Medical Cannabis Discussion

[Doc Safari]

I looked into it for glaucoma since I have glaucoma in my right eye, but I couldn't find enough evidence it actually makes a difference to make me want to try it.

[WillBrink]

Maybe where you are but, FWIW, none of that is true in CO. Med patients can buy and smoke high THC flower and eat brownies until their heads explode. None of that changed with passage of rec either.

Edited to add:

Here are the main differences between med and rec in CO:
- Med has higher possession limits
- Med is not subjects to the same taxes as Rec
- Med can purchase edibles with a higher unit dose of THC than Rec (Rec is 10mg THC/dose)

Licensed growers have to track plants grown under their Rec license separately from their Med license, so Med patients sometimes have access to different flower strains, but otherwise one can buy all the same stuff in a Rec shop as with a Med card.

As CO has recreational MJ and FL does not, makes sense. It would be interesting to read up on how each state deals with med vs rec (of they have both) compared to those with med only. I'll have to look into that some more. At the moment, FL is the only one I'm tracking in terms of med use of MM.

[kerplode]

Yeah, it's pretty interesting to see the different approaches the various states have taken.

[Hmac]

You have pretty much said all this in previous posts, funny how doctors are free to make opioid addicts without much thought, but not take a chance with MM for fear of the feds, so much for the hippocratic oath

Sent from my SM-N950U using Tapatalk

What does the Hippocratic oath have to do with marijuana?

[kerplode]

Personally, I give 0 shits if people use marijuana and I think that it should be 100% legal for everyone to use or not use as they see fit.

Having said that, however, I can't argue with Hmac's position on the subject...If I were a practicing MD and my livelihood depended upon keeping my DEA number, there is no way in hell I'd touch a MMJ applicant. Losing the ability to practice is, more or less, "doing harm" to your existing patients.

There are plenty of doctors who write MMJ papers, so it's not really a hardship if someone wants to get a card. My wife's Neuro guy offers all his patients a card as his standard of care, but that doesn't mean all MDs should be forced into that.

[WillBrink]

Interesting development. Pharma getting in on it (cuz they have no faith it works...) and FDA looks to pull CBD. And why? Because pharma filed INDs, not due to safety concerns nor efficacy per se by the FDA. Obviously CBD has been used before pharma ever existed.

https://www.nutraingredients-usa.com...dustry-meeting

And:

FDA Triggered Industry Shift From ‘CBD’ to ‘Hemp Extracts’ in Dietary Supplements

Amid the escalating demand for CBD in the United States, many companies are selling “hemp extracts,” a strategy based on regulatory and scientific considerations. Marketers of hemp extracts must distinguish their products from the compound (CBD) under investigation by GW Pharmaceuticals plc, which announced Thursday that an FDA committee unanimously recommended supporting approval of its new drug application for Epidiolex.

https://www.naturalproductsinsider.c...ry-supplements

[WillBrink]

For those who suffer migraines, a combo of THC and CBD was more effective than commonly prescribed med for migraines, and slightly more effective for cluster headaches:

Marijuana Treats Migraine Pain Better Than Prescription Medication, Study Finds

In another win for marijuana research, a study has found that the active compounds in cannabis are more effective at reducing the frequency of acute migraine pain than prescription migraine meds, and with fewer side effects.

The study included a total of 127 participants who suffered from chronic migraines and cluster headaches, severe headaches that occur on one side of the head, often around an eye. Migraine pain usually affects both sides of the head and is often accompanied by light sensitivity and nausea.

The cannabis-based medication the researchers gave the participants was a combination of the two active compounds in marijuana: tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the psychoactive compound that gets pot users high; CBD doesn’t get you high, but research has shown that it provides therapeutic benefits, including relieving seizures in epileptic patients.

The study had two phases. In the first, sufferers of chronic, acute migraines were given varying doses of the THC-CBD drug. The results showed that those who received a 200mg dose each day for three months experienced significantly less pain--about 55% less (lower doses didn’t provide the same pain relief).

Cont:

https://www.forbes.com/sites/daviddi.../#59cbbadc3700

Source:

https://www.ean.org/amsterdam2017/3r...17.2844.0.html

See also:

Front Neurosci. 2018

Endocannabinoid System and Migraine Pain: An Update.

Abstract

The trigeminovascular system (TS) activation and the vasoactive release from trigeminal endings, in proximity of the meningeal vessels, are considered two of the main effector mechanisms of migraine attacks. Several other structures and mediators are involved, however, both upstream and alongside the TS. Among these, the endocannabinoid system (ES) has recently attracted considerable attention. Experimental and clinical data suggest indeed a link between dysregulation of this signaling complex and migraine headache. Clinical observations, in particular, show that the levels of anandamide (AEA)-one of the two primary endocannabinoid lipids-are reduced in cerebrospinal fluid and plasma of patients with chronic migraine (CM), and that this reduction is associated with pain facilitation in the spinal cord. AEA is produced on demand during inflammatory conditions and exerts most of its effects by acting on cannabinoid (CB) receptors. AEA is rapidly degraded by fatty acid amide hydrolase (FAAH) enzyme and its levels can be modulated in the peripheral and central nervous system (CNS) by FAAH inhibitors. Inhibition of AEA degradation via FAAH is a promising therapeutic target for migraine pain, since it is presumably associated to an increased availability of the endocannabinoid, specifically at the site where its formation is stimulated (e.g., trigeminal ganglion and/or meninges), thus prolonging its action.

https://www.ncbi.nlm.nih.gov/pubmed/29615860

[WillBrink]

Personally, I give 0 shits if people use marijuana and I think that it should be 100% legal for everyone to use or not use as they see fit.

Having said that, however, I can't argue with Hmac's position on the subject...If I were a practicing MD and my livelihood depended upon keeping my DEA number, there is no way in hell I'd touch a MMJ applicant. Losing the ability to practice is, more or less, "doing harm" to your existing patients.

There are plenty of doctors who write MMJ papers, so it's not really a hardship if someone wants to get a card. My wife's Neuro guy offers all his patients a card as his standard of care, but that doesn't mean all MDs should be forced into that.

I'm not and expert on this topic and seems very state to state, but I can see both sides of it. I'm not aware of any state that forces docs to offer it.

[Hmac]

I'm not and expert on this topic and seems very state to state, but I can see both sides of it. I'm not aware of any state that forces docs to offer it.

Force doctors to prescribe a particular drug, offer a particular treatment, perform a particular operation? No...that will never happen. Especially not one that's illegal.

[WillBrink]

Is CBD the next big find for athletes? Maybe, but far more data is needed. Interesting though:

Andrew Talansky is almost always sore. The 29-year-old spent seven years as a professional cyclist racing for Slipstream Sports. He recently switched to triathlon and now spends hours training both on and off the bike. “I’m using muscles I haven’t used in years,” Talansky says. “My body is constantly inflamed.” Many athletes in his situation rely on common pain relief like ibuprofen, but when Talansky strained a hip flexor last fall, he reached for a bottle of cannabidiol (CBD), an extract from the cannabis plant, instead.

“I took it for a couple of weeks, and there was a noticeable difference immediately,” Talansky says. “And it wasn’t just that my hip was feeling better. I was less anxious, and I was sleeping better.”

Marijuana has long been considered an alternative pain medication, with THC, the principle psychoactive compound in the plant, getting most of the attention. CBD is another active component and could offer some of the same medical benefits (anti-inflammatory, anti-anxiety, analgesic), but without the side effect of getting high. CBD interacts with serotonin and vanilloid receptors in the brain, which affect mood and the perception of pain. It also has antioxidant properties. The World Anti-Doping Agency (WADA) removed CBD from its list of banned substances in January, which prompted many professional athletes, including ultrarunner Avery Collins and mountain biker Teal Stetson-Lee, to eschew ibuprofen for CBD. Some believe it’s a safer alternative to drugstore pain relievers and anti-inflammatories.

https://www.outsideonline.com/229626...gn=onsiteshare