The Benefits of Medical Cannabis
March 09, 2014
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By Dr. Mercola
Marijuana has been legalized in a number of US states; 20 states have
legalized cannabis for medical purposes; two states—Colorado and
Washington state—also permit recreational use. Certain forms of cannabis
are actually very potent medicine, with few or no psychoactive effects.
In California, medical marijuana has been legal for 18 years. Dr.
Allan Frankel, a board-certified internist in California, has treated
patients with medical cannabis for the past seven years.
By and large, cannabis is highly favored by people across the US.
According to Dr. Frankel, 85-95 percent of Americans are in favor of
medical cannabis, and 58-59 percent are in favor of legalizing
marijuana.
The federal government, meanwhile, wants to get rid of all medical use of marijuana, which of course begs the question: Why? According to Dr. Frankel, the answer is simple. "They want it. This is a huge market," he says.
And yes, medical cannabis is clearly competition to the
pharmaceutical industry, as the cannabis plant can take the place of a
wide variety of synthetic drugs, especially for mood and anxiety
disorders. The last thing they want is a therapy that's going to take
away from their bottom line.
Cannabis as Medicine
Dr. Frankel initially learned about medical cannabis through glaucoma
trials and cancer work performed at UCLA in the 70s and early 80s.
"I've always seen it as a medicine," he says.
"Eventually, I got interested in it. I thought my tool box was getting
too small for typical issues with patients related to anxiety, pain, or
the common issues where we just had inadequate medications.
I saw the cannabinoid future was something that was bright. Seven
years ago, I kind of picked up my formal white coat and sprayed a
little green on it..."
Green Bridge Medical is his professional corporation where he sees
patients, performs research, and provides physician and patient
education and outreach. For all its benefits, using cannabis in lieu of
other medicines has many challenges.
"It's a complicated process, as a physician in particular,
working inside the medical system, to work outside the medical system to
make these dose-consistent extracts available."
Many may find the idea of medical cannabis abhorrent or somehow
"wrong," as we've been indoctrinated to view marijuana as a dangerous
gateway drug that will lead you down a path of illicit drug use.
Many fail to realize that prescription drugs actually have FAR greater potential to turn you into "a junkie." Legal drug addiction
is also taking lives in record numbers. In the UK, one million people
are addicted to over-the-counter (OTC) and prescription painkillers and
tranquilizers.
That's significantly more than the number addicted to illegal drugs.1
In the US, there were four times more deaths among women from
prescription painkiller overdose than for cocaine and heroin deaths
combined in 2010.2
Pharmaceuticals in general are among the leading causes of death in the US, and some medicines have killed tens of thousands of individuals. The painkiller Vioxx is one classic example, which killed over 60,000 before being pulled off the market.
The diabetes drug Avandia
is another, and most recently, a study estimated that in a five-year
span, some 800,000 people in Europe were killed from inappropriate use
of beta-blockers in non-cardiac surgery patients. Deaths attributed to cannabis barely registers in comparison.
"I think that any intervention, regardless of how benign (I would
say in my 35 years of medical experience, cannabis should be considered
a benign substance overall), there are potential uses and abuses," Dr. Frankel says.
"For me, we're just talking about the real solid indications. The
issue of abuse and neglect is there, but I think it's relatively small.
I think the claim that it is a gateway drug has been pretty soundly
proven not to be correct.
Even if cannabis to some extent is a gateway drug (which I do not
believe it is), even if it is, it should be legalized to protect the
gateway [drug] issue, because legalization opens up communication."
What's the Difference Between Medical and Non-Medical Marijuana?
According to Dr. Frankel, cannabis has been cultivated in Northern
Europe since before the last Ice Age. Even back then, there were two
very distinct groups of strains. One is cannabis; the other is hemp.
There's plenty of confusion about the similarities and differences
between these two plants. While they are subspecies of the same plant
species, they look very different, and are extremely different in ways
that really matter when it comes to medicinal use.
The thing they have in common is that they both contain cannabidiol (CBD), which has medicinal properties. The amount
of CBD however, differs greatly between the two. Dosing, therefore, is
dramatically different where you to try to use hemp in lieu of cannabis,
as the latter, cannabis, is up to 100-fold more potent. Another
difference that appears to matter in terms of its usefulness as medicine
relates to differing terpene profiles. Hemp contains very little of
these valuable medicinal compounds.
Lastly, there's the tetrahydrocannabinol (THC) content. THC is the
psychoactive component of marijuana; it's the molecule that makes you
feel "stoned." (While cannabidiol (CBD) also has certain psychoactive
properties, it does NOT produce a high.) By legal definition, hemp
cannot have more than 0.3 percent tetrahydrocannabinol (THC) in it. So
to summarize:
- Hemp has less value for medicinal uses, as it only
contains about four percent CBD and lacks many of the medicinal terpenes
and flavonoids. It also contains less than 0.3 percent THC, which means
it cannot produce a high or get you stoned. However, for many disease
processes, THC is very much indicated and required. So, for many disease
processes, CBD alone has much less value.
- Cannabis is potent medicine courtesy of high
amounts (about 10-20 percent) of CBD, critical levels of medicinal
terpenes, and flavanoids, as well as THC in varying ratios for various
diseases. The higher the THC, the more pronounced its psychoactive
effects
How Marijuana Got a Bad Rap
"What happened in the '60s and '70s was that due to desires for
psychedelia, the changes in the war in Vietnam, and the war on drugs
with Nixon, the types of strains that were available and the demand for
psychedelia changed. Before we knew it, CBD—due to a lack of
'stoniness'—was bred out of the plant," Dr. Frankel explains.
As a result of growers breeding out the all-important CBD, marijuana
became known primarily as a plant that gets you high. Its original
medicinal properties and uses largely fell by the wayside. Things are
changing however.
"Five years ago, California Physicians, and other groups around
the world, didn't really know if we would find CBD-rich strains anymore,
but we have. Now there's many different varieties of it. We keep
bringing back new CBD rich strains every month or two. These plants
genes' haven't seen the light of day for God knows how long."
CBD is currently a Schedule 1 controlled substance, which means:
- The drug or other substance has a high potential for abuse
- The drug or other substance has no currently accepted medical use in treatment in the US
- There is a lack of accepted safety for use of the drug or other substance under medical supervision
There's no doubt that CBD needs to be rescheduled, as each of these
three points are blatantly wrong. Dr. Frankel actually thinks cannabis
should be de-scheduled altogether, as a plant really does not belong on any schedule of a controlled substance.
"How could we have a plant on a schedule? What if it's an all-THC
plant? What if it's an all-CBD? What if we find some other
psychoactivity? If you take the Physicians' Desk Reference (PDR) and
look at every product, none of them looks like a plant to me. This is
the only plant, and it's not just one medicine. One entry with one data
ID or MDI cannot be applied for cannabis. For example, we're actually
right now making different medicines with cannabis plants based upon
harvest time.
As the plants mature, the flowers get darker and darker. There's a
traditional time when you're just supposed to pick them. Of course,
what we've done is we picked them at different times in large amounts,
ground them all together so we can get very representative samples, and
see what happens in the last few weeks of flowering. The
medicine changes a lot in the last three weeks. You can make more
sedating medicine by letting it just stay on the vine three weeks
longer. Even how long you let it grow makes it a very different
medicine, a noticeably different medicine," he says.
Who's a Good Candidate for Medical Cannabis?
In his medical practice, Dr. Frankel treats a wide variety of
patients with medical cannabis, which has become his specialty. Despite
the many claims of cannabis performing miracles, he's reluctant to think
of it as a cure for anything. Occasionally, however, patients will
experience very dramatic results. For example, he has seen tumors
virtually disappear in some patients using no other therapy except
taking 40 to 60 milligrams of cannabinoids a day. The most common thing
he sees in cancer patients, however, are tumors shrinking, or a
metastasis disappearing. Sometimes tumors will shrink or vanish, only to
reemerge in other areas, months later, and then shrink or vanish
again... Other common ailments being treated with cannabis include:
- Mood disorders
- Pain disorders
- Degenerative neurological disorders such as dystonia
- Multiple sclerosis
- Parkinson's disease
- PTSD
- Seizure Disorders
He recounts how two dystonia patients with severe myofascial spasms
were able to return to normal life after taking two milligrams of
whole-plant CBD three times a day for a little more than one week. This
is quite astounding, considering each of them had spent more than a
decade undergoing neurosurgeries and taking multiple medications.
Dr. Frankel is very focused on trying to develop accurate
dose-consistent medicine. The Patient Access Centers he consults with
create a diverse collection of dose-consistent oral-buccal sprays. He
also believes it's very important to open up and start talking about
dosing—what works, what doesn't. It is his belief that some patients, in
large part due to lack of education about the medicine, may be taking
10, or even 100 times higher dosage than is really needed to treat their
ailment. Unfortunately, many doctors in this still highly controversial
field are afraid to recommend dosages, for fear of the repercussions.
"There's this false notion (I think I can very safely say it's
false) that doctors cannot recommend dosage because of this federal [law
against] aiding and abetting with cannabis. It's not true. It's just
not true," he says. "There are no [cannabis] medications that
we dose by body weight. We now have about 120 kids with seizure
disorder, and if you look at the surveys, across the board, the average
dose is 37 milligrams [of whole-plant CBD] per day, and there's no
relationship with body size."
How Can You Obtain Medical Cannabis?
In states where medicinal marijuana is legal, such as California, you
can join a collective, which is a legal entity consisting of a group of
patients that can grow and share cannabis medicines with each other. By
signing up as a member, you gain the right to grow and share your
medicine. Dr. Frankel explains:
"A patient or a human being 18 and over or with a parent's
consent in California can get a medical cannabis card recommendation
letter if they or any physician or doctor of osteopathic medicine (D.O.)
agree. It doesn't have to be for any specific condition. In other
states, it's very, specified. In California, there are 12 conditions
listed, but then it says 'or any condition agreed upon by the doctor and
patient,' which kind of opens it up quite a bit."
[With your medical cannabis card], you have the authority to go
to whatever collective you want and pretty much select what medicine you
want. Now, that is exactly what the good, the bad, and the ugly is. I
love free choice, but we need free choice with education. There's
virtually zero education going on in the collectives. I mean, there are
random places here and there that make an effort but it's really
minimal."
When cannabis is inhaled, smoked, or vaporized, its effects are rapid
and short-lasting. Orally, it's the most unpredictable and delayed.
When ingesting it, it can take up to two hours to take effect, but if
dosed appropriately, you can achieve once-a-day dosing with an edible
medicine.
When smoked, as little as 10 mg of CBD acts as a major appetite
suppressor. CBD is also an excellent painkiller, particularly for tooth
pain when the cannabis oil is applied sublingually or directly onto the
tooth. Cannabis oil can also help heal sunburn overnight. CBD is also
very effective for anxiety disorders. Just a couple of milligrams of
whole-plant CBD can effectively subdue anxiety without causing any kind
of mental deficiency or high.
In fact, to determine how much THC in an oral dose would be required
to get high, they made liquid edibles with 5mg, 10mg, and 20mg of THC.
The lowest dose, 5mg, did not produce a high. The upper two—10 and 20
mg—did. Taking 50-100 mg of oral THC could get you into serious trouble.
Paranoia is the most common side effect. Overdosing can also produce
nausea and vomiting.
The Power of Raw Cannabis
The video below features some of the top researchers on the healing
effects of Cannabis in its raw form. The leaves can be eaten in a salad
or juiced.
More Information
A British pharmaceutical company called GW Pharmaceuticals has a
cannabis product that is distributed in Canada and five other countries.
It's a 1:1 CBD-THC whole plant extract. "It's a very good medicine," Dr. Frankel says. "But it's expensive. That's the problem with pharmaceutical [companies]." Dr.
Frankel also consults with various states that are interested in
growing medicinal CBD, i.e. cannabis with a high CBD content and
hemp-level (extremely low) THC. He even gives the CBD seeds away. "I
make the offer: if any governor in the 50 states wants, absolutely free
– as long as I can do it legally – any of these high-ratio CBD strains,
I can make it happen. No cost," he says.
"This is one of the important points I'd to emphasize: I think
we're going to find ultimately that CBD is a nutritional supplement for
everybody. I think we were all using [cannabis] 100 years ago... I think
then, if they had hemp for food, there was CBD in it. Again, I wasn't
there, but my guess is that everybody had CBD in their diet up until 100
years ago or so. CBD appears in some of the newest data to
help protect your DNA epigenetic layer. That's important stuff for all
of the toxins that we have in our environment. I think we have more
toxins now, and we're missing one of the major protectants that we used
to use for this. That's a double whammy."
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