Arthritis and Medical Cannabis — Part I

This is the first in a series of blog posts that will discuss the use of medical cannabis, as well as other non-pharmacological products, in treating rheumatological conditions.

Introduction to Cannabis

Despite its upcoming legalization for recreational use in Canada, many Canadians are unfamiliar with the use and benefits of cannabis for treating medical conditions. That’s because, while cannabis is controlled by Health Canada and available for medical use at your physician’s advice and recommendation — similar to a prescription — over much of the past century its general use has been prohibited by law, with fines and even imprisonment levied against those found to be in possession of certain amounts.

However, cannabis has also been recognized as a helpful treatment for a variety of symptoms and side effects related to cancer and multiple sclerosis, rheumatological afflictions like lupus and arthritis, and related conditions like fibromyalgia. For the past few years, medical and healthcare advocacy groups around the world have conducted research and led lobbying efforts with government to loosen restrictions around the legality and availability of cannabis.

In Canada, as of July 1, 2018, cannabis will be thrust into the mainstream, as legalization will make it available for sale at Government-regulated stores, just like alcohol.

Dried cannabis leaves.

Dried cannabis leaves.

So, for the uninitiated — what is cannabis, and how can it help treat forms of arthritis?

Cannabis is a species of flowering plant, from the same family as hops; just like beer, cannabis has been used by humans for centuries. Hemp, a variety of cannabis, has historically been an important industrial crop for making paper and textiles, among many other materials.

Cannabis has also long been used for religious or spiritual purposes; due to the presence of natural chemical compounds called cannabinoids, the female cannabis plant possesses psychoactive qualities.

The consciousness-altering properties of cannabinoids are activated through heating — such as smoking, or by cooking with foods which can then be ingested. The most typical result of cannabis consumption includes changes in perception, elevated mood or euphoria, and an increase in appetite.

By smoking cannabis leaves or vaporizing and inhaling the plant matter ('vaping'), effects of cannabis are typically felt within a minute or two; when ingested through other means, it can take 30 to 60 minutes for the psychoactive effects to be realized. These effects can last for between two and six hours.

Cannabis Use for Medical and Health Care Purposes

In the modern era, cannabis has been used most frequently as a recreational and medicinal drug. Over the past few decades, medical researchers and physicians discovered that it can be used to manage and even reduce symptoms of disease, sometimes alongside other treatments, and sometimes on its own.

Cannabis is now recognized by many as an anticonvulsant, an anti-inflammatory, and an appetite stimulant; speculation, as well as research, continues to grow about its other health benefits.

Though its use continues to be prohibited by law in most countries (since 1922 in Canada; since 1937 in the United States), government approval and regulation of cannabis for medical use has taken place in Australia, Belgium, Canada, Germany, the Netherlands, Spain, and 23 U.S. states.

Medical-marijuana-sign.jpg

‘Medical cannabis’ or ‘medical marijuana’ are the terms used today for both the use of cannabis for health purposes, and the wholesale production and retail sectors that have grown around the trend.

Both are growing quickly, and Canada is poised to raise the profile of the cannabis sector in the English-speaking world once prohibition is lifted.

How Cannabis Works

While the recreational use of cannabis and risk of abuse may not be dissimilar to that of alcohol in the general population, it is due to medical research that our understanding of how cannabinoids send the signals to cell receptors in the body — and what the impact of these interactions may be — that cannabis is now accepted as a viable treatment option for some people.

These interactions are notable because of the role of cell receptors in the body. Receptors are actually special molecules within our cells that receive signals from chemical compounds (like cannabinoids), and which then tell the body to do certain things.

There are cell receptors, for example, that regulate hypothermia, sedation, and intestinal contractions — all involuntary physical states or reactions, and each of which must be carefully regulated in the body under various circumstances.

Cannabinoids interact with two specific types of receptors, helpfully known as cannabinoid receptors type 1 and 2 (or CB1 and CB2).

These receptors, found throughout the central nervous and immune systems (and thus associated with the brain, spine, and various organs and physical systems), can relay new signals throughout our body at the cellular level, producing a wide variety of responses, from anxiety and pain, to concentration and motor control, to digestion and inflammation. CB2 receptors in particular seem to be responsible for regulating inflammation, as well as playing a role in bone strength and health.

Thus, when we ingest cannabinoids, we're sending signals to our body to do some (or many) very important tasks. Of the dozens and dozens of different cannabinoids in cannabis, science has determined that, at the moment, two are notable for their effects on humans:

  • Tetrahydrocannabinol (THC) -—known for its energizing and intoxicating effects, it is believed THC can suppress immune functions, reducing inflammation and pain for people with certain autoimmune disorders.
  • Cannabidiol (CBD) — known for its sedating and relaxing effects, CBD appears to suppress anxiety or panic-forming responses, and is also considered an effective topical analgesic for joint and musculoskeletal pain.

Today, cannabis can be cultivated and cross-bred to produce endless 'strains', each with different levels of THC and CBD. Each strain can thus produce different effects, serving to produce different potential expressions of the drug on the body's crucially important CB1 and CB2 receptors.

This means that a strain of cannabis that may help someone with cancer symptoms may not be as effective for someone experienced lupus symptoms.

Is Medical Cannabis Right for You?

Now that you have a basic understanding of what cannabis is and how it works, how do you determine whether cannabis is right for you?

In our next blog post, we'll explore the different forms, types and strains of medical cannabis.

Until then, if you’re considering exploring medical cannabis for your arthritis symptoms or other rheumatological conditions, consult with your doctor for his/her opinion and to discuss the options. Medical advice is always recommended before considering new treatments for chronic conditions or disease, even for treatments available without a prescription.

After speaking to your doctor, we also recommend that you explore the many resources available to you on the Internet to understand the range of opinions, research and feedback from other patients who have tried or continue to use medical cannabis.

Stay tuned for Part II of this series, coming soon!