Clearing The Smoke On Medical Marijuana: A Focus On Older Adults
Medical marijuana tin salve hurting too symptoms of for certain age-related diseases, simply misconceptions most it are preventing farther research.
Medical marijuana is dorsum inward the limelight due to the increased number of states that receive got legalized job of the flora every bit a possible alternative to pharmaceutical drugs that offering relief to people who endure from chronic conditions. Several studies receive got shown that medical marijuana is an effective handling for diverse illnesses, too many researchers believe in that location is a greater potential to expand its handling to disorders such every bit Alzheimer’s disease, Parkinson’s disease, cancer, too post-traumatic stress disorder (PTSD). However, question is restricted yesteryear the Drug Enforcement Administration (DEA) classification of marijuana every bit a Schedule I drug, indicating that is has no medical value too is a danger to populace health. This classification leaves researchers inward the U.S. without the powerfulness to comport double blind studies too encourages the job of mice every bit evidence subjects.
This article attempts to clear upward many of the misconceptions most medical marijuana, such every bit addiction too harmful side effects. Additionally, it examines question findings that focus on chronic diseases most mutual with the 65 too older population, including Alzheimer’s too Parkinson’s disease, arthritis, cancer, osteoporosis, glaucoma, too depression. The article concludes with a give-and-take of the possible reasons behind the DEA’s determination to oppose the legalization of medical marijuana (cannabis).
Cannabinoids: More than Just THC
A principal describe of piece of work organisation regarding the job of medical cannabis is the possible psychoactive effect, which comes from i of the cannabinoids (chemical compounds) flora inward cannabis known every bit tetrahydrocannabinol (THC). However, THC is solely 1 of 100 types of cannabinoids flora inward cannabis (Rahn, n.d.). Another type of cannabinoid, cannabidiol (CBD), is a non-psychoactive molecule that has been shown to render relief for an array of symptoms associated with pain, gastrointestinal disorders, too neurological disorders. Cannabinoids receive got dissimilar effects, depending on which receptors they bind to inward the body. Both THC too CBD are non unusual compounds beingness introduced to the body, rather they copy compounds that the human trunk naturally produces, called endocannabinoids. These compounds, whether endogenously produced yesteryear the trunk or supplied from the cannabis plant, i time activated, are taken upward yesteryear cells to maintain internal stability too health.
Other concerns are the potential for addiction too harmful side effects from medical cannabis. The results regarding addiction from using marijuana are mixed. The worst side effects come upward from smoking cannabis with THC, such every bit dry out mouth, dry/red eyes, nausea, dizziness, blood pressure level problems, hallucinations, too impaired mental functioning. Prescription drugs, on the other hand, tin last fifty-fifty to a greater extent than addictive than medical cannabis too are to a greater extent than probable to receive got harmful side effects. For example, a prescription drug called Razadyne (generic name: galantamine), used to process Alzheimer’s illness related dementia, features a listing of side effects that tin last to a greater extent than serious than the status beingness treated, including: seizures, black/bloody stool, vomit that looks similar java grounds, abdominal pain, severe dizziness, blurred vision, depression, insomnia, too loss of appetite (American Society of Health System Pharmacists, 2017). Although such side effects mightiness non last every bit serious for a younger, healthier adult, it tin last the divergence betwixt life too decease to an ailing older adult. Possible side effects for medical cannabis are mild when compared to many prescription drugs and, every bit mentioned above, the THC chemical compound that has possible psychoactive effects does non receive got to last used inward medical cannabis; in that location are dissimilar compounds that tin last used for medicinal purposes with less harmful side effects. In addition, medical cannabis does non receive got to last smoked; other options include taking it orally or using it topically.
Polypharmacy: The “Other” Drug Problem
Across the nation, nearly 50 percentage of older adults are taking upwards of 10 dissimilar medications to process chronic illnesses, many of which are non medically necessary (Maher, Hanlol, too Hajjar, 2014). This phenomenon is known every bit polypharmacy. Polypharmacy increases hazard of negative wellness outcomes, such every bit unsafe drug interactions caused yesteryear lack of geriatric instruction inward medical schools too inadequate communication betwixt physicians, every bit good every bit higher healthcare costs due to hospitalization from drug-related complications. One ofttimes overlooked polypharmacy consideration is that many prescription drugs human activeness differently inward older patients than younger ones. Influenza A virus subtype H5N1 drug that has a long half-life volition concluding fifty-fifty longer inward the older patient. With solely seven percentage of physicians trained inward geriatrics, this element tin last easily overlooked when prescribing medications to older patients. The Institute of Medicine study (2006) flora that in that location were at to the lowest degree 400,000 preventable adverse drug events every twelvemonth inward hospitals, which increased annual wellness tending costs yesteryear unopen to $3.5 billion.
So how mightiness medical marijuana assist to trim back the number of medications prescribed to older patients? Bradford too Bradford (2016) examined how implementing state-level medical marijuana laws changes prescribing patterns too patient expenditures inward Medicare Part D for Food too Drug Administration (FDA)-approved prescription drugs. They flora that inward states where medical marijuana was legal, physicians gave out 4,593 fewer prescriptions for all weather condition inward the study (anxiety, depression, nausea, pain, psychosis, seizures, slumber disorders, spasticity), except for glaucoma, too 1,826 fewer prescriptions specifically for hurting medications annually per physician. Other findings exhibit that Medicare Part D spending, for both computer program too enrollee spending, roughshod yesteryear $104.5 i 1000 1000 inward 2010. In addition, the toll savings had risen to $165.2 i 1000 1000 yesteryear 2013. Overall, they suggested that if all states had implemented medical marijuana laws, the total savings to Medicare Part D would receive got been $468.1 million.
Medical Marijuana for Various Age-Related Diseases
Alzheimer’s too Parkinson’s disease
A review of electrical flow scientific studies shows that it is possible for medical cannabis to render symptomatic relief to patients afflicted with Alzheimer’s too Parkinson’s illness too may moderate the progression of both diseases. Cannabinoid compounds receive got locomote potential therapeutic agents against Alzheimer’s too Parkinson’s illness because of their known multifaceted neuroprotective properties (Aso, Juves, Maldonado, too Ferrer 2013). So far, CB1 too CB2 cannabinoid receptors receive got been isolated for handling because targeting them may trim back neuro-inflammation too impaired memory, without causing psychoactive effects (Campbell too Gowran, 2007). Overall, manipulation of the cannabinoid pathway offers an alternative approach for the handling of Alzheimer’s illness that may last to a greater extent than effective than electrical flow handling regimes. However, to a greater extent than question is needed to examine the long-term effects of medical marijuana on these neurological disorders.
Pain Management
Older adults are to a greater extent than probable than younger adults to sense hurting due to chronic weather condition too many rely on prescription opioids for hurting management. Medical marijuana has the potential to assist block out discomfort because it binds to hurting receptors. Currently, about 10 percentage of Americans job marijuana to command hurting (Bronstein, Dhaliwal, too Leider, 2011). Influenza A virus subtype H5N1 study of adults historic menses 50 too older flora that those living inward states that allowed them to legally job medical marijuana had reduced rates of hurting too less pain-related piece of work interference (Nichols, 2016).
Arthritis
Joints naturally make cannabinoids, simply over fourth dimension with arthritis, their powerfulness to practise thence declines. Injecting cannabinoids into arthritic joints tin decrease some of the pain, inflammation, too articulation impairment caused yesteryear osteoarthritis (Biro 2016; Ruhaak, et al, 2011). Oral cannabinoids receive got been flora to give minimal to moderate relief compared to a placebo inward those with musculoskeletal pain, including rheumatoid arthritis too fibromyalgia (Biro, 2016). Influenza A virus subtype H5N1 review of eighteen studies of the medical job of cannabinoids flora that it was rubber too modestly effective for rheumatoid arthritis too fibromyalgia (Lynch too Campbell, 2011). Medical marijuana has also been flora to meliorate sleep, which is a mutual number with those with arthritis.
Cancer
Marinol, which the DEA describes every bit the existing legal shape of medical marijuana, was developed to alleviate cancer handling side effects. Marinol is metabolized yesteryear the trunk real speedily too solely 10-20 percentage of the oral dose genuinely reaches systemic circulation. By contrast, medical marijuana that is smoked is rapidly absorbed yesteryear the trunk too to a greater extent than of the medicinal compounds genuinely attain the body’s systemic circulation. Marinol also has several precautions too side effects, including seizure disorders, adverse reactions for patients who receive got had view problems, mental wellness problems, too issues with centre abuse (Mirinol.com, 2016). Trial studies receive got indicated that medical marijuana increases appetite too reduces nausea with fewer side effects.
Osteoporosis
Osteoporosis occurs when the trunk makes besides niggling bone, the trunk loses bone, or both. One inward ii women too i inward 4 men volition suspension a os yesteryear historic menses 50 due to osteoporosis (NOF. org, 2016). Cannabinoids play a primal role inward the metabolism of os (Idris too Ralston, 2010). Medical marijuana injections could assist halt os loss due to osteoporosis, simply few trials or question studies on its effectiveness exist.
Glaucoma
Glaucoma is caused yesteryear impairment to the optic nervus due to increased optic pressure level (National Eye Institute, 2016). Studies receive got flora that medical marijuana reduces pressure level within the eye, relieving discomfort for 3 to 4 hours. However, other drugs currently available mightiness salve hurting for longer. More question is needed.
Depression
The question on medical marijuana too depression is soundless inward the early on stages too most studies are based on non-human subjects. Medical marijuana has been flora to reintroduce cannabinoids into the encephalon of rats, which helps to replenish depletion too trim back chronic stress too depression. Views are mixed whether medical marijuana leads to depression or if it treats depression (Lev-Ran, 2014). Another describe of piece of work organisation most using medical marijuana to process depression is that it may trigger psychosis inward people with a higher hazard of those weather condition (Baker, 2010). More question is needed to decide if the benefits outweigh the risks too how to avoid high-risk populations.
What’s Blocking Research that May Help Older Adults?
Several organizations back upward medical marijuana such every bit the Institute of Medicine, American Cancer Society, too the American Medical Association. Additionally, inward a 2015 Gallop poll, lxx percentage favored making it legal for doctors to prescribe marijuana inward social club to trim back hurting too suffering. With reputable organizations too a bulk of people favoring making medical marijuana legal, why such opposition?
One argue for this opposition is fearfulness too misunderstanding most the consequences of legalizing medical marijuana, including making it easier for teens too kids to access the drug, driving acre nether the influence, too abuse. Studies inward Colorado too Washington receive got shown that since medical marijuana was legalized, teen rates of job receive got been unchanged (Monitoring the Future Survey, 2015). In Colorado, in that location has been a slight increment inward emergency room visits of children nether historic menses nine from accidental ingestion, however, emergency rooms too poisonous substance command centers are far to a greater extent than probable to run into children who receive got ingested mutual seat substances similar laundry detergent or crayons (Washington Post, 2016). Safety precautions tin maintain kids away from medical marijuana, much similar parents maintain children away from flavored over-the-counter medicine. Furthermore, overall arrests for marijuana receive got declined significantly inward those states, saving the scheme millions of dollars. Traffic fatalities receive got also remained largely unchanged, too i study flora a nine percentage decrease later the legalization of medical marijuana (Anderson too Rees, 2011). Regarding the potential for abuse, Wallace (2015) recommends that patients should last monitored, too receive got routine follow-ups with prescribing physicians to assess progress with treatment.
On the other hand, prescription opioids tin last unsafe or fifty-fifty deadly for people of all ages. Currently, in that location are plenty opioids prescribed each twelvemonth to position a bottle inward every household. Opioids tin last dispensed every bit pills, patches, or a flavored lollipop. The charge per unit of measurement of children hospitalized for opioid poisoning increased 165 percentage from 1997 to 2012, too the charge per unit of measurement of toddlers beingness hospitalized has to a greater extent than than doubled (NPR, 2016). Overall, opioid-related fatal poisonings receive got quadrupled over the concluding ii decades (CDC, 2011). In 2010, prescription opioids were responsible for almost lx percentage (16,651) of all deaths due to drug overdoses inward the U.S. ( Jones, Mack, too Paulozzi, 2013). By contrast, in that location has never been a reported overdose due to marijuana (medical or otherwise).
Another barrier is marijuana’s federal classification. Marijuana is classified every bit a Schedule I drug—in the same shape every bit heroin. This classification makes it hard for whatever question to last conducted on the drug legally. In August of 2016, the DEA i time once to a greater extent than rejected the chance to reschedule marijuana to a Schedule II drug—a classification that would allow for to a greater extent than research. As Ingraham of the Washington Post explains, “The FDA has never approved whole flora marijuana every bit a drug… most drugs the FDA approves of are private chemic compounds, non plants. Penicillin is an FDA-approved drug, for instance. The mold it’s derived from is not.” He goes on to say that, “… the DEA cannot alter the legal status of marijuana unless the FDA determines it has a medical use. The FDA cannot decide it has a medical job inward part because of the highly restrictive legal status of the drug.” Pharmaceutical companies also stand upward to lose net from a alter inward marijuana’s classification. Insys Therapeutics, for example, is the maker of a synthetic THC drug too of late contributed $500,000 to oppose legislation inward Arizona that would allow for total legalization (Washington Post, 2016).
Some states receive got enacted their ain laws on marijuana that largely back upward physicians’ standpoints that medical marijuana provides medicinal benefits for their patients. Other suggestions include keeping marijuana every bit a Schedule I drug, simply create an allowance for medical marijuana research, or to amend the Controlled Substances Act.
The miseducation most medical marijuana over the concluding 50 years has been detrimental to the progression of question into the effects it may receive got on countless diseases. With a rapidly aging population comes an increment inward chronic disease. If in that location is a gamble that medical marijuana is every bit effective too cheap every bit some recent studies receive got shown, too provides hurting relief that curtails the national epidemic of prescription opioid overdoses, thence people with these debilitating diseases deserve the selection to select medical marijuana every bit an alternative. However, until the DEA changes medical marijuana classification from a Schedule I drug, researchers volition locomote on to confront multiple hurdles inward documenting the total reach of its benefits.
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| - Dr. Lisa Rill |
| Dr. Lisa Rill currently works every bit Research Faculty III at the Claude Pepper Center at Florida State University. Her question includes identifying ideal assisted living facilities, long-term tending undertaking forcefulness issues, nursing abode hazard scores, Medicare/Medicaid, too universal blueprint for senior housing. | |
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A version of this article, Clearing the Smoke on Medical Marijuana: Influenza A virus subtype H5N1 Focus on Older Adults written yesteryear Dr. Lisa Rill too Dr. Lori Gonzalez originally appeared inward CSA Journal Journal 68 - Volume 1, 2017.
