Applications of Clinical Cannabis in Medicine

As clinical cannabis is rapidly becoming accepted as a treatment for an array of chronic diseases and disorders, there is a growing and pressing need for clinical education surrounding medical marijuana—and alternative treatments for pain control. The use and acceptance of medical cannabis continues to evolve, as demonstrated by the growing number of states that now permit its use and applications for specific medical indications. 

While the marijuana plant contains over 100 different chemicals—or cannabinoids—each one produces a different effect on the body. Tetrahydrocannabinol (THC) was originally identified by Raphael Mechoulam, who later also described and named anandamide: a naturally occurring endogenous cannabinoid neurotransmitter that binds to cannabinoid receptors. The human endocannabinoid system is a biological system involved in regulating a variety of physiological and cognitive processes, including appetite, pain sensation, mood, memory, fertility, etc. The CB1 receptor (THC) occurs in the central and peripheral nervous system, while the CB2 receptor is located on immune cells, and the peripheral nervous system. Cannabidiol (CBD) does not have the psychotropic effects of THC, nor does it have the memory impairment or appetite effects; the two main chemicals used in medicine are THC and CBD.

The most common use for medical marijuana in the United States is for pain control: while marijuana is not strong enough for severe pain (i.e. post-surgical pain or a broken bone), it is said to be highly effective for the chronic pain that plagues millions of Americans, particularly as they age. Part of its attraction is that it is clearly safer than opiates—almost impossible to overdose, and far less addictive—and it can take the place of NSAIDs such as Advil or Aleve, if people cannot take them due to problems with kidneys, ulcers, or GERD.

Marijuana specifically appears to ease the pain of multiple sclerosis, and nerve pain in general. This is an area in which few other options exist; moreover, those that do—such as Neurontin, Lyrica, or opiates—are highly sedating. Patients claim that marijuana allows them to resume their previous activities without feeling drugged or disengaged. Marijuana is also said to be a highly effective muscle relaxant; many users swear by its ability to lessen tremors in Parkinson’s disease. Other successful clinical applications include fibromyalgia, endometriosis, interstitial cystitis, and most other conditions where the final common pathway is chronic pain.

Further users of marijuana include management of nausea and weight loss, and treatment for glaucoma. A highly promising area of research is its use for PTSD in veterans who return from combat zones. Many veterans and respective therapists have reported drastic improvements, recommending more research and studies, and a loosening of governmental restrictions on its study. Medical marijuana is also reported to help patients suffering from pain and wasting syndrome associated with HIV, as well as irritable bowel syndrome and Crohn’s disease.

Despite lingering controversy, use of botanical cannabis for medicinal purposes represents the revival of a plant with historical significance reemerging in today’s healthcare system. Legislation governing use of medicinal cannabis continues to change quickly, necessitating that pharmacists and other clinicians stay abreast of state regulations and institutional implications. Ultimately, as the medicinal cannabis landscape continues to evolve, hospitals, acute care facilities, clinics, hospices, and long-term care centers must consider the implications, address logistical concerns, and explore the feasibility of permitting patient access to this treatment.

Senior Vice-President of A4M/MMI Joseph Maroon, MD—Clinical Professor and Vice Chairman in the Department of Neurosurgery at the University of Pittsburgh Medical Center, and expert in clinical cannabis therapies—has published a white paper on the neurological benefits of cannabinoids.

SOURCES
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312634/
https://www.cannabis-med.org/?lng=en

Member of the Month: Yelena Lapidus, MD

A4M valued member Yelena Lapidus shares insight from her professional experience in this Member of the Month feature. 

I was born in Samara, a city situated in the southeastern part of European Russia. I lived there until I graduated from Medical School in 1996. I then moved to the United States and got my second residency at UC Davis Medical School. Currently, I own a clinic I am very proud of filled with unique integrative medicine that we personalize for each patient. I am fortunate to live on the coast in beautiful California where I get to be near my son who attends college at California Polytechnic State University, San Luis Obispo. I base my life around learning and I do not intend to stop!

Q1: Before joining A4M what was your medical background?

I began my medical background at Samara State Medical University in Russia 1994 with an OB/GYN Residency in 1996 specializing in surgeries and treatments for infertility and endometriosis. I studied Family Medicine at UC Davis with a rural track allowing me to do Obstetrics and prenatal care. In 2005 I started a Family Practice and also joined the World Hormonal Society. In 2006 I became board certified with the American Academy of Anti-Aging and Regenerative Medicine and bioidentical hormone therapy.

Q2: What anti-aging techniques have you incorporated into your practice? How did you do so?

I based my whole medical practice on a variety of Anti-Aging medicine technologies. Every single disease condition I treat with integration of this knowledge. I have studied all of the modules of the fellowship and incorporate this knowledge through protocols to evaluate every system of the body. We personalize our approach by getting a baseline of major systems through extensive hormone care, nutraceuticals, allergen testing, neurofeedback, and a variety of other methods. We strive to help our patients achieve whole body health and well-being through implementing new scientific discoveries and technological advances. Anti-Aging individualized patient care is our priority.

Q3: What are the benefits of practicing Anti-Aging Medicine, both as a professional and for your practice?

Practicing anti-aging allows me to focus on developing personalized programs for the health of my patients. I am able to focus on more healthy individuals and fewer sick patients. Seeing life changes my patients make are very rewarding. Our practice is health oriented, not disease oriented.

Q4: What are the changes you see in your patients?

Through Anti-Aging medicine my patients have more vitality and energy, better cardiovascular performance, lower A1C, lower weight, clearer skin, and improved strength. Outcomes of treatment and personal patient goals are achieved faster and are more sustainable.

Q5: Why would you recommend Anti-Aging Medicine to your peers?

I would recommend Anti-Aging Medicine to my peers because it allows you to help make significant life changes with your patients that will create a foundation for longevity. This is way more fun and personally rewarding than only taking care of sick patients. It is preventative & proactive health versus reaction/symptom/disease-oriented medicine.

Q6: Where do you see the future of Anti-Aging medicine 20 years from now?

20 years from now I believe Anti-Aging medicine will be a cornerstone to medical care. I hope that by then this way of practicing medicine will have grown in popularity as it proves itself again and again to be very effective in helping individuals become and stay healthy.

Member of the Month: Warren Willey, DO, ABAARM

A4M valued member Warren Willey, DO, ABAARM shares insight from his professional experience in this Member of the Month feature. 

Q1: Before joining A4M, what was your medical background?

I started going to A4M conferences not long after residency. My core philosophy and practice style mirrors A4M and its members. I focus on the actual cause of disease (not just hiding it with a drug) and working toward a better quality of life for people.

Q2: What anti-aging techniques have you incorporated into your practice? And how did you so?

I teach all aspects of lowering stress and inflammation. This is done through diet and exercise optimization, hormone balance, controlling and modifying the body’s reaction to stress, and maintaining good cognitive/brain function no matter what the age.

Q3: What are the benefits of practicing anti-aging medicine: as a professional, and for your practice?

This type of practice gets people well. It treats the cause of discomfort, not just the symptom of discomfort and disease. It empowers people (patients and doctors) to improve their quality of life, and in doing so, getting a little side effect called life extension!

Q4: What are the changes you see in your patients?

So many to list, but they can all be summed up with better quality of life. More healthiness and more happiness!

Q5: Why would you recommend Anti-Aging Medicine to your peers?

I recommend it to all my peers so each of them can really make a difference in peoples lives. The whole reason most of us went into this profession. Get out of the rat race, the readmissions, the paperwork, and all the things that take the pleasure out of practicing medicine!

Q6: Where do you see the future of Anti-Aging medicine 20 years from now?

Current Anti-Aging medicine and its continued advancement IS the future of medicine. It’s the only future our society can afford, both monetarily and for patients care and peoples quality of life. What standard western medicine is doing now has not, is not, and will not work in the future. The system has to change, and this type of medicine will pave the way for it to do so.