Medicinal cannabis patients in the US and elsewhere are beginning to replace or supplement conventional pharmaceuticals with cannabis, with very promising initial results.
For some conditions, such as pain, epilepsy and insomnia, cannabis may be a safer and more effective alternative to prescription drugs. However, more research is needed to better understand how and when cannabis works as a replacement for pharmaceuticals.
Epilepsy
Epilepsy is a common brain disorder that can cause seizures. There is no cure for epilepsy, but treatment can help control the seizures and prevent other problems. People with epilepsy have a higher risk of developing other diseases, such as high blood pressure or diabetes. These risks can be reduced by eating healthy foods and taking a healthy lifestyle.
Medical marijuana, a type of cannabis that contains a low amount of THC (tetrahydrocannabinol), can be used to treat seizures and other symptoms of epilepsy. It has been shown to reduce the number of seizures in some patients with drug-resistant epilepsy.
Epidiolex is the first oral solution containing cannabidiol (CBD) to be approved by the FDA for the treatment of seizures associated with two rare and severe forms of epilepsy in children and adults. The medication is now available in the US and Europe.
The potential of cannabis as a replacement for pharmaceuticals is becoming increasingly important as more people are developing treatment-resistant epilepsy and many suffer from seizures that haven’t responded to medication. However, there is a lot of uncertainty around the use of cannabis in the treatment of seizures.
For this reason, research into the use of cannabis extracts for the treatment of childhood treatment-resistant epilepsy is vital. Recent surveys of Australian parents/guardians of children and adults who use medicinal cannabis extracts for their child’s epilepsy indicate that they are keen to take part in future research and report on their experiences.
It is important to note that although there are a significant number of studies on the use of medicinal cannabis extracts in treating epilepsy, these are often small scale and haven’t been able to provide reliable evidence of efficacy for all groups of individuals. Despite these limitations, there is strong evidence that the use of medicinal cannabis extracts can have positive effects on the quality of life and well-being of people with epilepsy.
It is also essential that families are aware of the possible health risks involved with the use of cannabis extracts for their child’s epilepsy and are supported in making a decision about whether or not to use these products. This can be done through a shared decision-making process that involves all parties involved in the child’s care.
Pain
The potential of cannabis as a replacement for pharmaceuticals is an attractive proposition for pain patients, especially in light of the ongoing opioid epidemic. However, the current state of knowledge is limited regarding the efficacy and safety of this medicinal plant.
Pain is a complex sensory modality with an innate and instinctive response to specific, identified, damaging stimuli (National Academy of Sciences, 1985). It is triggered by the body’s pain receptors, which are nerve endings in the body tissues that respond to noxious stimuli such as pricks, cuts, burns, or other potentially harmful substances. These receptors send a message to specific, identified nerves in the spinal cord. The spinal cord transmits these messages to the brain. These messages initiate a response in the central nervous system that includes well-defined pathways in the brain stem reticular formation, thalamus, somatosensory cortex, and limbic system.
For most people, the experience of pain is a subjective one. Even the same person may have a different experience on separate occasions or over a lifetime. This is because the pain-transmission neurons in the spine respond to signals from the spinal cord differently and amplify or reduce them depending on how they perceive the experience.
This difference in the way the pain-transmission neurons process information is an essential part of pain’s complexity, because it explains why some people experience pain more than others. It also explains why some people feel pain for longer than others, and it is why different types of pain require different treatments.
Currently, the majority of cannabis-based pain medications are oral and contain delta-9 tetrahydrocannabinol (THC) and cannabidiol (CBD). Terpenes can increase the effectiveness of THC by activating opioid receptors in anti-nociceptive brain regions (Kroenke et al., 2015). The effect of terpenes may be due to a synergistic interaction between delta-9-tetrahydrocannabinol and CBD, or by the potentiation of THC by other molecules present in the cannabis plant, called the entourage effect.
In addition to the THC- and CBD-derived compounds, the cannabis plant contains hundreds of other potentially active chemicals. This could explain the preference of some patients for cannabinoid extracts, rather than pure THC or CBD. Moreover, these compounds could interact with the endocannabinoids in the body to produce additional analgesic effects. This could lead to the development of a new class of drugs that might be more effective than the existing drug classes for treating chronic pain.
Depression
Depression is one of the most common mental health problems worldwide. It causes a variety of serious symptoms that can disrupt a person’s daily life and relationships. The most severe cases of depression can cause suicidal thoughts and behaviors.
Treatment options for depression include psychotherapy, stress-reduction techniques and medications that target the brain. Medications can improve mood and reduce feelings of hopelessness, worthlessness and anger. However, they can have side effects and may not be effective for everyone.
Some antidepressants work by lowering levels of the neurotransmitter serotonin. Others increase them. These drugs can help with symptoms of depression such as anxiety, irritability and sleep problems. They can also make you feel euphoric or happy.
The most common type of antidepressant is a drug called an SSRI, such as Prozac and Zoloft. They work by blocking the reuptake of serotonin and other neurotransmitters. They are available in pill form and have been prescribed to thousands of people around the world.
But these medications can have unpleasant side effects. Many people experience insomnia, nausea, drowsiness or sweating. They also may have high blood pressure or low blood sugar. These symptoms can worsen if you’re already taking medications for other conditions.
Researchers are exploring new ways to treat depression. One possible method uses a powerful drug called ketamine, which can rapidly relieve some depressive symptoms and has been approved by the FDA for the treatment of patients with treatment-resistant depression. It works through receptors for another neurotransmitter, glutamate, which is dysregulated in depression.
Other research is examining drugs that open potassium ion channels in the brain. In animal studies, the potassium ion channel opener ezogabine reduced depression symptoms and improved mood.
The researchers believe that this approach could be used in humans to prevent and treat stress-related disorders like depression, which are more likely to occur in the presence of extreme stress. It’s also an appealing strategy for treating other medical conditions that result in anxiety and depression, such as post-traumatic stress disorder.
Depression is a major cause of disability and death in the United States. It’s estimated that nearly 20 million people suffer from depression each year. It’s a chronic condition that can be difficult to treat.
Anxiety
Anxiety is a common mental health problem that affects more than 40 million Americans every year, and it often leads to benzodiazepines like Xanax or Klonopin being prescribed for short-term relief. Although these drugs can ease anxiety, they also have a number of unpleasant side effects, including fatigue, confusion and disorientation. Moreover, they can lead to tolerance and dependence, which can be life-threatening if overdosed.
CBD (cannabidiol) is an alternative to benzodiazepines for treating anxiety disorders. The compound is derived from the cannabis plant and has antipsychotic, anxiolytic, antidepressant and neuroprotective properties.
The anxiolytic action of CBD is based on the modulation of 5-HT1A receptors, which are key targets in anxiety and depression. It also enhances the effects of serotonin neurotransmitters and brain-derived neurotrophic factors (BDNF), which are important for reducing anxiety.
To date, animal models and preliminary clinical trials have reported that CBD shows anxiolytic, antidepressant, antipsychotic, antiepileptic, and neuroprotective properties. Moreover, CBD can reduce stress, improve sleep quality and enhance social functioning in patients suffering from stress-related psychiatric disorders, such as post-traumatic stress disorder (PTSD) and schizophrenia (SCZ).
In a mouse model of PTSD, acute or sub-chronic administration of CBD significantly reduced fear conditioning, anxiety-like behaviors and long-term gene expression changes in the endocannabinoid system (ECS), hypothalamic pituitary-adrenal axis (HPA axis), and serotonin systems. It was also shown to decrease freezing induced by predator stress and aversive memory consolidation [123,134].
Studies in human subjects have shown that CBD treatment reduced anxiety symptoms in patients with social anxiety disorder. This was achieved by triggering changes in blood flow to areas in the brain linked to feelings of anxiety.
Several CBD-containing products have been developed to treat anxiety disorders. These include extracts, oils and capsules, which can be taken by mouth or vaporised through a vaporizer.
Anxiety is a common and serious disorder that can affect people of all ages and genders, but can be especially debilitating for those with social anxiety or other forms of depression. It can interfere with everyday activities and relationships, and it can even cause a person to have a poor job performance or even to stop working altogether.
