Tag Archives: medical marijuana

Medical Cannabis for Pediatric Moderate to Severe Complex Motor Disorders.

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SAGE Journals

“A complex motor disorder is a combination of various types of abnormal movements that are associated with impaired quality of life (QOL). Current therapeutic options are limited. We studied the efficacy, safety, and tolerability of medical cannabis in children with complex motor disorder. This pilot study was approved by the institutional ethics committee.

Two products of cannabidiol (CBD) enriched 5% oil formulation of cannabis were compared: one with 0.25% δ-9-tetrahydrocannabinol (THC) 20:1 group, the other with 0.83% THC 6:1 group. Patients aged 1 to 17 years (n = 25) with complex motor disorder were enrolled. The assigned medication was administered for 5 months.

Significant improvement in spasticity and dystonia, sleep difficulties, pain severity, and QOL was observed in the total study cohort, regardless of treatment assignment. Adverse effects were rare and included worsening of seizures in 2 patients, behavioral changes in 2 and somnolence in 1.”

https://www.ncbi.nlm.nih.gov/pubmed/29766748

http://journals.sagepub.com/doi/abs/10.1177/0883073818773028?journalCode=jcna

Medical Marijuana Use in Older Adults.

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Journal of the American Geriatrics Society banner“Symptom management in older adults, including pain and distressing non-pain symptoms, can be challenging. Medications can cause side effects that worsen quality of life or create other symptoms, and polypharmacy itself can be detrimental in older adults. 

Cannabinoids may offer a way of managing selected symptoms with fewer side effects.

Medical marijuana is an important area of study for older adults because of the side effects of other medications. It is also important for Baby Boomers, who are likely to have more experience with marijuana than older adults of previous generations. Therefore, geriatricians should understand medical marijuana’s clinical indications, adverse effects, and legal context.

This article reviews the evidence regarding indications for and risks of medical marijuana use in older adults.”

https://www.ncbi.nlm.nih.gov/pubmed/29668039

https://onlinelibrary.wiley.com/doi/abs/10.1111/jgs.15346

“Our study finds that the therapeutic use of cannabis is safe and efficacious in the elderly population.” https://www.ncbi.nlm.nih.gov/pubmed/29398248

“Medical cannabis significantly safer for elderly with chronic pain than Opioids”  https://www.sciencedaily.com/releases/2018/02/180213111508.htm

Marijuana Use Associations with Pulmonary Symptoms and Function in Tobacco Smokers Enrolled in the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS)

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“Marijuana use was found to have little to no association with poor pulmonary health in older current and former tobacco smokers after adjusting for covariates.

Among older adults with a history of tobacco use, marijuana use does not appear to increase risk for adverse lung function. ”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870739/

Accuracy of Patient Opioid Use Reporting at the Time of Medical Cannabis License Renewal.

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“The decision to authorize a patient for continued enrollment in a state-sanctioned medical cannabis program is difficult in part due to the uncertainty in the accuracy of patient symptom reporting and health functioning including any possible effects on other medication use.

We conducted a pragmatic convenience study comparing patient reporting of previous and current prescription opioid usage to the opioid prescription records in the Prescription Monitoring Program (PMP) among 131 chronic pain patients (mean age = 54; 54% male) seeking the first annual renewal of their New Mexico Medical Cannabis Program (NMMCP) license.

Seventy-six percent of the patients reported using prescription opioids prior to enrollment in the NMMCP, however, the PMP records showed that only 49% of the patients were actually prescribed opioids in the six months prior to enrollment.

Of the 64 patients with verifiable opioid prescriptions prior to NMMCP enrollment, 35 (55%) patients reported having eliminated the use of prescription opioids by the time of license renewal.

PMP records showed that 26 patients (63% of patients claiming to have eliminated the use of opioid prescriptions and 41% of all patients with verifiable preenrollment opioid use) showed no prescription opioid activity at their first annual NMMCP renewal visit.”

https://www.ncbi.nlm.nih.gov/pubmed/29623144

https://www.hindawi.com/journals/prm/2018/5704128/

Opioid prescriptions decreased in US states where marijuana was legally accessible

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“American states that permitted legal access to marijuana through medical cannabis laws or legalized its adult recreational use saw falls in opioid prescriptions over a five year period, research has found.

Researchers from the University of Georgia conducted longitudinal analysis of Medicare Part D records from 2010 to 2015. Their findings, published in JAMA Internal Medicine,1 showed a significant 14.4% average reduction in opioid prescriptions in states that allowed medical marijuana dispensaries. The effect was particularly pronounced in hydrocodone and morphine use.”

https://www.ncbi.nlm.nih.gov/pubmed/29618464

https://www.bmj.com/content/361/bmj.k1514.full

Cannabidiol to Improve Mobility in People with Multiple Sclerosis

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“Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) that affects an estimated 2.3 million people worldwide. The symptoms of MS are highly varied but frequently include pain, muscle spasticity, fatigue, inflammation, and depression. These symptoms often lead to reduced physical activity, negatively impact functional mobility, and have a detrimental impact on patients’ quality of life.

Although recent years have seen significant advances in disease modifying therapy, none of the current treatments halts or cures MS related symptoms. As a consequence, many people with MS (PwMS) look for alternative and complementary therapies such as cannabis.

The cannabis plant contains many biologically active chemicals, including ~60 cannabinoids. Cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC) are typically the most concentrated chemical components of cannabis and believed to primarily drive therapeutic benefit.

There is evidence that CBD has a number of beneficial pharmacological effects. It is anti-inflammatory, antioxidative, antiemetic, antipsychotic, and neuroprotective. The review of 132 original studies by Bergamaschi et al. describes the safety profile of CBD by highlighting that catalepsy is not induced and physiological parameters (heart rate, blood pressure, and body temperature) are not altered. Moreover, psychomotor and psychological functions are not negatively affected. High doses of up to 1,500 mg per day and chronic use have been repeatedly shown to be well tolerated by humans.

Additionally, there is also evidence that CBD may reduce the negative psychotropic effects, memory impairment, and appetite stimulation, anxiety and psychotic-like states of THC while enhancing its positive therapeutic actions.

 Anecdotal reports indicate that an increasing number of PwMS use cannabis (medical marijuana) as a supplement to improve their mobility.

Based on the following considerations, it is our opinion that CBD supplementation maybe advisable for PwMS to reduce fatigue, pain, spasticity, and ultimately improve mobility. “

https://www.frontiersin.org/articles/10.3389/fneur.2018.00183/full

Medical cannabis for paediatric developmental–behavioural and psychiatric disorders

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“Humans have used marijuana for millennia, variously as a spiritual sacrament, herbal medicine, dietary supplement or psychoactive inebriant. Use of Medical Cannabis (MC) is advocated for an increasing range of medical indications. Anecdotally, use of naturally occurring cannabis (phytocannabinoids) is said to have a calming effect in some children. There has been little drug discovery work in the field of child and adolescent mental health for many years, and there is an urgent need to develop safe and effective therapeutics for this vulnerable patient group. Medical cannabis may be one such treatment. In summary, MC has potential as a therapeutic option in the management of paediatric mental health symptoms; however, the evidence to support its use for these patients is not yet in. ” https://onlinelibrary.wiley.com/doi/full/10.1111/jpc.13902

Association of Medical and Adult-Use Marijuana Laws With Opioid Prescribing for Medicaid Enrollees

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“In this population-based, cross-sectional study using the all-capture Medicaid prescription data for 2011 to 2016, medical marijuana laws and adult-use marijuana laws were associated with lower opioid prescribing rates (5.88% and 6.38% lower, respectively).

Medical and adult-use marijuana laws have the potential to lower opioid prescribing for Medicaid enrollees, a high-risk population for chronic pain, opioid use disorder, and opioid overdose, and marijuana liberalization may serve as a component of a comprehensive package to tackle the opioid epidemic.

These findings suggest that medical and adult-use marijuana laws have the potential to reduce opioid prescribing for Medicaid enrollees, a segment of population with disproportionately high risk for chronic pain, opioid use disorder, and opioid overdose.

Marijuana is one of the potential nonopioid alternatives that can relieve pain at a relatively lower risk of addiction and virtually no risk of overdose.”

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2677000

“Medicare, Medicaid Opioid Scripts Decline in Medical Marijuana States”  https://www.medpagetoday.com/neurology/opioids/72105

Association Between US State Medical Cannabis Laws and Opioid Prescribing in the Medicare Part D Population

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“In this study, we investigated whether medical cannabis access was associated with prescription opioid prescribing in Medicare Part D. We found that overall opioid prescribing in Part D was lower when states permit access to medical cannabis. When examining data by individual drug classes, we found that prescriptions for hydrocodone and morphine had statistically significant negative associations with medical cannabis access via dispensaries; while not statistically significant, there were also negative associations between dispensary MCLs and fentanyl and “other opioid” use. Combined with previously published studies suggesting cannabis laws are associated with lower opioid mortality, these findings further strengthen arguments in favor of considering medical applications of cannabis as one tool in the policy arsenal that can be used to diminish the harm of prescription opioids.”

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2676999

“Rise of medical marijuana eases abuse of opioids, study says”   https://www.ajc.com/news/rise-medical-marijuana-eases-abuse-opioids-study-says/uyXDks4G81MMIsrmq2mkeL/

Unique treatment potential of cannabidiol for the prevention of relapse to drug use: preclinical proof of principle

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“Cannabidiol (CBD), the major non-psychoactive constituent of Cannabis sativa, has received attention for therapeutic potential in treating neurologic and psychiatric disorders.

Recently, CBD has also been explored for potential in treating drug addiction. Substance use disorders are chronically relapsing conditions and relapse risk persists for multiple reasons including craving induced by drug contexts, susceptibility to stress, elevated anxiety, and impaired impulse control. Here, we evaluated the “anti-relapse” potential of a transdermal CBD preparation in animal models of drug seeking, anxiety and impulsivity.

Rats with alcohol or cocaine self-administration histories received transdermal CBD at 24 h intervals for 7 days and were tested for context and stress-induced reinstatement, as well as experimental anxiety on the elevated plus maze. Effects on impulsive behavior were established using a delay-discounting task following recovery from a 7-day dependence-inducing alcohol intoxication regimen.

CBD attenuated context-induced and stress-induced drug seeking without tolerance, sedative effects, or interference with normal motivated behavior. Following treatment termination, reinstatement remained attenuated up to ≈5 months although plasma and brain CBD levels remained detectable only for 3 days. CBD also reduced experimental anxiety and prevented the development of high impulsivity in rats with an alcohol dependence history.

The results provide proof of principle supporting potential of CBD in relapse prevention along two dimensions CBD: beneficial actions across several vulnerability states, and long-lasting effects with only brief treatment. The findings also inform the ongoing medical marijuana debate concerning medical benefits of non-psychoactive cannabinoids and their promise for development and use as therapeutics.”

https://www.nature.com/articles/s41386-018-0050-8

“Non-psychoactive cannabis ingredient could help addicts stay clean. Preclinical study using rats shows that Cannabidiol can reduce the risk of relapse”  https://www.sciencedaily.com/releases/2018/03/180323104821.htm

“Non-psychoactive cannabis ingredient could reduce risk of relapse among recovering addicts. A preclinical study in rats has shown that there might be value in using a non-psychoactive and non-addictive ingredient of the Cannabis sativa plant to reduce the risk of relapse among recovering drug and alcohol addicts.”  https://www.news-medical.net/news/20180323/Non-psychoactive-cannabis-ingredient-could-reduce-risk-of-relapse-among-recovering-addicts.aspx

“Non-psychoactive cannabis ingredient could help addicts stay clean”  https://www.springer.com/gp/about-springer/media/research-news/all-english-research-news/non-psychoactive-cannabis-ingredient-could-help-addicts-stay-clean/15548156

“Non-psychoactive cannabinoid may enable drug addiction recovery”  https://www.drugabuse.gov/news-events/news-releases/2018/03/non-psychoactive-cannabinoid-may-enable-drug-addiction-recovery