The Continuing Role of Therapeutic Cannabis
The battle over recreational marijuana continues to make headlines across Canada and the United States, where Colorado became the first state to legalize marijuana for adults twenty-one and over in 2012; since then, nine other states have followed suit. Every day, there are countless stories and opinion pieces in newspapers about the financial benefits of investing in marijuana, followed by articles about raids on illegal dispensaries. In anticipation of legalization, however, one story has been pushed to the back pages: the ongoing use of medical marijuana.
When asked by a reporter about marijuana in the weeks leading up to Canada’s 2015 federal election, the Liberal leader and future Prime Minister of Canada Justin Trudeau stated that legalizing and regulating the plant – the world’s most commonly abused illegal substance – was a top priority. He said that it was time to “remove the criminal element,” from what he referred to as a failed system. And, although users across the country had hoped for barriers to be removed much sooner, if all goes as planned, Cannabis sativa will be legalized on October 17th of this year.
With the proposed legalization of recreational marijuana being a hot story, the many uses of medical marijuana have been pushed into the background – for now. This is one of the most controversial substances on earth. Its uses, benefits, and potential risks have been touted for well over a century, and one of its greatest advantages is its ability to alleviate pain.
Marijuana has been used for hundreds of years – smoked, eaten, or consumed as tea – for an list of ailments such as Alzheimer’s disease, cancer and to combat chemotherapy-related nausea, eating disorders like anorexia, glaucoma, muscle pain, multiple sclerosis, and even mental health issues including post-traumatic stress disorder (PTSD), mood disorders, and schizophrenia. Others believe it is also effective for helping those with sleep issues, epilepsy, and even autism, which impairs behaviour, communication, and social interaction.
Of course, some question the legitimacy of these claims, and how one plant can possibly treat such a vast number of medical conditions. Much of the reason lies in the composition of marijuana itself. It is composed of over four hundred individual chemicals with various attributes.
Marijuana has demonstrated itself to be particularly effective for treating pain, particularly neuropathic pain which causes shooting or burning pain, tingling, and numbness. This is often the result of nerve damage – such as ‘phantom limb syndrome’ from a missing leg or arm. Neuropathic pain can also be the result of diabetes, HIV or AIDS, shingles, and other conditions.
Opioids like morphine and highly controversial drugs like oxycodone and fentanyl which work by binding to opioid receptors in the brain and spinal cord are used to treat severe pain, but have drawbacks. In the United States, addiction to opioids is the leading cause of drug overdoses and has destroyed countless lives. By comparison, cannabis is not known to lead to overuse and is not as habit-forming as opioids, with chances of a fatal overdose being virtually non-existent.
While the use of medical marijuana to help alleviate pain and nausea are well-known, its use is also the subject of considerable research in other areas, such as in the treatment of traumatic brain injury (TBI) from violent contact sports such as football and hockey. Interest in the use of cannabis for these types of injuries has led to much scientific investigation and a patent for cannabinoids as antioxidants and neuroprotectants, which was filed in 2003. The U.S. patent cites the antioxidant properties found in cannabinoids – unrelated to NMDA receptor antagonism but related to memory function – and the advantages of these cannabinoids “in limiting neurological damage following ischemic insults, such as stroke and trauma, or in the treatment of neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease, and HIV dementia.”
The potentially serious effects of TBI from sports, automobile accidents, falls, or other forms of sudden contact with external forces can be temporary or last a lifetime. Damage to the brain continues even after the incident due to ongoing bleeding and swelling, as chemicals released by the body have a toxic effect on the brain.
TBI affects thousands of people every year, and approximately 52,000 die as a result; however, every year, some eighty thousand people will have to live with the consequences of these injuries and face many issues, including moderate-to-severe memory loss – particularly short-term memory loss – and struggling to deal with basic daily activities. People with TBI may have difficulty remembering where the house keys are, forget appointments, be unable to remember routes, and forget something they just read, along with experiencing drowsiness, headaches, nausea, disturbed sleep, or vomiting.
TBI is the subject of numerous research papers, such as 2014’s Effect of marijuana use on outcomes in traumatic brain injury and is associated with significant morbidity and mortality. This study and others of hundreds of people with TBI have promisingly demonstrated cannabinoids’ neuroprotective effects, although they have excluded patients fifteen years of age and younger.
And while there are traditional treatments and therapies for TBI such as anti-seizure medications, marijuana is proving itself to be beneficial in keeping the secondary effects of brain injury to a minimum, including preventing the body from releasing cytokines, the signalling proteins that can cause post-injury inflammation. Instead, marijuana helps the body to release minocycline, which has been shown to keep down swelling and neurological impairment in trials with mice.
And unlike medical anticonvulsant medications like carbamazepine – sold under the brand name Tegretol – which has side effects ranging from nausea and vomiting to dizziness, loss of balance and coordination, two cannabinoids found in marijuana, tetrahydrocannabinol (THC) and cannabidiol (CBD), have shown promise in treating TBI. Research conducted at the Tel Aviv University has demonstrated “a positive relationship between cannabis and traumatic brain injury,” particularly with cannabinoids administered to patients with TBIs soon after injury. If the cannabinoids are administered in the first three days, brain cells and long-term cognitive functions are protected.
As effective as marijuana can be for people who have suffered TBI and a host of other medical conditions, it is important to understand that there are still side effects associated with its use, and becoming informed in advance is vital for the user. Some effects, such as a sense of giddiness and an increase in appetite commonly known as ‘the munchies,’ are well-known, but the drug has also been associated with dry mouth, tiredness, feeling high, and problems with short-term memory loss.
While the upcoming legalization of recreational marijuana continues to make news across Canada, and as more and more states in the U.S. make it legal – thirty states, by last count, the most recent being Oklahoma – the role of medical marijuana to treat chronic pain, stress, depression, multiple sclerosis, epilepsy, and nausea from cancer treatment cannot be left behind.