Culturally, we uphold a dichotomy between natural medicines and standard Western treatment. The internet is equally awash with testimonials about ditching prescriptions for botanicals and eye-rolling about natural medicines that simply do not work. But for many of us, botanical options can and do live alongside their Western counterparts in the medicine cabinet. Not to mention that it may already contain plant-derived medicines such as aspirin, codeine/morphine, taxol, quinine, and digoxin. I personally use botanicals for prevention and supporting homeostasis, as well as for treatment when my symptoms are mild, because they tend to be gentler and less invasive. Sticking with the minimum effective treatment reduces side effects and potential negative interactions. Cannabis is the perfect example of such a minimally invasive natural medicine. In fact, its absence from the pharmacopoeia is recent; until the early part of the last century, it was ubiquitous in medicine. Let’s review some of the contexts under which cannabis can support or synergize with standard treatment, as well as some of the limited circumstances where it may be able to replace it. Disclaimer: I am not a doctor and these are only my opinions, non of which are intended as medical advice. Please consult with your doctor about potential treatment avenues with cannabis.
CANNABIS & CANCER
Using cannabis in conjunction with cancer treatment is both the most impactful synergy and the one we know the most about. Cannabis seems custom-made to address the symptoms of cancer and the side effects of radiation and chemo. Marinol, a synthetic version of THC, was approved in 1986 to treat chemotherapy-induced nausea and vomiting. Patients found relief but the medicine was expensive, and used in isolation THC’s less desirable effects—anxiety, feeling spaced-out—are maximized. Many cancer patients have greater success using cannabis itself to help with nausea, appetite and to avoid chemo-induced anorexia. There is also promising research on it as a treatment for chemo-induced peripheral neuropathy. Finally, cannabis seems uniquely effective in treating cancer pain: it works through different receptors than opiods and can therefore be used alongside them. Commonly patients find that cannabis reduces their need for opiates, improving their cognition and quality of life.
While cannabis is usually used only for symptom management, in the case of cancer it may actually treat the disease itself. There have been a relatively large number of studies that have demonstrated anti-tumor activity in animal models; a 2014 mouse study on found that THC and CBD increased the effectiveness of radiation against an aggressive type of brain cancer. Rick Simpson famously claimed to cure himself of cancer using a concentrate extraction method he developed, which now bears his name. Cannabinoids also decrease tumour-cell invasiveness and potential for metastasis, and they have anti-inflammatory and antioxidant properties that support health and cancer treatment in a more holistic sense. However, stories of patients with curable cancers who forego standard treatments in favor of cannabis are tragically common. The evidence is not supportive–or even suggestive–of cannabis as a replacement for clinical cancer treatment.
OTHER HEALTH USES
Cannabis is can be an excellent option for people experiencing non-cancer pain that is insufficiently controlled by other methods. Though dosing can be limited by psychoactivity, it has been shown time and again that the introduction of cannabis can reduce the amount of other drugs required to control pain. Ironically given its history as a narcotic with a “high potential for abuse,” this feature can also help with addiction recovery. Cannabis can stand in for more harmful drugs as crucial part of harm reduction, a strategy which gives patients a greater voice in their recovery.
Epilepsy is the other condition for which an FDA-approved cannabinoid medicine exists, this time based on CBD. Epidiolex is used to treat two rare and severe forms of childhood epilepsy. For decades, parents of children with epilepsy pooled resources to source high-CBD cannabis strains in the face of legal prohibition. Now, CBD is a hot heath trend being used for every conceivable condition. You can purchase it at Walgreen’s.
There are even a small number of conditions for which it may be possible to use cannabis as the primary treatment. Substituting cannabis is only appropriate when symptoms are mild and stem from non-progressive causes, such as with menstrual cramps, sleep issues, anxiety, migraine or chronic pain. Many people with these conditions turn to cannabis after having exhausted standard therapies without experiencing relief. That was my own journey treating endometriosis, and in fact it led directly to my work in the cannabis industry.
WHY IS CANNABIS EFFECTIVE?
So why is it that cannabis seems to treat so many types of illness? The short answer is because cannabinoids are powerful anti-inflammatories, and inflammation is at the root of much of our suffering. It is a major component in everything from acne to arthritis to Crohn’s to fibromyalgia. Where there is pain, there is inflammation.
So what are the risks? Cannabis’ ubiquity as a recreational drug lends credence to the perceived lack of interactions with prescription drugs, though as with much of cannabis, there is scant scientific research on this. One important risk we do know about, however, is CBD’s inhibition of cytochrome P450 enzymes, which play a role in metabolizing 60 percent of pharmaceuticals (and most chemo drugs). In fact, CBD is a more potent inhibitor of cytochrome P450 than the grapefruit compound bergapten, and is counter-indicated in all the same drugs as grapefruit. The effect is usually only significant if the patient is taking large doses of CBD, but large doses are often necessary to see results. Patients should check with their doctors and potentially use blood monitoring to see if adjustments are necessary.
As with any treatment, cannabis is unlikely to be a panacea. It is, however, broadly effective due it its unique ability to mimic our bodies’ natural compounds and tendency to harmonize and promote homeostasis. The risks of adding cannabis to a standard treatment regimen under the guidance of a supportive health professional appear to be small. And whether medical or recreational, the golden rule for cannabis use always applies: start low, go slow, take good notes.
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