Cannabis, Alzheimer's and dementia

By Jessica Edwards, Herbalist correspondent

All humans eventually face the reality that their lives will end.

For those of us who have been afflicted with or affected by Alzheimer’s disease or dementia, the end can be brutal, for caregivers and patients alike.

With an eye toward hope, researchers now are finding that cannabis might hold the key to unlocking an effective treatment for — and possibly the prevention of — diseases of the brain that come for many with old age.

Alzheimer’s is a progressive brain disorder, getting worse over time. It leads to memory loss and can impair a person’s ability to manage daily tasks; simple thoughts, such as “socks go on feet,” are lost in people in the advanced stages of the illness.

The disease affects more than five million Americans and is a leading cause of death, according to the National Institute of Health; it is also the most common cause of dementia. The institute defines dementia as the loss of cognitive functioning — thinking, remembering and reasoning — and behavioral abilities to such an extent that it interferes with a person's daily life.

The most promising area of the research is in treating the agitation and aggression present in many people living with these brain diseases, as seen in studies in the United States and Israel, in particular.

There also have been studies done using genetically modified, or transgenic, mice. Scientists have added human genes to the mice to better understand the mechanics of the diseases and medications that treat them.

Israel is leading the charge in this new area of research with numerous studies examining the potential link between medical cannabis oil and improved treatments for Alzheimer’s and dementia patients.

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Treating symptoms

Many people living with these conditions experience bouts of aggression. This can cause injury to themselves and their caretakers, as well as taking an emotional toll on everyone involved.

In 2016, a group of researchers in Tel Aviv, Israel, published a study in the Journal of Alzheimer's Disease, showing that cannabis had a positive effect on the behavioral and psychological symptoms of dementia. They found a significant decrease in delusions, agitation, irritability, apathy, sleep and caregiver distress.

Their conclusion was that adding medical cannabis oil to Alzheimer's and dementia patients’ medication regimen is safe and a promising treatment option.

Disease prevention

While treating symptoms such as these could be the most promising area of research, the most exciting is the potential cannabis might hold for the prevention of these disorders.

For instance, another group of researchers is examining the potential cannabis might hold as a neuroprotectant. This means that it might provide mechanisms for keeping the human brain healthy, destroying plaque that builds up in the brain and protecting healthy cognitive functions.

Specifically, cannabis reduces beta amyloid proteins in the neurons in the brain, according to a 2016 study from the Salk Institute in California. This means cannabinoids remove the toxic proteins that cause the plaque buildup that is believed to contribute to Alzheimer's.

Salk researchers found that high levels of the protein were linked with inflammation and higher levels of neuron degeneration. They found that exposing these cells to cannabinoids reduced the toxic protein levels and also stopped the inflammation response of the nerve cells. This allows the nerve cells to survive and function.

Caregiver perspectives

Gillian Jones is a longtime employee of The Berkshire Eagle and its parent company New England Newspapers Inc., the publisher of The Herbalist. A photographer, Jones is also the primary caregiver to her mother, Rita, 86, who has dementia and suffers from a multitude of related maladies, including arthritis, back pain, knee pain, swelling in her legs, lethargy, depression and anxiety.

Jones told The Herbalist that, even though her mom takes five different prescription meds, “overall, I was not satisfied with her pain management medications. Nothing seemed to really help”.

Looking for an alternative, Jones first turned to CBD oil.

“She didn't like the taste. The capsules were hard for her to swallow and felt a lot like more medication,” said Jones.

She then tried some CBD gummies, purchased at the Wild Oats Coop in Williamstown, as well as THC gummies from Berkshire Roots in Pittsfield and THC gummies or chocolate from Silver Therapeutics in Williamstown.

“The dosing is very conservative. I started with half and waited to see how she responded,” said Jones. “A little THC goes a long way, and you absolutely must be patient. I think that people have negative experiences because they take too much, because they don't feel anything right away.”

The Herbalist asked Jones how has it affected her mom’s daily life.

“Well, for starters, the swelling in her legs has decreased tremendously. We have not had to use compression socks in months. Furthermore, she seems to have more mobility when she is walking around. She is still slow but seems to be moving more easily and rarely complains about knee pain, as she did before taking daily CBD,” said Jones.

“When she takes the THC, she perks up. It reminds me of the movie, ‘Awakenings.’ She is more engaged with people, primarily her caregivers. She is talkative. She seems less anxious. She laughs. Even the foot nurse who visits quarterly noticed a difference. She said before, ‘She was just there.’ This last visit, she was chatty and interacting with the nurse.”

Jones said that, while her mother still experiences pain at times, she believes it is greatly reduced with the daily CBD and occasional THC.

Moreover, Jones’ mom takes the edibles without conflict, unlike her regular prescription medications, which she often refuses to take, said Jones. “I also think that she experiences less anxiety.”

“While sometimes she does act ‘high,’ as it were, when she takes the THC, she appears happy and comfortable, and frankly that is really all I want for her at this point,” said Jones.

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Changing attitudes

Attitudes toward cannabis within the medical community are beginning to change, as more research and studies like these are published.

Sherri Tutkus is a registered nurse, founder of the Green- Nurse Group, founding member of the Cannabis Nurses Network and a member of the American Cannabis Nurses Association. Having worked with Alzheimer's patients, she has seen firsthand that starting cannabis therapy earlier in the progression leads to better results than when started in the later stages of the disease.

Tutkus said that other countries might be ahead of the curve with research, but actual change will be affected closer to home with the help of medical professionals and advocates.

“Nurses here in the USA are going to be the game changers in the industry, because patients trust us,” Tutkus said.

She believes the key to understanding how cannabis affects the body and brain lies in the endocannabinoid system.

The endocannabinoid system is a series of receptors spread throughout the body. There are two known receptors that interact with cannabinoids, CB1 and CB2. CB1 receptors are found mostly in the brain and to a lesser extent, the body. CB2 receptors are located mostly within the immune system and the organs associated with it, such as the spleen. Cannabinoids work with these receptors like a lock and key.

The study of this interaction will be the foundation of all research into the potential cures, treatments, and therapies cannabinoids might provide, said Tutkus. Researchers, medical professionals and regulators all agree that cannabis requires expanded study with control groups that do not rely on self-reporting by patients.

With research well on its way in other countries and gaining momentum within the US, discoveries, understanding and treatment protocols are expected to start moving at an increasing pace.

“Nurses are going to be required to learn and know the endocannabinoid system in order to pass their nursing board examinations,” said Tutkus.