Medical cannabis, rather than opioids, are significantly safer for the elderly with chronic pain

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Medical Cannabis Significantly Safer for Elderly With Chronic Pain Than Opioids, According to Ben-Gurion University of the Negev Researchers

Medical cannabis therapy can significantly reduce chronic pain in patients age 65 and older without adverse effects, according to researchers at Ben-Gurion University of the Negev (BGU) and the Cannabis Clinical Research Institute at Soroka University Medical Center.

The new study, published in The European Journal of Internal Medicine, found cannabis therapy is safe and efficacious for elderly patients who are seeking to address cancer symptoms, Parkinson’s disease, post-traumatic stress disorder, ulcerative colitis, Crohn’s disease, multiple sclerosis, and other medical issues.

“While older patients represent a large and growing population of medical cannabis users, few studies have addressed how it affects this particular group, which also suffers from dementia, frequent falls, mobility problems, and hearing and visual impairments,” says Prof. Victor Novack, M.D., a professor of medicine in the BGU Faculty of Health Sciences (FOHS), and head of the Soroka Cannabis Clinical Research Institute. Novack is also the BGU Gussie Krupp Chair in Internal Medicine.

“After monitoring patients 65 and older for six months, we found medical cannabis treatment significantly relieves pain and improves quality of life for seniors with minimal side effects reported.”

This older population represents a growing segment of medical cannabis users, ranging from approximately seven percent to more than 33 percent, depending on the country. Recent U.S. polls indicate Americans over 65 represent 14 percent of the total population and use more than 30 percent of all prescription drugs, including highly addictive painkillers.

BGU researchers surveyed 2,736 patients 65 years and older who received medical cannabis through “Tikun Olam,” the largest Israeli medical cannabis supplier. More than 60 percent were prescribed medical cannabis due to the pain, particularly pain associated with cancer. After six months of treatment, more than 93 percent of 901 respondents reported their pain dropped from a median of eight to four on a 10-point scale. Close to 60 percent of patients who originally reported “bad” or “very bad” quality of life upgraded to “good” or “very good” after six months. More than 70 percent of patients surveyed reported moderate to significant improvement in their condition.

The most commonly reported adverse effects were dizziness (9.7 percent) and dry mouth (7.1 percent). After six months, more than 18 percent of patients surveyed had stopped using opioid analgesics or had reduced their dosage.

All patients received a prescription after consulting with a doctor who prescribed treatment. More than 33 percent of patients used cannabis-infused oil; approximately 24 percent inhaled therapy by smoking, and approximately six percent used vaporization.

While the researchers state their findings to date indicate cannabis may decrease dependence on prescription medicines, including opioids, more evidence-based data from this special, aging population is imperative.

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Cannabis can reverse ageing processes in the brain

Prof. Dr. Andreas Zimmer (left) and the North Rhine-Westphalia science minister Svenja Schulze (centre) in the lab of the Institute of Molecular Psychiatry at University of Bonn. Photo: Volker Lannert/Uni Bonn

Researchers at the University of Bonn restore the memory performance of Methuselah mice to a juvenile stage

Memory performance decreases with increasing age. Cannabis can reverse these ageing processes in the brain. This was shown in mice by scientists at the University of Bonn with their colleagues at The Hebrew University of Jerusalem (Israel). Old animals were able to regress to the state of two-month-old mice with a prolonged low-dose treatment with a cannabis active ingredient. This opens up new options, for instance, when it comes to treating dementia. The results are now presented in the journal Nature Medicine.

Like any other organ, our brain ages. As a result, cognitive ability also decreases with increasing age. This can be noticed, for instance, in that it becomes more difficult to learn new things or devote attention to several things at the same time. This process is normal, but can also promote dementia. Researchers have long been looking for ways to slow down or even reverse this process.

Scientists at the University of Bonn and The Hebrew University of Jerusalem (Israel) have now achieved this in mice. These animals have a relatively short life expectancy in nature and display pronounced cognitive deficits even at twelve months of age. The researchers administered a small quantity of THC, the active ingredient in the hemp plant (cannabis), to mice aged two, twelve and 18 months over a period of four weeks.

Afterwards, they tested learning capacity and memory performance in the animals – including, for instance, orientation skills and the recognition of other mice. Mice who were only given a placebo displayed natural age-dependent learning and memory losses. In contrast, the cognitive functions of the animals treated with cannabis were just as good as the two-month-old control animals. “The treatment completely reversed the loss of performance in the old animals,” reported Prof. Andreas Zimmer from the Institute of Molecular Psychiatry at the University of Bonn and member of the Cluster of Excellence ImmunoSensation.

Years of meticulous research

This treatment success is the result of years of meticulous research. First of all, the scientists discovered that the brain ages much faster when mice do not possess any functional receptors for THC. These cannabinoid 1 (CB1) receptors are proteins to which the substances dock and thus trigger a signal chain. CB1 is also the reason for the intoxicating effect of THC in cannabis products, such as hashish or marihuana, which accumulate at the receptor. THC imitates the effect of cannabinoids produced naturally in the body, which fulfil important functions in the brain. “With increasing age, the quantity of the cannabinoids naturally formed in the brain reduces,” says Prof. Zimmer. “When the activity of the cannabinoid system declines, we find rapid ageing in the brain.”

To discover precisely what effect the THC treatment has in old mice, the researchers examined the brain tissue and gene activity of the treated mice. The findings were surprising: the molecular signature no longer corresponded to that of old animals, but was instead very similar to that of young animals. The number of links between the nerve cells in the brain also increased again, which is an important prerequisite for learning ability. “It looked as though the THC treatment turned back the molecular clock,” says Zimmer.

Next step: clinical trial on humans

A low dose of the administered THC was chosen so that there was no intoxicating effect in the mice. Cannabis products are already permitted as medications, for instance as pain relief. As a next step, the researchers want to conduct a clinical trial to investigate whether THC also reverses ageing processes in the brain in humans and can increase cognitive ability.

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Medicinal properties of cannabis could provide non-addictive pain relief

Susan Ingram, Ph.D., an associate professor of neurosurgery in the OHSU School of Medicine, is the senior author of new OHSU research that suggests an avenue for developing treatments for chronic pain that harness the medicinal properties of cannabis while minimizing the threat of addiction, January 10, 2017. (OHSU/Kristyna Wentz-Graff)

Journal of Neuroscience study examines medicinal properties of cannabis

OHSU research suggests an avenue for developing treatments for chronic pain that harness the medicinal properties of cannabis while minimizing the threat of addiction.

The study, conducted in a rodent model, provides additional rationale for the development of therapeutics using cannabinoid receptors to treat chronic pain, which afflicts about 30 percent of the U.S. population. OHSU investigators studied the function of two forms of cell membrane receptors that bind cannabinoids that occur naturally within the body, called endocannabinoids.

“It may be an avenue where we can get better pain medications that are not addictive,” said senior author Susan Ingram, Ph.D., an associate professor of neurosurgery in the OHSU School of Medicine.

Ingram and colleagues report the treatment of chronic pain has challenged the medical system, with medications that are ineffective or create serious side effects: “However, emerging data indicate that drugs that target the endocannabinoid system might produce analgesia with fewer side effects compared with opioids.”

The body’s endocannabinoid system comprises receptors, endocannabinoid molecules and enzymes that make and degrade the endocannabinoids located in the brain and throughout the central and peripheral nervous system. The research team focused on two cannabinoid receptors, known as CB1 and CB2, in the rostral ventromedial medulla – a group of neurons located in the brainstem known to modulate pain. The study is the first to examine CB1 and CB2 receptor function at the membrane level in late adolescent and adult neurons.

The researchers observed that chronic inflammatory pain increased activity of CB2 receptors and decreased CB1 activity. Cannabis activates both CB1 and CB2 receptors equally. The study suggests that selective activation of CB2 receptors contributes to the medicinal benefit of cannabis while minimizing the propensity of the other cannabinoid receptor, CB1, to induce tolerance and withdrawal. Ingram said the next phase of the research will further explore this area of brain circuitry, which ultimately could lead to the development of a new class of pain medications.

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As more states legalize marijuana, adolescents’ problems with pot decline

Researchers at Washington University School of Medicine in St. Louis have found that the number of teens with marijuana-related problems, and the percentage using the drug, have declined even as states have legalized and decriminalized pot.

Researchers at Washington University School of Medicine in St. Louis have found that the number of teens with marijuana-related problems, and the percentage using the drug, have declined even as states have legalized and decriminalized pot.

Fewer adolescents also report using marijuana

A survey of more than 216,000 adolescents from all 50 states indicates the number of teens with marijuana-related problems is declining. Similarly, the rates of marijuana use by young people are falling despite the fact more U.S. states are legalizing or decriminalizing marijuana use and the number of adults using the drug has increased.

Researchers at Washington University School of Medicine in St. Louis examined data on drug use collected from young people, ages 12 to 17, over a 12-year span. They found that the number of adolescents who had problems related to marijuana — such as becoming dependent on the drug or having trouble in school and in relationships — declined by 24 percent from 2002 to 2013.

Over the same period, kids, when asked whether they had used pot in the previous 12 months, reported fewer instances of marijuana use in 2013 than their peers had reported in 2002. In all, the rate fell by 10 percent.

Those drops were accompanied by reductions in behavioral problems, including fighting, property crimes and selling drugs. The researchers found that the two trends are connected. As kids became less likely to engage in problem behaviors, they also became less likely to have problems with marijuana.

The study’s first author, Richard A. Grucza, PhD, an associate professor of psychiatry, explained that those behavioral problems often are signs of childhood psychiatric disorders.

“We were surprised to see substantial declines in marijuana use and abuse,” he said. “We don’t know how legalization is affecting young marijuana users, but it could be that many kids with behavioral problems are more likely to get treatment earlier in childhood, making them less likely to turn to pot during adolescence. But whatever is happening with these behavioral issues, it seems to be outweighing any effects of marijuana decriminalization.”

The new study is published in the June issue of the Journal of the American Academy of Child & Adolescent Psychiatry.

The data was gathered as part of a confidential, computerized study called the National Survey on Drug Use and Health. It surveys young people from different racial, ethnic and income groups in all 50 states about their drug use, abuse and dependence.

In 2002, just over 16 percent of those 12 to 17 reported using marijuana during the previous year. That number fell to below 14 percent by 2013. Meanwhile, the percentage of young people with marijuana-use disorders declined from around 4 percent to about 3 percent.

At the same time, the number of kids in the study who reported having serious behavior problems — such as getting into fights, shoplifting, bringing weapons to school or selling drugs — also declined over the 12-year study period.

“Other research shows that psychiatric disorders earlier in childhood are strong predictors of marijuana use later on,” Grucza said. “So it’s likely that if these disruptive behaviors are recognized earlier in life, we may be able to deliver therapies that will help prevent marijuana problems — and possibly problems with alcohol and other drugs, too.”

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End the Ban on Psychoactive Drug Research

Development of a rational scale to assess the harm of drugs of potential misuse, The Lancet, 2007 (Photo credit: Wikipedia)

It’s time to let scientists study whether LSD, marijuana and ecstasy can ease psychiatric disorders

Discovery of new psychiatric medication, whether for the treatment of depression, autism or schizophrenia, is at a virtual standstill. As just one example, the antidepressants on the market today are no more effective at reversing the mood disorder than those that first became available in the 1950s.

New thinking is desperately needed to aid the estimated 14 million American adults who suffer from severe mental illness. Innovation would likely accelerate if pharmacologists did not have to confront an antiquated legal framework that, in effect, declares off-limits a set of familiar compounds that could potentially serve as the chemical basis for entire new classes of drugs.

LSD, ecstasy (MDMA), psilocybin and marijuana have, for decades, been designated as drugs of abuse. But they had their origins in the medical pharmacopeia. Through the mid-1960s, more than 1,000 scientific publications chronicled the ways that LSD could be used as an aid to make psychotherapy more effective. Similarly, MDMA began to be used as a complement to talk therapy in the 1970s. Marijuana has logged thousands of years as a medicament for diseases and conditions ranging from malaria to rheumatism.

National laws and international conventions put a stop to all that. The Controlled Substances Act of 1970 declared that these drugs have “no currently accepted medical use” and classified them in the most stringently regulated category of controlled substances: Schedule I. The resulting restrictions create a de facto ban on their use in both laboratories and clinical trials, setting up a catch-22: these drugs are banned because they have no accepted medical use, but researchers cannot explore their therapeutic potential because they are banned. Three United Nations treaties extend similar restrictions to much of the rest of the world.

The decades-long research hiatus has taken its toll. Psychologists would like to know whether MDMA can help with intractable post-traumatic stress disorder, whether LSD or psilocybin can provide relief for cluster headaches or obsessive-compulsive disorder, and whether the particular docking receptors on brain cells that many psychedelics latch onto are critical sites for regulating conscious states that go awry in schizophrenia and depression.

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