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ALS Worldwide
5808 Dawley Drive
Fitchburg, WI 53711‑7209

ALS Worldwide
January 27, 2015

Medical Marijuana

Medical marijuana, also known as medical cannabis, refers to the parts of the cannabis herb used as a type of medicine or herbal therapy. It has been used throughout the world for more than 5000 years to treat various medical ailments, and is one of the 50 fundamental herbs of Traditional Chinese Medicine. Research and anecdotal evidence have made healthcare professionals, patients and caregivers more aware of the therapeutic potential for a range of diseases and disorders. These include ALS/MND, as well as pain, gastrointestinal illness, HIV/AIDS (especially the side effects caused by chemotherapy), breast cancer, brain cancer, and Alzheimer’s disease. Cannabis may be particularly useful in treating ALS/MND symptoms such as appetite loss, depression, pain, muscular spasticity, excess saliva and weakness.

An article titled, Cannabis Use in Palliative Care, published in the Journal of Clinical Nursing, recounts studies that have explored cannabis as a therapy for ALS/MND patients. Carter and Rosen (2001) and Amtmann et al. (2004) suggested that it may be of use in ALS/MND based on studies of other patient groups, particularly those with MS, for whom cannabis acted as an analgesic, muscle relaxant, bronchodilator, saliva reducer, appetite stimulant, sleep inducer and antidepressant. Carter and Rosen also made the point that emerging evidence suggests cannabis has strong antioxidant and neuroprotective benefits, which may prolong cell survival—a key issue for ALS/MND patients, who suffer from the death of motor neuron cells. An anonymous online survey conducted by Amtmann found cannabis to be moderately effective in reducing appetite loss, depression, pain, muscular spasticity, drooling and weakness for ALS/MND patients, with the longest relief reported for depression.

In 2003, a study led by Mary E. Abood, PhD, at California Pacific Medical Center, found that both plant-derived and synthetic THC counteracted neurodegeneration in the SOD1 mouse model. A study was then undertaken with human patients at the Forbes Norris MDA/ALS Center in San Francisco, CA using synthetic Marinol pills which have been FDA approved. Preliminary results were encouraging and safety was demonstrated. Although the study couldn’t prove that efficacy was statistically significant, symptomatic benefits were observed in insomnia, appetite, and spasticity.

Though cannabis has been politically contentious in the U.S. due to lack of FDA approval, the use of medical marijuana has been legalized or decriminalized in 23 states and District of Columbia, with still more allowing the use of the drug under certain provisions. Theoretically, it is still illegal on a national level, but it is our belief that the Justice Department is no longer pursuing violations in regards to medical marijuana.

Keep in mind there may be health risks associated with marijuana use. The plant contains many compounds that have different actions in the human body, and the amount of these compounds can vary from strain to strain. This frequently makes it difficult to know precisely what you’re getting. Studies have shown that THC, one of the chemical properties, can raise anxiety and cause paranoia, which may be frightening for some. Generally, though, the side effects of the purified extracts are mild and can be managed with careful dosing. As with all medications and supplements, the benefits of marijuana must be carefully weighed against its potential risks and discussed with a medical professional.

Other countries where medical marijuana has been decriminalized, to varying degrees, are Canada, Austria, Germany, Switzerland, the Netherlands, Czech Republic, Spain, Israel, Italy, Finland and Portugal. Marinol pills, which are synthetic THC, have been FDA approved and are currently available is 2.5mg, 5mg and 10mg doses. They are less effective than natural cannabis because they lack important chemical compounds. Sativex, available in the UK, Germany, Italy and Spain, is a natural marijuana derivative that has been approved in the UK and is designed to treat spasticity and neuropathic pain.

VARIETIES OF CANNABIS

There are two major types of cannabis plants used for medicinal purposes: sativa and indica. Each has somewhat different effects on the body and mind. There are also hybrid strains consisting of both plants. Indica is known for producing greater feelings of relaxation and can be helpful in treating anxiety, body pain, muscular spasms, seizures, headaches, and sleep disorders. For this reason, indica buds are generally smoked by medical marijuana patients in the late evening or right before bed. Sativa is known to be more energizing and is therefore better suited for daytime use. Sativa use can foster feelings of creativity, focus, well-being and fighting depression. The ideal product for an ALS/MND patient might be a hybrid that primarily contains indica, while still offering some of the benefits of sativa.