Parts 1 and 2 are also online.
From July and October.
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Broken System, Broken Health
Most populations worldwide, particularly those in North America, Europe, and the "West," have suffered a severe nutritional deficiency for close to 100 years. This nutritional deficiency is just now being recognized by medical science.
The cause of the deficiency is not so much simple ignorance, as was the case with scurvy (a disease caused by vitamin C [ascorbic acid] deficiency), as it is the result of scare tactics, propaganda, a political agenda, and unnecessarily restrictive legislation promulgated by the US government. The United States government policy regarding cannabis has affected the legality of cannabis and cannabinoids in virtually every nation of the world.
When the US demonized cannabis and passed knee-jerk political legislation created and imposed to satisfy the greed, racist agendas, and desire for power of a few wealthy and elitist individuals, knowledge of its health benefits all but died. Most Western nations followed suit in trying to stamp out the "evil weed." Ignorance of the body's need for cannabinoids and vehement, almost hysterical propaganda permitted, no, even forced cannabis to be "sent underground." People who had nothing more in mind than their own vested interests were allowed to control the health of nations.
Of the over a hundred cannabinoids thus far identified, the two most researched are phytocannabinoid tetrahydrocannabinol (THC) and cannabidiol (CBD). After the illegalization of cannabis, those who grew the plant were growing it to meet the demand of the illicit market – people who were looking to get high. They selectively bred their plants to increase THC, the cannabinoid best known for its psychoactive properties. The benefits of cannabinoids were no longer available to law-abiding citizens. And for those who partook of the more psychoactive cannabis, the reduction in CBD probably altered its health benefits and exacerbated its risks.
Over the past two decades, word of cannabis's almost miraculous properties leaked out, first in a trickle and then in an ever-stronger flow, as a few brave and desperate souls defied the law and risked imprisonment, trying to alleviate intractable pain and even to cure their "untreatable" cancers with cannabis. At the same time, scientists began to discover the role that cannabinoids play in human health. Health benefits, known for millennia and then lost, are being rediscovered and verified through application of the scientific method.
Research has lifted the curtain on the endocannabinoid system, revealing that it is not just a strange, vestigial appendix our bodies no longer need. No. What we are discovering is that the health of the endocannabinoid system, at its root, is critical to the health of the whole human organism. We find ourselves amazed that "tickling" these tiny endocannabinoid receptors can awaken an internal defense system intelligent enough to seek out and reverse inflammation (which some researchers believe to be the root of almost all illness), precise enough to restore blood sugar balance, and strong enough and discerning enough to destroy cancer cells and to leave healthy cells undamaged.
People have long dreamed of finding the one drug that will cure everything. That one drug will not be found in a medicine cabinet or a laboratory. Drugs are chemicals and, in and of themselves, chemicals are not intelligent. They cannot independently change and adapt to their environment. They cannot identify a disease, decide what they need to do, or plan and execute an attack. No, there will be no magic bullet miracle drug. And no, we are not claiming that cannabinoids are that miracle drug.
Cannabinoids are no more intelligent than any other chemical. We are not sure if they have the ability to cure cancer directly. We suspect that they trigger the cannabinoid receptors and if our bodies did not have cannabinoid receptors, we would be like the no-cannabinoid-receptor rats. No receptors. No response. But with receptors, cannabinoids become tools – keys – for activating the receptors and starting the chemical cascades that restore immune balance. The ubiquitous stress we face today – from the constant media stream of disaster, terrorism, and unrest; the phenomenal number of synthesized chemicals to which we are exposed; our highly-processed, unbalanced diets; and, for most of us, our sedentary lifestyle divorced from nature (and this list is by no means comprehensive) – drains our endocannabinoid reserves.
Clinical Endocannabinoid Deficiency Syndrome is endemic and manifests as autoimmune disorders, neuro-degenerative diseases, migraines, cancers, arthritis, allergies, and a high number of other inflammatory diseases. In fact, a growing number of physicians and researchers are hypothesizing that all diseases are at least in part related to an endocannabinoid deficiency.
The Pharmacologic and Clinical Effects of Medical Cannabis
A growing number of states are passing laws to legalize cannabis. Patient use is increasing as people discover the benefits of cannabinoid therapy. As this drug becomes more "mainstream," it is increasingly important that physicians, other medical professionals, pharmacists, hospitals, and clinics understand the benefits and risks associated with medical cannabis.6
In 1851, the United States Pharmacopeia listed marijuana as a legitimate medical compound. In 1937, the US went against the American Medical Association's vociferous objection and passed the United States Marihuana Tax Act of 1937. It was not until 1941 that marijuana was "de-listed" from the Pharmacopeia.6
Today, a strange, quixotic schism exists. Cannabis is considered to be a schedule 1 drug at the federal level; but, in half the states in this country it is prescribed, orally sprayed, vaped, inhaled, and eaten … and, in some cases, sold, not through pharmacies, but through government-sanctioned and licensed dispensaries. Some patients grow their own. And some patients participating in US medical cannabis studies receive "a cannabis strain or blend grown and created under contract at a federal research farm at the University of Mississippi."6
Two prescription cannabis-derived medicines marketed in the United States and Canada are dronabinol (schedule III – sold in the US as Marinol) and nabilone (schedule II – sold in the US as Cesamet). Both are delta-9 tetrahydrocannabinol (THC)-based (the component of cannabis best known for its psychoactive properties) and were approved in 1992 to treat cancer chemotherapy-induced nausea and vomiting. In 1993, the FDA approved dronabinol for a second condition – to reverse acquired immune deficiency syndrome anorexia.6
Starting around 2010, nabiximols11 (brand name Sativex), a combination of THC and CBD derived from two strains of Cannabis sativa, was approved in Canada, New Zealand, and eight European countries for treating unresolved cancer pain, and the pain and spasticity of multiple sclerosis pain. The oral spray delivers a dose of 2.7 mg THC and 2.5 mg CBD. Sativex is getting a "fast track" review from the FDA for treating cancer pain in the US.11
A number of studies have shown that nabiximols is highly effective for multiple sclerosis patients for the treatment of spasticity, spasms, bladder problems, tremor, and/or pain. Of patients treated with nabiximols, 40 percent achieved more than 30 percent improvement in symptoms, with only mild intoxication and no significant adverse cognitive or mood effects.11 However, the annual cost of Sativex in the countries where it has been approved is high, around $16,000 US.12
The pharmacologic responses patients experience with natural cannabis vary based on strain and quality of the herb (how fresh is it, how was it processed, and how has it been stored), formulation (the ratio of various cannabinoids and terpenoids will vary by strain and by quality handling issues; some of the components are more volatile and more easily destroyed or degraded), dose, method of administration, and patient physiology. Cannabis has proven effective for treating a wide variety of pain: neuropathic, chronic, and postoperative, and pain related to specific medical conditions such as fibromyalgia, rheumatoid arthritis, multiple sclerosis, cancer, and human immunodeficiency virus–associated sensory neuropathy.13
(THC and CBD)
THC is highly lipophilic (meaning, it tends to bind with fat in the body, which will slow its elimination). The pharmacokinetic half-life of the distribution phase is 0.5 hour; half of the drug taken will be disseminated throughout the body within half an hour. The half-life for the terminal phase varies substantially by patient with a mean of 30 hours; half of the drug taken will be eliminated within 30 hours. Cannabidiol is also lipophilic, but its terminal half-life is nine hours.6
Medical cannabis users most commonly ingest the drug through smoking. Cannabis smokers inhale about 50% of the THC in the herb. The rest is lost to heat or not inhaled, and up to 50% of inhaled smoke is exhaled. Some of the smoke retained in the lungs is metabolized locally. With all these "losses," the estimated bioavailability of a smoked dose of THC falls somewhere between 10 to 25 percent of the total THC in the cannabis. The absorption of smoked THC, the half-life of the distribution phase, and the half-life of the terminal phase parallel those of intravenously administered THC.6
Cannabis vaporization is growing in popularity among medical cannabis users because it is perceived as a cleaner, safer way to take the drug. Cannabinoids are volatile and vaporize at a far lower temperature than that required for burning plant matter. Heated air drawn through the cannabis aerosolizes the cannabinoids so they can be inhaled without the user having to inhale smoke.6
In clinical studies, the bioavailability of orally-administered THC ranges from 5 to 20 percent. Users often receive even less than that because stomach acids can degrade the drug and the liver will metabolize a significant portion of the drug before it ever reaches circulation (first pass effect). Compared to intravenous or inhaled administration, peak THC concentrations are delayed in oral administration, taking as long as one to three hours. This can make it difficult to determine the appropriate dose.6
Attempts to normalize THC dosage have been challenged by dosage variations and aberrations, routes of administration, and the high likelihood of developing tolerance in as few as four days of daily use (a risk practically nonexistent in intermittent use).6
Different patient populations respond to medical cannabis in different ways – based on individual hormonal variations, lifestyle differences (e.g., smoking), other health issues (e.g., cannabis can increase morbidity and mortality for patients with cardiovascular issues; cannabis can exacerbate psychiatric problems), and the interactions of cannabis with other medications the patient is taking.6
Consistent effects of THC, regardless of the route of administration, include heart rate increases of an average of more than 19 beats a minute, a feeling of being "high," decreased alertness, and decreased motor stability. However, due to unpredictable delays between serum (blood level) concentrations and the onset of the physiological effects (impairments), the two cannot be directly correlated, as is so often done with alcohol consumption.6
Further studies are needed to develop dosing regimens that produce more consistent and predictable results.
Clinical Effects of Medical Cannabis
Medicinal cannabis has been used to treat cachexia, cancer, glaucoma, human immunodeficiency virus infection/acquired immune deficiency syndrome, muscle spasms, seizures, severe nausea, and sleep disorders.6
Cachexia, a devastating metabolic disorder that affects some 9 million people worldwide, involves excessive weight- and muscle-loss. It is seen in the late stages of almost every major chronic illness and affects 16–42% of people with heart failure, 30% of those with chronic obstructive pulmonary disease, up to 60% of people with kidney disease, and as many as 80% of people with advanced cancer.14
Part 4 coming in December...
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Sir Jonn Desnoes, OMD, MD, PhD, is a physician, who is board certified in homeopathy and Chinese medicine. He is a former nationally syndicated radio talk show host, writer, researcher, athlete, and visionary. He was knighted for his humanitarian work as a medical missionary.
Jonn became interested in the study of cannabis and its health-restoring properties when a friend gave him a bottle of CBD hemp oil. He had suffered with intractable back pain for years as a result of multiple sports injuries incurred over 30 years as an athlete. Within 20 minutes of taking the CBD oil, his excruciating pain stopped. He has found that, as long as he continues to take the oil, he is virtually pain-free.
Sandra Kischuk, BSBA, MSMIS, MCPM, is a writer, editor, life coach, Toastmaster, and master gardener. Author of Fighting the Dragon: How I Beat Multiple Sclerosis, Sandra's writing interests include fiction, non-fiction, poetry, scripts, and other people's résumés. She has written web content for physicians, informational/marketing literature for attorneys, and continuing education courses for dental professionals, and edited professional communications and doctoral theses on subjects as diverse as religion, education, engineering, and psychology.