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Ask the Pharmacist

By: Ron and Marla Chapleau
June 18, 2017
 
 

Q: Last week, the Ask the Pharmacist article touched on what medical marijuana is. Can you tell me what sorts of ailments it can be used for and what side effects might be expected?

A: As mentioned last week, marijuana will not cure any disease or disorder but, rather, it can help provide relief from symptoms. In the case of nausea and/or vomiting due to chemotherapy, the current first-line agents, such as ondansetron (Zofran) or prochlorperazine (Stemetil), are still recommended as the first drugs to try.

For people whose symptoms are not adequately controlled, cannabinoids can be a suitable add-on therapy. While it is true that marijuana can also cause nausea and vomiting as a side effect, it does seem to help control chemotherapy-induced nausea according to anecdotal records (not based on studies but more on recipients saying it helped).

The THC (tetrahydrocannabinoid) component of marijuana has shown moderate effectiveness in the treatment of neuropathic pain and can be considered as an add-on medication. As for cancer pain, many people have tried marijuana since their traditional pain management was ineffective and/or the side effects were too cumbersome. A study done at a University in Israel discovered that those people who opted for marijuana for the treatment of their cancer pain experienced a significant reduction in pain within four months.

Spasticity and tremor often accompany Multiple Sclerosis (MS), and marijuana has been shown to be effective at reducing those symptoms when either smoked or taken orally. Cannabinoids may also help alleviate the pain associated with MS and minimize the involuntary loss of urine that some experience.

Smoking marijuana cigarettes seems to stimulate the appetite of AIDS patients, resulting in an increase in caloric intake and weight gain. The key word here is “seems” since studies were done using only the pharmaceutical version of cannabis and not medical marijuana. Any promise shown with marijuana would, once again, be anecdotal.

Marijuana can decrease the intraocular pressure within the eye, which would make one think it might be effective in treating a condition called glaucoma. However, this decrease is very short-lived and comes with a major downside. Marijuana also decreases the blood supply to the optic nerve which can result in other visual impairments; therefore, it is not recommended for glaucoma despite what you might read on the Internet.

There was a study done in the United States, looking at using the CBD (cannabidiol) component of marijuana in the treatment of epilepsy which did not respond to conventional drug therapy. At doses of 20 milligrams (mg) per kilogram (kg) per day and 10 mg/kg/day, there was a 42-per-cent and 37-per-cent reduction, respectively, in drop seizures per month as compared to placebo (17 per cent).

All of these ailments require more studies done to firmly establish the effectiveness, but so far, marijuana looks very promising in this area. Along with whether medical marijuana is likely to work for a particular ailment, the risk of side effects needs to be weighed against these possible benefits to determine if it is right for you.

In terms of side effects, the following are commonly associated with its use: dry mouth, red eyes, nausea and vomiting, dizziness/drowsiness, euphoria, altered judgement, anxiety, paranoia, psychosis, rapid heart rate, euphoria (“high” feeling) and more. With respect to anxiety, it has been shown to be strongly associated with marijuana; short-term use can trigger anxiety and panic attacks, and high doses can worsen an existing anxiety condition.

As well, youth are more susceptible to experiencing psychosis and more at risk of developing cannabis-related psychosocial harm when compared to adults.

Chronic or long-term use of marijuana can lead to a lack of interest or enthusiasm, impaired memory, chronic psychosis and heart attacks, to name only a few. The cognitive impairment develops slowly but becomes clinically significant after about two decades of use.

If smoking the marijuana, you have to consider the effects on the lungs as well; it has been determined that smoking three to four marijuana cigarettes equates to 22 tobacco cigarettes. Bullous emphysema (large air spaces within the lung tissue), chronic bronchitis, shortness of breath, pneumonia, etc., are all possible effects on the lungs.

Recently, marijuana has been possibly linked to testicular cancer in men. The risk for lung cancer remains unknown; however, abnormal cell growth in the lung has been noted among cannabis users which might be due to the fact that marijuana cigarettes contain 70 per cent more carcinogens when compared to tobacco.

Cannabis hyperemesis (severe cyclic nausea and vomiting) is becoming an increasingly-recognized problem with marijuana use, likely due to an increase in its use. On a positive note, this seems to gradually resolve over a few days to a week once the marijuana has been discontinued.

As stated earlier, more studies are needed to determine both effectiveness and side effects; under-studied does not equal safe.

For more information about this or any other health-related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination. Also check the website at www.gordon-pharmasave.com/ and the Facebook page at www.facebook.com/GordonPharmasave/?fref=ts

 

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