As cannabis has become a mainstream topic since its recreational legalization in 2018, there has been an overwhelming amount of new information, websites, stores, companies, research, and claims around the plant. The sheer amount of both scientific and conflicting information online can be overwhelming when first trying to learn about the cannabis plant. In this article, we share the basics of how medical cannabis works in the human body, and how it can seemingly assist with such a wide range of conditions and unwanted symptoms.
How can medical cannabis supposedly help so many different conditions? Is it ‘snake oil’?
Unbeknownst to many, medical cannabis has been legal in Canada since 2001, where it was used mostly for end-of-life treatment. Throughout the next decade, reports of cannabis-induced relief from individuals with conditions including severe chronic pain, epilepsy, arthritis, and others were being brought to the attention of doctors by their own patients. As these claims of a highly effective and non-pharmaceutical option continued to grow, research also grew in hopes of scientifically understanding its true benefits, while debunking what was being exaggerated. While there is still much to learn with such a complex plant, the most important part that has guided medical cannabis research was the human body’s innate endocannabinoid system.
The Endocannabinoid System
Before we jump into specific conditions, it’s important to understand “the how” at a basic level. Similar to other biological systems in our body, the endocannabinoid system (ECS) helps govern a wide variety of functions in our body including our inflammatory and immune responses, mood, hormones, memory, pain response, and more. With CB1 and CB2 receptors concentrated throughout the body and the brain, cannabinoids act on these receptors to regulate the level and activity of other neurotransmitters.
To act on these receptors, our body creates molecules named endocannabinoids, which are similarly structured to the phytocannabinoids produced in the cannabis plant. It is theorized that one reason our bodies develop conditions from unknown causes, such as Fibromyalgia, is because the body is not properly producing or regulating its own endocannabinoids. This is where medical cannabis can come in and potentially help the body return to homeostasis.
Discussing THC and CBD is another piece of the endocannabinoid and symptom relief puzzle. As the two phytocannabinoids that are most commonly used and recognized, they both play a role in mitigating unwanted symptoms. While THC is the component that recreational use is usually associated with, it itself has a wide range of medical benefits and contrary to popular belief and you don’t need to “get high” to utilize it. This is where a personalized dosing schedule from a medical professional comes in.
CBD, Medical Cannabis, and Commonly treated conditions
Having assisted tens of thousands of patients since 2014, Apollo has shared the most common conditions they see older adults for on a daily basis. Medical cannabis is often turned to as a third, fourth, or final option when other medications don’t work and/or provide too many unwanted side effects. This has, unfortunately, put the responsibility of advocacy and education on the patients themselves. “A very common sentiment we hear during a follow-up appointment is ‘I wish I had looked into this years ago,” says Kim Lam, lead patient care specialist at Apollo Clinics.
Arthritis is not just one thing, and there are multiple types with their own sets of symptoms and life-altering implications. The main two seen for medical cannabis treatment are osteoarthritis and rheumatoid arthritis. While both are very different in nature, the inflammation and pain in the joints remain the same. Note that while cannabis can be used to effectively treat the unwanted symptoms of arthritis, it cannot fix, heal, or reverse the condition.
Rheumatoid Arthritis (RA)
As an auto-immune or immunocompromised condition, RA is the body’s own immune system mistakenly attacking its own joints. Once diagnosed, physicians assess the patient’s risk factors and options and generally turn to traditional arthritis treatments such as disease-modifying antirheumatic drugs, hydroxychloroquine, glucocorticoids, methotrexate, and/or nonsteroidal anti-inflammatory agents. These medications have a lengthy list of side effects, and often times patients will discontinue their medication because of them.
Osteoarthritis is a very different condition, and is caused by “wear and tear”. Considered a degenerative disease, it can occur in any joint due to any type of overuse. The most common flare-up locations seen are arthritic knees, hips, back, and hands.
Medical cannabis for arthritis
A 2014 study found that CB2 receptors were present in high levels in the joint tissue of arthritic patients.1 CBD and medical cannabis have the potential to work as effectively as ibuprofen in regards to inflammation, with less stress on the liver and kidneys. Other benefits can include pain control, immune modulation, and sleep assistance. The Canadian Arthritis Society has helped fund multiple research grants and studies over the last decade that focus on medical cannabis, including Dr. Jason McDougall’s, a professor in the department of pharmacology and anesthesia at the Halifax university. Research in his lab found that cannabis molecules can attach themselves to nerve receptors and control the firing of pain-sensing nerves in the joint.2
For treating arthritis, ingestible options are often the first choice due to their long-lasting effects (4-12 hours) and ability to reach deep joints such as the hips and knees innately. Alongside ingestible products such as oils and soft gel capsules, topical creams have become popular among the arthritis community and for those with psoriatic arthritis. That said, there is less research around topicals and there can be difficulty penetrating deeper and larger joints.
Insomnia and Sleep Disorders
Did you know that 30% of all Canadians suffer from a sleep disorder? A Canadian Health Measures Survey found that 43% of men and 55% of women aged 18 to 64 have problems falling asleep or trouble staying asleep.3
Sleep disorders can often be tied to other conditions, stemming from chronic pain, physiological conditions, autoimmune conditions, and more. Because of this correlation, our body falls into what we refer to as the chronic fatigue cycle. When we sleep, our body uses that time to heal and recover. The less sleep we get, the less chance our body has to heal itself which creates an ongoing cycle of increased pain and decreased sleep.
Medical Cannabis for Sleep and Insomnia
One of medical cannabis’ greatest strengths is its ability to treat multiple coinciding conditions at the same time. One 2021 randomized, double-blind, placebo-controlled, crossover study, found a massive reduction in insomnia severity with no serious side effects reported when treating those with chronic insomnia.4
Dosage and product selection is very important when working to maximize effectiveness for sleep success. Formats such as ingestible oils and soft gel capsules are a great option as they have a long-lasting effect and can work to not only help you get to sleep but stay asleep.
Patients able to reduce or stop their reliance on harsher or more addictive pharmaceutical sleep medications is always a win. Cannabis specialists work to help Canadians better manage chronic fatigue, sleep apnea, insomnia, restless leg syndrome (RLS), nightmares, and more.
Chronic Pain and Medical Cannabis
Chronic, inflammatory, and neuropathic (nerve) pain is one of the reasons medical cannabis became such a large topic of discussion in the medical community over the last 2 decades. Why? Numerous individuals were going to their family doctors and specialists to let them know how much cannabis was helping them, despite it not being medically prescribed to them. As the opioid epidemic has surged over the last 20 years, medical cannabis has been introduced as a safe and effective alternative.
In a 2020 published research study, 751 chronic pain patients initiated medical cannabis treatment with Apollo Cannabis Clinics in Canada. After following Apollo’s treatment plan for 12 months with medical cannabis use, the study found a 43% reduction in pain interference with daily activities and a 37% reduction in pain severity. Those using opioids were also able to reduce their dose after 1 month. This and other recent similar studies have suggested that while cannabis may not be the end-all to chronic pain, it can be safely and effectively used (in conjunction with opioids if needed), and may help reduce the overall need for opioid consumption by reducing pain intensity.5
CBD For Anxiety
Anxiety disorders are seriously tolling conditions, and can negatively impact an individual’s social, work, and family life. With the pandemic and all else going on in the world over the past few years, anxiety disorders have continued to grow as a pressing issue for public health.
Anxiety disorders fall into separate categories and include:
- Social Anxiety Disorder
- Panic Disorder
- Generalized Anxiety Disorder
- Obsessive-Compulsive Disorder
- Post Traumatic Stress Disorder (PTSD)
- Separation Anxiety
Because there are so many different causes and types of anxiety, there is a wide variety of treatment options (both pharmaceutical and non-pharmaceutical) that can be used in conjunction to best manage unwanted symptoms. CBD oil has become a popular treatment option due to its low drug interaction profile, minimal side effects, and positive results. A 2019 retrospective case series followed 103 adult patients who were using CBD as an adjunct to usual treatment. Over the first month of treatment, 79.2% of adults who presented primary concerns of anxiety found a decrease in their anxiety score.6
It has been noted that in some instances, extremely high amounts of THC can cause temporary anxiety or panic attacks as an unwanted side effect. The important thing to note here is that this can occur when individuals use high doses of THC, usually recreationally. This is why it is so important to obtain a prescription and guidance from a medical cannabis clinic, to ensure your safety and to maximize the relief a patient can find. With all this said, medical cannabis specialists will respect your choices as to what you are comfortable with in terms of both products and dosing.
We hope you were able to take away some useful information about the uses of medical cannabis for common conditions treated among older adults. If you have questions, there is a great frequently asked questions resource here that may offer some more insight for you surrounding medical cannabis in Canada. Medical cannabis specialist appointments are a great way to learn more and speak to a doctor or nurse practitioner where you can ask questions specific to your medical history and needs. Appointments are free of charge and covered by your provincial healthcare system.