Very excited about this announcement of the first randomized controlled clinical trial in the U.S. to investigate cannabis as a treatment option for migraine headaches. Clinically, I have seen numerous patients benefit from cannabinoid-based medicines when other migraine treatments have failed, so this is a huge step forward in advancing our understanding.
Opinion: AU/NZ College of Anaesthetists Position Statement On the Use of Medicinal Cannabis
My opinion on the Australian and New Zealand College of Anaesthetists position statement on the use of medical cannabis for non-cancer chronic pain: Unbalanced, uninformed and hypocritical.
Last week, the Faculty of Pain Management at the Australian and New Zealand’s College of Anaesthetists (ANZCA) published guidance for health practitioners recommending against the prescription of medicinal cannabis for the treatment of chronic non-cancer pain (CNCP). We’ve seen a number of similar reviews over the last few years in both Australia and Canada and they continue to follow the same playbook. I weigh-in on the latest one in this video. I also encourage you to check out the balanced and very well-researched analysis written by Rhys Cohen here: https://www.cannabiz.com.au/medicinal-cannabis-and-chronic-pain-absence-of-evidence-is-not-evidence-of-absence/
Remember: “Absence of evidence is not evidence of absence.”
CBD Reduces Plaque, Improves Cognitive Function in Model of Familial Alzheimer's
There is a dire need for novel therapies to improve outcomes for patients with Alzheimer’s Disease, which is considered one of the fastest-growing health threats of our time.
In a promising new study published in the Journal of Alzheimer’s Disease, investigators reported that a two-week course of high dose CBD helped reduce plaque and improve cognitive function in an experimental model of early onset familial AD.
Familial disease is an inherited version of Alzheimer’s in which symptoms typically surface in the 30s and 40s and occurs in about 10-15% of patients.
Next steps include determining optimal doses and giving CBD earlier in the disease process. They also are exploring delivery systems including the use of an inhaler that should help deliver the CBD more directly to the brain.
See article below for more information. https://www.sciencedaily.com/releases/2021/03/210309192548.htm Citation for journal article, available here https://pubmed.ncbi.nlm.nih.gov/33612548/
Medical Cannabis and Cognitive Performance in Middle to Old Adults Treated For Chronic Pain
A new study assessing the relationship between long term medical cannabis use and cognitive function amongst middle-aged and older chronic pain patients has shown no association with declines in cognitive performance.
Researchers assessed psychomotor reaction, attention, working memory and new learning. Dosage, concentrations, length of time using medical cannabis and frequency of use were also assessed.
These results are extremely encouraging and should support patients and practitioners alike in their risk-benefit analysis when determining whether medical cannabis is a suitable treatment option.
Read the full research paper here.
Opioid Prescribing in Canada Following the Legalization of Cannabis
For anyone out there who still needs to be convinced that cannabis can reduce opioid prescribing AND reduce public and private healthcare costs, here’s a brand new Canadian study (linked here) that I was fortunate to be a part of.
Our findings support the hypothesis that easier access to cannabis for pain may reduce opioid use for both public and private drug plans.
Overall the findings are very encouraging, although I do worry that patients are increasingly turning to the non-medical cannabis system for access. While cannabis has a superior safety profile compared to most other medications, there are contraindications & drug interactions that patients need to be aware of. Working with a licensed healthcare professional is crucial to ensuring patient safety--particularly when you’re talking about weaning things like opioids, benzodiazepines, etc.
This is yet another reason why we need to #CoverCannabis in Canada for patients who could benefit. Please help us continue to spread the word by sharing your own #CoverCannabis stories on social or sharing this post. Have a wonderful weekend everyone!
Landmark Study Proves CBD Has No Impact on Driving
A landmark study published in the latest issue of the Journal of the American Medical Association has shown that CBD does not impair driving, while moderate amounts of THC (the main intoxicating component) produce mild driving impairment lasting up to four hours.
This is the first study to illustrate the lack of CBD effects on driving and to also provide a clear indication of the duration of THC impairment.
Why this is so important: “With cannabis laws changing globally, jurisdictions are grappling with the issue of cannabis-impaired driving. These results provide much needed insights into the magnitude and duration of impairment caused by different types of cannabis and can help to guide road-safety policy not just in Australia but around the world. These results should allow for evidence-based laws and regulation for people receiving medical cannabis,” said Dr. Thomas Arkell, lead author on the study.
The study was led by the Lambert Initiative for Cannabinoid Therapeutics at the University of Sydney (Australia). Summary is available here and the full study is available in the current issue of JAMA here.
Opioids and Cancer - Friend or Foe?
The effect of opioids on cancer progression, metastases, and recurrence is increasingly being questioned by researchers and clinicians, and serves as an important reminder of the urgent need for more research into safe and effective non-opioid alternatives.
In a review published in the journal, Current Opinion in Supportive and Palliative Care, investigators examined the evidence for the action of opioids on the processes involved in cancer progression. In other words - they’re trying to figure out if taking opioids to treat cancer pain could actually cause the disease to progress faster.
The analysis showed there is sufficient in vitro and animal model work to make a plausible case for a detrimental effect of opioids on cancer progression and advised: “In the light of the uncertainty of opioid effect on cancer, any decision making should be tempered by knowing that stress and pain undoubtedly contribute to cancer progression.”
Given the high rates of pain prevalence amongst cancer patients, the importance of identifying non-opioid alternatives cannot be overstated. While more research is undoubtedly needed, the role of cannabinoids in treating cancer-related pain is promising and urgently warrants further investigation.
Cannabinoids are already a well-known and evidence-based treatment option for chemotherapy induced nausea and vomiting. While treating this symptom, I’ve seen several patients also experience reductions in their cancer-related pain and anxiety, which has allowed us to reduce their opioid and anti-anxiety medications in some cases. In many cases, cannabinoid therapy has also helped reduce or eliminate other intolerable side-effects caused by these powerful medications, including constipation, insomnia and lack of appetite.
Full article available here.
#CannabisISMedicine #MedicalCannabis #CancerTreatment #AlternativeMedicine #MindfulMedicating #CBD #CannabinoidMedicine #BreastCancerTreatment #Chemotherapy
Recent Trends in Cannabis Use in Elderly Americans
I wanted to share a quick update with you on some research I’m doing, investigating medical cannabis use & effectiveness in older adults.
Its excellent safety profile and multimodality make medical cannabis particularly appropriate and beneficial in the senior population -- especially as polypharmacy is the number one cause of hospitalizations due to adverse drug reactions amongst this group.
Have a watch of this short video for more info.
For the full article referenced click here.
New Warnings About Benzodiazepine Use and Dementia Risk
There have been several studies that have indicated that have linked benzodiazepine use to an increased risk for Alzheimer's disease (AD).
This is one out of Finland is one of the largest.
Lead author Vesa Tapiainen, MD, PhD, said: “These drugs are often used to treat sleep problems, but their efficacy for this indication diminishes over time, whereas the risks for adverse events remain.”
In addition to insomnia, benzodiazepines and other so-called "Z" drugs, such as zolpidem (multiple brands) and zopiclone (Lunesta, Sunovion), are used to treat other neuropsychiatric symptoms of dementia, such as anxiety.
Commenting on the study’s findings, David S. Knopman, MD (Mayo Clinic, Alzheimer's Association Medical and Scientific Advisory Council), noted that many studies have suggested that patients who are exposed to certain psychoactive drugs, such as those with cholinomimetic properties, are at increased risk for dementia.
"I therefore find it plausible that benzodiazepines and related drugs could carry the same risks," he said.
The "bottom line" for Knopman is that use of certain psychoactive drugs seems to increase the risk for dementia. However, it is unclear whether the drugs are temporarily worsening cognition or symptoms are being treated with these drugs, said Knopman.
"In other words, the direction of causality from drugs to dementia could go in either direction, and this study that used administrative data can't determine the direction of causality," he said.
Nevertheless, a take-home message is that benzodiazepines and related sleep medications should be avoided "if at all possible" in older individuals, said Knopman.
Similar to benzodiazepines and “Z” drugs, cannabinoid-based medicines have anxiolytic, anticonvulsive and relaxing effects. When dosed low and slow by an experienced healthcare practitioner, cannabinoids can be equally or more effective than these medications in managing symptoms, but with a far superior side-effect profile.
Read the full study here.
Cannabis Proven to Help Insomniacs Sleep
Australia has always been a special place for me and as those who follow my page know, I spent several weeks there last year providing cannabinoid medicine education to Australian physicians. There are many parallels between the Australian medical system and our own, so I aim to keep up with the research coming forward, which led me to this new study.
Completed by the University of Western Australia, this world-first study has “ shown that medicinal cannabis can be used as a treatment for adults suffering from chronic insomnia.”
The researchers found statistically significant improvements in a range of objective and subjective sleep measures, including total sleep time, wake time during the night, time to sleep, quality of sleep and feeling rested after sleep. Participants also reported a significant improvement in subjective measures of stress, fatigue and social functioning.
Lead researcher, Professor Peter Eastwood said: “Positive patient experiences with minimal side-effects are critical to the success of any insomnia drug and highlights the potential for this treatment to address a key area of unmet need.”
I couldn’t agree more.
Full article available here.