this holds especially true for your gut. There, hundreds of residential species eat, breed, and excrete waste. Somehow, your intestines manage to thrive with this zoo inside them—for the most part. In some cases things aren’t so wonderful: your gut starts attacking itself in an autoimmune response that’s bad for microbes and host alike.
People with this condition, known as inflammatory bowel diseases like Crohn’s disease or ulcerative colitis, face a chronic problem. Current treatment options are laden with side effects and require constant tweaking to remain effective. Some of those people have turned to marijuana for treatment—but their stories about how it has helped them have remained just that, stories, until now. A new study from University of Massachusetts and University of Bath researchers is the first to demonstrate the physical process by which cannabis affects IBD, opening up the possibility of creating new drugs to treat these chronic ailments.
Although numerous IBD patients use cannabis products to help treat their illness, and the phenomena has been subject to some medical research, nobody knew exactly how the medically active parts of marijuana (known as cannabinoids) had an anti-inflammatory effect on irritated bowels before this study. Ironically, however, the researchers weren’t even looking for this precise answer; they just happened upon it in the course of trying to understand how the healthy intestine regulates itself.
In the gut, a thin layer of epithelial cells mediates between our bodies and the microbial “zoo” living within. Beth McCormick of the University of Massachusetts has been studying the role these cells play in regulating the gut microbiome for well over a decade, and the starting point for this current research was her prior discoveryof a chemical pathway by which epithelial cells help neutrophils, a kind of white blood cell, to cross into the gut and eat up some of the microbes. But that was clearly only half of the answer. In order to produce balance, something else had to stop too many neutrophils from getting in and killing peaceful microbes and even the gut itself—leading to IBD.
The answer, reported in the new study out Monday in the Journal of Clinical Investigation, is a different pathway, also in the epithelial cells of the gut lining. That chemical pathway produces substances that prevent neutrophils from getting through the epithelial cells and into the gut. And it turns out those substances, in mice at least, are endocannabinoids. These fatty substances bind to the same chemical receptors as the cannabinoids found in, well, cannabis. Patients missing this secondary pathway “were more likely to develop ulcerative colitis,” McCormick says.
Although the current research is in mice, it points to a possible result in humans as well. It would help explain why cannabinoids seem to provide relief for people with IBD, because they perform basically the same regulatory function as the endocannabinoids would if the body were producing them itself. More research, of course, is needed, but McCormick says it opens up the possibility of creating new IBD treatments that work on the new pathway—including, perhaps, therapeutic agents extracted from marijuana.
And that’s not all, says Vanderbilt University gastroenterologist Richard Peek, who wasn’t involved in the new study. McCormick’s findings “may not just be specific to the intestine,” Peek says. Epithelial cells are found on the surfaces of organs throughout the body, so this mechanism of action may exist in other systems as well, he says. That would change our understanding of autoimmune responses elsewhere in the body, too.
This is good news for the 1.6 million Americans who currently have IBD. But given how common a treatment cannabis is for IBD, some might ask why researchers didn’t look for its mechanism of action in the gut before. That’s partially because cannabis research tends to be politicized, says Peek. He thinks that this discovery may open up new possibilities for the legalization of medical marijuana. For McCormick, their “unbiased approach” was the key to finding this result: they weren’t looking to explain cannabis’s mechanism of action, they just found it. “Sometimes, as they say in the field, the blind squirrel finds the nut,” she says.
Thursday, 10 May 2018
Tel Aviv, Israel: The adjunctive use of CBD extracts is safe and effective in adolescent patients with refractory epilepsy, according to clinical data published online ahead of print in the journal Brain & Development.
Israeli researchers assessed the sustained daily use of extracted CBD oils in a cohort of young patients with treatment-resistant epilepsy.
Thirty-five percent of participants experienced a reduction in mean monthly seizure frequency of 75 percent or greater following CBD treatment. Forty-one percent of patients either partially or completely tapered their use of anti-epileptic drugs during the study period due to improvements in their condition. Patients who were younger than ten years of age at treatment onset experienced higher improvement rates compared to older subjects. The most commonly reported adverse side-effect of CBD treatment was somnolence, which was reported in 14 percent of patients.
Authors concluded, “In concordance with recent encouraging evidence, this open-label study using parental report, showed that CBD- enriched cannabis extract appears to have potential anti-seizure effect as an add- on treatment in pediatric patients with refractory epilepsy, with a favorable safety profile.”
The findings are similar to those of other recent trials reporting that the use of CBD extracts reduces seizure frequency and improves other symptoms of epilepsy. Regulators at the US Food and Drug Administration are anticipated to grant market approval this summer to a proprietary formulation of CBD oil, known as Epidiolex, for the treatment of Dravet syndrome and Lennox-Gastaut syndrome, two types of severe pediatric epilepsy.
Cannabis therapy mitigates symptoms of the chronic pain condition fibromyalgia and is associated with a reduction in the use of other prescription drugs, according to clinical data published online ahead of print in the Journal of Clinical Rheumatology. An estimated 3 to 6 million Americans are afflicted by fibromyalgia, which is often poorly controlled by standard pain medications.
Israeli investigators assessed the safety and efficacy of inhaled cannabis in a cohort of 26 patients with fibromyalgia. They reported that medical cannabis treatment “was associated with significant favorable outcomes in every item evaluated,” such as reductions in pain and increases in energy.
Most patients also reduced their use of conventional prescription drugs, such as opiates and benzodiazepines, during the trial period. Nearly half of the participants (46 percent) reduced their prescription drug intake by more than 50 percent during the study. Several patients were also able to return to work following the initiation of cannabis therapy.
Researchers concluded, “Medical cannabis treatment had a significant favorable effect on patients with fibromyalgia, with few adverse effects.”
Prior trials evaluating the use of either whole-plant cannabis or synthetic cannabinoids have similarly shown efficacy in patients with the disease.
Regular cannabinoid administration significantly reduced the frequency of migraine headache in a new clinical trial.
Findings in a new study suggest that daily cannabinoid treatments can effectively reduce the frequency of migraine headache. A team of Italian researchers presented the findings of their new clinical trial at the 3rd Congress of the European Academy of Neurology in Amsterdam earlier this summer. Regular cannabinoid treatments were found to reduce the frequency of migraine by over 40 percent.
The 19th leading cause of disability worldwide, migraine involves severe head pain, and is commonly accompanied by nausea and sensitivity to light and sound. The condition typically begins in childhood, adolescence or early adulthood. According to the U.S. National Library of Medicine, approximately 12 percent of the United States population is affected by migraine headaches. About 5 million Americans are estimated to experience at least one migraine attack per month.
In the study, headed by Dr. Maria Nicolodi, the efficacy of oral cannabinoids was compared to amitriptyline, an antidepressant commonly prescribed for migraine. For three months, the 79 study participants, each diagnosed with chronic migraine, were given daily treatments of either a 200 mg dose of a cannabinoid combination including tetrahydrocannabinol (THC) and cannabidiol (CBD), or 25 mg amitriptyline.
Both substances were effective for reducing migraine frequency, but the THC-CBD combination “yielded slightly better results than” the pharmaceutical drug (40.4 percent vs. 40.1 percent).
“We were able to demonstrate that cannabinoids are an alternative to established treatments in migraine prevention,” said Nicolodi.
The study also found the THC-CBD combination to be effective for treating acute pain brought on by migraine, reducing pain intensity by 43.5 percent. The cannabinoids provided that same level of pain relief to patients diagnosed with cluster headache, a condition involving a series of short but extremely painful headaches, provided the patients had experienced migraine earlier in life. The cannabinoids were found to have no effect, however, on cluster headaches in patients with no previous migraine history.
The cannabinoids were also well-tolerated, with reported side effects including just drowsiness and difficulty concentrating. In female subjects, the incidence of stomach ache, colitis and musculoskeletal pain decreased.
Previous studies have also found cannabinoids effective for reducing the frequency of migraine in humans. Just recently, a published research review concluded that preclinical evidence suggests cannabis could effectively treat headache disorders.
The efficacy of cannabinoids for migraine could be related to their interactions with the endocannabinoid system’s CB1 and CB2 receptors. Migraine is thought to be associated with an abnormal fluctuation in brain neuronal activity, which activates the trigeminovascular system and leads to an inflammatory response that causes pain. Studies have found evidence that cannabinoids act upon these cannabinoid receptors to elicit a response that inhibits the trigeminovascular system and restricts inflammation.
You can access an abstract of the study, “Cannabinoids suitable for migraine prevention,” through the European Academy of Neurology.
Learn more about the research investigating the efficacy of cannabinoids for migraine and other pain conditions by visiting our education page. Keep up with the latest cannabis-related scientific research through our news feed
A new study from researchers at Cleveland Clinic has found that agonists of cannabinoid receptor type 2 (CB2) have a therapeutic effect on Alzheimer’s disease.
Cannabinoids could be beneficial for inhibiting the progression of Alzheimer’s disease, suggest findings in a new study published in the European Journal of Pharmacology. Researchers from the Anesthesiology Institute at Cleveland Clinic found that agonists of the cannabinoid receptor type 2 (CB2) provide neuroprotective and anti-inflammatory effects that reduce damage to brain cells.
Alzheimer’s disease, an irreversible progressive brain disorder that gradually destroys memory and thinking skills, accounts for 60 to 80 percent of dementia cases and affects an estimated 5.1 million Americans. The disease is characterized by neuroinflammation and the buildup of protein fragments called amyloid-beta, which interfere with cell communication and nutrient transport in the brain, causing cells to eventually degenerate and die.
In the Cleveland Clinic animal study, researchers found that administering CB2 agonists effectively suppressed neuroinflammation and promoted the clearance of amyloid-beta plaques to in turn promote the recovery of brain cells and improve cognitive performance.
“The brains of patients with [Alzheimer’s disease] show increased expression of cannabinoid receptor type 2 (CB2) receptors and glial markets,” the study’s abstract reads. “CB2 receptors act as a negative feedback regular; when activated by a CB2 agonist, they can help limit the extent of the neuroinflammatory response and the subsequent development of neuronal damage in the central nervous system.”
“Collectively, these findings suggest that [a CB2 agonist] has a potential therapeutic effect in the setting of AD,” the researchers conclude.
The CB2 receptor is one of the two major receptors of the body’s endocannabinoid system, which is responsible for regulating an array of functions and processes. Located primarily in immune cells but also throughout the central nervous system, CB2 receptors have been found to be associated with managing inflammation and limiting damage to tissue.
Cannabinoids found in cannabis, including tetrahydrocannabinol (THC) and cannabidiol (CBD), have been shown to interact with cannabinoid receptors. In the study, researchers used MDA7, a compound and CB2 agonist, to mimic the effects of cannabinoids.
Previous studies on cannabinoids and Alzheimer’s disease also indicate that the compounds are effective at reducing the buildup of plaque and inflammation associated with Alzheimer’s disease. A 2014 animal study found chronic CBD treatments provided neuroprotective, anti-oxidant and anti-inflammatory effects, which in turn promoted the regeneration of brain cells.
The CB2’s association with neuroprotective and anti-inflammatory responses suggest that it and cannabinoids could be beneficial in treating other degenerative diseases related to neuroinflammation, such as multiple sclerosis, Parkinson’s disease, Huntington’s disease, and traumatic brain injury.
Of the 29 U.S. states with comprehensive medical marijuana laws, 11 have approved cannabis specifically for the treatment of Alzheimer’s disease, which is currently the sixth-leading cause of death in the U.S.
You can access the entire study, “Activation of CB2 receptor system restores cognitive capacity and hippocampal Sox2 expression in a transgenic mouse model of Alzheimer’s disease,” via Science Direct.
Learn more about the research already done on cannabinoids and Alzheimer’s disease by visiting our education page
During a cardiac emergency, the sudden stoppage of blood flow puts severe stress on the rest of the body. During a cardiac arrest, valuable oxygen and nutrients are cut off. The real damage occurs when the person is revived and the blood flow returns. The quick influx of blood flow often causes injury to the ischemia region of the brain. This secondary damage is referred to as ischemia/reperfusion injury. The result is severe oxidation damage that can trigger neurons to die off.
Chinese researchers from the Fudan University in Shanghai have found a way to protect against this oxidative damage and prevent the neurons from dying off. For the first time, researchers have shown that cannabidiol (CBDs) can protect against brain ischemia/reperfusion injury. Cannabidiol is one of the many cannabinoids found in the controversial cannabis sativa plant. An extract of cannabis contains at least 40 percent cannabidiol. This active ingredient may soon be used as an extract in hospital emergency rooms to prevent brain damage following heart attack or stroke.
Cardiac specialist, Dr. Sean McCormick, believes CBDs will soon be used as emergency medicine. “CBD treatments will most certainly exist in emergency rooms for stroke and cardiac patients in the future,” he said. “Not only will CBD extracts prevent inflammatory damage, but they may also heal existing damage.”
The Chinese researchers commented that CBDs could have medicinal applications for all sorts of neurological conditions. “Increasing evidence indicates that CBD is a molecule with potentially neuroprotective properties that can be used to treat neurodegenerative disorders,” they wrote. They said that CBDs also exhibit anti-inflammatory, anxiolytic, and immunomodulatory effects, which have been demonstrated in vivo and in vitro.
In a mouse hippocampus neuron cell line, the researchers demonstrated that CBD protects neurons against oxygen-glucose-deprivation/reperfusion (OGDR) injury. CBD extract also prevents mitochondrial energy crisis, protects cellular metabolism, and prevents overall cytotoxicity.
The key was found in the way CBD alleviates oxidative stress, by boosting the energy production of the mitochondria. It did so by activating the pentose-phosphate pathway of the neuron cells, which bolstered energy homeostasis of the cells. Writing in the journal Redox Biology, the researchers said, “We found that CBD significantly improved basal respiration, ATP-linked oxygen consumption rate, and the spare respiratory capacity, and augmented glucose consumption in OGD/R-injured neurons.”
They concluded, “We propose, for the first time, that CBD stimulates glucose metabolism through the pentose-phosphate pathway to maintain the redox balance and energy conservation during neuronal ischemia/reperfusion injury.”
Science continues to support the medicinal properties of cannabis. Cannabis contains over 100 cannabinoids that are begging to be explored. Cannabidiol proves to be both anti-inflammatory and neuroprotective. It could be of great benefit to many. CBDs are an intelligent design that interact with receptors and cells to allow the body to self-heal. Real medicine is synthesized in nature and cannabis continues to unleash its healing properties. Emergency rooms can easily embrace CBDs for an easy and effective way to protect patients from the brain damage that often follows cardiac events.
Thursday, 26 January 2017
Derby, United Kingdom: The administration of THCV (tetrahydrocannabivarin), a non-psychoactive component of cannabis, is positively associated with glycemic control in type 2 diabetics, according to the randomized, placebo-controlled data published in the journal Diabetes Care.
Investigators from the University of Nottingham, School of Medicine assessed the twice daily administration of various cannabinoids (CBD or THCV or CBD and THCV in combination) versus placebo over a period of 13 weeks in 62 non-insulin dependent subjects with type 2 diabetes.
Authors reported that the administration of THCV alone “significantly decreased fasting plasma glucose” levels and improved pancreatic cell function. By contrast, other treatment therapies failed to show detectable metabolic effects.
Investigators concluded, “THCV could represent a new therapeutic agent in glycemic control in subjects with type 2 diabetes.”
Population-based observational studies have previously reported that cannabis consumers typically possess lower BMI and other favorable indices related to diabetic control compared to those without a history of marijuana use.
For more information, please contact Paul Armentano, NORML Deputy Director, at: email@example.com. Full text of the study, “Efficacy and safety of cannabidiol and tetrahydrocannabivarin on glycemic and lipid parameters in patients with type 2 diabetes: A randomized, double-blind, placebo-controlled parallel group pilot study,” appears in Diabetes Care.
Neuropathy is the damage to the sensory, motor or automatic nerves that occurs from an underlying cause. Studies have shown cannabis is effective at significantly reducing neuropathic pain.
OVERVIEW OF NEUROPATHY
Peripheral neuropathy, which is often simply referred to as neuropathy, is a condition where nerves are damaged, causing weakness, numbness and pain. Among the most common causes of neuropathy is diabetes mellitus, but the condition can also be caused by infections, alcoholism, traumatic injuries, autoimmune diseases, medications, infections, tumors, and inherited disorders.
The symptoms associated with neuropathy depend on what types of nerves are damaged. Damage to sensory nerves, which receive sensation and damage, can cause tingling and stabbing or burning pain. Damage to motor nerves, which control how the muscles move, can cause muscle weakness and a lack of coordination. If damage occurs in autonomic nerves, which control functions like blood pressure, heart rate, digestion, and bladder processes, an individual can experience heat intolerance, bowel and bladder problems, digestive issues and changes in blood pressure. Neuropathy can also increase the risk of infection and burns and other skin traumas because one may not realize they’re injured or feel temperature changes and pain.
Neuropathy treatment focuses on managing the underlying condition that is causing neuropathy and relieving symptoms. Medications are often used to manage pain. Transcutaneous electrical nerve stimulation (TENS), plasma exchange and intravenous immune globulin, and physical therapy can also help ease symptoms.
FINDINGS: EFFECTS OF CANNABIS ON NEUROPATHY
Cannabis has been shown to be highly effective at relieving neuropathic pain (McDonough, McKenna, McCreary & Downer, 2014). Cannabinoids found in cannabis interact with the two main cannabinoid receptors (CB1 and CB2) of the endocannabinoid system within the body. These receptors regulate the release of neurotransmitter and central nervous system immune cells to manage pain levels (Woodhams, Sagar, Burston & Chapman, 2015).
Because of cannabis’ effectiveness at reducing pain, its use is prevalent among the chronic pain population. Luckily, studies indicate that long-term cannabis use for managing pain is safe. After a year of regular use, patients with chronic pain were found to be at no greater risk of serious adverse effects than non-cannabis users (Ware, et al., 2015).
Evidence also indicates that cannabinoids can support the health of neurons. Cannabinoid receptors have been shown to be involved in neuroprotection, indicating that cannabinoids can help protect from damage that leads to neuropathy and encourage neural cell survival (Blazquez, et al., 2015) (Castelli, et al., 2014), (Fernandez-Ruiz, et al., 2007)
STATES THAT HAVE APPROVED MEDICAL MARIJUANA FOR NEUROPATHY
Currently, Arkansas, Montana, New Mexico, New York, North Dakota, Pennsylvania, and West Virginia have approved medical marijuana for the treatment of neuropathy. In Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment. In addition, a number of other states will consider allowing medical marijuana to be used for the treatment of neuropathy with the recommendation from a physician. These states include: California (any debilitating illness where the medical use of marijuana has been recommended by a physician), Connecticut (other medical conditions may be approved by the Department of Consumer Protection), Massachusetts (other conditions as determined in writing by a qualifying patient’s physician), Nevada (other conditions subject to approval), Oregon (other conditions subject to approval), Rhode Island (other conditions subject to approval), and Washington (any “terminal or debilitating condition”).
Several states have approved medical marijuana specifically to treat “chronic pain,” a symptom commonly associated with neuropathy. These states include: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New Mexico, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, and West Virginia. The states of Nevada, New Hampshire, North Dakota, Montana, Ohio and Vermont allow medical marijuana to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania, Washington, and West Virginia have approved cannabis for the treatment of “intractable pain.”
RECENT STUDIES ON CANNABIS’ EFFECT ON NEUROPATHY
Using cannabis has been shown to significantly improve pain.
Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS)
Blázquez, C., Chiarlone, A., Bellocchio, L., Resel, E., Pruunsild, P., García-Rincón, D., Sendtner, M., Timmusk, T., Lutz, B., Galve-Roperh, I., and Guzmán, M. (2015). The CB1 cannabinoid receptor signals striatal neuroprotection via a PI3K/Akt/mTORC1/BDNF pathway. Cell Death and Differentiation, 22(10), 1618–1629. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4563779/.Castelli, M.P., Madeddu, C., Casti, A., Casu, A., Casti, P., Scherma, M., Fattore, L., Fadda, P., and Ennas, M.G. (2014). Δ9-Tetrahydrocannabinol Prevents Methamphetamine-Induced Neurotoxicity. PLoS ONE, 9(5), e98079. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4028295/.
Fernández-Ruiz, J., Romero, J., Velasco, G., Tolon, R.M., Ramos, J.A., and Guzman, M. (2007, January). Cannabinoid CB2 receptor: a new target for controlling neural cell survival. Trends in Pharmaceutical Sciences, 28(1), 39-45. Retrieved from http://www.cell.com/trends/pharmacological-sciences/fulltext/S0165-6147(06)00267-7.
Fishbein, M., Gov, S., Assaf, F., Gafni, M., Keren, O., and Sarne, Y. (2012, September). Long-term behavioral and biochemical effects of an ultra-low dose of Δ9-tetrahydrocannabinol (THC): neuroprotection and ERK signaling. Experimental Brain Research, 221(4), 437-48. Retrieved from http://link.springer.com/article/10.1007%2Fs00221-012-3186-5.
Jiang, W., Zhang, Y., Xiao, L., Van Cleemput, J., Ji, S.P., Bai, G., and Zhang, X. (2005). Cannabinoids promote embryonic and adult hippocampus neurogenesis and produce anxiolytic- and antidepressant-like effects. Journal of Clinical Investigation, 115(11), 3104–3116. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1253627/.
Kim, S.H., Won, S.J., Mao, X.O., Jin, K., and Greenberg, D.A. (2006, March). Molecular mechanisms of cannabinoid protection from neuronal excitotoxicity. Molecular Pharmacology, 69(30), 691-6. Retrieved from http://molpharm.aspetjournals.org/content/69/3/691.long.
López Rodríguez, A.B., Siopi, E., Finn, D.P., Marchand-Leroux, C., Garcia-Segura, L.M., Jafarian-Tehrani, M.H., and Viveros, M.P. (2013). CB1 and CB2 cannabinoid receptor antagonists prevent minocycline-induced neuroprotection following traumatic brain injury in mice. Cerebral Cortex. Retrieved from http://cercor.oxfordjournals.org/content/early/2013/08/19/cercor.bht202.abstract.
Marsicano, G., Goodenough, S., Monory, K., Hermann, H., Eder, M., Cannich, A., Azad, S.C., Cascio, M.G., Gutiérrez, S.O., van der Stelt, M., López-Rodriguez, M.L., Casanova, E., Schütz, G., Zieglgänsberger, W., Di Marzo, V., Behl, C., and Lutz, B. (2003, October 3). CB1 Cannabinoid Receptors and On-Demand Defense Against Excitotoxicity. Science, 302(5642), 84-8. Retrieved from http://science.sciencemag.org/content/302/5642/84.
McDonough, P., McKenna, J.P., McCreary, C., and Downer, E.J. (2014, October). Neuropathic orofacial pain: cannabinoids as a therapeutic avenue. The International Journal of Biochemistry & Cell Biology, 55, 72-8. Retrieved from http://www.sciencedirect.com/science/article/pii/S1357272514002581.
Panikashvili, D., Simeonidou, C., Ben-Shabat, S., Hanus, L., Breuer, A., Mechoulam, R., Shohami, E. (2001, October). An endogenous cannabinoid (2-AG) is neuroprotective after brain injury. Nature, 413(6855), 527-31. Retrieved from http://www.nature.com/nature/journal/v413/n6855/full/413527a0.html.
Peripheral neuropathy. (2014, December 2). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/basics/definition/con-20019948.
Pryce, G., Ahmed, Z., Hankey, D.J., Jackson, S.J., Croxford, J.L. Pocock, J.M., Ledent, C., Petzold, A., Thompson, A.J., Giovannoni, G., Cuzner, M.L., and Baker, D. (2003, October). Cannabinoids inhibit neurodegeneration in models of multiple sclerosis. Brain, 126(Pt 10), 2191-202. Retrieved from https://academic.oup.com/brain/article/126/10/2191/314489/Cannabinoids-inhibit-neurodegeneration-in-models.
Sagredo, O., Garcia-Arencibia, M., de Lago, E., Finetti, S., Decio, A., and Fernandez-Ruiz, J. (2007, August). Cannabinoids and Neuroprotection in Basal Ganglia Disorders. Molecular Neurobiology, 36(1), 82-91. Retrieved from http://link.springer.com/article/10.1007%2Fs12035-007-0004-3.
van der Stelt, M., Veldhuis, W.B., Bar, P.R., Veldink, G.A., Vliegenthart, J.F., and Nicolay, K. (2001, September 1). Neuroprotection by Δ9-Tetrahydrocannabinol, the Main Active Compound in Marijuana, against Ouabain-Induced In Vivo Excitotoxicity. The Journal of Neuroscience, 21(17), 6475-9. Retrieved from http://www.jneurosci.org/content/21/17/6475.long.
Ware, M.A., Wang, T., Shapiro, S., and Collet, J.P. (2015, September 15). Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS). The Journal of Pain. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/26385201.
Witting, A., Chen, L., Cudaback, E., Straiker, A., Walter, L., Rickman, B., Moller, T., Brosnan, C., and Stella, N. (2006, April 18). Experimental autoimmune encephalomyelitis disrupts endocannabinoid-mediated neuroprotection. PNAS, 103(16), 6362-7. Retrieved from http://www.pnas.org/content/103/16/6362.full.
Woodhams, S.G., Sagar, D.R., Burston, J.J., and Chapman, V. (2015). The role of the endocannabinoid system in pain. Handbook of Experimental Pharmacology, 227, 119-43. Retrieved from http://link.springer.com/chapter/10.1007%2F978-3-662-46450-2_7.
Xapelli, S., Agasse, F., Sardà-Arroyo, L., Bernardino, L., Santos, T., Ribeiro, F.F., Valero, J., Braganca, J., Schitine, C., de Melo Reis, R.A., Sebastiao, A.M., and Malva, J.O. (2013). Activation of Type 1 Cannabinoid Receptor (CB1R) Promotes Neurogenesis in Murine Subventricular Zone Cell Cultures. PLoS ONE, 8(5), e63529. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3660454/.
Zogopoulos, P., Vasileiou, I., Patsouris, E., and Theocharis, S. (2013, April). The neuroprotective role of endocannabinoids against chemical-induced injury and other adverse effects. Journal of Applied Toxicology, 33(4), 246-64. Retrieved from http://onlinelibrary.wiley.com/wol1/doi/10.1002/jat.2828/full
Inflammatory bowel disease, which caused 51,000 deaths in 2013, is the chronic inflammation of the digestive track. Studies have shown marijuana reduces the pain, nausea and diarrhea associated with the disease and even shows promise as a treatment that encourages remission.
OVERVIEW OF INFLAMMATORY BOWEL DISEASE
Inflammatory bowel disease (IBD) is chronic inflammation of lining of the digestive track. The two major types of IBD are ulcerative colitis, which affects the innermost lining of the large intestine and rectum, and Crohn’s disease, which can affect different areas of the digestive track and often sees the inflammation spread deep into affected areas. More rare types of IBD’s include collagenous colitis and lymphocytic colitis.
The symptoms associated with IBD vary depending on inflammation severity. The disease causes abdominal pain, rectal bleeding, severe diarrhea, fever, weight loss, fatigue, blood in one’s stool, and malnutrition. The pain caused by IBD can be debilitating.
Heredity and abnormal behavior by the immune system are likely what cause Crohn’s disease. Those who have family members with the disease are more common to acquire it themselves. When the immune system responds to fight off a virus, bacteria, fungi and other microorganisms, at times it can respond abnormally and also attack the harmless cells in the digestive track, which in turn leads to inflammation.
There is no confirmed cure for inflammatory bowel disease. However, treatments significantly reduce the disease’s associated symptoms and in some cases, even bring about remission. Treatment efforts commonly include anti-inflammatory, antibiotic, anti-diarrhea, and pain relief medications. In some cases, a feeding tube may be necessary to allow the digestive track to rest and lower inflammation. Surgery may be employed remove the damaged portion of the digestive track.
FINDINGS: EFFECTS OF CANNABIS ON INFLAMMATORY BOWEL DISEASE
Cannabis has been determined to effectively address the symptoms associated with inflammatory bowel disease disease. Cannabinoids found in cannabis, including tetrahydrocannabinol (THC) , possess anti-inflammatory effects, offer pain relief, reduce nausea and stimulate appetite. As a result, cannabis use is common among those with inflammatory bowel disease. One study found that 17.6% of inflammatory bowel disease patients use marijuana to treat their symptoms, and although use was also found to be associated with a higher risk of surgery, patients reported an improvement in abdominal pain (83.9%), abdominal cramping (76.8%), joint pain (48.2%), and diarrhea (28.6%) (Storr, et al., 2014).
The benefits of cannabis help those with inflammatory bowel disease to manage their discomfort and experience a better quality of life. In one study, after three months of being treated with cannabis, inflammatory bowel disease patients reported improvements in their general health perception, social functioning, ability to work, physical pain and depression. These same patients also saw an increase in body weight and body mass index (Lahat, Lang & Ben-Horin, 2012). In another study, individuals with inflammatory bowel disease reported that marijuana was “very helpful” in relieving their abdominal pain, nausea and diarrhea (Ravikoff, et al., 2013).
STATES THAT HAVE APPROVED MEDICAL MARIJUANA FOR INFLAMMATORY BOWEL DISEASE
Currently, Maine, Michigan, New Jersey, New York, Ohio and Pennsylvania have approved medical marijuana specifically for the treatment of inflammatory bowel disease.
Other states have approved medical marijuana to treat only specific types of inflammatory bowel diseases, including Arizona (Crohn’s disease), Arkansas (Crohn’s disease, Ulcerative Colitis) Connecticut (Crohn’s disease, Ulcerative Dolitis), Florida (Crohn’s disease), Georgia (Crohn’s disease), Hawaii (Crohn’s disease), Illinois (Crohn’s disease), Louisiana (Crohn’s disease), Maine(Crohn’s disease), Massachusetts (Crohn’s disease), Michigan (Crohn’s disease, Ulcerative Colitis), Minnesota (Crohn’s disease), Montana (Crohn’s disease), New Hampshire (Crohn’s disease), New Jersey (Crohn’s disease), New Mexico (Crohn’s disease), Ohio (Crohn’s disease, Ulcerative Colitis), Pennsylvania (Crohn’s disease), Rhode Island (Crohn’s disease), Washington (Crohn’s disease), and West Virginia (Crohn’s disease).
A number of other states will consider allowing medical marijuana to be used for the treatment of inflammatory bowel disease with the recommendation from a physician. These states include: California (any debilitating illness where the medical use of marijuana has been recommended by a physician), Connecticut (other medical conditions may be approved by the Department of Consumer Protection), Massachusetts (other conditions as determined in writing by a qualifying patient’s physician), Nevada (other conditions subject to approval), Oregon (other conditions subject to approval), Rhode Island (other conditions subject to approval), and Washington (any “terminal or debilitating condition”).
In Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment.
Several states have approved medical marijuana specifically to treat “chronic pain,” a symptom commonly associated with inflammatory bowel disease. These states include: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New Mexico, Ohio, Oregon, Pennsylvania, Rhode Island and Vermont. The states of Nevada, New Hampshire, North Dakota, Montana, Ohio, Vermont, and West Virginia allow medical marijuana to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania, Washington, and West Virginia have approved cannabis for the treatment of “intractable pain.”
RECENT STUDIES ON CANNABIS’ EFFECT ON INFLAMMATORY BOWEL DISEASE
Three months of inhaled cannabis treatment caused an increase in quality of life measurements, disease activity index and caused gains in weight and body mass index in patients with inflammatory bowel disease.
Impact of cannabis treatment on the quality of life, weight and clinical disease activity in inflammatory bowel disease patients: a pilot prospective study.
Borrelli, F., Fasolino, I., Romano, B., Capasso, R., Maiello, F., Coppola, D., Orlando, P., and Battista, G. (2013, May). Beneficial effect of the non-psychotropic plant cannabinoid cannabigerol on experimental inflammatory bowel disease. Biochemical Pharmacology, 85(9), 1306-1316. Retrieved from http://www.sciencedirect.com/science/article/pii/S0006295213000543.
Di Carlo, G., and Izzo, A.A. (2003, January). Cannabinoids for gastrointestinal diseases: potential therapeutic applications. Expert Opinion on Investigative Drugs, 12(1), 39-49. Retrieved from http://www.tandfonline.com/doi/pdf/10.1517/135437220.127.116.11?needAccess=true.
GBD 2013 Mortality and Causes of Death Collaborators. (2015, January 10). Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet, 385(9963), 117-71. Retrieved from http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61682-2/fulltext.
Inflammatory bowel disease (IBD). (2015, February 18). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/basics/definition/con-20034908.
Lahat, A., Lang, A. and Ben-Horin, S. (2012). Impact of cannabis treatment on the quality of life, weight and clinical disease activity in inflammatory bowel disease patients: a pilot prospective study. Digestion, 85(1), 1-8. Retrieved from https://www.karger.com/Article/Purchase/332079.
Lal, S., Prasad, N., Ryan, M., Tangri, S., Silverberg, M.S., Gordon, A., and Steinhart, H. (2011, October). Cannabis use amongst patients with inflammatory bowel disease. European Journal of Gastroenterology & Hepatology, 23(10), 891-6. Retrieved from Cannabis use amongst patients with inflammatory bowel disease. Retrieved from http://journals.lww.com/eurojgh/pages/articleviewer.aspx?year=2011&issue=10000&article=00011&type=abstract.
Lim, C.T., Kola, B., Feltrin, D., Perez-Tilve, D., Tschöp, M.H., Grossman, A.B., and Korbonits, M. (2013). Ghrelin and cannabinoids require the ghrelin receptor to affect cellular energy metabolism. Molecular and Cellular Endocrinology, 365(2), 303–308. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3566541/.
Pertwell, R. (2001, June). Cannabinoids and the gastrointestinal tract. Gut, 48(6), 859-867. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1728337/.
Ravikoff Allegretti, J., Courtwright, A., Lucci, M., Korzenik, J.R., and Levine, J. (2013, December). Marijuana use patterns among patients with inflammatory bowel disease. Inflammatory Bowel Diseases,19(13), 2809-14. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4126607/.
Storr, M., Devlin, S., Kaplan, G.G., Panaccione, R., and Andrews, C.N. (2014, March). Cannabis use provides symptom relief in patients with inflammatory bowel disease but is associated with worse disease prognosis in patients with Crohn’s disease. Inflammatory Bowel Diseases, 20(3), 472-80. Retrieved from http://journals.lww.com/ibdjournal/Abstract/2014/03000/Cannabis_Use_Provides_Symptom_Relief_in_Patients.6.aspx.