Dazed and Confused: The Myths and Realities of the use of Cannabis in Today's Medicine.
The use of cannabis as a recreational and medical drug is plagued with controversy. While some states in the US have voted and approved the recreational use of it, marijuana still remains a crime at a Federal level. Even though research has shown both positive and negative effects of cannabis, the support of its use is at an all time high -- pun intended!
With the passage of Proposition 64 legalizing the recreational use of marijuana in California last November, it seemed timely to hear about research surrounding this issue. The Howell Foundation hosted Drs. Susan Tapert and Igor Grant in May, with the objective of discussing the good, the bad, the myths and the realities of cannabis.
The first question to be asked is if the use of marijuana is bad or good for you. According to research conducted by Dr. Tapert, in young adults, not good.
Dr. Tapert became interested in addictive behavior research as an undergraduate at University of Washington. Her focus on adolescence started during her graduate studies in the UCSD-SDSU Joint Doctoral Program in Clinical Psychology, where she specialized in neuropsychology and behavioral medicine. Her dissertation presented the the reciprocal effects of neuropsychological functioning and substance use in youth. Her focus today continue to include assessing substance abuse and its effects on the brain in different settings, including the environment and social settings.
To understand how marijuana specifically harms the brain in teenagers and young adults -- a time when the brain is going through major developmental changes-- Dr. Tapert set out to first, identify the demographics related to substance abuse; and second, to compare brain function between users and non users in areas such as cognitive behavior, memory and sequencing events.
- It was hard to find individuals that had not paired the use of cannabis with alcohol.
- Individuals using canniboids demonstrated impairment in cognitive behaviors such as learning new information, memory, recall and sequencing events; displayed through careless errors in a variety of tasks.
- After a month of abstinece, MRI's showed differences in the white and gray matter in the brain. Blood flow to the brain had increased.
- Even after a month of absinence, some cognitive impairments were still visible. However, the longer the period of abstinece, the improovement of normal brain function in the areas of verbal memory, working memory and attention.
- After Alcohol, the use of marijuana is the second reason for substance abuse treatment programs, over other substances like cocaine or ecstasy.
- Mood and substance abuse are also correlated. Some symptoms of depression are apparent when using cannabis, even though users reported feeling better when using marijuana.
Dr. Tapert will be using the information on adolesccence and the use of cannabis to develop a focalized effort in substance abuse based on motivational enhancement therapy and cognitive behavior therapy. Amongst the most successful techniques in treating an adolescent for substance abuse, Dr. Tapper focuses on:
- Motivation building exercises
- Specific goal setting and how to achieve them
- Refuse engaging in canabis use when someone offers it, as well as
- Coping mechanisms to destress
Her next challenge is the ABCD study, which is intended to follow young individuals as early as 10 years old. By examining the causes, factors and results of cannabis use in children, she is seeking to expand her research of the effects of early cannabis use on the brain.
You can see her presentation here.
Not all Marijuana is Created Equal!Using derivative substances of Marijuana for medical reasons is another story. In comparison to Dr. Tapert's presentation, Dr. Grant presented the reasons behind his advocacy for the use of cannabis as a medical alternative.
Dr. Grant addressed the benefits of using cannabis as an alternative method to medicine; which gave the audience a broad perspective on the role it plays in our health. Once the fog of societal pressure and government restrictions finally lifts, research has proved that there are significant benefits of cannabis use in managing neuropathic disorders.
Dr. Grant specializes in the study of cannabis and its effects on neuro-behaviors, and is currently Professor and Chair of the Department of Psychiatry at the University of California, San Diego School of Medicine. Among other things, he heads the Center for Medicinal Cannabis Research. His long list of research publications include regarding the study or marijuana include "The Use of Cannabis for Headache Disorders", "Medical Use of Cannabinoids", "Research on Medical Marijuana", among others. Ultimately, once the hype over cannabis being good or bad is forgotten, many discover the usefulness of the chemicals contained in marijuana.
The history behind the use of cannabis as an alternative form of medication has been quite controversial. After the 30's, cannabis was classified as a narcotic, which in turn affected research related to its benefit. After Dr. Raphael Mechoulam discovered tetrahydrocannabinol, --- or THC, the active ingredient in cannabis in the 60's -- the interest of the use of cannabis resurfaced. Several factors have led to prove its validity as an alternative method to treating specific disorders.
New drug classifications of marijuana have created political shifts in the sense that perhaps, marijuana is not as bad as other hard drugs; at least not as bad as the DEA made it out to be. Adding the research that scientists have done on understanding the effects of cannabis in the brain and in the body, and one can built a very strong case on the positives of its use.
Along with the anecdotal reports on the benefits described when using cannabis, the discovery that brain cell communication through the release of chemicals attached to receptors caused further signaling from one cell to another. These were in fact receptors for THC -- called CB1 and CB2 receptors. The internal signaling system in the brain – or endocannabinoid signaling system-- serves a function; whereas CB1 receptors are typically related to neurological functions, CB2 receptors are related to immunologic responses. By understanding the functions of the receptors, the effects of the use of cannabis can be predicted; especially in the areas of appetite, movement, coordination, attention, memory and planning.
By the 90's, the National Academy of Sciences published a report on the possible benefits of the use of medicinal cannabis, calling for more research to be conducted in 4 key areas:
• Appetite stimulation
• Nausea and vomiting control
• Analgesia - pain management
• Movement and neurological disorders
If, however, you think that being able to get marijuana is difficult, try doing research with it! Dr. Grant went on to explain the perils of sourcing the subject of his research. Even so, research currently conducted by Dr. Grant on the use of cannabinoids for the treatment of neuropathic chronic pain are showing extraordinary results. All the studies— all of them — show high levels of efficacy in the areas of chronic pain, multiple sclerosis, and control of nausea. Moderate effects on improving sleep in those with chronic pain has also been reported.
The struggle between society - government- science, however, still remains. On the one hand, there is clear evidence that using the drug during adolescence is harmful for the brain; and on the other, the use of the same drug is helping people with neuropathic, chronic pain management.
You can read more about the research Dr. Grant is conducting here.
Going back to basics, perhaps?
About the Doris A. Howell Foundation:
The Doris A. Howell Foundation for Women’s Health Research is committed to keeping the women we love healthy, advancing women’s health through research and educating women to be catalysts for improving family health in the community.
The organization does so by funding scholarships to students researching issues affecting women’s health; providing a forum for medical experts, scientists, doctors, and researchers to convey timely information on topics relevant to women’s health and the health of their families through its Lecture and Evening Series, and by funding research initiatives that improve the health of under-served women and increase awareness and advocacy in the community.