Medical marijuana: Hype vs Hope

Nearly half the states in America have legalized marijuana for medical use, and many others are close to passing it. One of the major objections is the lack of robust evidence. But research is still limited, creating a “catch 22”: There’s limited evidence supporting the efficacy of cannabis-based therapies, and that’s because of a lack of research. But research (in the U.S.) is severely restricted by federal law.

Gradually, however, even some mainstream organizations are starting to call for more cannabis-related research and acknowledging that some evidence already exists.

Case in point: A 395-page report from the National Academies of Sciences, Engineering, and Medicine (NAS) found “conclusive or substantial evidence” that marijuana-related compounds can effectively treat chemo-induced nausea, chronic pain and patient-reported spasms related to multiple sclerosis. It cited moderate to limited research for other conditions, outlined the potential risks and called for more study.

Marijuana contains dozens of chemicals called cannabinoids. The two cannabinoids most frequently used in medicine are Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is what produces the “high.”

Pain Relief

Humans been using cannabis for pain relief for centuries and science appears to support the link between marijuana- or cannabis-based medicine and pain relief in numerous indications. Here are three of many examples:

  • Rheumatoid arthritis:A small rheumatoid arthritis study found patients who took a cannabis-based medication had less pain and slept better. Marijuana may help fight pain-causing inflammation.
  • Cancer pain and chemo nausea:Marijuana has been shown to prevent the nausea that often accompanies chemotherapy. It is also associated with relief for patients with advanced cancer pain–pain not fully relieved by opioids.
  • Menstrual cramps:Despite an abundance of anecdotal data from women, there’s little hard evidence on the impact of cannabis specifically menstrual pain. (There is, however, evidence to support both its pain-relief and antispasmodic properties.) That’s not stopping the production of therapeutics. In 2016, Whoopi Goldberg co-founded a medical marijuana company focused on dysmenorrhea; it markets such products as sipping chocolate and a bath soak. Another company, Foria Relief, offers marijuana compounds in the form of a vaginal suppository.

Neurodegenerative Diseases–Another Promising Area

Based on existing studies, cannabis appears to relieve the symptoms of neurodegenerative diseases such as multiple sclerosis, Huntington’s, Parkinson’s and Alzheimer’s diseases, and amyotrophic lateral sclerosis. For example:

  • MS patients who used marijuana in some form experienced a major decline in muscle spasms and stiffness, tremors and pain. It also appeared to improve sleep.
  • Early research in Parkinson’s suggests cannabis reduces the pain associated with the disease, and a small study out of Israel found that after 30 minutes of smoking marijuana, patients showed considerable reduction in tremors, muscle rigidity and pain.
  • Cannabinoid products appear to help Alzheimer’s patients gain weight, and alleviate symptoms such as agitation, anxiety, depression, insomnia and hallucinations. Even more promising, one very early study suggests it may slow the production of beta-amyloid proteins, which lead to the plaque build-up on the brain associated with Alzheimer’s.

Accordingly, cannabinoids–especially derivatives without psychotropic effects–could become a potential treatment of neurodegenerative disorders. But much more research is needed.

Epilepsy

Epilepsy wasn’t mentioned in the NAS study, but the body of evidence continues to expand–even in the U.S. The FDA has given some epilepsy centers “compassionate use” permission to use a CBD extract for a limited number of patients.

CBD has been shown to reduce seizures in pediatric and adolescent patients, and newer research suggests it does the same for adults with Lennox-Gastaut syndrome, a particularly difficult-to-treat form of epilepsy. What’s interesting, Scientific American reports, is that despite the growing evidence, researchers are largely in the dark about how it actually works.

Other Conditions with Moderate and Limited Evidence

There are several other conditions where the evidence is moderate or limited–but again, keep in mind that may have less to do with lack of efficacy than it does with lack of research.

  • AIDS/HIV: Some very small studies suggest that HIV-positive marijuana smokers ate and slept better, experienced improved moods and had less neuropathic pain.
  • Asthma: Some early research suggests marijuana reduces exercise-induced asthma and also has a dilating effect on airways. Asthma, like many other breathing disorders, involves airway inflammation; CBD’s anti-inflammatory properties have made it a target for researchers.
  • Tourette syndrome:Several small studies suggest that cannabinoid extracts can reduce both motor and vocal tics in patients with treatment-resistant Tourette.

One Disappointment: Glaucoma

When medical marijuana first hit the mainstreamglaucoma, along with chemo-induced nausea, was one of the key conditions explored. But this one hasn’t stood the test of time. Yes, marijuana does lower the eye pressure, but it also lowers blood pressure which could result in reduced blood supply to the optic nerve, damaging it– which in turn might harm the optic nerve, according to the Glaucoma Research Foundation.

Moving Forward

Many opponents of medicinal marijuana cite the lack of evidence for its benefits. But those same opponents–at least those with policy-making powers–restrict research.

Various physician associations and healthcare organization are calling for, at the very least, more research into the medical benefits of marijuana. It’s beyond politics for them. But as long as it remains political for the federal government, most research will remain “limited.”

~ Health Scams Exposed