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

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

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

A Day In Court For Medical Cannabis

Today's post from safeaccessnow.org (see link below) will be of particular interest for people living in or near Washington DC but the ramifications of the outcome will be of interest world-wide. In October 2012, the US Court of Appeals is finally going to hear arguments about the benefits of medical cannabis, especially in relation to chronic pain. Many neuropathy patients already know how cannabis/marijuana can reduce their pain levels but many more find legal access almost impossible. Different countries across the world have different laws and expert opinions on the subject but if the USA officially backs it as a valid treatment, the rest of the world tends to sit up and take notice. Unfortunately, the powers that be in the States are hampered by hysterical overreaction to the very name cannabis and it will take sound scientific arguments for them to turn against public opinion.

 

Want to Join ASA for Medical Cannabis Patients’ Day in Federal Court?
September 6th, 2012 Posted by Mike Liszewsk

After a full decade of waiting, medical cannabis patients will finally have theirday in federal court on October 16, 2012when the United States Court of Appeals for the D.C. Circuit agreed to hear oral arguments in Americans for Safe Access v. Drug Enforcement Administration. The hearing will be a historic day in the medical cannabis movement and ASA’s staff have been fielding a great many inquiries from our members about how they can get a “front row seat” to history. Well, not everyone will be so lucky as to sit in the front row seat in the courtroom, but many of our members will be able to watch the hearing live. Below are details on how you can join ASA in the courtroom that day, but first, some brief background on the case.

The Legal Battle to Reschedule Cannabis, 10 Years in the Making

The history of this case begins in 2002 when Coalition for Rescheduling Cannabis (CRC) filed its petition, the courts will finally review the scientific evidence regarding the medical value of marijuana. Since “marijuana” (cannabis) was originally placed and has since remained in Schedule I of the federal Controlled Substances Act, the U.S. Government holds the position that the plant has no accepted medical value and is unsafe to use for medical purposes. The appeal case on Oct. 16 with challeng the July 2011 Drug Enforcement Administration (DEA) denial of the CRC petition, which was filed in 2002. ASA’s Chief Counsel, Joe Elford, summarizes the case as,
“…a rare opportunity for patients to confront politically motivated decision-making with scientific evidence of marijuana’s medical efficacy. What’s at stake in this case is nothing less than our country’s scientific integrity and the imminent needs of millions of patients.”

While a decision in the case will not come for several weeks after oral arguments, many medical cannabis patients and their loved ones will no doubt want to join Elford in the courtroom as he presents ASA’s argument before the court.

How to Attend Your Day in Federal Court

The Oct. 16th oral argument hearing will be held E. Barrett Prettyman Federal Courthouse, however, those planning to attend should take note that there is very limited seating, and ASA cannot reserve seating for the public. The hearing is currently scheduled for 9:30am in Courtroom 11 (4th floor), which has a maximum capacity of only 80 members of the public. While there is a chance that the hearing may be moved to a larger courtroom, the largest courtroom available has a maximum capacity of 200 members of the public.

Those wishing to be in the courtroom that day should be prepared to wake up early and wait in line, as seating is first come, first served. The courthouse opens at 8am, and the line to view the hearing begins right outside the Courtroom 11 doors. Typically the courtroom begins seating members of the public at 9:10am, with the hearing beginning at 9:30am. It appears as though ASA vs. DEA will be the second hearing held in Courtroom 11 that morning, so safe access advocates packing the courtroom may end up sitting through the case unrelated to medical cannabis, Gang Luan vs. US.

What to Bring, and What Not to Bring

Security at the E. Barrett Prettyman Federal Courthouse is higher than most federal buildings in DC, and many items are not allowed in the courthouse, much less the courtroom. Nobody is permitted in the courthouse without presenting a valid government-issued photo ID card. Backpacks, briefcases and purses are permitted in the courthouse, but electronic devices are only by attorneys who can practice federal court and credentialed members of the media. Technically, certain kinds of electronic devices are permitted, but since nearly every device is capable of recording audio and/or video, it applies to most electronic devices. The court does have lockers where electronic devices capable of recording may be stored while attending a hearing. Traditional film cameras are strictly forbidden as well. Additionally, visitors are forbidden from bringing in “all liquids, aerosols, and gels in excess of 3.4 ounces (100 ml).”

Getting to the Courthouse

The courthouse is located at 333 Constitution Ave NW, Washington, D.C. 20001. Both locals and those coming in from out of town to attend the hearing are highly encouraged to take public transportation. TheDC Metro system has two stops that are short walks to the hearing on the Red line at Judiciary Square, and Green/Yellow lines at Archives.There are a handful of public parking lots nearby, but they are not cheap, nor are they closer to the courthouse than the Metro stations.
Although there are 4 entrances to the courthouse, individuals with physical disabilities should use either the 3rd ST entrance or John Marshall Park entrance.
ASA looks forward to seeing you on YOUR day in federal court to watch history unfold before our eyes!

http://safeaccessnow.org/blog/?p=3118

 

 

 

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

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

Neuropathic Pain Recognition A Medical Failure

Today's post from phcris.org (see link below) is another article (this time from Australia) calling for better awareness of neuropathic pain. It makes the point that not only the general public are pretty much unaware of neuropathy as a problem but many doctors either misdiagnose, or fail to recognise the problem from patients' accounts. The story has always been that because patients find it difficult to describe their symptoms, doctors miss vital clues, or fail to take the patient seriously. Frankly, I wonder if that's true. Neuropathic symptoms may be difficult to describe but they're pretty much unique and a few minutes discussing the problem with the patient must surely lead to an inescapable conclusion that nerve damage may be playing a role in their complaint. I have a feeling that doctors are more wary of the failure rate when it comes to official diagnosis (for records and insurance companies) and treatment rather than anything else, therefore they are tempted to send their patients home, with a 'learn to live it' advice, to avoid lengthy and inconclusive testing procedures and treatment regimes that rarely work anyway.

Raising awareness of neuropathic pain
02 July 2015 PHCRIS

 

One in three people over the age of 65, and one in five Australians suffer from chronic pain. With an ageing population and increased instances of long-term chronic illnesses such as cancer, diabetes and coronary disease, the need for improved pain management will only increase.

According to Painaustralia—a national not-for-profit body established to improve the treatment and management of pain in Australia—chronic pain remains one of the least understood and most poorly resourced areas in Australia’s primary health care system, with over 80% of people with chronic pain missing out on treatment that could improve their health and quality of life.

Formed in February 2011 to facilitate the implementation of the National Pain Strategy, Painaustralia works with healthcare professionals, health consumers and the national government, to implement best practice models for improved pain management and health care outcomes.

Lesley Brydon, Painaustralia’s Chief Executive Officer, discussed her goals for the National Pain Strategy recently.

“The National Pain Strategy (NPS-2010) sets out a blue print for best practice assessment, and treatment of pain, with a major focus on primary care, where currently chronic pain is very poorly understood and treated,” she said.

“Significant advances in the understanding and treatment of chronic pain made in the past decade have not been translated into clinical practice, and consequently, chronic pain remains a severely neglected area of health care.”

Painaustralia’s Manage Chronic Pain fact sheet, has since been made available through Medical Director, and provides useful information for primary health care practitioners and their patients.

“In addition to providing resources to primary health care practitioners via our website, Painaustralia also advocates for team-based care led by General Practitioners (GPs) working with Allied Health Practitioners, for improved patient outcomes,” Lesley said.

“Online education for pain management is provided for GPs through the RACGP’s GP Learning website, and Allied Health Practitioners, Nurses and Pharmacists through the Australian and New Zealand College of Anaesthetists’ Faculty of Pain Medicine website.”

While Painaustralia has been successful in raising awareness of, and improving, chronic pain management in Australia since its establishment in 2011, it has also been working with international bodies to raise the profile of pain management and treatment worldwide.

On 20 October 2014, Painaustralia joined the International Association for the Study of Pain, the Australian Pain Society, the New Zealand Pain Society, the Faculty of Pain Medicine, and the Australian and New Zealand College of Anaesthetists in launching the Global Year Against Neuropathic Pain, which arises from a lesion or disease affecting the somatosensory system.

Neuropathic pain is often misunderstood and mistreated by health practitioners, due to symptoms, such as shooting or burning pain and numbness, being difficult for patients to describe.

As a result of this, the global campaign has focused on educating health care providers about the causes, signs and symptoms of neuropathic pain, through the creation and dissemination of a series of fact sheets for clinicians and health care professionals that cover specific topics related to neuropathic pain, including: What is Neuropathic Pain; Mechanisms of Neuropathic Pain; Epidemiology of Neuropathic Pain; Central Neuropathic Pain; and HIV Associated Sensory Neuropathy.

The Global Year Against Neuropathic Pain fact sheets, from the International Association for the Study of Pain, have been translated into multiple languages and can be downloaded from the Painaustralia homepage.

This news item was featured in This Week in PHC Issue: 02 July 2015.

http://www.phcris.org.au/news/newsfeed/2015/july/painaus.php