the facts about a guide for exploring medical cannabis€¦ · 1 the facts about medical cannabis...

i The Facts About Medical Cannabisa

The Facts About Medical Cannabis

A guide for exploring whether medicinalmarijuana is rightfor you.

1 The Facts About Medical Cannabis

Introduction:Who this guide is for…

This guide is by no means a comprehensive report onmedical cannabis. It is intended to give an accessibleintroductory overview which will let the reader judgewhether they wish to learn more about what is arelatively new (and yet remarkably ancient) subject.

We will outline in Part 1 what medical cannabis is,how it actually works, at a very high level,and explain some of the key terms required tounderstand the discussion around the medical use ofthis remarkable plant.

In Part 2 we will discuss some of the major effectsof cannabis on symptoms such as pain, nausea andanxiety. We will then look at some specific conditions,such as arthritis, cancer, PTSD, and see how medicalcannabis is being used in the treatment andmanagement of these individual disorders.

Part 3 gives an overview of the process for accessing medical marijuana in Canada – whether it be directly purchased from a licensed producer or with the assistance of a care centre.


An ancient healing plant with a 21st century future

PART ONE Get to Know Medical Cannabis 1


What is medical marijuana?And what is cannabis? How does it work?

While the interest in cannabis as medicine stems from itswide range of physiological effects, the fact of the matteris that first and foremost cannabis is, simply, a plant. Theplace we need to begin then is with the plant itself.

However, there are a few terms we need to get straightbefore we can usefully describe the plant which peoplerefer to as both ‘cannabis’ and ‘marijuana’ (and thenthere’s ‘hemp,’ too).

The Terminology‘Cannabis’ is the proper botanical term for an entireplant genus, within which there are several specieswith various physical forms and a wide range ofchemical properties. Three of these species – Cannabissativa and Cannabis indica and Cannabis ruderalis –have been the most actively used by human beings forthe qualities of their fibers and their resins.

‘Marijuana’ refers to any species of cannabis in its roleas a source of pharmacological effects. So in discussingmedical cannabis we’re talking about marijuana– all marijuana is cannabis, but not all cannabis ismarijuana. The terms ‘medical marijuana’ and ‘medicalcannabis’ can, and are, used interchangeably, but theindustry generally prefers the more botanically-basedlabel of ‘medical cannabis’.

‘Hemp’ is a term used to refer to the cannabis plantin its various roles as a source of unique and usefulfibrous and seed materials.

‘Hemp’ and ‘marijuana’ are therefore useful termsfor distinguishing between the two primary humanapplications for the cannabis plant.

The PlantCannabis varieties areflowering annuals, meaningthey germinate, flowerand die in a single season.Cannabis is unusual in beingdioecious – it does not self-pollinate, but instead individual plants aremale or female. The femaleplant produces the flowersfrom which marijuanaproducts are derived. Themale plants are used in producing hemp products.

The first pair of leaves on a plant will usually have asingle leaflet, with the number gradually increasingup to a maximum of about thirteen leaflets per leaf.Approaching the top of a flowering plant, the countdecreases again until reaching a single leaflet perleaf at the top. The bulk of the plant has seven or nine,which is the ‘iconic’ form of leaf most commonly usedto represent marijuana.

The leaves are long and pointed, and have a distinctiveserration that results from a consistent diagonal veinpattern. Each serration vein typically connects to thecentral vein roughly in line with the notch of the nextserration down, producing a very even pattern.

A typical marijuana leaf, this one showing nine leaflets with thecharacteristic serrated edges and diagonal vein pattern.

SATIVA

INDICA

RUDERALIS


Branches grow from the central stem, and seedlingscan grow rapidly with the right conditions. The plantgrows into a bush-like structure, as small as a fewfeet high, and as tall as 20 feet high, and produces apungent flower whose appearance and odor will alsovary greatly from strain to strain.

Marijuana as MedicineHistorically, medical interest in cannabis has beentraced back as far as the time of Chinese Emperor ShenNung, circa 2697 BC, in texts which advise cultivatingthe female plant for its greater medicinal properties.Across the centuries and across the world, marijuanahas a long and rich history of therapeutic use.

The question is, what is it in marijuana that actuallymakes people feel better? We’ll document some of theeffects of marijuana shortly, but first it’s important tounderstand the basic science and chemistry at work inthis unique plant.

Marijuana contains literally hundreds of naturalchemical compounds, an unusual number of whichpossess psychoactive and therapeutic properties.When these compounds make their way into theblood stream, whether by inhalation or ingestion,they interact with the body to produce effects that cansupport healing, wellness and symptom relief. Beingunique to marijuana plants, the chemical compoundsthat make it an effective source of medication arecalled cannabinoids.

Cannabinoids

At its simplest, cannabinoids are pharmacologicallyactive compounds. In other words, they are thesubstances in cannabis that produce a physiologicaleffect of some kind.

In the case of cannabinoids, however, this simpledefinition quickly gets complicated by the number ofmembers of the cannabinoid family, and the variouseffects they are observed to have. The key compoundsof interest in cannabis are summarized to the right, butthis is far from a comprehensive list.

THE MAJOR CANNABINOIDS

THC (Delta-9-Tetrahydrocannabinol)THC is the most psychoactive cannabinoid found inmarijuana. THCA (tetrahydrocannabinolic acid) is highlyconcentrated in the flowering clusters or buds. It converts tothe more active form of THC as it dries.

CBD (Cannabidiol)CBD is the second most predominant cannabinoid inmarijuana. This compound continues to provoke interest forits therapeutic value. It has little or no psychoactive properties.Researchers and patients have begun to focus on thebeneficial effects of using THC and CBD together, as well ason individual effect on diseases and afflictions. CBD reducesanxiety and panic in some patients. It is an anti-inflammatorysedative and a neuroprotective agent. Medical demand ishigh for CBD-rich strains, so marijuana breeders have begunproducing high CBD levels plants.

CBM (Cannabinol)The third most prevalent chemical compound in marijuana,cannabinol is the incidental product of the chemicalbreakdown of THC. You may find higher levels of CBMin improperly stored marijuana resulting in diminishedmedical effects.

TerpenoidsThese plant-produced odor molecules result in marijuana`sdistinct aroma. They affect the quality of the experience byaltering THC’s effects. The terpenoids alter the effects of thecannabinoids pharmacologically, determining the characterof the effect, i.e. relaxing, energizing, etc.

FlavonoidsMarijuana has over 20 known flavonoids, a large class ofwater-soluble plant pigments that contribute to plant color.Marijuana has unique flavonoids – dubbed cannaflavins –that have both anti-inflammatory and antioxidant properties.Flavonoids may immobilize viruses and allergens. Studieshave demonstrated their carcinogenic properties as well.


Every cannabinoid molecule can be thought ofas being like a key, with an associated lock withinthe human nervous system. These ‘locks’ are thecannabinoid receptors. It’s when a cannabinoidmolecule connects with a receptor in the body that aphysiological effect is produced.

Again, the concept is fairly simple. But cannabinoidsand the various cannabinoid receptors create arelatively complex system. The receptors are found inmany places in the body, and are classed into two keytypes – CB1 and CB2. The distinction is quite technical,but can be thought of as mainly about whether thereceptors reside in the brain, CB1, or in the peripheralnervous system, CB2. (To be accurate, CB2 receptorsare also found in the brain, but in relatively smalldensities. Likewise, CB1 receptors are found outsidethe brain, but mainly in the central nervous system).

Within the brain, CB1 receptors are found primarily inthe hippocampus and cerebral cortex. Outside of thebrain, the CB2 receptors are found in several places,including the immune system, organs, spinal cord andgastrointestinal tract.

The locations of these receptors do seem relevant tothe effects associated with cannabinoid interactionswith them. So, for example, CB1 receptors mostlyreside in those parts of the brain that deal withthings like memory formation, cognition and affect,with the hippocampus playing a key role in manykinds of seizures. And we then find cannabinoids having positive effects on conditions like Alzheimer’s disease, depression and epilepsy. CB2 receptors are found in thetissues around the joints – and cannabinoids are knownto have an analgesic effect on arthritic conditions.

The chemical structure of a THC molecule.

Endocannabinoids

Why is the body full of receptors for the varioussubstances in marijuana? The answer goes a longway towards understanding the breadth and depthof the effects of this unique plant. Our bodies actuallyhave their own cannabinoid production systems inplace, and the substances they produce are called theendocannabinoids (or ‘the cannabinoids within’).The endocannabinoids and their many receptors forma natural system that regulates many complex bodilyprocesses, including the management of pain, stressand inflammation.

It’s because the body’s own endocannabinoid system is involved in so many processes that medical cannabis has such a broad range of positive effects. The extraordinary collection of reports that a substance will relieve pressure in the eye for glaucoma sufferers, reduce nausea for cancer patients and ease serious depression (among many other things) can make that substance sound far too good to be true. But when we realize that the cannabinoids in marijuana are natural substitutes for those produced by our bodies, which are themselves integral to all of these physiological processes, it suddenly begins to make sense.

With the body’s ownendocannabinoid system

involved in so many systemsand processes, it should not

be surprising that medicalcannabis has such a broad

range of positive effects.


The vastness of the system does provide uniquechallenges for cannabis researchers, however. Bothendocannabinoids and cannabinoids come in severalvarieties (see the sample in the sidebar above for just asampling), and the receptors can each receive severalof these varieties (this is where they behave a littlebit less like ordinary locks and keys). This makes thebiochemical mapping of strict cause and effect withcannabinoids and medical conditions much harder toachieve than with many synthetic pharmaceuticals.

So while the effects of cannabis treatments on manymedical conditions may be relatively easy to see andstudy, often we’re still speculating at precisely whatmechanisms are in play to achieve those effects.

Since medical research into cannabis has only recentlybegun to lose much of its social and political stigma,not too mention its legal complications, we are justat the beginning of a growing wave of research andunderstanding into exactly how specific cannabinoidsachieve the many and varied effects that we canobserve in patients.

Strains

Not surprisingly, the plant that fits so well into such abiochemically complex system is itself quite complex.This complexity has been exploited prodigiously byhorticulturists both ancient and modern. These daysan ever-expanding range of variations of the cannabisspecies is being developed, tested and adjusted. Thesevarieties are typically referred to as ‘strains’.

The medical purpose of this activity is to developa range of combinations of the primary activeingredients in medical marijuana, allowing doctorsand scientists to have a broader toolkit at theirdisposal in pairing conditions with treatment.

Most commonly, cannabis growers will pay closeattention to the levels and ratios of THC and CBD.These are the two most active cannabinoids and havevery different properties, as well as complex effectson each other.

THC and CBD

In very broad terms, a higher ratio of THC producesa ‘stronger’ form of marijuana, while a higher ratioof CBD yields a ‘milder’ product. Since THC is the mostpsychoactive element in cannabis, it is the mostassociated with psychological effects. These range fromeuphoric sensations (which no doubt play a role inmanaging things like pain and depression) to anxietyand panic, which some users of cannabis do experience(though this does appear to be relatively uncommonand greatly affected by the circumstances when thedrug is taken). CBD, on the other hand, is not believedto have much psychoactive effect at all, and seems tomitigate those effects from the THC in a given strain.

Both can range from less than 2% to as much as 15%(or more) in a given strain.

It’s important to keep in mind, however, that thereare literally hundreds of distinct chemical compoundsin marijuana. We can probably assume that most ofthese compounds aren’t involved at all in the effectsof medical marijuana. Nevertheless, it’s also safe toassume that a good number of these compounds arein fact at play in any effect, and that the levels andratios of these active ingredients are relevant to exactlyhow a given strain effects a given condition (and thisis broadly believed to be the case by cannabis usersand researchers alike). For that matter, from individualpatient to individual patient there will a be a great dealof variation in the effects of different strains.

…a higher ratio of THCproduces a ‘stronger’

form of marijuana, whilea higher ratio of CBD

yields a ‘milder’ product.


THC and CBD ratios, then, simply give a reference pointfor what to expect in terms of the effects of a strain ofcannabis. They should not be taken as the whole storyor an absolute predictor of how a strain will react witha given user or condition.

Side EffectsAs with any medical substance, there are side effectsto marijuana use. Compared with the adverse effectsof other medical substances, those of cannabisare generally mild and “within the range of effectstolerated for other medications.” (Institute of Medicine

Report, 1999)

The most common short-term side effect of marijuanause is diminished psychomotor performance. Aswith alcohol consumption, no one should operateany vehicle or dangerous equipment while under theinfluence of marijuana, THC, or any cannabinoid drug.

Also in the short term, a minority of marijuana usersexperience dysphoria, or unpleasant feelings. This isoften described as sensations of paranoia, panic, or sudden anxiety. There is evidence that these experiences are often related to the conditions and contexts of marijuana use.

There are two chronic effects of marijuana use that areof greater medical concern: the effects of long-termsmoking and the effects of THC.

Like any form of smoking, marijuana smoking isassociated with increased risk of cancer and lungdisease. For this reason, physicians may be reluctantto prescribe long-term use of smoked cannabis for anybut the most serious of conditions. Cannabis does havea growing variety of delivery modes available, eachwith it’s pros and cons.

A second concern associated with chronic marijuanause is dependence on the psychoactive effects of THC.Although few marijuana users develop dependence,some certainly do. The effects of marijuanadependence are similar to those for other forms ofsubstance abuse. In particular, anti-social personalityand conduct disorders are closely associated withsubstance abuse.

In terms of the addictive potential of a drug, marijuanarates quite low. A study of dependence statistics by theInstitute of Health ranks five abuse-able substancesin the following order: nicotine (32%), opiates (23%),cocaine (17%), alcohol (9%) and marijuana (9%).

Significantly, to date there is no established lethaloverdose threshold for marijuana, and no knowncases of anyone dying from cannabis overdose.

…to date there are noknown cases of anyone

dying from cannabisoverdose.

8 The Facts About Medical Cannabis6 The Facts About Medical Marijuana in Florida

An alternative for symptom relief, healing and wellness

PART TWO A New Dayfor Patients 2


What conditions can be improved or treated by medical cannabis?

Medical cannabis promises a new era of alternativesfor symptom relief, healing and wellness for patients who can’t find relief with conventional pharmaceuticals.

Cannabis should not be considered a cure-all wonderdrug, but its effects can be very positive, even life-changing, in many cases and across a wide range ofconditions.

We’ll look at several specific conditions that benefitfrom medical cannabis treatments, but we’ll firstreview some of the more general effects of marijuanathat are at the heart of its specific benefits.

SYMPTOMS THAT BENEFIT FROM MEDICAL CANNABIS Nausea, Appetite-lossWhile these are two separate effects, and typicallywould involve separate prescriptions when treatedmedically, they do go hand in hand. Medical cannabisoffers a powerful combined treatment for thisimportant duo.

Marijuana’s positive effects on appetite stimulationand nausea suppression are among it’s best knownqualities. The very first approved prescriptioncannabinoids (nabilone and dronabinol) were in factspecifically for use in treating the vomiting associatedwith chemotherapy. (Tramer, 2001)

Similarly, the effects of THC on appetite have been welldocumented. In a trial of patients with AIDS-relatedweight- and appetite loss, THC was associated with astable weight in patients, compared to a measurableweight loss in the non-THC subjects. (Beal, 1995) As well,the THC patients experienced increased appetite,decreased nausea and improved mood. In the long

term, the study found that over the following 12 monthperiod, THC use was associated with an ongoingimprovement in appetite.

Nausea and lack of appetite, and the lack of foodenergy and weight loss that follow, leave the bodyeven more weakened and less able to heal and recoverfrom whatever condition the patient is fighting. Byalleviating these compounding symptoms in a waythat no other available substance seems to do, medicalcannabis offers a unique and powerful aid to healingand recovery.

Digestive DisordersThe presence of cannabinoid receptors (primarilyCB2) in the gastrointestinal (GI) system itself goesa long way towards explaining why cannabis usesoothes many GI tract symptoms. These receptorsallow cannabis to have an “inhibitory effect on gastricemptying and intestinal transit” (Pertwee 2001), meaningthat the entire system relaxes and the GI tract tries lessactively to empty itself. Along with this, inflammationand pain signals are reduced. The overall effect is asmoother, more regular digestive function.

…the THC patientsexperienced

increased appetite,decreased nausea

and improvedmood.


PainOne of the most significant and well-studied effectsof marijuana on the body is in pain reduction. Thesame processes in the brain and nervous system thatproduce euphoric, mood-elevating sensations are atwork in blocking the body’s pain receptors.

Cannabinoids seem to have the most impact on chronicpain and inflammation, rather than the acute painof something like a fresh injury or a dental problem.However, when combined with opiates, cannabinoidscan reduce the overall dosage of opiates required formany types of pain. For patients with chronic pain, beit from arthritis, neuropathy, or the painful complexof factors that occur with conditions like HIV/AIDS andcancer, marijuana can be a unique tool that is highlyeffective while presenting a much lower level of sideeffects and addiction concerns than the alternatives.(Karst 2003, Greenwald and Stitzer 2000, Noyes et al., 1975)

…the patient left the clinic and returned

within the hour, virtually symptom-free,

having smoked a small amount of

marijuana in that time.

InflammationCB2 receptors throughout our immune system(with the highest concentration being in the spleen)play a key role in mediating inflammation as part of the natural physiological response to injuries and infection. But when the body’s inflammatory response is overactive or falsely triggered, excessive inflammation can quickly become a source of pain and tissue damage. The cannabinoids in marijuana are known to provide a uniquely localized treatment for many forms of inflammation. Significantly, CB2 receptors have been found in the tissues around our joints and extremities, which is now thought to provide the key mechanism for the analgesic effects of cannabis use in arthritic patients.

Convulsions and SpasmsSpastic and convulsive episodes are among the mostdebilitating and unpredictable symptoms of severalserious disorders. Medical marijuana has a powerfulhistory in this area.

One well-known case involved a young man seekingtreatment for severe spasticity, whose symptoms werenot responding to conventional medications (drugswhich also had unpleasant side effects). The patienthad found that marijuana smoking was providingsignificant symptom relief, and was asked by hisdoctors to refrain from it. After a six week period ofsuch restraint, he returned to the doctor with moresevere symptoms than previously seen. In order todemonstrate for the doctors the remarkable effect ofthe cannabis on his spasticity and related symptoms,the patient left the clinic and returned within the hourvirtually symptom-free, having smoked a small amountof marijuana in that time. This striking case motivatedthe first proper clinical trial of a cannabinoid drug. (Petro

and Ellenberger, 1981)

Research is finding that the cannabinoid CBD is likelyresponsible for marijuana’s anti-convulsive properties.A range of conditions like MS and epilepsy that producespasms or convulsions seem to respond very well tocannabis treatments, and this can have the addedbenefit of allowing the patient to reduce or eliminate farmore toxic drug therapies.


DepressionThe psychoactive effects of cannabis primarily occurby way of the CB1 receptors, which are the onesfound in the brain. It’s been shown that when theseCB1 receptors are artificially blocked, stress-copingabilities decline quickly and depression may actuallybe induced. (Huestis et al., 2001) This is strong evidencefor the role of endocannabinoids, and therefore ofcannabinoids, in managing the physiology of mentalstates like depression.

Changes in the levels of cannabinoid CB1 receptorare observed in both human and animal subjectsexperiencing clinical depression. (Mangieri and Piomelli,

2007). Marijuana’s well-known reputation as both anelevator of mood and an aid to mental relaxation,seems to be borne out by studies finding thatregular users of marijuana experience lower levels ofdepression and higher levels of positive affect (Denson

and Earleywine, 2006) than non-users.

AnxietyAnother very commonly described effect of marijuana use is a calming, relaxing, even tranquilizing property. Studies and found reduced anxiety with cannabinoid use in both animals and humans. (Rubino

et. al, 2008) Researchers are finding that the brain’s endocannabinoid system is integral in stress reactionsand fear management. (Akirav and Maroun, 2007) CBD

seems to be especially important in reducing anxiety,performing as well as existing anxiety medications.(Zuardi and Guimaraes, 1997) There is a strong body of medical research and evidence supporting the anecdotal reports of marijuana’s anxiolytic effects.

InsomniaGood, regular sleep is a fundamental physicalrequirement. Lack of sleep does more than make aperson tired. It leads to chronic fatigue and physicalexhaustion, and has pronounced effects on mentalprocesses like memory formation, reasoning andemotional control. It aggravates existing physicalailments and leaves one more susceptible to otherillness. Medical marijuana helps many patients findconsistent, restful sleep. This is an area where thevariations between strains show clear differences. Somestrains of cannabis seem to provide a stimulant effect,at least initially, which users find helps them feel sharp,awake and focused – not at all what one wants forcombating insomnia. However, many cannabis indicastrains have been found to have relaxing, sedativeeffects and users report good sleep as a result.

CONDITIONS BENEFITING FROM MEDICAL CANNABIS TREATMENTFor patients suffering from a wide range of unrelatedconditions, simply discovering the potential effects ofmedical cannabis on these individual symptoms canbe enough to make them very interested in learningmore about it. In the following section we discussseveral of the major physical disorders where medicalcannabis is increasingly being used to very positiveeffects.

While there is a commonality to the symptoms we’vejust described as they occur in many disorders, thereare also many detailed and condition-specific effectsof medical cannabis that are emerging as it becomesmore openly and rigorously studied around the world.

…CBD seems to be especially important in

reducing anxiety,performing as well as existing anxiety

medications.


Crohn’s Disease

Arthritis

Neuralgia

Seizures

Depression & Anxiety

Glaucoma

Parkinson’s

Cancer Symptoms

Cancer Treatment

Side Effects

Multiple Sclerosis

HIV AIDSSymptoms

Lupus

Fibromyalgia

Chronic Pain

Nausea

Appetite

GastrointestinalDisorders

A BROAD RANGE OF PHYSICAL CONDITIONS

TAR

GET

ED E

FFEC

TSFU

LL-BO

DY

CO

ND

ITION

S

Medical cannabis offers a valuable treatment for a broad range of conditions, having both targeted and full-bodyeffects. The above image shows some of the more prevalent conditions with demonstrated benefits fromcannabinoid interventions.


Arthritis

Migraine and Headache Pain

Cancer Treatment

At its worst, arthritis is a crippling and chronic disease. Pain and discomfort are thecondition’s signature symptoms. The strong anti-inflammatory effect attributed toTHC’s interaction with the CB2 cannabinoid receptors around the joints makes itwell-suited for use in treating rheumatoid and osteoarthritis. Patients with chronicpain from rheumatoid arthritis have been shown to experience decreased painboth with movement and at rest, as well as improved sleep. (Blake 2006) And in thelong term, the reduced inflammation provided by cannabis treatment may serveto slow the progress of certain cases of arthritis by reducing the tissue damage thataccompanies prolonged periods of inflammation. Both internal and external use (as a salve or poultice) are appropriate to achieve the desired effects.

Migraine headaches inflict intense, long-lasting pain that interferes will all normalfunctioning, and which often goes on to induce nausea and cramping. Marijuana has long been used by many to medicate their own headaches, and science now supports those practices. Cannabis’s inhibitory effect on serotonin type 3 receptors in the brain is believed to play a strong role in diminishing the onset of migraine and headache pain. (Fan, 1985) Migraine sufferers who use medical cannabis commonly report a strategy of smoking a small amount at the first indication of an incident coming on. This would get the marijuana into the system almost instantly, which would in fact allow for very fast results. As well, the anti-nausea property of marijuana can help to minimize the overall discomfort and length of the migraine experience.

Radiation and chemotherapy continue to be the strongest tools in actively treating cancers. These forms of treatment are, by their nature, ordeals for the patients. Marijuana has a solid history of mitigating some of the worst side effects of these harsh regimens. By easing nausea and vomiting while stimulating some appetite in patients who often have virtually none, cannabis therapy not only eases discomfort but helps to maintain the strength of the patient. The physical pain that accompanies both cancer and its treatments has also been shown to be relieved significantly by various THC treatments, comparable in effectiveness to drugs like codeine. (Noyes, 1975, Staquet 1978) The side effects of these cannabis treatments have generally been considered to be mild. Furthermore, the depression and anxiety that very often accompany cancer diagnoses and treatments also respond well to medical cannabis in many patients.

• anti-inflammatory

• pain relief

• improved movement

• mitigation of tissue damage

• can stave off migraines if taken at onset

• eases nausea and vomiting

• shorter headache duration

• diminished intensity

• mitigates side-effects of chemotherapy and radiation therapy

• eases nausea and vomiting

• stimulates appetite

• pain relief with milder side effects than opiates

• can help with depression and anxiety


TESTIMONIAL

“With regard to the treatment for his cancer, Danny was given numerous rounds of radiationand chemotherapy, which caused him to lose 60 pounds due to extreme nausea and total lossof appetite. Dan was hospitalized 15 times, for a total of 57 days, and underwent 14 surgeries.

The list of pharmaceuticals he was given was lengthy, to say the least. They included Coumadin, Lovenox, Ambien,Lasix, along with a Fentanyl patch, oxycodone, and morphine for pain; for depression and anxiety, lorazepam,trazodone, and Celexa. Some of these medications caused Danny to hallucinate and behave erratically, whichfrustrated and angered him because he knew his behavior wasn’t right. There were many antibiotics for themultiple infections he developed due to a weakened immune system. Compounding matters, Dan discovered hewas allergic to many medications, severely restricting the meds he could take.

The anti-nausea medications in particular didn’t work, leading him to the point of trying medical marijuana,provided by a family member as a gift. It led to an immediate change in the quality of life he had left. It reduced hispain and took away his nausea and loss of appetite, which enabled him to live far beyond all projections given byhis oncologist at the Mayo Clinic. We were told by the oncologist that this was beyond anything he’d ever seen.

During his two-year battle with cancer, Danny insisted on maintaining and growing his lawn care, snow removal,and landscaping business, Dan Peterson Services, which he started on his own in 2001, not to mention trying touphold his duties as a husband and father of four. He couldn’t have done these important things without the use ofmedical marijuana to alleviate his nausea, pain, and lack of appetite.

[…]

The use of medical marijuana by our son allowedhim a much greater quality of life, with reduced painand suffering. After witnessing the near-miraculousbenefits it provided to our son, my wife and I agreedthat we would go to jail or prison, if need be, tosupport him in this particular use of what is presentlyan illegal drug.”

Jerry and Carmen PetersonParents of Danny Peterson

In testimony before the Minnesota Health Housing andFamily Security Committee, given in support of efforts topass medical marijuana legislation in Minnesota.

“He couldn’t have donethese important things

without the use ofmedical marijuana to

alleviate his nausea, pain,and lack of appetite.”

Note: The testimonials in this e-book are quotes taken from publicly available sources. They are individual experiences, reflecting real life experiences of those who have used marijuana products in some way or another. However, they are individual results and results do vary. Vida does not claim that they are typical results that consumers will generally achieve with the use of any medicinal marijuana products. The testimonials are not necessarily representative of everyone who will use medicinal marijuana products.


Crohn’s Disease and GI Tract Disorders

Glaucoma

Inflammatory bowel diseases (IBDs) such as ulcerative colitis and Crohn’s afflict over amillion people in the United States alone with pain, diarrhea and digestive difficulties.Many cases ultimately require surgical intervention to remove affected bowel segments.Recent studies have found that cannabis treatments can produce overall effects ofpain relief, decreased inflammation, reduced diarrhea and diminished gastrointestinalhypermotility (which manifests as frequent and sudden urges to void the bowels).(Schicho and Storr, 2013) Acting as a muscle relaxant, cannabis can ease gastrointestinalcramping and spasms. Cannabinoids also appear to speed the healing of injuredepithelial tissues.

Studies have also foundbroader potential effects ofcannabis treatment, includinga lower incidence of surgicalintervention, and reduced needfor other drugs. (Naftali et al., 2013)

Since the drugs typically usedin treating these conditionscan bring a host of unpleasantside effects, anything thatcan reduce the need for suchinterventions is of great benefitto patients.

Glaucoma, a disease in which progressive damage to the optic nerve leads togradual, irreversible vision loss, is the second leading cause of blindness. As earlyas 1971, cannabinoids had been shown to effectively lower pressure in the eye,slowing progressive vision loss. (Hepler and Frank, 1971) Furthermore, in glaucoma,the final stages of vision loss occur via the selective death of retinal ganglion cells.Substances with specific neuroprotective effects are the key to combating this visionloss, and cannabinoids appear to have just such effects. (Yoles et al., 1996, Mechoulam et

al., 2002) Cannabis, then has proven to be very useful in the treatment of glaucoma,in both its short and long term effects.

• reduced pain and discomfort

• diminished incidence of diarrhea and GI hypermotility

• eased cramping and spasms

• less need for other drug therapies and surgery

• reduced intraocular pressure

• neuroprotective effects

• slowing of progressive vision loss

“This March marked eight years since my surgery andthis August will mark nine since my diagnosis. I showno signs of needing surgery again in the foreseeable

future. My health is one hundred percent attributableto my decision to ignore everyone’s discouragement

years ago and replace all those drugs (includingAsacol and Prednisone) with marijuana.”

Angela Bacca, Crohn’s Disease PatientFrom ‘Marijuana Put My Crohn’s Disease Into Remission and It’s Not A Joke’,

posted on ladybud.com



HIV/AIDSHIV/AIDS afflicts tens of millions of patients with a varying complex of pain, nausea,wasting syndrome and depressive disorders. The HIV-positive population representsone of the largest groups using medical cannabis, with studies finding rangesbetween 23% and 37% of patients using it to some extent. (Ware et al., 2003)

Pain comes in many forms across those infected with HIV. It includes headaches,neuropathy, chronic back pain, throat pain, arthralgia, lymphoma and carcinomas,as well as the pain that accompanies many treatments. Cannabis has proven to beeffective at managing many of these pain conditions. Neuropathy in particular is veryprevalent and well-studied in this population. Nerves become damaged, both by theHIV virus and by medications used in treatment. Damaged nerves can become hypersensitive, translating ordinary stimuli into pain signals, or even sending pain signalswhen there is in fact nothing stimulating the nerves at all. Cannabis use has beenwidely reported as effective in managing neuropathic pain, and studies have backedup these reports. (Abrams et al., 2007)

Nausea occurs commonly with HIV, and can be a product of the opportunisticillnesses that result from the infection, or as a major side effect of treatments such as antiretrovirals. Marijuana is very effective at nausea control and this provides bothan improved quality of life and facilitates proper treatment regimens with essentialmedications.

Loss of appetite and body weight pose serious problems for HIV patients. The overallweakening that results from low food intake exacerbates every other complicationof the condition. It also makes day-to-day life consistently unpleasant, which in turncontributes to emotional strain and depression. With appetite stimulation being astrong feature of cannabis use, medical cannabis has shown significant benefits in thiskey area for HIV patients, with studies finding reduced weight loss, and even weightgain in some cases. (Dejesus et al., 2007)

The mood-lifting quality of marijuana manifests itself as a anti-depressive effect inmany who use it, and depression is a common challenge for those struggling withcomplex chronic illnesses such as HIV. THC has alsobeen shown to help with the duration and quality ofsleep, which aids with both the physical and mentaldemands of managing illness.

A final important aspect of medical marijuana in thetreatment of HIV/AIDS is the apparent absence ofsignificant interactions with the other medicationsinvolved, particularly the antiretroviral drugs.

• chronic pain management

• nausea control

• appetite stimulation

• slowed/reversed weight loss

• depression management

• improved sleep

• lack of interactions with key medications

… with studies findingreduced weight loss,

and even weight gainin some cases.


Multiple SclerosisMS is a chronic, progressive neurological disorder where the immune systemattacks the central nervous system. More specifically, the target is the myelin sheatharound neurons which facilitate transmission between neurons. The result is agradual breakdown of the central nervous system, and with that comes a hostof symptoms, including pain, muscle spasms, tremors, loss of balance, bladderdysfunction, and more.

Marijuana use has let to reported improvements in virtually every symptom of thedisease, including spasticity, pain, mood, weight loss, fatigue, vision, sexual function,bladder control, balance, and walking. (Consroe et al., 1997) The symptoms that have themost evidence of benefit from medical cannabis are spasticity control, neuropathy,bladder control and vision (nystagmus, an eye-muscle disorder that commonlyoccurs in MS patients). Anything that can impact these core effects of the disease istruly life-changing, as outlined in testimonials like the one below.

• reduction of spasticity

• appetite stimulation and reduced weight loss

• neuropathic pain management

• improved sleep

• improved walking

• management of nystagmatic vision loss

• improved balance

TESTIMONIAL

“Some days I would be semi-ambulatory. Most days I was completely bedridden. My eyesight became very blurred and I lost all ability to focus. Unable to walk, read, or be with my family, I became very depressed. . . One evening some old friends came to visit and we smoked several joints. When my friends got up to leave, I stood up to say goodbye. Everybody in the room suddenly stopped talking and stared at me. At first I could not understand what was wrong. Then I realized I was standing, I had spontaneously stood up, unassisted, as if standing up was a perfectly natural. . . .

I quickly discovered that when I did not smoke marijuana my condition worsened, I suffered more frequent spasms, and the spasms were more intense. When I smoked marijuana my condition stabilized, then dramatically improved. After smoking marijuana my spasms were much more controlled and less severe. Marijuana caused me to feel better. I regained control over my limbs and could walk totally unaided. My vision, often blurred and unfocused, improved. I do not like breaking the law. […] However, I do like to walk, talk, read, and see. Marijuana allows me to do these simple, human things by controlling the symptoms of my MS. If I am forced to choose between maintaining my health with an illegal drug or obeying the law, I would choose to maintain my health.” Greg PauflerIn testimony submitted to the DEA In the Matter of Marijuana Rescheduling and in Idaho v. Hastings.



PTSD and Anxiety DisordersPost-traumatic stress disorder (PTSD) develops as a consequence of experiencingsome kind of terrifying or profoundly disturbing event in one’s life, whether it be adirect experience or the witnessing of a terrible event. The consequence is that thenormal physiological responses to danger (sometimes summed up as our ‘fight orflight response’) get triggered long after the original events that caused the disorder,and they can be triggered in unpredictable and inappropriate ways. Essentially theperson experiences intense fear even if there’s apparently no immediate cause forit. Characterized by depression, anxiety, insomnia, irritability and a general lack ofemotional control, it can be an extremely isolating condition.

There is mounting evidence that the endocannabinoid system is at work in stressreactions, emotional regulation and the control of fear. (Jankord and Herman, 2008) Thissystems seems to interact with a key hormonal system, such that it may in fact be arole of endocannabinoids to reset things after extreme emotional stress. (Viveros et al.,

2007) This research, though early, is extremely promising for the treatment of PTSD.

Aside from these long term prospects for medical marijuana and PTSD, it is clearlythe case that managing some of the core symptoms of this anxiety can be a great aidin managing the condition. Medical marijuana has been shown to reduce anxiety,in both human and animal studies. CBD seems to be of particular use on this front,and has outperformed standard anxiety medications in experimental comparisons.(Zuardi and Guimaraes, 1997)

Additionally, marijuana’s positive effect on sleep can have a great impact on thequality of life and capacity to manage emotions. Anti-depressant, mood elevatingeffects also play a role in bringing about real change in overall condition for PTSDpatients, and those suffering from a range of anxiety disorders where these coresymptoms present with similar consequences.

• anti-anxiety effects

• improved sleep

• improved mood

• depression management

• long-term promise for targeted PTSD therapy

19 The Facts About Medical Cannabis17 The Facts About Medical Marijuana in Florida

Is it right for me? Where do I get medical marijuana?

PART THREE Accessing MedicalCannabis in Canada 3


Accessing Medical Marijuana in Canada

1. Consult a healthcare practitioner.Cannabis is not appropriate for every patient and every condition – you need to know if it’s right for you. You can start by talking to your family doctor, but you can consult with any doctor who is familiar with rapidly evolving use of medical cannabis. In some provinces and territories, nurse practitioners will be qualified to consult with patients and assess the appropriateness of medical marijuana for their situation. A care centre such as a National Access Cannabis location can also arrange a consultation with minimal wait time.

2. Obtain your Medical Document or Medical Marijuana Card.Health Canada regulations require that you have a Marihuana for Medical Purposes Regulations (MMPR) Medical Document, which is much like a standing prescription. It indicates that the patient is legally permitted to have medical marijuana, and specifies the type and amount of cannabis the patient may take and possess.

The information required to make a valid medical document is fairly simple and is listed here:

• Patient’s full name

• Patient’s date of birth

• Address where patient consulted with the healthcare practitioner

• Daily grams of dried marijuana patient is authorized to use

• Period of use (i.e. number of days, weeks or months). This cannot exceed one year from the date the medical document is signed by the healthcare practitioner

• Healthcare practitioner’s name and, administrative information: profession, licence number, province of licence, business address, phone number, fax number and email address, if applicable

• Attestation by the healthcare practitioner that the information contained in the document is correct and complete

• Document must be signed and dated by the healthcare practitioner.

National Access Cannabis will issue you an electronically secured, wallet-sized medical marijuana card indicating your legal status. This provides an extra level of convenience and personal security.

3. Order your product from a licensed producer.National Access Cannabis will assists you in placing your order with a licensed producer, and with selecting the right strain. The producer will then send your order by mail to your home address.


About National Access Cannabis

National Access Cannabis is a new kind of company devoted to improving quality of life by creating a network of safe, responsible care centres right across Canada.

We are dedicated to health and to working in consultation with health professionals. We’re committed to responsibility, through our secure non-transferable medical marijuana access card system. Above all, National Access Cannabis is dedicated to people and their well being. We listen. We assure individual safety by screening for drug interactions. We offer follow-through consultations. We are Canada’s leader in developing safe, responsible and conscientious access to legal medical marijuana.

The NAC Medical Marijuana Card offers our members peace of mind. The National Access Cannabis Card means freedom from worry about legal misunderstandings when you travel in Canada. And as we grow, your card will be welcomed at NAC locations nationwide, so you’ll always access to medication and services. The Card replaces the paper authorization issued by physicians and offers real-time verification – anytime, anywhere.

A National Access Cannabis membership makes the complex process of legal medical marijuana simple. Come in and talk to us. Or start by visiting us online at www.nationalaccesscannabis.com .

the facts about a guide for exploring medical cannabis€¦ · 1 the facts about medical cannabis...

Documents