Daily Archives: September 19, 2019

Today I briefly touch on medical cannabis since many of you have been asking me about this new treatment over the past year.

Cannabis plant has a number of active compounds (Cannabinoids) that work on the Endocanabanoid System (ECS) of the body. ECS is a widespread neuromodulatory system that plays a major role in the functioning of our central nervous system and homeostasis. There are at least 8 known Cannabinoids but the two most well known and studied are THC and CBD.

Tetrahydrocannabinol (THC) – Is the substance which causes marijuana ‘High’ and hence the reason for its recreational use. It can cause euphoria but also anxiety/paranoia. It is a CNS depressant and as such can cause mental slowness, drowsiness, and impaired reaction time.

Cannabidiol (CBD) – Has almost no psychoactive effects when administered independently of THC. Very early clinical studies have shown anti-inflammatory, anti-anxiety, anti-nausea, and “pain-killing” effects. These CBD effects are the focus of emergent medical management of many chronic conditions. CBD (unlike THC) does not cause driving impairment and can safely be consumed during the day. It also seems to moderate some of the psychoactive effects of THC when taken in a balanced (1:1) formulation (For example less likely to cause paranoia/anxiety). This overall risk/benefit profile has led many doctors to now consider medical cannabis as a tool in managing many chronic pain conditions.

With the above primer out of the way, here are a few considerations that go into deciding if medical cannabis is appropriate treatment for a patient:

– It is never the first line medication. In other words, to be considered, a patient must first have tried other (better studied) medications.

– It is expensive! Unfortunately, as of the writing of this blog, no private or public formulary covers the cost of medical cannabis (small exception is Veterans Affairs). Typical cost for medical cannabis can range from $200-$300 per month.

– Patients with current, past, or family history of psychosis are not candidates for therapy.

– Pregnant and lactating mothers are advised against consumption as there are reported evidence of physiological effects on their fetus/newborn.

– It is not a sleeping medication but some clinicians provide a night time dose of balanced formulation to address patient sleep and pain at the same time.

– Currently, there are a number of Cannabis clinics with expertise in prescribing of medical cannabis. If considered an appropriate therapy, patients are referred to these clinics to obtain their first prescription.

– Medical Cannabis is obtained from online licensed producers (LPs) and are delivered to the patient’s home.

– Consumption is ideally done through ingestible oils (administered by a metered syringe) or inhalation via a vaporizer.

Hope this quick blog is helpful in answering your questions as to whether medical cannabis is appropriate for you. It is important to note that the science of cannabis consumption is still emerging. As mentioned, the cannabis plant has a number of other trace Cannabinoids as well as other compounds such as Flavonoids, and Terpenes. We do not know the full potential benefits and harms of these products.

As always, Keep it Healthy!
Dr. Matin

P.S. Here is a link of previous blog posts: https://www.greenbeltfht.com/?cat=23

P.S.S. This summer I read an amazing book by Dr. Matthew Walker “Why We Sleep”. It is a MUST read for any one who suffers from chronic fatigue and non refreshing sleep. Even if you are a sound sleeper, this amazing book gives you insight to an activity that you do on average 20-25 years of your life! https://tinyurl.com/y6fs46dt