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(HealthNewsDigest.com) – We’re often asked, “What conditions can cannabis (aka “medical marijuana”) be used for?” There are many, but we thought, “Why not ask the patients what condition/s they use cannabis for?” 4,276 patients responded to our survey, and 39 conditions were mentioned. The top five are:
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Anxiety – 63% (out of 4,276)
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Insomnia – 60%
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Depression – 43%
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Pain – 36%
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Headache/Migraine – 25%
Other conditions mentioned include cancer, epilepsy, multiple sclerosis and many more. However, remember that the above conditions are often side-effect of many other conditions, and it wouldn’t be uncommon for a person with cancer to use cannabis for The most common pharmaceuticals cannabis replaced or reduced intake of are:
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Painkillers – 51%
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Antidepressants – 27%
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Anxiolytics – 10%
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Barbiturates – 3%
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Anticonvulsants – 2%
So, why might cannabis help patients with their condition and help reduce intake of other medications? Here’s some reasons why …
Anxiety
“Anxiety” is an umbrella term describing various different anxiety-related conditions, such as generalized anxiety disorder (GAD) and social anxiety disorder (SAD). Until recently, post-traumatic stress disorder (PTSD) was also put under the “anxiety” umbrella, but the most recent edition of the DSM has listed PTSD as a separate condition.
The first port-of-call for treating anxiety when it comes to medication are antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). SSRIs block the reabsorption of serotonin, making more serotonin available. Anxiety is often associated with a serotonin deficiency, hence antidepressant prescriptions. Of particular interest is the serotonin receptor 5-HT and its subtypes.
However, like many conditions, easing anxiety is more complex than a simple matter of “get more serotonin into the system”. Norepinephrine, dopamine and vanilloid receptors are also involved, and it is postulated that serotonin deficiency is just one part of the chain that causes anxiety. Sometimes, when antidepressants have failed, anxiolytics are prescribed – minor tranquilizers often in the barbiturate or benzodiazepine class of drugs, which are quite addictive. Moreover, anxiolytics in such drug classes can potentially make anxiety worse if used in the long-term.
Cannabinoids and some terpenoids also seem to be able to modulate serotonin, dopamine, norepinephrine and vanilloid receptors, and this could be one of the reasons why cannabinoid-based medications can possibly be used as an adjunct or even replacement for some antidepressants. Another issue with antidepressants is that they can take several weeks to work properly, with some being effective and some being ineffective. This means a person taking antidepressants may need several months to find an antidepressant that works for them.
Insomnia
Insomnia is often related to stress. Those whose bodies go through drastic shifts in cytokine (proteins important for cell signalling) production are more prone to developing insomnia. Those with insomnia also have elevated levels of cortisol and adrenocorticotropic hormones whilst sleeping. Insomniacs also tend to lack the inhibitory neurotransmitter gamma-aminobutyric acid (GABA).
Cytokines also play a massive role in immune response and inflammation, so unsurprisingly insomniacs tend to suffer from infections more often and recover more slowly from injuries. Insomnia is both a condition unto itself, and is a common side-effect of other conditions. The endocannabinoid system (ECS) may play a role in regulating sleep, increasing non-rapid eye movement (NREM) sleep time. However, although cannabinoid signalling may be important for sleep stability, it may not be necessary for sleep homeostasis.
Cannabis contains THC, which may help induce sleep and relaxation through activation of CB1 receptors. Terpenes like myrcene and humulene may also help give some types of cannabis its “sleepy” effects. Small doses of CBD may actually have an “alerting” effect, even though it may also help patients feel less anxious. Taken in combination with THC, high doses of CBD may induce more “sleepy” effects, especially if the terpenoid profile includes terpenes such as myrcene, humulene and linalool – not uncommon in indica-dominant strains of cannabis. However, the way in which cannabinoids and terpenoids interact with one another and the human body is not fully understood as of yet, so the precise physiological effects of different cannabinoid-terpenoid profiles on different individuals cannot be determined.
Depression
Depression (or, more specifically, major depressive disorder/unipolar depression) is treated very similarly to the way anxiety is treated. Antidepressants are the first go-to, as depression is often associated with low levels of serotonin. Interestingly, anxiety and depression are often comorbid, but treatment methods may differ in some key ways. To make matters more complex, bipolar disorder (aka “manic depression”) can sometimes be mistaken for unipolar depression, and antidepressants such as SSRIs are not necessarily the best way of treating bipolar disorder.
So, as you can see, depression is a condition that can be very difficult to diagnose, and its comorbidity with so many other health problems can make it both a mask and a symptom of other concerns. Plus, depression can lack any outward symptoms, making treatment more sensitive still.
Our survey shows that people with anxiety preferred indicas, whereas people with depression showed a preference for sativas. This would make sense intuitively. “Anxious people are up, whilst depressed people are down.” Yet, our approach to both depression and anxiety is similar in many respects. This suggests that, yes, both anxiety and depression are linked to serotonin in some manner, but there may also be significant differences in how they manifest. The pathways that induce both conditions may be different on some level. The ECS may actually help us understand the way in which anxiety, depression and other mood disorders arise, and how they’re different and similar. The ECS may also teach us more about how antidepressants work.
A sativa high in THC, limonene and beta-caryophyllene may be fine for someone with depression or ADHD, but someone prone to anxiety may want to avoid such a profile. Someone with depression, meanwhile, may want to avoid indicas high in myrcene and other “sedative” terpenoids. As for CBD, it does seem to have use for those with depressive disorders due to it possibly having an effect on the 5-HT1A serotonin receptor. Therefore, those with depression (or indeed any other condition) may not necessarily want to avoid sativas or indicas per se, but rather pay attention to the cannabinoid and terpenoid profile and see which ones have positive, negative or neutral effects, whether on their own or in combination with one another. CBD may be a potential antipsychotic, possibly making it useful for bipolar disorder.
Chronic Pain
Chronic pain is pain that lasts three months or longer. Injuries, surgery, chronic illness, recovering from an infectious disease … All of these things can result in long-lasting pain. Being in constant pain has a psychological impact, and it’s perhaps unsurprising that those who are in constant pain are likely to be depressed, which can exacerbate the pain. Non-steroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen), mild analgesics (e.g. acetaminophen) and antidepressants are the most commonly prescribed drugs for pain, but opioids are also often prescribed for moderate- to high- levels of pain.
Where NSAIDs, mild analgesics and antidepressants might be pretty well tolerated, opioids have a high addiction rate, and taking even mild NSAIDs and analgesics alongside opioids can increase their power exponentially. Mixing in opioids with a bunch of other drugs and medications can increase the chances of overdose, and generally just increase the amount of pills a patient is popping. Cannabis could potentially reduce the number of pain pills necessary, hence why so many patients suffering from chronic pain use it to decrease their intake of opioids, NSAIDs, benzodiazepines and antidepressants.
There could be a few good reasons for this, including:
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THC may modulate opioid receptors, and thereby work as an analgesic to some extent.
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Various cannabinoids and terpenoids act as an anti-inflammatory, including THC, CBD, CBG, alpha-pinene, limonene and many more.
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CBD also has an effect on serotonin receptors, with anxiolytic and stress-beating properties.
Indeed, this multi-pronged, “total” pain-beating effect of cannabis potentially makes cannabis superior to opioids for the treatment of long-term pain. At least some patients seem to agree.
Headache/Migraine
Headaches and migraines are so commonplace and a side-effect of so many different ailments, that it’s almost surprising that so little is known about how they arise. Environmental causes, lack of oxygen to the brain, deficiency or overabundance of serotonin, sensory stimulation, stress … All of these things can cause headaches, and the way in which they develop seems to be an interaction of many different factors.
Due to the huge number of variables that can cause headaches to arise, treating them can be very difficult. Usually, NSAIDs and acetaminophen are prescribed, but there is little else that is effective for headaches and migraines. Opioids can be prescribed in some cases, but they can only be used intermittently. Triptans, such as sumatriptan, can be prescribed as well, but are expensive and can cause nausea and vomiting. Triptans are also contraindicated with antidepressants due to both affecting serotonin receptors and increasing the chance of serotonin syndrome.
Targeting the ECS may prove to be a safer, more well-tolerated solution, especially for persistent headaches and migraines. The “multi-modal” painkilling properties of cannabis, mentioned above under the “Chronic Pain” section, may be another reason why cannabis could be useful for headaches and migraines.
Overall
Although we cannot say anything for definite from our study, it does paint an interesting picture. There are few if any medications with the broad-range use of cannabis combined with such a great safety profile. We will be using this study as a sort of “launchpad” for future studies, where we will hopefully uncover more interesting patterns and give you better-quality information. This unique plant deserves our attention, and we’d be fools to not research its potential medical properties.
About Doctor Frank:
Dr Frank D’Ambrosia is one of the US’ leading voices for medicinal cannabis policy reform. Through his medical practice, he aims to empower and educate people on the benefits of the substance for countless ailments.
Five years ago, Dr Frank became fascinated with the science of cannabis and it’s success in relieving medical conditions such as depression and head trauma. He began to explore the possibilities of marijuana as medicine. After 30 years of treating and operating on patients, many of whom would never find relief from their chronic pain, Dr Frank decided to dedicate his practice to helping patients through medical cannabis. His practice now counsels patients all over the country, daily, on the use of marijuana to manage pain.
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