EDITORIAL NOTE: Although today's is a lengthy post, I hope at least some of the information will be useful to you. If it isn't, you could scroll to the bottom for the latest edition of The Alex and Ronni Show. In fact, you could watch it even if you do read the entire post.
Elders and Cannabis – Part 1 can be found here.)
To pick up from where we left off on Monday discussing legal issues of cannabis, here is a map from Governing showing which states permit medical and/or recreational marijuana – or not. Visit governing.com for other variations from state to state.
MEDICAL USES OF MARIJUANA
Cannabis has been used as a medical treatment for thousands of years. Nowadays we know that the two main chemicals in marijuana used for medical purposes are tetrahydrocannabinol (THC) and cannabidiol (CBD).
THC gets you high, CBD does not, no matter how much you imbibe, and both are useful in treating medical conditions. At legal dispensaries, in addition to buds of marijuana themselves, you can buy edibles that contain entirely CBD, entirely THC or a combination of both in various proportions.
For my sleep problem, my first try was an edible containing CBD. For me, I might as well have had a glass a water – it did nothing for my sleep. I switched to a THC tincture and it puts me to sleep within about 45 minutes – not enough time to get high or, more likely, to notice that I'm high.
The number of conditions that cannabis helps is long and includes cancer. There are two U.S. Federal Drug Administration (FDA)-approved pills containing cannabis, Marisol and Cesamet, that are often prescribed to help control nausea and vomiting during chemotherapy.
I don't know if it is still so, but back in the 1990s, my step brother was prescribed Marinol to control some of the effects of AIDS.
The top two reasons elders use cannabis is for arthritis pain and difficulty sleeping. Dr. Igor Grant is a distinguished professor and chair of the Department of Psychiatry at the University of California, San Diego and the recipient of one of the rare federal grants allowing him to research the potential benefits of pot. From CBS News:
"'First of all, there is increasing evidence that cannabis is helpful in the management of certain kinds of pain,' Grant said. And it's the kind of discomfort experienced by seniors, like sharp pains felt by nerve damage, caused by things like chemotherapy or diabetes...
“Kerry Stiles, 78, wears a pacemaker. And he discovered pot at the Rossmoor retirement community in Walnut Creek, across the bay from San Francisco. 'I drop it under my tongue, about five or six drops, and that helps me sleep,' Stiles said.”
Moving on from pain and sleep, a January 2018 study from Ben-Gurion University of the Negev (BGU) and the Cannabis Clinical Research Institute at Soroka University Medical Center reported in Science News found that
”...cannabis therapy is safe and efficacious for elderly patients who are seeking to address cancer symptoms, Parkinson's disease, post-traumatic stress disorder, ulcerative colitis, Crohn's disease, multiple sclerosis, and other medical issues.”
There is conclusive or substantial evidence that cannabis or cannabinoids are effective:
• For the treatment for chronic pain in adults
• Antiemetics in the treatment of chemotherapy-induced nausea and vomiting
• For improving patient-reported multiple sclerosis spasticity symptoms (oral cannabinoids)
There is moderate evidence that cannabis or cannabinoids are effective for:
• Improving short-term sleep outcomes in individuals with sleep disturbance associated with obstructive sleep apnea syndrome, fibromyalgia, chronic pain, and multiple sclerosis
There is limited evidence that cannabis or cannabinoids are effective for:
• Increasing appetite and decreasing weight loss associated with HIV/AIDS
• Improving clinician-measured multiple sclerosis spasticity symptoms
• Improving symptoms of Tourette syndrome (THC capsules)
• Improving anxiety symptoms, as assessed by a public speaking test, in individuals with social anxiety disorders
• Improving symptoms of post-traumatic stress disorder
There is limited evidence of a statistical association between cannabinoids and:
• Better outcomes (i.e., mortality, disability) after a traumatic brain injury or intracranial hemorrhage
There is limited evidence that cannabis or cannabinoids are ineffective for:
• Improving symptoms associated with dementia
• Improving intraocular pressure associated with glaucoma
• Reducing depressive symptoms in individuals with chronic pain or multiple sclerosis
Hardly any of this information is definitive – at least in the U.S. - because, as NORML reported in 2010:
”Lawmakers and health regulators demand clinical studies on the safety and efficacy of medical cannabis, but the federal agency in charge of such research bars these investigations from ever taking place...
“Under federal law, the National Institute of Drug Abuse – NIDA - (along with the U.S. Drug Enforcement Administration) must approve all clinical and preclinical research involving marijuana.
“NIDA strictly controls which investigators are allowed access to the federal government’s lone research supply of pot – which is authorized via a NIDA contract and cultivated and stored at the University of Mississippi.”
Nothing has changed with the federal government's position toward cannabis research since this report.
POTENTIAL SIDE EFFECTS OF USING CANNABIS
If you can stand one more list, here is a one about possible side effects of from the same study [pdf] done by the U.S. National Academies of Science and published in January 2017:
• Statistical association between cannabis smoking and worse respiratory symptoms in respiratory disease with long-term cannabis smoking
• Increased risk of motor vehicle crashes
• Development of schizophrenia or other psychoses, with the highest risk among the most frequent users
• Statistical association between increases in cannabis use frequency and progression to developing problem cannabis use
• No statistical association between smoking cannabis and incidence of lung cancer
• Impairment in cognitive domains of learning, memory and attention (acute cannabis use)
• Small increased risk for development of depressive disorders
• Increased risk of suicide ideation and suicide attempts with a higher incidence among heavier users
• Increased incidence of social anxiety disorder with regular cannabis use
• Being male and smoking cigarettes are risk factors for the progression of cannabis use to developing problem cannabis use
• Major depressive disorder is a risk factor for the development of problem cannabis use
Limited or no evidence:
• Increased risk of acute myocardial infarction
• Statistical association between cannabis smoking and developing chronic obstructive pulmonary disease
• Statistical association between cannabis use and death due to cannabis overdose
Due to the lack of research, I don't buy a lot of this list – especially those in the moderate, limited and no evidence categories which is why, with so much anecdotal evidence of the therapeutic value of cannabis, the federal government needs to catch up with the 30 states and approve the research.
Whether the FDA, Attorney General Jeff Sessions or anyone else in the federal government likes it or not, it is only a matter of time now until cannabis is accepted as both a medical treatment and for recreational use, as alcohol is accepted.
In fact, Bloomberg News recently reported that the alcohol industry is concerned as is the soft drink industry. Here is their short video report:
It is true that as we get older, we get sicker: cancer, diabetes, Parkinson's disease, heart conditions, etc. are called “diseases of age” for a reason. If cannabis can help control symptoms, it should be legally available to everyone.
Of course, it's important to consult a physician first. In my case, it was a doctor who first suggested cannabis for my sleep difficulty.
Now, whenever I see my doctors – cancer and primary care – I am handed a printout of my current drugs from their records so I can confirm them. We recently added cannabis to the list so that when prescriptions are being added, subtracted or changed, interactions can be taken into consideration.
HOW TO IMBIBE CANNABIS
For years of illegal marijuana, almost everyone smoked it or, occasionally, made brownies and other edibles with it. I still have a 1996 paperbook titled Brownie Mary's Marijuana Cookbook that includes recipes for pot macaroni and cheese, shrimp casserole and spagetti sauce.
These days, cannabis is much MUCH stronger than in the past. If you are smoking it, what once took a joint or two to get high, requires only a couple of tokes. These days, in addition to hand-rolled joints, there are various kinds of pipes and vaporizers.
In states where cannabis is legal, you can also buy tinctures to take by mouth, creams to rub into your skin, candies along with ingestible oils that come in capsules. Visit this page at Leafly for more information about how to use cannabis.
Most of the links through this story have additional good information about cannabis in general and as related to elders.
Here's the latest episode of The Alex and Ronni Show.