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medical marijuana

Marijuana and Seizures: Reality, or Just an Excuse?

December 20, 2014 by James Bogash

marijuana and seizures
johny87/Dollar Photo Club

With seemingly half the states in the US passing some version of permissive cannabis laws, the list of conditions that benefit from its use just seems to grow.

But are there really benefits to marijuana use that extend beyond a different viewpoint while listening to Pink Floyd or attending a Parrothead event?

Before we answer that, let’s go over some background on marijuana by covering some of the more popular active constituents of cannabis.  The plant is a veritable cornucopia of bioactive compounds–with some 483 compounds having been identified to date.

  1. Tetrahydrocannabinol (THC) is the most famous component of the plant, known for producing the relaxation high associated with smoking marijuana.  It also has pain-blocking and anti-nausea properties .
  2. Cannabidiol (CBD) is another cannabinoid that has the most accepted medical use, especially with seizures.

CBD oil is something that has been gaining ground in the treatment of both migraines and seizures.  Despite it’s name, CBD oil is really a mismosh of compounds, including multiple types of healthy fats, amino acids and fiber.  It does contain a small amount of the CBD noted above.  While we don’t really know which aspect of CBD oil is having a positive effect on the brain, it really doesn’t matter to those who see a benefit.

It is beyond the scope of this article to go into the different strains being grown with varying levels of THC and CBD, mainly because it’s outside of my realm of knowledge.  It is clear that regular medical users seem to have different experiences with different strains.

One thing that is clear, if you can rise above the debate of its legalization, there are clear medical benefits of marijuana compounds in migraines and epilepsy.  I’ve had patients over the years who have successfully controlled their seizures using marijuana when medications were not able to.  In some cases I’ve felt it might have been just pure stress reduction from the euphoria, in other cases something else was at play.

This particular study, while a little detailed, takes in in-depth look at just what mechanisms may be at play in the anti-seizure effects of the cannabinoids.  In it, researchers looked at one of the two main cannabinoid receptors (CB2R) in the brains of rats to see what effect a marijuana-like synthetic compound had inside the cell.

While I will not go into specifics (no really–if you want to read more about the compound used, termed WIN 55,212-2, (R)-(+)-[2,3-dihydro-5-methyl-3-(4-morpholinylmethyl) pyrrolo[1,2,3-de]-1,4-benzoxazin-6-Yl]-1-naphthalenylmethanone, then feel free to study it yourself….) suffice it to say that research has moved beyond the idea that compounds found in marijuana have anti-seizure effects to trying to figure out exactly how they work.

The skeptic in me would say that this is just so we can create a synthetic compound (like the $1.50 word above) to mimic marijuana’s effect so some drug company can patent it later.  But only because this is the model they live by.

In the meantime, if you have migraines or seizures and your neurologist seems hesitant to discuss the medical use of marijuana, it might be time to find a new one.

 

Filed Under: Migraine, Seizures / Epilepsy Tagged With: cannabinoids, CBD, CBD oil, marijuana, medical marijuana, THC

Medical Marijuana Use and Opioid Deaths; Surprising Findings

September 26, 2014 by James Bogash

The concerns with opioid use are becoming legendary.  Despite grave concerns, prescriptions for this class of drugs continue to rise.

The only thing I can figure is that the same group of physicians that are writing prescriptions for hydrocodone, Percocet and Vicodin are also ordering CT scans on every patient.  And maybe even writing antibiotic prescriptions for clearly viral related illnesses.

Regardless, there does not seem to be a clear end in sight to the overuse of opioids.  Sometime in 2010 the number of deaths associated with prescription pain killers (principally opioids) surpassed deaths from illegal drugs like heroin and cocaine.  Interesting when you consider the fact that the illegal drugs are obtained illegally with no type of gatekeeper (and so should be easier to get with the right connections) and the prescription drugs have to go through a gatekeeper that is supposed to restrict access to only those that need the drug.

Of course, the illegal drugs are purchased with cash that is paid for by the users while the prescription drugs are largely paid for by the insurance companies.  Kind of a sick system if you really think about it.

Despite all this, the uproar that accompanies medical marijuana legislation is quite loud.  Those who oppose legislation say it’s a bad idea and will cost society.  Ironically, this same group does not seem to have a problem with handing out opioids like Halloween candy to everyone who visits the ER or urgent care with so much as a sprained pinky.  And this overuse is actually supported by the insurance companies.  Crazy.

Considering that some people use medical marijuana for pain control, it would be interesting to see what happens to opioid overdosages in those states that have passed medical marijuana laws.  Conveniently enough, this particular article addresses just that question.

(Disclaimer:  Those who know me could easily confirm that I am NOT and have never used marijuana.  Not even an inhale.  So the opinion expressed in this article is in no way tied to my personal attachments or lack thereof for marijuana.)

In the study, researchers looked at opioid overdose deaths across all 50 states from 1999-2010 and compared the states with medical cannibis legislation.    Here’s what they found:

  • Three states (California, Oregon, and Washington) had medical cannabis laws effective prior to 1999.
  • Ten states (Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Rhode Island, and Vermont) enacted medical cannabis laws between 1999 and 2010.
  • States with medical cannabis laws had a 24.8% lower rate of opioid overdose deaths.
  • In general, the longer the laws had been in effect, the lower that state’s risk of opioid overdose deaths.

Makes for kind of a hard argument supporting the use of medical marijuana for chronic pain control instead of opioids.  This protection (which can only come from a shift to marijuana away from opioids) is despite the fact that insurance covers prescription drugs and marijuana users are paying cash.  Talk about a windfall for the insurance companies.  You’d think they’d be lining up to get laws passed in all 50 states just to save money (opioid costs are a large chunk of chronic pain expenditures).

I think I’ll file this one under ‘natural pain relief.”

 

Filed Under: Natural Pain Relief Tagged With: chronic pain, marijuana for chronic pain, medical marijuana, opioid overdose, opioids

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