AILMENTS & REMEDY
This information has been compiled by David Villareal, RPh, CCM and Brian J. Ellinoy, PharmD, excerpted primarily from the reference Cannabis Pharmacy by Michael Backes. It is provided for educational and informational purposes only and is not intended to prevent, diagnose, treat or cure any condition or disease or serve as a substitute for medical treatment. Specific medical problems should be directed to a qualified health care practitioner.
An active compound in marijuana called tetrahydrocannabinol (THC) has been found to promote the removal of toxic clumps of amyloid beta protein in the brain, which are thought to kickstart the progression of Alzheimer's disease. The finding supports the results of previous studies that found evidence of the protective effects of cannabinoids, including THC, on patients with neurodegenerative disease.
The endocannabinoid system controls bronchospasm and airway dilation. Only very small doses of THC are required for the dilation of lung airways. In addition, CBD’s anti-inflammatory effects in asthma may also be helpful, which suggests possibly using THC and CBD in combination. The terpene pinene, commonly found with THC, has bronchodilator activity as well.
The very large number of cannabinoid receptors (CB-1 and CB-2) throughout the gastrointestinal system may serve as the basis for the possible effective relief of many GI disorders, including vomiting, diarrhea, inflammation and cramping found in Crohn’s Disease and Irritable Bowel Syndrome (IBS).
Relieving depression with cannabis currently lacks supporting data and is generally not recommended. However, carefully using CBD for the anxiety and THC for the insomnia and stress which frequently accompany depression can be very helpful.
Oral cannabis has been shown to be very effective remedy for insomnia and other sleep disorders. THC in a 5-7.5mg dose taken orally an hour before sleep is a common recommendation; however, dosage adjustments (e.g. down or up) may be required depending on individual uniqueness in sleep patterns or sensitivity to THC psychoactivity.
RHEUMATOID ARTHRITIS (RHEUMATIC DISEASES)
As the use of medical cannabis is embraced, there may be an increase in its use for the remedy of the rheumatic diseases. Possible main benefits may be its anti-inflammatory, pain relieving, and immunomodulatory properties. There are many conventional options to treat inflammation, including numerous biological medications, but they can have many disturbing side effects when used to treat chronic pain. A high CBD cannabis tincture may offer effective pain relief and may also be complemented with a topical preparation to ease pain in a specific area of the body.
Based on the large number of CB-1 receptors in the hippocampus, amygdala, and other brain structures the endocannabinoid system is thought to regulate anxiety. Using CBD may therefore be quite effective in easing anxiety, as may low doses of THC. Limonene and linalool, terpenes commonly found in cannabis, may also add to the anti-anxiety effect.
Observationally, small doses of THC under 2.5mg sublingually have been used to encourage hyperfocus in ADD patients. However, using cannabis to remedy symptoms of ADD is extremely controversial because of the potential for THC to impair the neurological development of young brains. The hope is that research will lead to the development of optimal cannabis ADD regimens.
Skin inflammation can be reduced by topical application of CBD and THC, making cannabis useful in the alleviation of dermatitis and other skin conditions. Since it is unclear whether CBD, THC or a combination of both are optimal, experimentation with different topical products may be necessary.
A preliminary study in 2011 of cannabis use in fibromyalgia showed effectiveness in relieving pain, stiffness, and insomnia. Low doses of THC have been successful along with CBD added to mitigate psychoactive THC side effects.
With the current opioid crisis many individuals are seeking alternatives to ease both acute and chronic pain. The pain relieving and anti-inflammatory properties of cannabis may be helpful as an adjunct to current therapies to enhance their effectiveness or as a single agent. In addition to THC/CBD combinations the raw form of THC, known as THCa, may offer pain relief without being psychoactive.
Despite the lack of clinical studies there is substantial anecdotal evidence supporting the use of CBD-rich cannabis oil to alleviate symptoms of Asperger’s syndrome and other types of autism. More studies are obviously needed to confirm these findings.
While there is lots of data supporting the use of cannabis for anorexia in cancer or HIV/AIDS, little research has been done on the effectiveness of cannabis in mitigating anorexia nervosa. While it theoretically makes sense, anorexia nervosa is so complex that cannabis is not usually recommended at the present time.
Historically cannabis has been used to remedy side effects of chemotherapy (e.g. nausea, vomiting, neuropathy), as well as pain, insomnia, stress, and appetite suppression. Only anecdotal evidence currently exists for direct cancer activity (no studies as yet) but data is accumulating.
Recent preliminary evidence shows that oral cannabis may offer neuroprotective and anti-inflammatory effects to mildly sedate patients with dementia. Multiple daily doses of small amounts of THC have been recommended.
CBD and THC are neuroprotective for the optic nerve and THC also lowers intraocular pressure. Both are recommended orally as adjuncts to conventional glaucoma treatment but not alone, as THC has been found to not lower intraocular pressure consistently.
Many individuals have experienced comfort and relief using cannabis as part of their MS regimen. Pain relief may be obtained from THC or its non-psychoactive form THCa. Muscle relaxation, spasticity, and tone may be improved with CBD. Various delivery methods of vaping, tinctures, and edibles are available to help determine one’s optimum level of comfort. Tinctures offer the advantage of being able to easily titrate doses when starting cannabis.
Cannabis has been found to be effective as prophylaxis for migraine headaches, using small doses of THC to reduce headache frequency and intensity. It also can ease pain and nausea after headache onset using larger THC doses, with buffer doses of CBD to mitigate against increased THC psychoactivity.
Early studies have shown that CBD reliably delivers a range of anticonvulsant effects without intoxication. A severe form of epilepsy, Dravet syndrome, strikes very young children and can be catastrophic. The parents of a young girl, Charlotte Figi, found that CBD oil, unlike traditional therapies, halted her seizures. Popular CBD-rich varieties include ACDC, Harlequin and Ringo’s Gift. CBD-rich tinctures are recommended in a 20:1 ratio or higher. Two other cannabinoids, THCA and CBDA, are being explored as well. Like CBD they both are non-psychoactive.
GW Pharmaceuticals developed Epidiolex, which contains CBD dissolved in sesame oil. Epidiolex was the first prescription pharmaceutical of CBD approved by the FDA on June 25, 2018.