6 minute read
SENIORS + CANNABIS
CANNABIS SHOULD BE CONSIDERED A FIRST-LINE TREATMENT IN SENIORS BY DR. DEBRA KIMLESS
I was asked what makes seniors different from any other adult when it comes to medical cannabis? I thought about this for a while. Seniors (not just our children) should be considered our future, especially when it comes to accepting cannabis as medicine. Seniors have the good fortune of having life experiences. Some experiences make them question current thoughts and conventional wisdom. This is especially true when it comes to their health and healthcare. Many seniors have serious repercussions from their past choices, even if they were told by conventional teachings that their choices were good ones. They are now paying a heavy price in the form of poor health. Seniors spend their hard earned and well-deserved time, energy, and money going from doctor to treatment facility to consultant to pharmacy only to continue to experience poor health and a poor quality of life they did not count on. In the US, people over the age of65 are taking an average of5 different prescription medications a day. This does not include the over-the-counter medications that are also being used. This is a staggering statistic! These medications are not without risks. Side effects from pharmaceuticals are well-reported, and often, patients are prescribed other medications to counteract the side effect ofa medication, only to require another medicationtocounteractthesideeffectofthedrug usedtocounteractthesideeffectoftheinitialdrug. By the way, there are no double blind randomized trialsstudying thesafetyorefficacyordoseeffects of multiple pharmaceutical drugs taken by a single person. How can this be? The FDA only approves single molecules for single indications. No one has ever questioned or examined what happens when a human body is given a panoply of pharmaceuticals
in perpetuity. We just assume that it is okay. This is the common practice of modern medicine and when written here in black and white seems absurd. Frustrated, many seniors are open to new methods of regaining health beyond the traditional pharmaceutical route. This means embracing a lifestyle method that focuses on health and well-being by putting themselves and their healthcare first. This method is described as the therapeutic order of healthcare. Imagine the therapeutic order as a pyramid (think of the old food pyramid) where the base of the pyramid consists of lifestyle elements that include nutrition—especially plant-based eating— exercise, socialization, and sleep. If injury or illness occurs after a proper foundation is established then the next step up the pyramid is discovering the root cause, and then addressing the cause with the least invasive and least riskytherapies first. So this next step on the pyramid includes for example: physical therapy, psychological therapy, meditation, acupuncture, massage, and herbal remedies. The remainder of the pyramid includes, in a stepwise manner, the traditional medical therapeutic modalities starting with over-the-counter medications, then pharmaceutical drugs and finally surgical interventions. As you can see in this model, the traditional medical treatment options should be the last considerationsand notthefirstlinetreatment.
So where does medical cannabis fit into the therapeutic order pyramid? It should be considered a first-line therapy along with other herbal treatments and before pharmaceuticals. How can this be? Cannabis has been illegal for decades and is still federally illegal. It is a schedule 1 drug, which means it is in a category of drugs that are considered highly addictive and have no medicinal value.
Sadly,cannabishasbeenvilifiedforsocialandeconomic reasons, and the schedule 1 designation has nothing to do with whether or not it has medicinal value. In fact, cannabis has been used safely and effectively as a medicine for thousands of years. Cannabis medicines were even included in the US Pharmacopeia until 1941 when cannabis prohibition replaced alcohol prohibition. This means that up until 1941, pharmacists and physicians would have the option to treat patients with cannabis medicines for all kinds of indications. Our US government even has a patent on cannabinoids as antioxidants and neuroprotectants that was issued in 2003 (patent number US6630507B1). So clearly, cannabis does have medicinal value. We humans (and almost every other living creature) have a biological system in our bodies called the endocannabinoid system (ECS). The ECS governs every other biological system in our body, and its purpose is to maintain a physiologic balance. The word endocannabinoid is a combination where “endo” means from within and “cannabinoid” refers to the chemicals our own body makes—which are similar to the chemicals that the cannabis plant makes. The ECS gently tries to keep everything in check. When injury or illness strikes, supplemental help is in order; that’s where cannabis comes in. The chemicals in the cannabis plant interact with our ECS to help regain and maintain that physiological balance. Cannabis medicines anditsinteractionswiththeECScanbeabeneficial treatment for a whole host of medical indications. Usingcannabisasafirst-linetreatmentmayprevent having to take many pharmaceuticals or reduce or replace them entirely. Does that mean seniors have to smoke something or feel intoxicated or high in order to use this herbal remedy? Absolutely not! Cannabis is different from most traditional pharmaceutical remedies in that there are many ways to take it and there are differentamountsofcannabischemicalsand combinations that make up cannabis medicine. Inhalation is the most commonly thought of method, but it is certainly not mandatory. In fact, surveys report that most people over the age of 40 prefer methods other than inhalation. The medical issue and patient and physician preference will help guide the best method of administration. Topicals or under the tongue preparations are popular methods of administration. As an example, for a localized pain, topical
cannabis creams and ointments can be used effectively. Because it stays on the skin there is no intoxication or feeling “high.” The under the tongue preparations, like tablets or tinctures, allow the medicine to be absorbed quickly with a fast onset of action without having to smoke. These types of preparations are easily titrated so you can start at low doses and see the effects within 30 minutes and take more only if needed and without risking intoxication or that feeling of being high.
So, can cannabis be used freely without concern? The answer is no. Just like with all medicines, cannabis and its constituents is a medicine. Medical cannabis can interact with other medications, especially if you are a patient taking many different pharmaceutical medications. Although cannabis has been shown to be a much safer medicine than traditional pharmaceutical drugs, and with less toxic side effects, cannabis including CBD must be used with care. My recommendation is to talk to your physician or healthcare provider and discuss your interest in taking cannabis medicine. Request that they help guide you so you can maximize the potential benefits of cannabis medicine for your specific condition. The goal is always to do no harm, to improve health, and embrace a better quality of life. Seniors deserve to maximize their valuable time pursuing the things they want to do without being side-lined by their conditions or the treatments. Cannabis can help achieve this goal.
