Epilepsy Talk

New Data Back Use of Medical Cannabis for Epilepsy, Pain, Anxiety | April 5, 2021

Two new studies offer positive news about medical cannabis, suggesting that marijuana products improve physical and cognitive symptoms, boost quality of life, and rarely produce signs of problematic use.

In one study, patients with epilepsy who used medical cannabis were nearly half as likely to have needed an emergency department visit within the last 30 days as was a control group. In the other study, 3 of 54 subjects who used medical cannabis showed signs of possible cannabis use disorder (CUD) over 12 months.

The findings show that “there is improvement in a range of outcome variables, and the adverse effects seem to be minimal, compared to what we might have hypothesized based on the bulk of the literature on the negative effects of cannabis on health outcomes,” cannabis researcher Ziva Cooper, PhD, of the University of California at Los Angeles, said in an interview. Dr. Cooper moderated a session about the studies at the virtual annual meeting of the College on Problems of Drug Dependence.

In one study, cannabis researcher Ryan Vandrey, PhD, of Johns Hopkins University, Baltimore, and colleagues compared medical cannabis users (number, 808; mean age, 38; percentage female, 63%) to a control group of people who were interested in medical cannabis (n, 468; mean age, 35; percentage female, 62%).

In both groups, 79% were White. The groups had similar levels of primary medical conditions, such as neurologic (38% and 36%, respectively, for the medical cannabis group and control group) and chronic pain (25% and 23%, respectively.)

The wide majority of those in the medical cannabis group – 58% – were cannabidiol (CBD) users, relying on a component of cannabis (marijuana) that does not make people high. Fewer than 20% used tetrahydrocannabinol (THC), which does make people high, or a combination of both CBD and THC.

Most of those in the medical cannabis group used the drug as an adjunct (39%) to other treatments or last-resort (29%) treatment instead of first line (11%) or second line (18%).

In patients with epilepsy, about 45% of controls reported a past-month ED visit, compared with about 25% of medical cannabis users. The gap in past-month hospital admissions was even wider, at about 35% for the controls and about 15% for the medical cannabis.

After an initial survey, the researchers followed subjects prospectively; some either started or stopped using medical cannabis. From baseline to follow-up, those in the medical cannabis group improved more, compared with those in the control group on a variety of measures of quality of life, anxiety, and depression.

“Folks who were in the control condition at baseline and then initiated cannabis use started to look more like the baseline cannabis users,” Dr. Vandrey said. “The folks who were cannabis users at baseline and then stopped for whatever reason started to look like the controls. And the controls [who never started using medical cannabis] stayed the same.”

As for adverse effects, two-thirds of medical cannabis users reported no problems; the highest number, 14%, reported high cost.

As for limitations, Dr. Vandrey reported missing data, a reliance on self-reports, and poor follow-up with about a third of participants agreeing to complete follow-up assessments. “We are continuing to collect data on this,” he said, “and we’re hoping we’ll be able to drill down more as we get bigger.”

The study was funded by the Realm of Caring Foundation.

In the other study, led by cannabis researcher Staci Gruber, PhD, of McLean Hospital in Belmont, Mass., and Harvard Medical School in Boston, researchers tracked 54 subjects (mean age, 49; 20 male and 34 female; 48 white) for up to 2 years after they began medical cannabis use. Most had pain (36) or anxiety/PTSD (31), and all had to have abstained from recreational cannabis use for at least 1 year.

At follow-ups, the users reported improved mood and anxiety via various measures, and they saw some improvement in quality of life. “We did not see worsening cognitive performance,” Dr. Gruber said. “In fact, we saw improved performance or no change on measures of executive function, in contrast to what we see in the literature.”

Research has suggested that as many as 30% of recreational cannabis users develop cannabis use disorder (CUD), Dr. Gruber said. But only 3 of the 54 patients showed signs of possible CUD at 12 months, she said, even though frequency of use jumped substantially vs. baseline.

Information about study funding was not available.

Dr. Cooper disclosed relationships with FSD Pharma, Beckley Canopy Therapeutics, and Insys Therapeutics. Dr. Vandrey disclosed work with Zynerba Pharmaceuticals, Canopy Health Innovations, and FSD Pharma. Dr. Gruber reported no disclosures.

This story originally appeared on MDedge.com.

SOURCE: MedScape.com by R. Dotinga


14 Comments »

  1. Reblogged this on Disablities & Mental Health Issues.

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    Comment by Kenneth — April 5, 2021 @ 11:01 AM

  2. This is an interesting topic simply due to the fact that so many are reticent to speak on the subject. Any of us that aren’t younger, remember the war on drugs pretty well, it’s tough to openly discuss the subject without looking around in paranoia.

    But I’ll take a shot at it. In my observations I have noticed that anything kept in the dark for the “betterment” of others will build up a mystique. Those against this “thing” will build evidence to support the supposition – in this case backed by government dollars. Those that support the legality of this “thing”, In this case something illegal, have neither the funding or public support to build the science data necessary for a proper understanding.

    I’m not suggesting any moral right or wrong, simply that science is, like most other concepts, subject to human error and emotion. In the TV news – scientists are held up as moral and objective. I know lots, perhaps hundreds of scientists from materials, to chemistry to AI. They are all emotional and seldom much different from others when challenged. Scientific thought processes don’t always follow scientists into everyday life.

    Point: Science can be trusted, scientists are just people. Science done under a moral or political agenda should be scrutinized and reproduced before it’s accepted. Under that idea, it’s safe to say that most science done on the topic of marijuana pre 2000 is probably heavily biased in the negative.

    Public opinion on the other hand sees a secret being released. The magic is still in the air and us monkeys see a shiny object that works like a miracle and frees us from pain, our mortal nemesis.

    Placebophen is, in my opinion, about half of the benefit of CBD and THC. My Epilepsy came years after I was legally using both. It could be argued from a timeline perspective that since they predate my epilepsy and my epilepsy is related to how I “focus” my attention – and marijuana helps my creative “focus” – that maybe there is a negative connection. I accept that possibility.

    My last thought: When you feel better and happier, everything is easier to deal with. In reality, for some people pot does just that. It helps some people feel just plain better and happier – “perma-grin” in the venacular. Whether its CBD or THC – our endocannaboid system rewards us endlessly and very few are caused to suffer by the drug (not including the trade itself). So while I hope there are significant finds and molecular mechanistic answers, I suspect it will be simpler to the layman… A healthier endocanniboid system is part of a healthy human system.

    Liked by 1 person

    Comment by William — April 5, 2021 @ 12:45 PM

    • Brilliant, William and so eloquently said. One could say “Follow the money”, but it’s much too complex a situation for that.

      The ignorance, fear, lack of testing or acknowledging patient results — and of course the selfish, self-interested points of view, are staggering.

      As you say, these are just a microcosm of the problems.

      Thank your input and all we can learn from that.

      Like

      Comment by Phylis Feiner Johnson — April 5, 2021 @ 1:33 PM

  3. Cannabis products also have a great role to play for those who wish to reduce or eliminate their dependence on pharmaceutical medication for epilepsy (and other conditions such as chronic pain and anxiety/depressive disorders). I am using it to titrate off of my seizure meds. (4/5ths of the way there, 1/5 to go).
    I don’t know if I will have to take cannabis for the rest of my life or if I will be able to gradually let it go once all the synthetic drugs have cleared out. If I do have to take it for life I don’t mind a bit. I would rather take an all natural substance that is not going to give me osteoporosis.
    Also, much of the negative medical “literature” about cannabis is talking about smoking it which is, of course, bad for your respiratory system. With so many options in edibles widely available now, this is no longer a concern. Take two gummy bears and call me in the morning.

    Liked by 1 person

    Comment by paleobird — April 5, 2021 @ 1:11 PM

    • Gummy bears are illegal in Pennsylvania. Don’t ask me why. 🙂

      But I think most of the issue is not whether you will end up staying on a natural like cannabis. It’s more of finding a mix that works for you.

      That’s the journey my husband has been going through. And though it’s educational, it’s also not fun.

      Pain relief please. Not getting up stoned in the morning…

      Like

      Comment by Phylis Feiner Johnson — April 5, 2021 @ 1:40 PM

  4. I heard only 3 states in the United States have not legalized it yet, and there was an article just in today’s newspaper pertaining to passage of allowing it- keep your fingers crossed, Phyllis!!!

    I have done some research and some of the other medications I take for purposes other than epilepsy do not mix well with it; perhaps just the cannabis would relieve conditions enough so I would not have to depend on those meds and be able to use the cannibis

    Liked by 1 person

    Comment by Karen — April 5, 2021 @ 1:22 PM

  5. Karen, fingers, eyes and toes crossed!!!

    Like

    Comment by Phylis Feiner Johnson — April 5, 2021 @ 1:42 PM

  6. Yes, we are nearly there to getting federal level legislation on this. It’s the federal prohibition that keeps completely legal dispensaries having to operate as cash-only businesses with security guards with guns to protect all that cash. (Some arcane rule about taking plastic “crossing state lines”)
    I don’t like the feeling of being stoned either but I have found that there are a lot of micro-dosing options in edibles such as the mints I take. After a bit of experimentation I have found a precise dose that keeps me reliably asleep and nocturnal seizure free all night without leaving me fuddle-headed in the morning.

    Liked by 1 person

    Comment by paleobird — April 5, 2021 @ 1:56 PM

  7. We have marijuana cards, but can’t cross state lines. There’s little we can do other than go to expensive and inept dispensaries.

    Still many options to try. And different dispensaries carry different “brands”. So, it’s like “rock around the clock.”

    Or a not so scenic tour around the surrounding environs!

    Like

    Comment by Phylis Feiner Johnson — April 5, 2021 @ 2:07 PM

  8. We have seen a tremendous difference since my 20 year old son is on medical Cannibus! He is a different person. Although he still has seizures that we have not gotten to the bottom of. His cognitive performance is truly different. Finding the right dose is the key. The Docotors originally gave him 20 drops 3 times a day. He was totally out of it and dehydrated. He now takes 5 drops in the morning and evening and this is great.
    You need to keep trying to find the right balance.

    Whereas on Keppra he was violent and sucidal. On Depekote he was enormous b/c it upped his thryoid levels to around 7 and many more unleasant affects.
    He is also on Lamactol, but I don’t think it helping nor hurting.

    Liked by 1 person

    Comment by Mara Lynn — April 5, 2021 @ 5:17 PM

  9. Congratulations on finding the right balance of cannabis. It’s not often easy and often takes true perseverance. But you did it. Hooray for you!!!

    Like

    Comment by Phylis Feiner Johnson — April 5, 2021 @ 8:59 PM

  10. The words ”epilepsy & seizures” seems to be the popular terms used, as I did not see what type/s of seizures that this medical cannabis will help stop seizures. Is it ALL seizures ? Is it ALL TYPES from petit mal, grand mals, focal, & the rest of them ? I learned where CBD oils are not so trustworthy to try because of the concentrations of the drug/herb, whatever it is, that you never know just how the brain will respond or react to taking it, as even more seizures can happen, & sometime that is never a condition that can be reversed as to what was before a CBD was taken. If the same happens with cannabis, then WHO wants to play Russian Roulette with their brain ? I don’t want to say FOLLOW THE MONEY, but FOLLOW THE MONEY. DREAM ON. All my life is in books written pages, lived and learned from fools & from sages. NOT HALF.

    Liked by 1 person

    Comment by James D — April 6, 2021 @ 9:38 AM

  11. I have been wondering about this for some time. I have only had 2 seizures (first day, which led to tests indicating epilepsy). I have recently changed from Dilantin to Lamictal. For the most part it has been a good change for me as I was so tired on Dilantin and had no motivation to do anything. The lamictal has helped a lot in these areas. I’m able to read again without falling asleep and I actually feel like doing things, but am waking in the middle of the night so not able to get the sleep I should. I wonder if the CBD gummies would help with this. They are legal in our province although pretty expensive apparently, so I could get them without difficulty.

    Liked by 1 person

    Comment by Cathy Urlacher — April 6, 2021 @ 12:34 PM

  12. Hi Cathy, I remember switching from Dilantin to Lamictal. Wow…what a difference!

    In the beginning, Lamictal made me hyper/crazy. So I changed my nighttime pill to 6PM.

    But I think CBD gummies would be custom made for this! (Of course they weren’t legal in the dark ages!)

    Like

    Comment by Phylis Feiner Johnson — April 6, 2021 @ 1:10 PM


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    About the author

    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I also had epilepsy for decades. My mission is advocacy; to increase education, awareness and funding for epilepsy research. Together, we can make a huge difference. If not changing the world, at least helping each other, with wisdom, compassion and sharing.

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