How Does Cannabis Stack Up As Medicine?
How Does Cannabis Stack Up As Medicine? The development of cannabinoid-derived medications represents a huge frontier to treat a remarkable number of diseases and disorders. The reason being is that evidence suggests the body’s own “cannabinoid system,” called the endocannabinoid system — or ECS — is the most important physiological system in our bodies. It literally plays a vital role in every aspect of our health.
When consumed, exo-cannabinoids (which include plant-based and synthetically-derived cannabinoids) can alter this system, often in ways that can promote health and alleviate symptoms. However, while targeting the endocannabinoid system may be able to address a massive number of conditions, it’s not so simple as just consuming some weed. For some conditions, it is actually that simple. Chronic neuropathic pain, for example, responds extremely well to virtually any method of cannabis. However, other conditions are not always best treated with cannabis. Below is a summary of findings on the most common conditions that qualify for medical cannabis.
Chronic pain is one of those conditions that the use of cannabis seems to be a "no-brainer." In contrast to prescription narcotics — like OxyContin — the safety profile of cannabis is far more benign. Also, prescription narcotics aren’t generally effective long-term, they don’t treat inflammation (only numb pain), and present significant risks for potential fatal overdose or as a gateway to heroin.
Cannabinoids, acting on the CB1 receptor, help temper pain. The pain relieving properties of cannabis have been known for thousands of years. More recent studies have demonstrated the ability of cannabinoids to model nociceptive and neuropathic response in numerous pain models. In fact, THC at very modest levels appears effective in treating pain. It’s important to note, however, THC produces biphasic effects, meaning that low to moderate doses elicit the desired effects, while high doses can exacerbate the condition.
For more on chronic pain, read our blog, "Using Cannabis to Treat Chronic Pain."
Cannabis is indispensable to treat many of the associated cancer symptoms and cancer treatment-related symptoms. Appetite loss, nausea, vomiting are all very common, and cannabis seems to treat these symptoms better than anything else available. Dr. Donald Abrams, one of the leading oncologists and cannabis advocates, praises cannabis because it can replace five or six different drugs — without adverse side effects.
What’s more complicated, however, is whether cannabis can “cure” cancer. While there have been numerous studies in the lab that demonstrate the ability of cannabis to kill cancer cells, lab results don't always neatly translate to efficacy on humans. Further, the term "cancer" does not describe a single disease: it’s an umbrella term used to describe hundreds of different related conditions. It’s a highly complex set of diseases, and it would be difficult to develop a "cure" that was effective against all of its forms. And, thus far, we’ve had just one very small study on humans — not experimental animal models — (conducted by Dr. Manuel Guzman) that provided encouraging, but modest results.
Having communicated with most of the leading researchers who are studying cannabis for its potential curative properties, most believe cannabinoids hold promise, but would not suggest cannabis — in its current forms — is a cure. If anything, in many patients it does seem to work synergistically with other treatments to potentially extend life or improve efficacy of traditional treatments, but we don't know yet conclusively. More important, no one should use cannabis in place of other treatments that have proven effective through high-quality, controlled studies. The survival rates for nearly all forms of cancer have improved dramatically since the 1970s.
On the numerous anecdotal success stories of cannabis curing cancer, Dr. Manuel Guzman, who has been at the forefront of studying cannabis and cannabinoids to treat cancer, stated: "Although it is possible – and of course desirable – that cannabis preparations have exerted some antineoplastic activity in some particular cancer patients, the current anecdotal evidence reported on this issue is pretty poor, and, unfortunately, remains far from supporting that cannabinoids are efficacious anticancer drugs for large patient populations."
Guzman also notes that when considering anecdotal reports, there are numerous potential factors we can't rule out: Was there a placebo effect? Did the tumor stop growing by natural or endogenous reasons - (some tumors regress spontaneously owing to the body’s antitumor defenses)? How many patients have taken cannabis who haven't seen a therapeutic effect (we only hear the success stories)? Was the effect of cannabis due – at least in part – to their standard therapy, but perhaps enhanced by cannabis? What were the parameters of tumor progression that were monitored and for how long (were the actions short or long-term)? For more on this topic, read Dr. Guzman's article, "Do Cannabinoids Cure Cancer?"
It’s important to note that there have been pharmaceutical versions of cannabis that have been approved to treat cancer-related symptoms — like Marinol — however, the vast majority of patients (90%+) prefer botanical cannabis to pharmaceuticals. Marinol, for example, is synthetically isolated THC. Patients complain that without CBD and other cannabinoids, it produces far too intense of a high. Scientifically speaking, Marinol is, in fact, far more psychoactive than most botanical cannabis.
Glaucoma affects over four million Americans and is the leading cause of irreversible blindness. Most states consider glaucoma to be a qualifying condition to treat with cannabis. So it was surprising to review the research and only to find few patients who’ve had significant success with cannabis. Cannabis actually does not appear to be the best treatment option for glaucoma. While it does reduce intraocular pressure (IOP) — which is extremely important — it doesn’t do it as well as newer topical drugs and surgical procedures. Most important to note, a patient would need to use cannabis six to eight times per day to effectively treat their glaucoma.
However, research into cannabinoids is ongoing, and the future looks promising in that it's likely scientists will develop effective cannabinoid-derived medications to treat glaucoma. Also, while few ophthalmologists are willing to recommend cannabis to treat early to mid stage glaucoma patients, for late stage patients it may be appropriate. These patients often suffer from chronic pain and nausea. However, cannabis would be used to treat the accompanying symptoms, not targeting the glaucoma itself.
AIDS-associated anorexia and wasting syndrome
Research has demonstrated that cannabis administered in various forms — inhalation or oral — helps patients restore weight while improving mood and quality of life. There’s no evidence that it has an impact on whether cannabis has an impact on morbidity or mortality, but given its relative safety profile, the benefits of cannabis appear to far outweigh any risks.
Research proves both CBD and THC produce remarkable antiinflammatory effects, thanks to their ability to inhibit adverse cell proliferation, suppress cytokine production, and induce apoptosis (sudden cell death). CBD, in particular, has generated a lot of enthusiasm, because it appears highly effective, while not producing psychotropic effects. While psychotropic effects may be desirable in certain situations, clearly they’re not desirable at all times -- like operating machinery or driving a car.
Early research suggests CBD may be highly effective to treat rheumatoid arthritis and diseases related to gastrointestinal issues such as ulcerative colitis and Crohn’s disease.
Most research thus far has focused on spasticity, however, multiple sclerosis — or, MS — comes with many symptoms including pain and sleep disturbances, inflammatory issues, muscle spasms, abdominal complaints and mood issues. Research has shown that a blend of THC and cannabidiol (CBD) is effective in treating all of these symptoms. For a remarkable case study, read about Jabe Couch's story.
In 2009 the National Multiple Sclerosis Society made the following statement: “[I]t is clear that cannabinoids have a potential for both management of MS symptoms such as pain and spasticity, as well as for neuroprotection.”
"Arthritis" is a term used to describe over 200 rheumatic diseases that affect the joints and surrounding tissues. It causes inflammation and stiffness resulting in severe pain in the joints and muscles.
Not only is cannabis an analgesic, it’s also anti-inflammatory, and many patients report it provides tremendous relief from joint, bone and muscle pain. Inhalation (smoking or vaping) provides instant relief, but tends to be short in duration. Edibles take longer to relieve symptoms, but the duration of relief is longer. Many patients report that they will consume via inhalation and follow with an edible to provide relief that lasts through the night.
There hasn't been a significant amount of research studying cannabis as a treatment for PTSD, however, many PTSD patients have reported cannabis is the only thing that has helped them. In fact, the anecdotal evidence coupled with scientific plausibility has been persuasive enough that the FDA and DEA approved the first randomized controlled-trial (RCT) of botanical cannabis to conduct a comprehensive study of its potential efficacy.
The explanation for why cannabis appears to be effective as a treatment in PTSD is two-fold: Firstly, PTSD patients are anandamide-deficient. Anandamide is a vitally important neurotransmitter, that’s also considered the “body’s own THC.” In fact, it’s often called the body’s “bliss molecule.” Cannabis appears to be able to help correct the deficiency. Also, cannabis may be helpful through a mechanism called “aversive memory extinction.” PTSD patients frequently complain of recurrent memories of traumatic events, and THC actually helps patients “forget” these memories.
For more on PTSD, read our blog, "Cannabis Treats PTSD: What’s the Science Behind It?"
Cannabis has consistently demonstrated efficacy in treating epilepsy. According to the National Epilepsy Foundation, “Cannabidiol, or CBD, does not cause psychoactive effects but has shown some positive effects on certain body systems and may potentially affect seizures." In one study, participants over a 12-week period showed (on average) a 36.5 percent reduction in monthly motor seizures, with a monthly frequency of seizures cut in half (from 30 motor seizures a month to 15.8).
If you're interested in learning more about other conditions, you can find links to other articles written by the author below:
- Multiple Sclerosis and Cannabis
- Cannabis vs. Opioids for Chronic Pain
- Cannabis and Traumatic Brain Injury (TBI)
- Is Cannabis More Effective Than Prescription Drugs to Treat Fibromyalgia?
- How Does Cannabis Affect Neurodegenerative Disorders?
- Is Cannabis Effective in Treating Insomnia?
- How Does Cannabis Affect Autism?
- Cannabis and Arthritis
- Can Cannabis Cure Cancer?