Let me get a few things out of the way before we start this conversation. I’m only addressing medical marijuana, not recreational, and specifically as it’s used to treat seizures. I believe that any treatment should be used in consultation with a doctor that you trust. I’m not a doctor, though like many Medical Moms I’ve passed for one. None of this should be taken as medical advice. Lastly, any preconceived notions you have about the pot your friends smoked in high school, get rid of it because that’s not what we’re talking about.
When I saw the following video, I started researching medical marijuana (MM). I still have lots of questions, but I wanted to share what I’ve learned.
Please watch this (subscribers will have to click through to blog)
In what I’ve read about MM and Epilepsy, there are two cannabinoids, or chemical compounds, to take into consideration. The first is cannabidiol or CBD. It has a more sedative effect, inhibits cancer cell growth, and has been shown to relieve anxiety, nausea, inflammation, and convulsions. The second cannabinoid is tetrahydrocannabinol or THC. This is responsible for “getting high,” or the psychoactive effect of cannabis. It has an analgesic effect that can be used to treat pain, and it stimulates hunger which can be medically beneficial. The plants that have been used to treat people with Epilepsy have a very high CBD:THC ratio, sometimes 30:1.
There are several ways to consume MM. Vaporizing MM allows it to enter the bloodstream quickly but without the associated risks of smoking it. Because the plant is heated but not ignited, it prevents the formation of carbon monoxide and carcinogens. Edibles are brownies, soups, sauces, cookies that use oil infused with cannibas. It may be more difficult to get an appropriate dose and can be easier to over-consume. MM can also be absorbed in the form of tea, soda, and topical lotions. I believe this video refers to MM being taken as a drops. According to United Patients Group:
Cannabis can also be made into tinctures and tonics, which are then added to food and liquids, applied on the skin, or consumed directly in small amounts or by placing drops under the tongue. This is particularly useful when nausea and vomiting are present, such as when undergoing chemotherapy treatments. Tinctures and tonics are made much in the same way as edibles, but instead of cooking them in butter or oil, the cannabis flowered tops and leaves are soaked in alcohol. The solids are then finely strained, leaving behind a liquid that contains the THC and other cannabinoids that produce the needed medical relief.
There seem to be two major factors that are impeding the safe use of MM.
First, though MM is legal in 20 states and in D.C., (including all of my neighbors – even you NH as of this summer) it remains illegal under the federal Controlled Substances Act. The federal government is now in an awkward position of “turning a blind eye.” While they can’t commit to not prosecuting people who use, grow, or distribute MM, they claim to have other priorities. Those priorities include preventing marijuana distribution to minors and stopping drug trafficking by gangs and cartels. In a DOJ memorandum from Deputy Attorney General James Cole:
Outside of these enforcement priorities, the federally government has traditionally relied on state and local law enforcement agencies to address marijuana activity through enforcement of their own narcotics laws. For example, the Department of Justice has not historically devoted resources to prosecuting individuals whose conduct is limited to possession of small amounts of marijuana for personal use on private property….the Department advised that it was likely not an efficient use of federal resources to focus enforcement resources on seriously ill individuals, or on their individual caregivers. In doing so, the previous guidance drew a distinction between the seriously ill and their caregivers on the one hand, and large scale for-profit enterprises on the other.
However, the Department of Justice under the Obama Administration has already spent over $300 fighting MM and has carried out an unprecedented amount of raids. This has led to lots of conversations between the DOJ, DEA, Congress and the Attorney General.
The second major factor impeding the safe use of MM is research. Doctors have been, and should be, hesitant to prescribe a substance that hasn’t been properly tested and is kind of illegal, sort of. The stories shown in the video are compelling testimony, but medicine is based on science and data. The importance of sharing these stories is to urge scientists to get to work so doctors can get on board. Fortunately GW Pharmaceuticals has announced a trial for cannabinoids as specifically related to Epilepsy treatment. GW is known for Sativex which was the first cannabis derived medicine to be put on the market. Our local, and highly regarded in my circles, Epileptologist Dr. Elizabeth Thiele from Mass General will be involved in this trial. This is what the Wall Street Journal has to say:
Dr. Ben Whalley, Senior Lecturer in Pharmacology at the Reading School of Pharmacy, said, “Our research collaboration with GW over the last several years has shown that GWP42006 not only exerts significant anticonvulsant effects in a wide range of preclinical models of seizure and epilepsy but is also better tolerated compared to existing anti-epileptic drugs. It is also noteworthy that GWP42006 appears to employ a different mechanism of action to currently available anti-epileptic treatments. Together, these findings fully support the exciting clinical development that is now underway and represent an important step towards a more effective and better tolerated treatment for epilepsy.”
This is clearly a lot of information to take in and it only leads me to more questions. I’d really love to hear from you. What are your thoughts and questions? Do you have any resources to share regarding this topic? On friday I will share my personal response to what I learned.
- Wall Street Journal – GW trial
- Epilepsy.com – GW trial
- CNN – State and Federal laws
- HuffPo – State and Federal laws
- Peace for Patients – Americans for Safe Access
- Real of Caring Foundation – Stories of Charlotte and Zaki and others
- Cannabis Search – consumption methods
- ProCon.org – list of states that have legalized MM and tons of other info
- ProCon.org – Did You Know? list
- United Patients Group – consumption methods
- DOJ Memorandum – State and Federal laws, very interesting document straight from the government and currently being hotly contested