By Angela Underwood
While medicinal marijuana can help heal a range of diseases from opioid addiction to seizure disorder, moderation is still key, according to two cannabis experts.
cannabisMD Medical Advisory Board Members Dr. Jordan Tishler and Dr. Junella Chin charge that medical marijuana can heal or hurt, which is why using the plant properly is paramount.
“Treatment for anxiety and mild unipolar depression is most effective, and entirely dependent on dose and timing,” Dr. Tishler said. “Low dose 5-15mg is best, and it is best delivered at bedtime to avoid unnecessary day time intoxication.”
Evidence and experience treating other mental health issues with cannabis is less solid, according to Tishler, adding Attention Deficient Hyperactive Disorder (ADHD) and Autism appear promising, but results remain to be seen.
And there are some mental health issues that marijuana can make worse, he added.
“There are a number of studies that attempt to show that cannabis can worsen psychoses and bipolar mania,” Dr. Tishler said, adding while most of these studies can only show association, not causation, a few truly implicate cannabis. “Certainly, patients with either of these conditions should consider carefully before cannabis treatment, especially if the treatment is for some other problem like pain.”
Although the research for ADHD and cannabis is still in its
a study of 30 patients in Germany suggests that for adult patients
with ADHD, who experience side effects or do not benefit from standard medication, cannabis may be an effective and well-tolerated alternative, according to Dr. Chin.
Both Tishler and Chin agree because of prohibition, the medical community is playing catchup with cannabis.
“Research should never be illegal, unless it’s unethical,” Dr. Tishler said. “We lost nearly 100 years of advances due to the entirely political, and racist, prohibition. More important than what we’d have learned about cannabis is what we’d have learned about human physiology, as well as the development of non-cannabis medications that are multi-compound interactive medications.”
Dr. Chin said there is no precedent and no other drug in the world that is used recreationally and medicinally for therapeutic uses.
“The historical record of safe use is unparalleled,” she added.
Speaking of recreational use, both physicians have strong opinions on the legalization of cannabis and how the medical community will continue to deal with the drug and diagnoses.
“National recreational legalization without a firm national medical system in place first will entirely undermine patient care,” Dr. Tishler said.
Companies will continue their ongoing attempts to treat all people as recreational consumers and will not provide the appropriate care or products that patients need, he added.
“Ultimately recreational users are looking for new and exciting possibilities, whereas patients need reliable, consistent medication,” Dr. Tishler said.
Studies show that cannabinoids influence the expression of key genes for different neurotransmitters, according to Dr. Chin, adding for this reason, it makes it very difficult to have linear cause and effect relationships.
“Understanding the interrelationship of the genetic diversity of individuals and the administered plant product can help develop an ideal therapeutic strategy for the treatment of a disease,” Dr. Chin said. “We need more studies on plant pharmacogenomics, but then how do we get standard, consistent medicine and reproducible results among all the different chemovars? This is a challenge and needs to be researched.”
Even with legalization, the stigma of medical marijuana has affected many people’s willingness to try it as medication, according to Dr. Tishler.
“This particularly affects those who might need it most – the elderly and sick,” Dr. Tishler said. “Reaching out to these groups to dispel these harmful ideas is an uphill battle, particularly in light of the attitude that the industry displays toward patients v. recreational users.”