Maine: Medical Marijuana Program Expanded To Include Patients With PTSD, Other Debilitating DisordersJune 27, 2013
Patients diagnosed with post-traumatic stress, Crohn’s disease, and other debilitating disorders will now be eligible for cannabis therapy, under legislation approved yesterday absent the Governor’s signature.
The new law expands the list of qualifying conditions for which a Maine physician may legally recommend cannabis to include “post-traumatic stress disorder,” “inflammatory bowel disease” (such as Crohn’s and/or ulcerative colitis), and “dyskinetic and spastic movement disorders and other diseases causing severe and persistent muscle spasms” (such as Parkinson’s disease and/or Huntington’s disease). It is the second time that Maine legislators have acted to expand the pool of patients who may have access to medicinal cannabis.
Under state law, qualified patients in Maine may either cultivate their own cannabis or obtain it from one of eight state-licensed dispensaries.
Four states — Connecticut, Delaware, New Mexico, and Oregon — specifically allow for the use of cannabis to treat symptoms of post-traumatic stress. Clinical trial data published in the May issue of the journal Molecular Psychiatry theorized that cannabinoid-based therapies would likely comprise the “next generation of evidence-based treatments for PTSD (post-traumatic stress disorder).”
Survey data published in 2011 in the European Journal of Gastroenterology and Hepatology reports the use of cannabis therapy is common among patients with inflammatory bowel disorders. Most recently, researchers at the Meir Medical Center, Department of Gastroenterology and Hepatology in Israel reported that inhaling cannabis reduces symptoms of Crohn’s disease compared to placebo in patients non-responsive to traditional therapies. Investigators concluded, “Our data show that 8-weeks treatment with THC-rich cannabis, but not placebo, was associated with a significant decrease of 100 points in CDAI (Crohn’s Disease and activity index) scores.” (The CDIA is a research tool used to quantify the symptoms of Crohn’s disease patients.) Five of the eleven patients in the study group also reported achieving disease remission (defined as a reduction in patient CDAI score by more than 150 points).
NSAIDs (non-steroidal anti-inflammatory drugs such as ibuprofren) are among the most widely used analgesic substances in the world. However, the consumption of these products is associated with various adverse and life-threatening side-effects such as heart-attack, stroke, and internal bleeding. In fact, according to a 2001 analysis, in the United States alone, “gastrointestinal complications induced by nonsteroidal anti-inflammatory drugs (NSAIDs) cause more than 100,000 hospitalizations and an estimated 16,500 deaths annually.”
Could these adverse gastrointestinal effects be offset by cannabis? A just published study in the European Journal of Pharmacology indicates that the most likely answer is ‘yes.’
Researchers at West Virginia University assessed the impact of THC administration in an animal model of NSAID-induced gastric inflammation. Investigators reported that low doses of THC provided gastroprotective effects, significantly attenuating gastric hemorrhages and lesions.
They concluded: “The results of the present study suggest that delta-9-THC … may also possess gastroprotective effects in NSAID using patients. … As current antacid regimens may be associated with undesirable effects, such as reduced bone density, increased risk of bacterial infection, and vitamin deficiencies, other approaches to prevent NSAID-induced gastric ulcers are needed. In addition to their gastroprotective effects, cannabinoids produce other beneficial effects, including pain reduction. … Thus, cannabinoids may have the added benefit of reducing the effective analgesic dose of NSAIDs, as well as reducing the incidence of NSAID-induced gastric ulcers.”
Full text of the study, “Acute delta-9-tetrahydrocannabinol blocks gastric hemorrhages induced by the nonsteroidal anti-inflammatory drug diclofenac sodium in mice,” appears online in the European Journal of Pharmacology.
Study: Cannabis Smoking Not Associated With Increased Lung Cancer Risk Or Other Serious Pulmonary ComplicationsJune 19, 2013
A forthcoming review to be published in journal Annals of the American Thoracic Society reiterates that the ingestion of cannabis smoke poses nominal pulmonary risks compared to those associated with tobacco smoke. The author of the paper, Donald P. Tashkin, MD, emeritus professor of medicine and medical director of the Pulmonary Function Laboratory at the David Geffen School of Medicine at University of California, Los Angeles performed US-government sponsored studies of marijuana and lung function for over 30 years.
A preview of Dr. Tashkin’s forthcoming review appears on the American Thoracic Society news website here. It reads:
Dr. Tashkin found that regular smoking of marijuana by itself causes visible and microscopic injury to the large airways that is consistently associated with an increased likelihood of symptoms of chronic bronchitis that subside after cessation of use. He also found that the evidence does not indicate that habitual use of marijuana leads to significant abnormalities in lung function when assessed either cross-sectionally or longitudinally, except for possible increases in lung volumes and modest increases in airway resistance of unclear clinical significance.
The author finds no clear link between marijuana use and the development of COPD or lower respiratory tract infections. In addition, “findings from a limited number of well-designed epidemiological studies do not suggest an increased risk for the development of either lung or upper airway cancer from light or moderate use, although evidence is mixed concerning possible carcinogenic risks of heavy, long-term use,” Dr. Tashkin notes. “In summary, the accumulated weight of evidence implies far lower risks for pulmonary complications of even regular heavy use of marijuana compared to the grave pulmonary consequences of tobacco.”
The full paper will be available later this month.
In May, presenters at the annual meeting of the American Academy for Cancer Research reported that subjects who regularly inhale cannabis smoke possess no greater risk of lung cancer than do those who consume it occasionally or not at all — according to an analysis of six case-control studies, conducted between 1999 and 2012, involving over 5,000 subjects (2,159 cases and 2,985 controls) from around the world.
Last year, clinical data published in the Journal of the American Medical Association (JAMA) reported that subjects’ exposure to moderate levels of cannabis smoke, even over the long-term, is not associated with significant adverse effects on pulmonary function.
Vaporizers, which heat marijuana to a point where cannabinoid vapors form, but below the point of combustion, reduce subjects’ intake of potentially hazardous combustible compounds. In several clinical trials, investigators have concluded that vaporization is a “safe and effective” cannabinoid delivery mode that “does not result in exposure to combustion gases.” Researchers also report that vaporization results in higher plasma concentrations of THC compared to smoked cannabis.
Another study has once again affirmed that the enactment of statewide medical cannabis laws is not associated with increased rates of adolescent marijuana consumption.
According to data published this week in the American Journal of Public Health, the passage of medical marijuana laws in various states has had no “statistically significant … effect on the prevalence of either lifetime or 30-day marijuana use” by adolescents residing in those states.
Researchers at the University of Florida College of Medicine evaluated the effects of medical marijuana laws on adolescent marijuana use rates during the years 2003 and 2011. Investigators “found no evidence of intermediate-term effects of passage of state MMLs (medical marijuana laws) on the prevalence or frequency of adolescent nonmedical marijuana use in the states evaluated.” Authors concluded, “Our results suggest that, in the states assessed here, MMLs have not measurably affected adolescent marijuana use.”
The study’s findings rebut often repeated claims from cannabis prohibitionists that the passage of therapeutic cannabis laws adversely impacts teens’ usage of the substance.
In fact, numerous published studies have contradicted this claim. A 2012 analysis of statewide cannabis laws and adolescent use patterns of commissioned by the Institute for the Study of Labor (IZA) in Germany concluded: “Our results suggest that the legalization of medical marijuana was not accompanied by increases in the use of marijuana or other substances such as alcohol and cocaine among high school students. Interestingly, several of our estimates suggest that marijuana use actually declined with the passage of medical marijuana laws.”
A separate 2012 study by researchers at McGill University in Montreal and published in the journal Annals of Epidemiology reported similar findings, concluding: “[P]assing MMLs (medical marijuana laws) decreased past-month use among adolescents … and had no discernible effect on the perceived riskiness of monthly use. … [These] estimates suggest that reported adolescent marijuana use may actually decrease following the passing of medical marijuana laws.”
Previous investigations by research teams at Brown University in 2011 and Texas A&M in 2007 made similar determinations, concluding, “[C]onsistent with other studies of the liberalization of cannabis laws, medical cannabis laws do not appear to increase use of the drug.”
Full text of the study, “Effects of State Medical Marijuana Laws on Adolescent Marijuana Use,” appears online in the American Journal of Public Health.
Preclinical study data published online in the scientific journal Nutrition & Diabetes reports that tetrahydrocannabivarin (THCV) — a naturally occurring analogue of THC — possesses positive metabolic effects in animal models of obesity.
British researchers assessed the effects of THCV administration on dietary-induced and genetically modified obese mice. Authors reported that although THCV administration did not significantly affect food intake or body weight gain in any of the models, it did produce several metabolically beneficial effects, including reduced glucose intolerance, improved glucose tolerance, improved liver triglyceride levels, and increased insulin sensitivity.
Researchers concluded: “Based on these data, it can be suggested that THCV may be useful for the treatment of the metabolic syndrome and/or type 2 diabetes (adult onset diabetes), either alone or in combination with existing treatments. Given the reported benefits of another non-THC cannabinoid, CBD in type 1 diabetes, a CBD/THCV combination may be beneficial for different types of diabetes mellitus.”
Last month, Harvard Medical School researchers published observational data in The American Journal of Medicine reporting that subjects who regularly consume cannabis possess favorable indices related to diabetic control as compared to occasional consumers or non-users of the substance. Writing in an accompanying commentary, the journal’s Editor-in-Chief stated: “These are indeed remarkable observations that are supported, as the authors note, by basic science experiments that came to similar conclusions. … I would like to call on the NIH and the DEA to collaborate in developing policies to implement solid scientific investigations that would lead to information assisting physicians in the proper use and prescription of THC in its synthetic or herbal form.”
Observational trial data published in 2012 in the British Medical Journal previously reported that adults with a history of marijuana use had a lower prevalence of type 2 diabetes and possess a lower risk of contracting the disease than did those with no history of cannabis consumption, even after researchers adjusted for social variables such as subjects’ ethnicity and levels of physical activity.
Full text of the study, “The cannabinoid ?9-tetrahydrocannabivarin (THCV) ameliorates insulin sensitivity in two mouse models of obesity,” is available online here.