HIV Neuropathy And Marijuana

Today's post from medireview.com (see link below) follows on from yesterday's post about the medical benefits of marijuana but in this case, relates it directly to people living with HIV. The title was deliberately set to draw your attention but in fact, the article talks about the general facts and fables about the HIV patient using marijuana. The two posts together should give you a great deal of information to help you make a decision as to whether to pursue marijuana as an option for helping your HIV related pain but even armed with this knowledge, always discuss it with a health professional to get confirmation. At least you'll have the facts behind your arguments.
 

Debunking the top HIV/AIDS-medical marijuana myths 
Posted on October 28, 2013 by Tara-Michelle Ziniuk in Feature Story
 
People living with HIV/AIDS are not strangers to stigma. It’s been suggested that using medical marijuana would only increase the stigma they experience by also causing them to be seen as drug users. Medical marijuana users with HIV/AIDS have endured skepticism and been questioned on why they would need cannabis when “AIDS cocktails” and other treatments exist. And yet, studies conducted in North America have found that up to a third of people living with HIV/AIDS consume cannabis to help relieve their symptoms.

Canadians with HIV/AIDS have been granted access under the Marihuana Medical Access Regulations (MMAR) since 2001, yet obstacles to access continue today—the fear of stigma being amongst them.

Here, The Medical Marijuana Review looks at the top myths and truths about HIV/AIDS and medical marijuana.

Myth: Medical marijuana is bad for the immune system; people living with HIV/AIDS already have compromised immune systems, so they should not use it.

Truth: Research has debunked claims of harm to the immune system. A study conducted at San Francisco General Hospital found that AIDS patients using medical marijuana gained immune-system cells and kept their virus under control as well as patients who received a placebo. They also gained more needed weight.

Clinical trial data indicates that cannabis use does not adversely affect CD4 and CD8 T cell counts, and it may even improve immune function.

Myth: People with HIV/AIDS are just looking for an excuse to use marijuana; there are no known benefits.

Truth: Smoked marijuana has been shown to be beneficial in the relief of nausea due to HIV medications, when prescription anti-nausea medications have failed.

One study found evidence that smoked marijuana can relieve the pain of peripheral neuropathy caused by certain HIV medications.

There has also been evidence that low doses of marijuana have helped people living with HIV/AIDS to fall asleep and sleep long and better. It’s also increased their appetite and helped with anxiety and depression, all of which are common in patients.

Clinical trials have found that cognitive functions are not affected at the suggested dose of smoked marijuana.

Myth: Better, more effective drugs exist for people living with HIV/AIDS. They do not need medical marijuana.

Antiretroviral treatments can be extremely effective at prohibiting the advancement of the disease, but they are also expensive and inconsistent, with a range of unpleasant side effects.

Antiretroviral drug therapy has had a profoundly positive effect on the prognosis of AIDS, but its serious side effects include nausea and loss of appetite, often leading to unhealthy weight loss and challenges with taking required medications. Cannabis can be used to increase appetite, improve overall mood, and manage pain and nausea.

One study has reported that patients who use cannabis therapeutically are over 3 times more likely to adhere to their antiretroviral therapy regimens than non-cannabis users.

Myth: People living with HIV/AIDS should not open themselves up to the increased stigma that comes with marijuana use.

Truth: Because of the social impact of the disease, people living with HIV/AIDS both in and outside of North America tend to experience discrimination and can be subject to isolation, potentially leading to depression. Medical marijuana is particularly useful for treatment as it has been proven to be a viable medical option for depression in addition to its other benefits.

Myth: There is no professional or legitimate support for people living with HIV/AIDS to use medical marijuana.

Truth: AIDS Care has published support for medical marijuana use for people living with HIV/AIDS and is published by the National Library of Medicine and the National Institutes of Health in the United States. There is also support from the American Academy of HIV Medicine and the Canadian AIDS Society, an organization made up of over 125 AIDS service organizations.

AIDS Community Care of Montreal: http://accmontreal.org/

Canadian AIDS Society: http://www.cdnaids.ca

Fact sheets: http://www.cdnaids.ca/cannabisastherapyforpeoplelivingwit

http://medireview.com/2013/10/debunking-the-top-hivaids-medical-marijuana-myths/#.UnpTEhD4KSo

Medical Marijuana And Neuropathy

Today's Canadian post from thetelegram.com (see link below) contains a video which you can view by visiting the original page and was written in 2011 but is still very relevant in many parts of the world today in 2014. It talks about one man's problems receiving medical marijuana that helps him cope with his HIV-related neuropathic symptoms. Many people living with neuropathy have found that marijuana can significantly reduce their pain and discomfort. Not only that but the scientific evidence of that last few years, seems to back that up completely. Yet there is still a problem with the authorities in many areas, who view marijuana as an illegal substance and apply criminal laws to those who take it for justified medical reasons. It really is about time that this discussion was settled for good and law makers were brought up to date with the latest medical evidence. Too many innocent people are being criminalised for unjust reasons.

HIV sufferer has medical marijuana confiscated Barb Sweet Published on July 07, 2011

A St. John’s man had $1,500 of medical marijuana confiscated when he went to pick up a package at Purolator and was met by the RCMP instead.

Richard Oakley, who tested positive for HIV 25 years ago, moved back to the province from British Columbia three months ago to be near family.

He told The Telegram he received the first package since coming home without a problem from his designated grower in B.C.

But last week he kept trying to claim his second delivery of marijuana and marijuana-laced chocolates and Purolator told him to come back Monday. That’s when he was met with the RCMP officer.

Oakley said he was assured there’d be no problem. Then he got a call saying it was shipped illegally.

“They’re going against my civil rights as a human being. They are taking away my quality of life,” Oakley said, sifting through a stack of papers chronicling his diagnosis and access to treatment, including marijuana.

“I don’t want to cause any trouble. I just want to live my life.”

Oakley said he understood as long as the package doesn’t smell and doesn’t advertise its contents, it should be acceptable.

The marijuana eases his nausea from taking a cocktail of medicine, and relieves his pain.

He also has neuropathy, which freezes nerves in his feet. The marijuana also eases that so he can go for walks and keep the blood flowing.

Since his supply was taken, he hasn’t been able to endure his pills, said Oakley, a longtime volunteer AIDS activist in B.C.

“I’m getting sicker by the minute. I can’t take my medication without throwing up,” said Oakley, who has an authorization from Health Canada for medical marijuana.

“It took years and years to get the licence,” he said.

He warns if the disease takes over, it will cost the Newfoundland government a lot of money to take care of him.

Oakley left home at 13 when his mother died and went to Calgary to live with an older brother, who has since moved to Nova Scotia. He eventually ended up in B.C. and wants to continue studies he left off years ago at MUN, as well as be near his family here — he has a dozen siblings and they have numerous children and grandchildren between them all.

Oakley said he contracted HIV in the mid-to-late 1980s — the height of the AIDS crisis when a diagnosis was almost a certain death sentence. Oakley said he always took care to be tested and got accidently popped with a needle while helping care for people with the disease.


He said he suffers from survivor’s guilt because of friends who have died.

“I’m after losing 200 people. I am a miracle,” he said, adding he’s had lymph node cancer and pneumonia that nearly killed him. A long scar under his jawline marks the place where the cancer was cut out.

He said doctors and the people at treatment centres have kept him going all these years.

“I’ve never spread it. I’ve always been into prevention and the quality of life of all involved,” Oakley said.

But he worries the seriousness of HIV and AIDS is leaving the public consciousness because it can be treated and people’s lives pcan be rolonged.

He also worries about the implications for the spread of the disease through addictions to drugs like OxyContin where people may share needles.

“I am really concerned about Newfoundland. They are shooting up OxyContins and doing all kinds of things and hiding the fact AIDS is here...Everybody wants to put it in the closet,” Oakley said, adding people may no longer be as worried about spreading the disease through unprotected sex.

“A lot of mainlanders come here. They got it (AIDS and HIV) and they don’t care, some of them.”

He said there should be mandatory AIDS testing for prostitutes and addicts and anyone else at risk.

RCMP media spokesman Sgt. Boyd Merrill confirmed Wednesday the RCMP is investigating the matter involving Oakley’s package and believes the licence was properly obtained.

However, the RCMP is trying to determine if the supplier of the drugs is registered under Health Canada’s guidelines before it considers handing the package over to Oakley.

No charges are being considered at this point, Merrill said.

Purolator national director of security and loss prevention Susan Munn said the courier company doesn’t have access to an approved grower’s list and cannot identify whether a package is illegal under federal narcotics laws or legal under medical marijuana regulations.

But she said if it’s suspicious or damaged, the company is obligated to notify police.

According to Health Canada, one company has a contract through the federal government to supply medical marijuana.

Oakley said he doesn’t deal with the federal supplier, but has the designated grower in B.C.

bsweet@thetelegram.com

http://www.thetelegram.com/News/Local/2011-07-07/video-2636606/HIV-sufferer-has-medical-marijuana-confiscated/1

Medical Marijuana For HIV And Nerve Pain

Today's post from verywell.com (see link below) is an interesting and (importantly) up to date evaluation of the benefits of medical marijuana for people living with HIV. Now up to 40% of people with HIV also have neuropathic problems; either due to the virus attacking the nervous system, or the drugs that have been and are currently used to suppress it. HIV patients have long been aware of the potential of medical marijuana to treat the side effects of HIV but the proof has been a long time coming. The many millions of people with neuropathy who don't have HIV as the cause, are also rapidly being made aware of the non-invasive and much safer aspects of marijuana in reducing their symptoms. This sort of article is therefore of interest to everyone with nerve damage, irrespective of the cause but especially for people with HIV who have found standard drug treatments for their nerve damage, plus the aggressive HIV drugs, a sort of double-whammy in relation to damage to their systems. In that respect, they are very much in the same group as cancer patients, whose neuropathy is also brought about by their treatment. Definitely worth a read and maybe a starting point for investigating whether medical cannabis/marijuana can benefit you too.

The Benefits of Medical Marijuana for HIV By Dennis Sifris, MD and James Myhre - Reviewed by a board-certified physician.
Updated February 26, 2017

An Unbiased Look at the Pros and Cons of Cannabis Use

From the earliest days of the HIV epidemic, marijuana (cannabis) has been used to treat many of the complications of disease, ranging from the symptoms of HIV wasting syndrome to side effects associated with antiretroviral drug use.

While newer generation drugs have greatly reduced the incidence and severity of many of these conditions, marijuana is still popularly embraced as a means to alleviate the pain, nausea, weight loss and depression that can accompany infection.

There have even been suggestions that marijuana may afford long term benefits by effectively slowing—or even preventing—progression of the disease.

So what are the facts? Are there any studies to support these claims, or is the use of marijuana in treating HIV all buzz and no benefit?

Early Use of Marijuana for HIV

From the early-1980s to the mid-1990s, HIV was a major contributor to death and illness in the United States. Early generation HIV drugs were prone not only to premature failure, they often came with serious and sometimes debilitating side effects.

Moreover, people living with the disease were at high risk of illnesses we don’t see as frequently these days, including Kaposi’s sarcoma (a rare form of skin cancer), AIDS dementia, and the aforementioned HIV wasting syndrome.

It was, in fact, this last condition which first spurred support for the use of medical marijuana. Doctors, who at the time had few options for treatment, surmised that marijuana’s appetite-stimulating properties could benefit those experiencing the profound, unexplained weight loss as a result of this still-mysterious condition.

Since laws at the time largely forbade the use of marijuana in clinical settings, doctors began to prescribe the Schedule III drug Marinol (dronabinol), which contains a synthetic form of tetrahydrocannibinol (THC), the active ingredient of cannabis.

While Marinol proved to be successful in alleviating many of the symptoms of HIV wasting, many still preferred the “instant hit” afforded from three to four puffs of a marijuana cigarette.

Research Supporting Marijuana in Treating HIV Wasting

While the support for marijuana in the treatment of HIV wasting is strong, much of the supporting research is still limited. This is due, in large part, to the fact that laws regulating marijuana use have constrained rigorous scientific investigation.

By contrast, studies supporting the use of Marinol have been relatively well established. Both short-term and long-term research have concluded that Marinol can increase appetite and stabilize weight with persons with advanced wasting, while affording an average gain of one percent in lean muscle mass.

By contrast, there is little data demonstrating the efficacy of smoked marijuana in achieving the same results. Most research, in fact, seems to show that Marinol is far more effective in achieving weight gain. Despite this, people tend to prefer smoking marijuana for its perceived benefits, from the immediacy of effect to its stress-relieving properties.

Moreover, drugs like Megace (megestrol acetate) are known to be more effective in stimulating weight gain than even Marinol (although weight gain tends to be due to increases in body fat rather than lean muscle mass).

Of the three drugs, none seem to have any effect on reversing cachexia, the muscular atrophy associated with severe wasting.

Today, most approaches to therapy include a combination of appetite stimulants and anabolic drugs (like testosterone and human growth hormone) to treat severe wasting. To this end, marijuana may offer benefit beyond weight gain and appetite stimulation. By increasing a person's overall sense of well-being, there is evidence that medical marijuana can greatly improve one's adherence to HIV therapy.

In fact, a study published in the Journal of Acquired Immune Deficiency Syndromes concluded that persons experiencing severe gastrointestinal symptoms were 3.3 times more likely to adhere to their HIV drugs if supplemented with smoked marijuana.
Marijuana in Alleviating HIV-Associated Nerve Pain

In addition to its appetite stimulating properties, marijuana has been frequently used to alleviate the painful nerve condition called peripheral neuropathy, a side effect largely associated with earlier generation HIV drugs.

Peripheral neuropathy occurs when the exterior sheath covering nerve cells in stripped away. When this happens, the exposed nerve endings can cause an uncomfortable “pins and needles” sensation that can progress to a seriously debilitating condition. In some cases, the neuropathy is so great as to make walking or even the weight of a bedsheet on one's feet impossible to bear.

A number of research teams have studied the analgesic effects of marijuana in treating this often incapacitating condition. One such study, conducted at the General Clinical Research Clinic at San Francisco General Hospital, measured the effects of smoked marijuana in persons with peripheral neuropathy versus a non-THC marijuana placebo used in a second group.

According the research, smoked marijuana reduced daily pain by 34 percent, twice the number seen in the placebo group. Moreover, 52 percent of those who smoked marijuana had greater than 30 percent reduction in pain, compared to only 24 percent in the placebo arm.

The investigator concluded that the use of smoked marijuana was comparable to currently available oral agents used to treat HIV-associated peripheral neuropathy.

Could Marijuana Stop HIV Disease Progression?

While there is ample research to support the use of marijuana in treating a number of HIV-associated conditions, there have been loftier suggestions that the drug may, in fact, slow disease progression.

A study conducted at Louisiana State University showed that daily doses of THC correlated to lower levels of viral activity and better survival rates in monkeys infected with SIV (the simian form of HIV). In addition, the monkeys experienced a dramatic spike in CD4+ T-cells, as well as less weight loss when compared to non-THC counterparts.

According to the study, when dosed over a 17-month period, THC appeared to decrease damage to the immune tissues of the gut, a primary site of HIV infection. By doings so (and apparently at the genetic level), disease progression was significantly slowed and healthy immune response maintained.

While it is not entirely clear how THC effects these changes, it is believed that the stimulation of CR2 (a cannaboid receptor linked to positive therapeutic response) can inadvertently block one of two major receptors key to HIV infection.

If true, this may pave the path to a therapeutic approach by which CR2 could be stimulated to bolster immune function and slow the disease itself. What it doesn’t suggest is that marijuana, whether smoked or taken in oral form, can afford any benefit to treating HIV itself.

Adverse Effects of Marijuana Use

The subject of medical marijuana remains highly contentious and politically charged. While, on the one hand, there are a growing number of beneficial indications for medical use, there are a number of well-documented consequences that can undermine those benefits.

As a drug, THC acts on specific brain receptor cells that play a role in normal brain development and function. When used recreationally, THC over-excites these cells, providing the “high” that users actively seek. In teenagers, this level of excessive stimulation can dramatically impact cognitive function over the long term, manifesting with poor memory and diminished learning skills. (The same does not appear to be true for adults who regularly smoke.)

Furthermore, heavy marijuana use is linked to a number of adverse physical and mental effects, including:

Breathing problems, similar to those seen in tobacco smokers
Increased heart rate, problematic to those with coronary heart disease
Possible fetal development problems during pregnancy
Worsening of symptoms associated with mental illness, including schizophrenia
Intoxication and slowed response time, nearly doubling the risk of a fatal car crash
Impairment of male fertility due to lower total sperm count

While the adverse effects of low-level, recreational cannabis use appear to be low, they can be serious in vulnerable individuals. These effects are largely dose-dependant and can vary from person to person.

Contrary to common belief, marijuana can be addictive. Treatment for this addiction is constrained primarily to behavioral therapies. No medications currently exists to treat cannabis addiction.

Medical Marijuana Laws by State

The legal landscape surrounding medical marijuana is fast changing. Today, more than half of the U.S. states now allow for comprehensive, public medical marijuana and cannabis programs.

While the Federal government still classifies marijuana as a Schedule I drug (i.e. having the high potential for dependency and no accepted medical use), the push for legalization has gained momentum, with some states allowing retail sales to adults. Laws in these states vary but generally provide protection from criminal action if marijuana is used for medical purposes. Home cultivation in some states is also allowed.

As of 2016, eight U.S. states (Alaska, California, Colorado, Maine, Massachusetts, Nevada, Oregon, Washington) have legalized marijuana for both medical and recreational use.

Despite these legislative changes, as a Schedule I drug, marijuana remains technically illegal from a Federal standpoint. As such, medical marijuana cannot be covered by health insurance nor can it technically be prescribed by a physician, who risks legal action even in states where medical marijuana is legal.

Sources:

Badowski, M. and Perez, S. “Clinical utility of dronabidol in treating weight loss associated with HIV and AIDS.” HIV AIDS. February 10, 2016; 8:37-45.

Haney, M. “Effects of smoked marijuana in health and HIV+ marijuana smokers.” Journal of Clinical Pharmacology. November 2002; 42(11 Supplement):34S-40S.

De Jong, B.; Prentiss, D.; McFarland, W.; et al. “Marijuana Use and Its Association With Adherence to Antiretroviral Therapy Among HIV-Infected Persons With Moderate to Severe Nausea.” Journal of Acquired Immune Deficiency Syndromes. January 1, 2005; 38(1):43-46.

Abrams, D.; Jay, C.; Shade, S.; et al. “Cannabis in painful HIV-associated sensory neuropathy: A randomized placebo-controlled trial.” Neurology. February 13; 2007; 68(7):515-521.

Molina, P.; Amedee, A.; LeCapitaine, N.; et al. “Modulation of Gut-Specific Mechanisms by Chronic Δ9-Tetrahydrocannabinol Administration in Male Rhesus Macaques Infected with Simian Immunodeficiency Virus: A Systems Biology Analysis.” AIDS Research and Human Retroviruses. June 2014; 30(6):567-578.

https://www.verywell.com/medical-marijuana-for-hiv-4129028

How Can Marijuana Help Neuropathy Sufferers

Depending on the laws and cultural attitudes within your own area, today's video about the usefulness of marijuana for pain problems (especially neuropathy) may or may not be relevant for you. Unfortunately, reactions to marijuana as a medical tool range from the hysterical and mistrusting to being totally convinced of its efficacy; much of the former is based on preconceptions stemming from various governments' wars on drugs as a whole. Many neuropathy sufferers already benefit from the use of medical marijuana but if you're a non-smoker, or an ex-smoker, you may find it much more difficult. The video suggests using vapourised marijuana, to avoid the worst lung problems but this does add to the expense, as well as being somewhat tricky to use. You also have to be able to accept getting high, which contrary to popular myth is not for everyone! Nevertheless, this video is a useful explanation of how marijuana works medically.

Problems With Legalising Marijuana For Neuropathy Pain

Today's post from inforum.com (see link below) is really a local news story but is symptomatic of the arguments surrounding marijuana as a medical drug. Rational argument and scientific evidence seems to strongly suggest that marijuana is one of the most effective pain medications for people living with severe neuropathy, yet outdated laws both local and national stand firmly in the way. Sometimes the punishments for possession are so severe that people are discouraged from using something that will relieve their pain. Slowly but surely, official attitudes are changing but it's a slow and painful process as this story from North Dakota illustrates.

Backers fire up attempt to get medical marijuana legalized in ND
By Helmut Schmidt on Jan 21, 2015 .

FARGO – If you ask Rilie Morgan, it’s time for North Dakota to make medical marijuana legal.

The affable silver-haired financial planner, who goes by his middle name, Ray, has neuropathy.

The neurological affliction has for the past two years given the 64-year-old Fargo man constant tingling in his feet and calves, sometimes punctuated by sharp shooting pains.

“It’s like when your hand or foot falls asleep and you get a tingling sensation. It’s constant. It’s 24/7,” Morgan said.

“If your mind is busy, then it’s not too bad. But once in a while there is some pain, a shooting pain that’s like, ‘Wow! Where did that come from?’ ” he said. “You always know it’s there.”

Morgan, a partner in a Fargo financial firm, said a painkiller he uses can cause liver damage. He used morphine for several months after a back surgery. That’s a route he doesn’t want to take again.

He said medical cannabis may make the pain “a little more tolerable. I’d like to explore the possibility anyway.”

State Rep. Pamela Anderson, a Fargo Democrat, has taken up Morgan’s cause, and introduced House Bill 1430 on Monday.

The bill would allow patients and caregivers to possess up to 2½ ounces of cannabis – or products such as cannabis oils, beverages, vapors, extracts, ointments or pills – for medical use.

It also has a provision that allows people who have obtained a prescription for medical marijuana to cultivate up to six marijuana plants.

The bill lists a number of ills eligible for treatment: cancer, glaucoma, HIV, hepatitis C, amyotrophic lateral sclerosis (Lou Gehrig’s disease), Crohn’s disease, ulcerative colitis, agitation due to Alzheimer’s disease and post-traumatic stress disorder.

Conditions that lead to wasting, severe debilitating pain or nausea, seizures, or severe and persistent muscle spasms, including those characteristic of multiple sclerosis are also listed, with an option for more to be added.

HB 1430 was crafted from information on what other states have done to regulate medical marijuana that was provided by the Council for State Governments, Anderson said.

She said she’s heard from people suffering from glaucoma, multiple sclerosis or seizures who would support legalizing medical cannabis in North Dakota.

To date, 23 states and the District of Columbia allow the use of medical cannabis, including neighboring Minnesota and Montana.

Rep. Kathy Hawken, R-Fargo, a co-sponsor of the bill, has her own connection to the issue – a son who suffers from seizures.

“More than one neurologist has said that if he could, he would prescribe medical marijuana,” Hawken said. “They think it does work.”

She said the bill contains controls on medical marijuana products from farm to pharmacy.

But she’s unsure of its fate – at least this year.

“I think it is something that will eventually pass. This session? Well, stranger things have happened,” Hawken said. “Realistically, at least the discussion will start.”

The 29-page bill provides for:
Exemptions from prosecution for the possession, manufacture or sale of medical marijuana for those licensed, and for people certified as in need of medical marijuana by a physician.
Creating a system to license manufacturing and distribution of medical marijuana products.
Criminal penalties for violating provisions of the medical marijuana law.
Protections from discrimination in schooling and housing for medical cannabis users, unless allowing the use would violate federal law or regulations.

Rep. Eliot Glassheim, D-Grand Forks, another bill sponsor, said he used to smoke a joint now and then 30 years ago.

“It seems to me the whole hysteria was misplaced,” Glassheim said.

Now, he’s being treated for cancer.

“It’s not in remission, but it’s not spreading. I feel OK,” he said. He understands that others dealing with the side effects of cancer treatments could benefit from having medical marijuana available as an option.

“I certainly could imagine a situation where you’re nauseous or where you’re in unbearable pain,” Glassheim said.

Supporting the bill, “just seemed to me to be a rational thing to do,” he said.

Glassheim expects some resistance.

“It may have to wait until next session. I expect it will pass one of these days,” he said. “It’s one of these bills people have to get their minds around.”

Morgan, meanwhile, is plan a trip to Arizona to test-drive the idea of becoming a snowbird as he nears retirement. Arizona also allows medical cannabis to treat a number of ailments, he said.

But he will hop on a plane to Bismarck to testify for HB 1430, he said.

“I think medical marijuana has been understudied” for its efficacy, Morgan said. “I think it’s time to explore the options and let pharmaceutical companies see what they can come up with. It’s time.”

Other sponsors of HB 1430 are Andrew Maragos, R-Minot; Marvin Nelson, D-Rolla; Mary Schneider, D-Fargo; and Marie Strinden, D-Grand Forks.

Lower pot penalties?

Another House bill aims to lower penalties for college students caught with small amounts of marijuana on campus.

HB 1394, sponsored by Reps. Lois Delmore, D-Grand Forks, Thomas Beadle, R-Fargo, Kim Koppelman, R-West Fargo, and Hawken, would make the possession of one-half ounce to a full ounce of marijuana a Class B misdemeanor, down from its current designation as a Class B felony.

Possession of less than a half-ounce of marijuana would be charged as an infraction, rather than as a Class B misdemeanor.

If someone is found guilty of possession of an ounce or less of marijuana, the bill also calls for the conviction to be sealed by the court after two years if there are no further drug possession convictions.

Delmore said the bill is designed to make sure that the mistake of smoking pot in a dorm or elsewhere on campus isn’t one that haunts a student the rest of their lives.

“If you have something like that on your record, you have a hard time getting a job” or housing, she said.

http://www.inforum.com/news/3661275-backers-fire-attempt-get-medical-marijuana-legalized-nd

Alternative To Medical Marijuana For Chronic Pain

Today's post from sciencedaily.com (see link below) is a serious look at medical cannabis, from a serious source and is worth our attention. THC (the active ingredient of cannabis) works very well for people in chronic pain, especially neuropathic pain but it does carry side effects, caused by it acting on cannabinoid CB1 receptors in the brain. Scientists have been working on an agent that works on the CB2 receptors in the brain and they do not produce the side effects associated with THC.  This agent is (as usual) confusingly called AM1710 but that's not really important. What's important is that this agent may end up replacing the need for THC based medical cannabis and working just as well, without the side effects. It sounds trivial but a by-product of this is that a new agent will have a positive image in the eyes of the law and society, which remains stubbornly resistant to the benefits of medical cannabis. It's still a work in progress but looks very promising for the future, where any viable alternative will be welcomed by neuropathy patients and other chronic pain sufferers everywhere.

An alternative to medical marijuana for pain?
Date:March 4, 2015 Source:Elsevier
 
Summary:

Medical marijuana is proliferating across the country due to the ability of cannabis ingestion to treat important clinical problems such as chronic pain. However, negative side effects and the development of tolerance limit the widespread therapeutic use of THC, the major psychoactive ingredient in cannabis. THC's side effects are produced via its actions at cannabinoid CB1 receptors in the brain. Thus, scientists theorized that an agent with similar mechanistic actions, but that activate CB2 receptors instead, may eliminate the unwanted side effects while maintaining an equivalent level of efficacy.

Dr. Andrea Hohmann and her colleagues at Indiana University tested this strategy and found that, unlike Δ9-THC, repeated dosing with the cannabinoid CB2 agonist AM1710 suppresses chemotherapy-induced pain in mice without producing tolerance, physical withdrawal, motor dysfunction, or hypothermia. Moreover, the therapeutic effects of AM1710 were preserved in mice lacking CB1 receptors but absent in mice lacking CB2 receptors.

Their findings are reported in the current issue of Biological Psychiatry.

"Our study is important because it demonstrates beyond doubt that activation of cannabinoid CB2 receptors suppresses neuropathic pain without producing signs of physical dependence (i.e., a withdrawal syndrome) or other unwanted side effects associated with activation of CB1 receptors in the brain," said Hohmann.

Their studies used animals that were treated with a chemotherapeutic agent (paclitaxel) to produce pain. When animals were given AM1710, a CB2 agonist, its pain-suppressive effects were fully preserved and its therapeutic effects were maintained even after repeated dosing.

Alternatively, and as expected, when animals were given Δ9-THC, they developed complete tolerance to the pain-suppressing effects of THC and with repeated dosing, THC was no longer effective in suppressing neuropathic pain.

When the THC-treated animals were challenged with a drug that blocks CB1 receptors in the brain, the animals showed a prominent withdrawal syndrome, indicating signs of physical dependence following removal of THC. Strikingly, this was not the case with the CB2 agonist; blocking either CB1 or CB2 receptors produced no signs of withdrawal in animals treated chronically with the CB2 agonist.

Hohmann added, "We think our data suggests that CB2 receptors are an important target for suppressing chronic pain without unwanted side effects (e.g. psychoactivity, addiction)."

"It is important to know whether the benefits of cannabis ingestion for pain could be attributed in large part to the stimulation of CB2 receptors," commented Dr. John Krystal, Editor of Biological Psychiatry. "CB2 agonists, in theory, would present less risk regarding addiction and intoxication than the ingestion of cannabis or THC."

More work will be necessary before CB2 receptor agonists could be prescribed for use in humans, but for now, these data support the therapeutic potential of CB2 agonists for managing pain without the adverse effects associated with cannabis.

Story Source:

The above story is based on materials provided by Elsevier. Note: Materials may be edited for content and length.

Journal Reference:
Liting Deng, Josée Guindon, Benjamin L. Cornett, Alexandros Makriyannis, Ken Mackie, Andrea G. Hohmann. Chronic Cannabinoid Receptor 2 Activation Reverses Paclitaxel Neuropathy Without Tolerance or Cannabinoid Receptor 1–Dependent Withdrawal. Biological Psychiatry, 2015; 77 (5): 475 DOI: 10.1016/j.biopsych.2014.04.009

http://www.sciencedaily.com/releases/2015/03/150304075336.htm

Marijuana for Neuropathy The Argument Continues

Although there are several other posts about marijuana use for neuropathy here on the blog, today's interesting post from Neurology Today (see link below), looks objectively at the arguments for and against.

Whenever Marijuana or Cannabis appear in the titles of posts here, the visitor figures rise. Whether that's because of the controversy surrounding marijuana, or because people really want to know if it works in controlling neuropathic pain I don't know but it's an issue that always excites people's interest. In the Netherlands we like to chuckle at those puritanical Americans (and others) who see marijuana as the epitome of everything evil and the beginning of the slippery slope to hard drug use but in fact, believing that marijuana is completely harmless, is possibly equally misguided. In the case of people with HIV and neuropathy who want to use it to relieve their pain, it's hard to justify the political restrictions but at the same time, THC (the chemical component of the drug) needs to be proved to help and not to hinder.
The idea of getting high to control your pain may seem attractive but not everyone likes to get high. Many people like to feel in complete control of what they're doing and getting stoned by definition, means relinquishing some control. On the other hand, you may reject the various anti-depressants that are officially approved because of their mind-altering side effects and yet feel that marijuana can only be good for you, thus creating contradictions all round. Evidence based research is therefore essential, for all our benefits and if THC is proved to be effective for many people (and that certainly seems to be the case) then maybe they can refine it so that smoking cannabis is not the only option.

As Another State Approves Medical Marijuana, Neurologists Urge Caution About Prescribing
FALLIK, DAWN Neurology Today: 18 February 2010

ARTICLE IN BRIEF

Neurologists point out the dearth of evidence-based research to support medical marijuana for neurological conditions, but some offer anecdotal reports that show it helps manage certain symptoms.

Last month, New Jersey became the 14th state to approve the use of medical marijuana for specific diseases, including multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS).

But some neurologists practicing in already approved states said that while a chemical in the plant may help some patients, more research is needed on how it affects symptoms and causes. And they cautioned doctors to set boundaries within their own practice to prevent the “free-for-all” storefronts in place in California, which they say has become too lax in its standards.

“How do you separate wishful thinking versus clinical data?” asked Denis Petro, MD, a neurologist in Pennsylvania who has been openly supportive of medical marijuana laws and helped found Patients Out of Time, a patient advocacy group.

Dr. Petro, who testified in support of the law in New Jersey, said that while some patients would benefit from using marijuana, particularly for neuropathic pain, the drug is not appropriate across the board for symptom management and disease modification.

The FDA has not approved botanical marijuana for medical use in the US, but it has approved two drugs in capsule form for therapeutic uses — dronabinol (Marinol) and nabilone (Cesamet). Both contain synthetic delta-9-tetrahydrocannabinol (THC), the active ingredient in botanical marijuana. The FDA approved dronabinol in 1985 and nabilone in 2006 for nausea and vomiting in chemotherapy patients who had failed to respond to conventional antiemetic treatments. In 1992, dronabinol was approved for anorexia associated with weight loss in AIDS patients.

RESEARCH CHALLENGES

In March 1999, a report by the Institute of Medicine, “Marijuana and Medicine: Assessing the Science Base,” called for evidence-based research into the effects of marijuana and its cannabinoid components, for specific diseases, concluding that “if there is any future of marijuana as a medicine, it lies in its isolated components, the cannabinoids and their synthetic derivatives.”

In May 1999, the Department of Health and Human Services (HHS) released guidelines specific to conducting research on marijuana. Among procedures, the HHS established that investigators had to first make an inquiry to the National Institute on Drug Abuse (NIDA) to determine the availability and costs of marijuana, and the NIDA had to determine that marijuana is available to support the study; researchers had to file an Investigational New Drug application through the FDA, and investigators had to register with the federal Drug Enforcement Agency to conduct research using a Schedule I controlled substance. (Under the Controlled Substances Act, Schedule 1 substances are defined as having a very high potential for abuse, having no accepted medical use in the US, and lacking accepted safety data for use under medical supervision.)

“A few years ago, to do research on this was almost like asking for trouble; everyone assumed that if you did research on cannabinoids that meant you agreed with it,” said Joseph I. Sirven, MD, chair and professor of neurology at the Mayo Clinic in Scottsdale, AZ. In a 2004 paper in Neurology, Dr. Sirven reviewed studies regarding the efficacy of marijuana for the management of epilepsy and MS; he found limited scientific evidence regarding its use.

“Now the doors have opened, so we can at least ask the questions without fear of reprisal. But we're just in the infancy stages as far as research,” he said.

THE UNDERLYING MECHANISM

Cannabinoids affect neurological function through THC, which binds to cannabinoid receptors and triggers a cellular response. There are two kinds of cannabinoid receptors: CB1 receptors are mainly found in the brain, and CB2 receptors are located in the immune system and peripheral nerves throughout the body.

The body produces its own internal “endocannabinoids,” which appear to function primarily in helping the body maintain homeostasis. Via specific receptor binding, cannabinoids inhibit the release of potentially toxic, excitatory neurotransmitters, such as glutamate, thus protecting the nervous system from overstimulation. Cannabinoids are also strong antioxidants and reduce CNS inflammation by removing free radicals, which are damaging, electrically charged oxygen species.

The main advantage of using marijuana over other drugs such as opiates for pain management is its side effect profile, doctors said. There is little chance of an overdose with marijuana and it does not cause constipation, which can cause problems in those with neuromuscular diseases.

PERSPECTIVES ON CLINICAL USE

Doctors in states that have medical marijuana laws varied greatly on how they incorporated the drug in their practice. Some said they would rather use other medications and rarely mentioned cannabis to their patients because they were skeptical of its success. Others said their patients had had success with the drug, and that the public perception of how it was used was skewed.

Gregory T. Carter, MD, a professor of rehabilitation medicine who co-directs the ALS clinic at the University of Washington in Seattle, has been recommending medical marijuana under state law for a decade. His patients, a majority of whom are older and never used marijuana recreationally, either eat the drug or use it in a vaporizer, inhaling the mist three times, two to three times daily.

Dr. Carter is the senior author of a 2004 paper in the American Journal of Hospice and Palliative Medicine that included results of an anonymous survey about marijuana use among ALS patients; 13 of 131 respondents reported using cannabis in the previous 12 months. Although the small number of people with ALS that reported using cannabis limits the interpretation of the survey findings, the study authors suggested that the results indicated that cannabis may be moderately effective for reducing symptoms of appetite loss, depression, pain, spasticity, and drooling. Cannabis was reported to be ineffective for reducing difficulties with speech and swallowing, and sexual dysfunction. The longest relief was reported for depression (approximately two to three hours).

Dr. Carter pointed to several studies in which cannabanoids provided neuroprotective benefit, including a 2004 study by the Forbes ALS Research Center in San Francisco, published in the journal Amyotrophic Lateral Sclerosis and Other Motor Neuron Disorders. The investigators reported that treatment with THC was “extremely effective” at reducing oxidative damage in spinal cord cultures and delayed motor impairment in ALS mouse models.

“For patients, it works really well to treat the symptoms of ALS,” he said. “It dries the mouth out, eases pain and spasticity, elevates mood, and improves appetite. It replaces four or five other medications.”

In his June 2009 literature review in the Journal of Opioid Management, Dr. Carter found only 33 American controlled clinical trials on the safety and therapeutic use of cannabinoids since 1998 for a variety of medical conditions.

The dearth and size of published studies, as well as the lack of long-term studies, makes Mark Spitz, MD, hesitant about recommending medical marijuana. The professor of neurology and director of the comprehensive epilepsy program at the University of Colorado-Denver in Aurora said maybe a couple dozen of his 2,000 patients use the legally approved marijuana.

“They don't like getting high,” he said. “Patients wouldn't take it in the morning or during the day because they feel like it impairs their thinking and concentration. They would only take it before bed.”

Those who do use marijuana tell him that it helps the frequency and the duration of their seizures, Dr. Spitz said. When they can't get it for financial reasons, they say they feel worse, he added.

Dr. Spitz said much of the current research was indirect. He cited, for example, a 1990 study in the American Journal of Epidemiology that found that among risk factors for illicit drug use and first onset seizure, marijuana use was shown to be protective factor, while regular alcohol use was a risk factor.

“It's not a substitute for western medicine,” he said. “I have been working with regular seizure medications as the first line of therapy.”

Although Colorado approved the use of medical marijuana in 2000, Dr. Spitz said patients initially had a hard time finding it. The original state law allowed growers and dispensers to each supply only five patients. In 2007, the law was changed, however, and now storefront operations are in many locations across the state, as ubiquitous as Starbucks.

It's a scene that's popular in California, which passed the first medical marijuana use law in 1996. Unlike New Jersey, which strictly limits prescriptions to specific diseases, California's law is broader and more prone to abuse, doctors said. The California law does not restrict medical marijuana for use in specific diseases. Doctors must provide a physician's recommendation for state residents to legally purchase and smoke eight ounces. The business there has expanded to an estimated $14 billion marijuana market, according to an April 2009 story in The Washington Post.

Dr. Sirven, who specializes in epilepsy, said he has not written any prescriptions for medical marijuana, because he isn't sure whether it's effective for his patients. The decision not to prescribe it was made collectively by his practice at Mayo, he said.

But he said that doesn't mean the door is closed, particularly when it comes to pain management and appetite stimulation. “Given the absence of evidence, I feel uncomfortable prescribing it until I have better data,” he said. “My advice to New Jersey would be to advocate for clinical trials because they have the opportunity to help other states decide — is there anything to this or should we just be stopping this?”

http://journals.lww.com/neurotodayonline/Fulltext/2010/02180/As_Another_State_Approves_Medical_Marijuana,.1.aspx

The Risks Of Selling Marijuana For Medical Use

Today's post from kwtx.com (see link below) is a salutory warning to all those producing and/or selling marijuana for medical purposes. Despite the proven benefits of smoked marijuana for people living with neuropathic pain, many areas of the world have laws which see this as being part of a social drug problem and can prosecute, leading to severe sentences. In this particular case, the last paragraph makes us wonder if there is more to the story than meets the eye but the principle of being able to issue marijuana for medical pain relief should be defended against outdated science and state laws. The problem is, you can defend the theory all you like but you need to be aware of local laws and not run foul of them. Maybe in 20 years the whole issue will be seen as a non-argument but at this moment, you may be running a risky business.

 

Waco Man Sentenced To Probation In Marijuana Trafficking Case 
January 13th 2015 

MGN Online

WACO (January 8, 2015) A Waco man was sentenced to federal probation Wednesday after he earlier pleaded guilty to participating with other family members in a marijuana growing and distribution ring.

U.S. District Judge Walter S. Smith, Jr., sentenced Chad K. Koss to serve 3 years on federal probation with the condition that the first six months he be confined to his home between 10 p.m. and 6 a.m. each day.

Smith also assessed a $1,000 fine and ordered Koss to pay $100 in special assessment to the court, court records showed.

Koss pleaded guilty on October 23, 2014 to conspiracy with intent to distribute more than 50 kilograms of marijuana stemming from an investigation of what authorities described as a two-state pot distribution operation.
Just the day before, Smith sentenced Koss' mother, Le'Ann Koss, 60, to serve 70 months in prison, followed by five years on supervised release and ordered her to pay a $2000 fine and $200 in special assessment to the court.

His brother, Conner Koss, 26, of Hewitt, was sentenced to 121 months in prison, five years on supervised release and ordered to pay a $1000 fine and $100 in special assessment to the court.

The same day Smith sentenced Brian Thomas Smith, 23, to serve two years in prison, three years on supervised release, pay a $1000 fine and $100 in special assessment to the court in connection with the operation.

Koss' father, Phillip Larry Koss, 59, also pleaded guilty to the same charge, but after his plea he asked for a new attorney.

Chad Koss was arrested April 10, 2014 in Waco on a federal warrant.

He was released from custody after posting a $25,000 unsecured bond.

Phillip, Le'Ann and Conner Koss were arrested on Nov. 29, 2013 at their home in Waco.

Affidavits submitted for the search and arrest warrants said Phillip Koss and his son Conner maintained a residence in California for growing high-grade marijuana.

Court records say the defendants arranged to transport the marijuana to their residence in Hewitt for distribution.

In a search of the family's Waco home, authorities recovered about 12 pounds of tetrahydrocannabinol, commonly known as THC, several firearms and about $27,000 in cash, the U.S. Attorney's Office said.

On Dec 16, 2013, a McGregor officer assisted California authorities as they served search warrants on two Yuba County homes owned by Chad and Conner Koss, McGregor police Investigator Joe Coy said at the time.

Officers seized about 150 pounds of processed high-grade marijuana, a large amount of marijuana buds, business records and a .40-caliber pistol from the 20-acre property owned by Chad Koss, Coy said.

Other agents served a search warrant in Dobbins, Calif., at a residence owned by Conner Koss where they recovered 30 pounds of high-grade marijuana buds, along with an additional 50 pounds of processed marijuana.

Agents also seized equipment they say was used to process marijuana into hashish, Coy said.

The Waco raid was the culmination of a three-month investigation tied to earlier raids involving Baylor students, a McGregor police source said at the time, but records show a Department of Public Safety narcotics officer started an investigation in February 2012 and in March 2012 found bags in the trash outside Conner Koss' residence in Hewitt that contained cocaine and marijuana residue.

Phillip Koss is the owner of "Stretch for Life," a local business offering non-medicinal therapy for victims of stroke, neuropathy, Parkinson's disease, and dystonia.

In 1983 he was convicted of homicide and was sentenced to 10 years on probation, Texas Department of Public Safety records showed.

http://www.kwtx.com/home/headlines/287913181.html

How Careful Do We Need To Be With Medical Marijuana

Today's post from webmd.com (see link below) looks at a possible warning about medical cannabis and pain problems. This blog is broadly in favour of neuropathy patients trying medical cannabis to relieve their neuropathic symptoms, largely because it remains one of the very few proven methods of doing this. However, all marijuana is not the same and like anything else, you need to dose it to your needs and be careful not to overdo it. This article talks about so-called 'skunk' marijuana, which is super strong and highly potent. It raises question marks as to what this could do to the brain and advises caution to say the least. However, the conclusions are that for pain relief, these warnings can be seen as speculative and a little vague. Lots of people and organisations have their own agendas when it comes to marijuana - taking good advice and doing as much of your own research as possible is strongly advised and what may work for you may not work for others - careful dosage is the key.

Powerful New Pot May Harm the Brain
But marijuana advocate calls the study 'speculative'
By Dennis Thompson HealthDay Reporter WebMD News from HealthDay

WEDNESDAY, Dec. 2, 2015 (HealthDay News) -- Smoking high-potency marijuana might damage nerve fibers that connect the brain's two hemispheres, a new study reports.

MRI scans of nearly 100 people -- including some diagnosed with psychosis -- associated frequent use of high-potency "skunk" marijuana with damage to the corpus callosum, the largest white matter structure in the brain.

"We found that frequent use of high-potency cannabis significantly affects the structure of white matter fibers in the brain, whether you have psychosis or not," said senior researcher Dr. Paola Dazzan, of the Institute of Psychiatry, Psychology & Neuroscience at King's College London.

Further, her team said the damage appears to be dose-dependent. "This reflects a sliding scale where the more cannabis you smoke and the higher the potency, the worse the damage will be," Dazzan said in a college news release.

This is vital information, given that the potency of street marijuana has increased over the last decade, the study authors said.

Reactions to the findings in the United States were mixed, however.

Dr. Scott Krakower, assistant unit chief of psychiatry at Zucker Hillside Hospital in Glen Oaks, N.Y., agreed that the study "supports the idea that using high-potency marijuana can be detrimental."

The upshot? "People should be aware that using this agent isn't benign, and that there are changes to the brain," he said.

But marijuana advocates said the study had limitations.

The damage observed by the researchers appears to be very minor, amounting to a "2 percent change in the corpus callosum" structure, said Mitch Earleywine, chair of NORML, a group that promotes marijuana legalization.

Earleywine, who is also a professor of psychology at the State University of New York, Albany, added that the researchers did not measure the study participants' memory or brain function. "So we have no idea if this had any impact on anything that matters, like memory or impulsivity or depressive symptoms," he said.

For this study, researchers used MRI to examine white matter in the brains of 56 patients who had been diagnosed with psychosis, as well as 43 healthy people from South East London.

The researchers specifically examined the corpus callosum, an area of the brain particularly rich in receptors that respond to THC, the chemical in pot that produces intoxication.

Participants also were asked about their drug use, including the potency of the marijuana they typically use.

Researchers said they were particularly interested in "skunk" marijuana, since previous studies have shown it induces psychotic symptoms, or a break from reality.

"Skunk" is British slang for pot that is highly fragrant and therefore assumed to have higher potency, said Paul Armentano, deputy director of NORML.

The study found that frequent use of high-potency cannabis was linked to significantly higher mean-diffusivity -- a marker of damage in white matter structure -- in the corpus callosum.

However, Earleywine questioned why the researchers didn't look at the hippocampus or areas associated with memory, which are the brain areas that most marijuana studies consider.

The corpus callosum "is a brain area that usually focuses on communication between the hemispheres, or tasks like finding the words for your emotions or having the right hand know what the left hand is doing," he said, adding that the study didn't measure any of these functions.

The researchers also appeared to rely on the participants' own description of both their marijuana use and the potency of their pot, Armentano said.

"It's all rather arbitrary and speculative," he said.

Sean Clarkin is director of strategy and program management with the Partnership for Drug-Free Kids. He said this study should open the door for a healthy "periodic check-in" on a person's marijuana use, to keep it from becoming too frequent or involving increasingly potent pot.

"It provides some scientific basis to say let's be more vigilant than we've been, particularly in the progression from occasional to habitual use," Clarkin said.

The study was published online recently in the journal Psychological Medicine.

http://www.webmd.com/mental-health/addiction/news/20151202/powerful-new-pot-may-harm-the-brain-researchers-say

HIV And Marijuana For Pain Symptoms

Today's post from medireview.com (see link below) is another article looking at the benefits or not, of marijuana for people in pain. This one is slightly different in that it looks at myths and truths concerning marijuana and HIV as a whole and this of course includes people with HIV also living with neuropathy. That said, it's of interest to all people considering using marijuana to relieve their pain symptoms. As with all these articles (see alphabetical list to the right of the blog), the more information you have, the more likely you'll make the correct choice for yourself.

Debunking the top HIV/AIDS-medical marijuana myths 
Posted on October 28, 2013 by Tara-Michelle Ziniuk in Feature Story
 
People living with HIV/AIDS are not strangers to stigma. It’s been suggested that using medical marijuana would only increase the stigma they experience by also causing them to be seen as drug users. Medical marijuana users with HIV/AIDS have endured skepticism and been questioned on why they would need cannabis when “AIDS cocktails” and other treatments exist. And yet, studies conducted in North America have found that up to a third of people living with HIV/AIDS consume cannabis to help relieve their symptoms.

Canadians with HIV/AIDS have been granted access under the Marihuana Medical Access Regulations (MMAR) since 2001, yet obstacles to access continue today—the fear of stigma being amongst them.

Here, The Medical Marijuana Review looks at the top myths and truths about HIV/AIDS and medical marijuana.

Myth: Medical marijuana is bad for the immune system; people living with HIV/AIDS already have compromised immune systems, so they should not use it.

Truth: Research has debunked claims of harm to the immune system. A study conducted at San Francisco General Hospital found that AIDS patients using medical marijuana gained immune-system cells and kept their virus under control as well as patients who received a placebo. They also gained more needed weight.

Clinical trial data indicates that cannabis use does not adversely affect CD4 and CD8 T cell counts, and it may even improve immune function.

Myth: People with HIV/AIDS are just looking for an excuse to use marijuana; there are no known benefits.

Truth: Smoked marijuana has been shown to be beneficial in the relief of nausea due to HIV medications, when prescription anti-nausea medications have failed.

One study found evidence that smoked marijuana can relieve the pain of peripheral neuropathy caused by certain HIV medications.

There has also been evidence that low doses of marijuana have helped people living with HIV/AIDS to fall asleep and sleep long and better. It’s also increased their appetite and helped with anxiety and depression, all of which are common in patients.

Clinical trials have found that cognitive functions are not affected at the suggested dose of smoked marijuana.

Myth: Better, more effective drugs exist for people living with HIV/AIDS. They do not need medical marijuana.

Antiretroviral treatments can be extremely effective at prohibiting the advancement of the disease, but they are also expensive and inconsistent, with a range of unpleasant side effects.

Antiretroviral drug therapy has had a profoundly positive effect on the prognosis of AIDS, but its serious side effects include nausea and loss of appetite, often leading to unhealthy weight loss and challenges with taking required medications. Cannabis can be used to increase appetite, improve overall mood, and manage pain and nausea.

One study has reported that patients who use cannabis therapeutically are over 3 times more likely to adhere to their antiretroviral therapy regimens than non-cannabis users.

Myth: People living with HIV/AIDS should not open themselves up to the increased stigma that comes with marijuana use.

Truth: Because of the social impact of the disease, people living with HIV/AIDS both in and outside of North America tend to experience discrimination and can be subject to isolation, potentially leading to depression. Medical marijuana is particularly useful for treatment as it has been proven to be a viable medical option for depression in addition to its other benefits.

Myth: There is no professional or legitimate support for people living with HIV/AIDS to use medical marijuana.

Truth: AIDS Care has published support for medical marijuana use for people living with HIV/AIDS and is published by the National Library of Medicine and the National Institutes of Health in the United States. There is also support from the American Academy of HIV Medicine and the Canadian AIDS Society, an organization made up of over 125 AIDS service organizations.

AIDS Community Care of Montreal: http://accmontreal.org/

Canadian AIDS Society: http://www.cdnaids.ca

Fact sheets: http://www.cdnaids.ca/cannabisastherapyforpeoplelivingwit

http://medireview.com/2013/10/debunking-the-top-hivaids-medical-marijuana-myths/#.Uo-TO-LheSo

Marijuana Chewing Gum May Be An Option For Neuropathic Pain

Today's short post from news.morningstar.com (see link below) announces the arrival of cannabis chewing gum as an alternative to smoked or vaporised cannabis for pain relief. if and when it is apporved and developed to the right strengths for slow release cannabis, it could prove to be a very valuable option for people who can't smoke cannabis, or inhale it via various mechanisms. Chewing gum may be an acceptable means of delivering cannabinoids without the unpleasantness normally associated with smoking. Ironically, it can be equated to nicotine chewing gum which is used to help people stop smoking. This short article is aimed at MS sufferers but it applies to all people who suffer chronic nerve pain and other symptoms and could be an important development in the field of pain control.

MS patients may someday find relief in marijuana chewing gum
By Kathleen Burke, MarketWatch 8-17-15 11:06

Marijuana-infused gum enters clinical trials

Patients can smoke it, eat it and soon, they may be able to chew it.

Cannabis-focused biotech company AXIM Biotechnologies (AXIM) last week said it launched clinical trials on humans for medical cannabis chewing gum as a treatment for multiple sclerosis. The gum, MedChew RX, contains 5 milligrams of cannabidiol -- a non-psychoactive component of cannabis -- and 5 milligrams of THC -- a psychoactive cannabinoid.

Medical marijuana chewing gum "should allow for predictable and controlled release of the active ingredients," George Anastassov, chief executive of AXIM, said in a statement. It should not be socially stigmatizing, should have a pleasant taste and consistency and no undesirable side effects, he added. "Chewing gum meets all these criteria."

AXIM already has a cannabinoid chewing gum product, known as CanChew, on the market, however it does not contain THC and does not offer any medical claims.

The psychoactive component of THC is an effective way to treat patients with degenerative diseases, in addition to the medicinal properties of cannabidiol, which can be used to treat neurological conditions such as epilepsy. Additionally, the act of chewing helps preserve cognition and memory, as well as promotes overall oral health, Anastassov told MarketWatch.

While the current trials of the gum are only for MS patients, Anastassov says Axim hopes to expand the range of conditions it can be prescribed for.

"For multiple sclerosis, the market for treatment is quite large," Anastassov says. "Eventually, we will try to enlarge the conditions for this medication, such as pain." (More than 2.3 million people are affected by MS globally, according to the National Multiple Sclerosis Society.)

He says pain is one of the most predominant symptoms patients of a wide variety of diseases including MS suffer from globally, and there have been few game-changing drugs in the pharmaceutical market to help treat it.

There is no cure for MS, but current treatments work to speed recovery from attacks, slow the disease's progression and manage symptoms, according to the Mayo Clinic. The most common treatments used to manage symptoms are physical therapy, muscle relaxants and medications to reduce fatigue, depression and pain.

The Phase 1 trial of the gum is slated to begin in the second quarter of 2016. Though medical marijuana is legal in 23 states and the District of Columbia, it is classified on the federal level as a schedule I drug, which gives it the same illegal status as heroin and LSD and is considered to have no accepted medical use.

While the FDA has yet to approve any product containing cannabis, it has approved Marinol -- which contains dronabinol, a synthesized form of THC -- for anorexia, chemotherapy and AIDS patients. The FDA's website says it will continue to assess the effectiveness of marijuana for medical use, and will work with companies on medical cannabis research.

If the gum is approved by the FDA, it could be available in all 50 states, even if they have not legalized medical marijuana. "That's why we're going through the FDA," Anastassov says. "There's no ambiguity as to where it's legal."

-Kathleen Burke; 415-439-6400; AskNewswires@dowjones.com

http://news.morningstar.com/all/market-watch/TDJNMW20150817248/ms-patients-may-someday-find-relief-in-marijuana
-chewing-gum.aspx#.VdL9RQJMOlA.twitter

Medical Marijuana for Neuropathic Pain

As a follow-up to yesterday's article; today's post is an informative video from videojug.com (see link below) about the various medical benefits of medical marijuana, including of course neuropathic pain. The video comes with written information which is reproduced below.

Medical Marijuana Benefits

David G. Ostrow (Medical Marijuana Doctor) gives expert video advice on: What conditions can marijuana treat?; Do most physicians believe in the power of medical marijuana to treat illness?; Why Is medical marijuana an effective way to treat nausea? and more...


What conditions can marijuana treat?

Medical cannabis has been used to treat many many conditions over the several millennia that it's been used. However, in modern day medicine - which is evidence based - I think the best science is in the area of pain reduction or analgesia. It is a non-addictive alternative to opiate drugs for peripheral neuropathy which doesn't respond very well to the typical opiate drugs. And that peripheral neuropathy is most typical in persons with HIV and/or diabetes. It's useful for the anorexia, nausea, that's directly caused by the disease or caused by medications for diseases- such as cancer chemotherapy. A number of trials have shown that it's very effective for cancer pain in terminal cancer. After that I would say multiple sclerosis is one of the areas where it's most widely used. Some people have recommended it for glaucoma, but there are some pretty potent drugs for glaucoma that are typically used and don't require ingesting a compound like marijuana or THC, so that seems to be the preferred way to use it.

Do most physicians believe in the power of medical marijuana to treat illness?

Most physicians will not admit to believing that marijuana or medicinal cannabis is useful except in very rare instances. This, I think, is the result of the misinformation and myths about marijuana and medical marijuana that have been propagated by the US government ever since the war on drugs began back in 1937. And the fact that the double blind placebo controlled study that is just now coming out and people who have spent their lives believing that marijuana is a highly addictive and dangerous substance are not likely to read or even believe that data. So I think we have a long way to go in educating America's physicians, nurses, health care practitioners about the truth and the usefulness of medicinal cannabis so that they will feel more comfortable using it. And that really is the purpose of the organization, The Medical Marijuana Policy Advocacy Project that I and others have established.

Why Is medical marijuana an effective way to treat nausea?

Medical marijuana is an effective way to treat nausea because it can be very easily titrated by the patient, most of whom only require a few puffs of smoke or a small amount of vaporized gas from marijuana. It doesn't have other side effects and it will not only treat the nausea but it will increase appetite, where anorexia often goes along with chronic nausea with cancer or chemotherapy. And so you're really getting two benefits at the same time.

How does medical marijuana help people with glaucoma?

Medical marijuana is supposed to decrease intraocular pressure which is the actual cause of glaucoma or the pathogenesis of it. The mechanism I'm not exactly sure of. It opens, it presumably opens up the canals through which the excess intraocular fluid can drain, but at the same time, we have topical agents that are very strong and very effective. They're usually prostaglandin derived compounds. And so I don't think that [unintelligible] cannabis is going to get very widely used in this area.

What do HIV and AIDS experts say about medical marijuana?

I would say that if you surveyed all the different medical specialties, it would be the HIV/AIDS and oncologists that would be most enthusiastic and positive about medicinal cannabis. At least in those states, like California, that have state sanctioned and regulated medicinal cannabis programs. The majority of patients on those programs are HIV positive patients. They use it primarily for pain relief, but the so-called side effects of euphoria, of increased appetite, well-being, etc., are just as important as the pain-relieving properties in HIV-related disease.

How is medical marijuana used in the treatment of Alzheimer's patients?

Medical marijuana is not yet in clinical trials for Alzheimer's. There's early laboratory evidence that in rats or in in vitro cultures that exposure to whole extracts and perhaps some individual components of marijuana may interfere with the formation of the amyloid deposits and fibulary tangs that are diagnostic of Alzheimer's disease. But I do not know of any clinical trials in humans that have looked at this. They would be very difficult to do because we know that Alzheimer's is a long-term chronic disease that actually begins long before there is any clinical evidence of it being there. So you would have to start with people at high risk of Alzheimer's disease and follow them for many years to determine marijuana's effectiveness there.

Is there an effective way to inhale marijuana without smoking it?

The best way health wise; and particularly for people who find that their throat or lungs are irritated by smoke from marijuana, is to vaporize it. And that is to put it in a chamber and expose it to a very high level of heat so the compounds are paralyzed or released as a gas rather than burnt. And then that gas is collected and allowed to cool. And then you just breath it as if you were breathing air from a plastic balloon, or a rubber balloon or something. And that is basically what vaporization is all about. And that's an alternative that the American Institute of Medicine is recommended. They did research on that as an alternative delivery mechanism. But the federal government has not been willing to fund those kinds of studies. Although there are some being conducted with private funds.

http://www.videojug.com/interview/medical-marijuana-benefits-2

How The US Is Changing Its Mind On Marijuana

Today's interesting post from the Australian abc.net.au (see link below) takes a slightly different look at the progress of marijuana legalisation in the United States. The gradual recognition of the benefits of medical marijuana for a variety of conditions (including neuropathic pain) has led to more and more states legalising the herb thus allowing many more people to take advantage. It's one of the few areas where the USA actually seems to be taking a more liberal stand than most of the rest of the world. Worth a read.

The dope on legalising marijuana in the US
Ben Knight reported this story on Sunday, March 23, 2014
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ELIZABETH JACKSON: This month in the US, the District of Columbia became the latest jurisdiction to vote to decriminalise marijuana.

There's been a sea change in public attitudes towards the drug in America.

In the space of less than 10 years, public support for marijuana legalisation has gone from around 25 per cent to almost 60 per cent.

Much of that has to do with the medical marijuana revolution, which began in San Francisco back in 1996.

Ben Knight reports from Washington, DC.

BEN KNIGHT: Not surprisingly, there are lots of reasons for the shift in public support for marijuana law reform in the US.

One of them is simply demographics. As the baby boomers get older, there are simply more people who have had some kind of experience smoking dope, including this guy:

BARACK OBAMA: I didn't have a dad in the house, and I was angry about it, even though I didn't necessarily realise it at the time. I made bad choices. I got high, without always thinking about the harm that it could do. I didn't always take school as seriously as I should have. And the only difference is that I grew up in an environment that was a little bit more forgiving. So when I made a mistake, the consequences were not as severe.

BEN KNIGHT: It was a powerful message from president Barack Obama, because he didn't just admit that he'd used marijuana, but that he'd misused it, and that he'd been luckier than a lot of other teenagers - especially black teenagers.

In many places in this country, minorities make up the vast bulk of marijuana arrests. But this is an issue that unites the left and right wings of politics.

Libertarian Republicans look at the amount of taxpayer money that goes into marijuana prosecutions - and the cost to society - and they compare that to the tax dollars they see coming back in from states that have legal medical marijuana.

Others on the right take the view that the government simply shouldn't be regulating what people choose to do in their own lounge rooms.

Now the debate is of course far from over, and there are very real concerns, particularly about the effect of marijuana on young developing minds, and what kind of message legalising it - or even just decriminalising it - sends to teenagers.

But there's little doubt that either that marijuana supporters are winning that debate. And a lot of that has to do with medical marijuana.

(Rabbi Jeffery Kahn enters)

BEN KNIGHT: Jeffery, how are you?

JEFFERY KAHN: Great. Welcome - delighted that you're here.

BEN KNIGHT: Thank you, great to be here.

(Voiceover): This is the Takoma Wellness Centre in Washington, DC.

JEFFREY KAHN: This door leads to the dispensary.

BEN KNIGHT: Wow, look at it.

(Voiceover): There are thousands of centres like this in 20 states across the US. The owner of this one is Rabbi Jeffrey Kahn.

JEFFREY KAHN: Many of our patients are older. They have never had an experience with cannabis.

BEN KNIGHT: He started this business with his wife Stephanie in 2010.

Their only experience with marijuana was through Stephanie's parents, both of whom used medical marijuana but who had to do it illegally.

STEPHANIE KAHN: We really saw what it could do, but we also saw the fear that they had.

BEN KNIGHT: Stephanie's father was first, after he was diagnosed with multiple sclerosis.

STEPHANIE KAHN: Back in the 70s, the doctors started saying 'try marijuana.' And this was the 70s - he had a teenage daughter, and he was a very straight-laced businessman - and he was like, 'no, I'm not going to.'

But eventually he ended up trying it and it made a huge difference. It helped his spasms, it helped his neuropathies in his fingers and his feet, and it helped pain - it really helped him.

But we were all scared to death. I mean this was, again, the 70s and my parents particularly were afraid that someone was going to go knocking down their door and arrest them.

BEN KNIGHT: Then, after her father died, the family moved from Miami to Washington, where Stephanie's mother was diagnosed with cancer.

STEPHANIE KAHN: We hadn't been living here, we didn't know anybody, we couldn't get anything for her, she couldn't. And so she essentially was diagnosed in June 2009, and died in august 2009, and she wasted away. And the doctor kept saying 'you really need to try some of this and to use it just so you can take something down - eat something.'

BEN KNIGHT: This was at exactly the time that the District of Columbia voted to legalise medical marijuana. Stephanie and Jeffrey didn't think twice about opening their own dispensary.

STEPHANIE KAHN: I just fell in love with the idea. This would be something in my parents' memory. We can open some place that they could have gone to, that people like them could go to and feel safe and get help.

I get choked up every time I talk about this.

It was really important that we could do something here in their neighbourhood. It just meant a lot.

BEN KNIGHT: Tell me about your patients. I mean, do they remind you of your parents?

STEPHANIE KAHN: Yes, a number of them do, it's really amazing.

JEFFREY KAHN: I think that we're going to find some form of legalisation in just about every state. It's what's happening - there really isn't significant opposition, and I think that the old laws just don't really make any sense to anyone anymore.

BEN KNIGHT: This is Ben Knight in Washington for Correspondents Report.

http://www.abc.net.au/correspondents/content/2014/s3969374.htm

The Safety Of Medical Marijuana As A Pain Killer

Today's post from webmd.com (see link below) is a recent one looking at the safety of medical marijuana, which if we're honest as neuropathy patients, is what concerns us most. Most people these days have researched enough to realise that the moral, legal and addictive qualities of medical marijuana are not so important; what they're interested in is whether it works as a pain killer for neuropathic symptoms and it quite clearly does for most users. This article assumes that and looks at a study of the drug's safety in comparison with other drugs used to treat neuropathy including opioids. It comes to the conclusion that medical marijuana is a useful addition to the doctor's tool chest when it comes to neuropathy medication. Worth a read.

Medical Marijuana Seems Safe for Chronic Pain
And the drug modestly reduced people's pain scores
By Dennis Thompson HealthDay Reporter WebMD News from HealthDay
WEDNESDAY, Oct. 7, 2015 (HealthDay News)

 Medical marijuana appears mostly safe for treating chronic pain, at least among people with some experience using the drug, a new study suggests.

People who used pot to ease their pain didn't have an increased risk of serious side effects, compared to people with pain who didn't use marijuana, a Canadian research team found.

But, medical marijuana users were more likely to have less-serious side effects, the study authors said. These side effects included headache, nausea, sleepiness and dizziness, the research revealed.

"In terms of a side effect profile, we felt the drug had a reasonably good safety profile, if you compare those effects to other medications," said study lead author Dr. Mark Ware. He is director of clinical research for the Alan Edwards Pain Management Unit at McGill University Health Center in Montreal.

Although this study focused on the safety of medical marijuana, Ware reported that participants also appeared to experience some pain relief through their use of the drug. The researchers also saw improvements in mood and quality of life in the marijuana users.

Findings from the study were reported online recently in the Journal of Pain.

The trial is the first and largest study of the long-term safety of medical marijuana use by patients in chronic pain, Ware said.

The researchers followed 215 adult patients with chronic pain who used medical pot for one year. The researchers compared the marijuana users to a control group of 216 chronic pain patients who didn't use medical marijuana. The study involved seven pain treatment centers across Canada.

The people using pot were given leaf marijuana containing 12.5 percent THC from hospital pharmacies, Ware said. THC is the chemical in marijuana that causes intoxication. People could use pot however they liked -- smoking it, eating it in food, or inhaling it from a vaporizing device.

There was no difference in serious side effects between the two groups, the researchers found.

Marijuana users did have a 73 percent increased risk of minor side effects, the study found.

Mitch Earleywine, chair of NORML, a marijuana legalization advocacy group, said many of these side effects could be reduced by changing the way the pot is used.

"Essentially, people who used vaporized cannabis would have no more adverse events than controls," said Earleywine, who's also a professor of psychology at the State University of New York at Albany.

Ware said he hopes the study will provide valuable information for patients considering medical marijuana for pain treatment.

"This is a paper they should bring to the attention of their physician or health care provider," Ware said. "Anybody who is interested in using cannabis to treat pain should know this information, as it can influence the decision-making process considerably."

Since the study focused on people familiar with marijuana, however, it might not be as useful for patients who've never tried pot before, he added.

"For somebody reading this who's never tried it, the effects they experience might be different," Ware said.

Paul Armentano, deputy director of NORML, said the study provides further evidence that the use of marijuana doesn't deserve to be criminalized.

"These findings, and others like it, are in direct conflict with cannabis' present schedule I status under federal law, a classification that fails to acknowledge the substance's clinical efficacy and acceptable safety profile," he said.

Dr. Jonathann Kuo, an interventional pain management specialist at North Shore University Hospital in Manhasset, N.Y., said medical marijuana has the potential to be a valuable alternative for doctors who specialize in chronic pain management.

"We frequently find that opioids [such as OxyContin, Percocet, Vicodin] are not a good long-term solution for chronic pain," Kuo said. "We'd like to see some more of these long-term safety profiles of medical cannabis, and studies like these are important steps forward in that direction."

However, Kuo said larger follow-up studies looking at pot's safety and effectiveness are needed.

"I'd like to see more definitive studies before prescribing this to my patients in the future," he said.
 
SOURCES: Mark Ware, M.B.B.S., director, clinical research, Alan Edwards Pain Management Unit, McGill University Health Center, Montreal; Jonathann Kuo, M.D., interventional pain management specialist and attending physician, North Shore University Hospital, Manhasset, and Long Island Jewish Medical Center, New Hyde Park, N.Y.; Mitch Earleywine, Ph.D., professor, psychology, State University of New York at Albany, and chair, NORML; Paul Armentano, deputy director, NORML; Sept. 16, 2015, Journal of Pain, online

http://www.webmd.com/pain-management/news/20151007/medical-marijuana-seems-safe-for-chronic-pain-patients-study-finds