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Medicinal marijuana, also known as medical marijuana, is still controversial, and by many people it is even treated as a dangerous drug. Meanwhile, it is known that medicinal marijuana is invaluable in many cases: it helps relieve chronic pain, it can be helpful in the treatment of fibromyalgia, multiple sclerosis, epilepsy, autism spectrum disorders or rheumatic diseases. What healing and therapeutic properties does medicinal marijuana have? How is the treatment going, who can prescribe medical marijuana and are there any contraindications to its use?

What is medicinal marijuana (medical marijuana)?

Medicinal marijuana (medical marijuana)is dried hemp, a vegetable pharmaceutical raw material with a very rich composition. Drought is made from hemp flowers that are grown under strict control - indoors, without the use of pesticides or pesticides.

As the drug explains. Albert Jeznach, what distinguishes medical marijuana from recreational marijuana is validation, i.e. the assessment of the composition and concentration of active substances. This means thatthe composition of each batch of medicinal marijuana is strictly definedand controlled at every stage of production - the concentration of active ingredients is within a strictly defined range. Each batch of the drug is tested without exception - those that do not meet a specific standard are not marketed.

Medicinal marijuana - chemical composition and strains of medical marijuana

The composition of medical marijuana is very rich - the dried flower contains almost 500 different substances, including cannabinoids, and also incl. terpenes, i.e. substances that can modify the action of cannabinoids.

Medicinal marijuana ingredients:

  • THC (tetrahydrocannabinol)- affects the receptors in the brain, causes, among others, euphoria and pain reduction, has the ability to reduce nausea and vomiting, improves appetite, reduces spasticity
  • CBD(cannabidiol)- reduces some side effects associated with high doses of THC, alleviates the symptoms of certain diseases, e.g. RA, anxiety syndrome, post-traumatic stress disorder
  • CBG (cannabigerol)- has anti-inflammatory effects
  • THCV (tetrahydrocannabivarin)- relieves symptoms of epilepsy and Parkinson's disease
  • Terpenes:
  1. terpinolene - has antibacterial, antifungal and reclaxing properties
  2. limonene - has anti-depressant and anti-anxiety effects
  3. linalool - has anti-inflammatory and analgesic effects
  4. mircen - anti-inflammatory and relaxing
  5. pinene - has anti-inflammatory properties, reduces stress, dilates the bronchial tubes
  6. caryophyllene - has an analgesic and anti-inflammatory effect
  • Alkaloids
  • Flavonoids.

Cannabinoids are considered the main healing ingredients of medical marijuana. More than 100 have been identified so far, and the ones we hear about the most and have the most important therapeutic effects are THC and CBD.

The treatment primarily uses two marijuana strains: a sativa strain and an indica strain, as well as numerous hybrid varieties.

Medicinal marijuana - properties and application in medicine

Numerous scientific studies have proven thatmedicinal marijuana has a number of healing and therapeutic properties , and thus - widely used in medicine.

As the drug explains. Albert Jeznach, the properties of a given strain are primarily influenced by the proportions between the most important active substances of medicinal marijuana - THC and CBD.

Depending on the specific combination of these substances (present in the inflorescence), the variety will have a stimulating effect (this effect is typical for THC-rich sativa strains) or relaxing and relaxing (characteristic for indica strains). The selection of the appropriate variety and dose depends on the patient's needs.

The list of diseases and disorders for which medical marijuana is used is very long and growing.

Medical marijuana can be considered in the event of failure of the treatment of choice, i.e. with documented effectiveness, in the following cases:

  1. treatment of chronic pain, including cancer pain and pain resulting from nerve damage after chemotherapy or radiotherapy
  2. as an adjunct treatment for certain types of cancer (e.g. to alleviate the side effects of chemotherapy)
  3. migraines
  4. myasthenia gravis
  5. fibromyalgia
  6. spasticity
  7. drug-resistant epilepsy
  8. Parkinson's disease
  9. Alzheimer's disease - THC slows down the degradation of brain cells, slowing down the development of the disease
  10. dystonii
  11. autoimmune diseases
  12. asthma
  13. multiple sclerosis
  14. borreliosis
  15. anorexia
  16. bulimii
  17. anxiety
  18. depressed
  19. bipolar disorder
  20. sleep disorders, including insomnia
  21. autism - helps to control anxiety and aggression
  22. ADHD - facilitates focus and concentration of attention
  23. PTSD (Post Traumatic Stress Disorder)
  24. inflammatory bowel diseases (alleviating inflammation)
  25. IBS (Irritable Bowel Syndrome)
  26. Crohn's disease
  27. glaucoma
  28. Sjögren's syndrome, otherwise dryness syndrome or Mikulicz-Radecki's disease
  29. social phobias
  30. OCD (Obsessive Compulsive Disorder)
  31. alcoholism and other addictions
  32. HIV / AIDS
  33. dystonii
  34. Huntington's chorea
  35. of Tourette's syndrome
  36. ataxia
  37. dyskinesia
  38. tężyczki
  39. bruxism
  40. psoriatic arthritis
  41. chronic fatigue syndrome
  42. spine injuries
  43. Ehlers-Danlos syndrome
  44. mucopolysaccharidosis
  45. Hashimoto's diseases
  46. AZS
  47. diabetes
  48. excessive muscle tension
  49. eating disorders
  50. hepatitis C.

How is medicinal marijuana used?

Medicinal marijuana is in the form ofdried material, which is applied by vaporization - inhaling compounds that evaporate when the cannabis is heated to the right temperature. - Heating, not burning, because during the combustion of dried material, at a temperature of about 600 degrees C, a significant part of active compounds is lost, including even 30 -50 percent. THC - underlines the drug. Albert Jeznach.

As the expert explains,dried hemp should be ground (not grinded) in a herb grinder , and then placed in the heating chamber of the vaporizer (a medical device available, among others, in pharmacies) . During the gradual heating, the cannabinoids and terpenes are released from the herb, which are then inhaled by the patient in the form of vapor.

It is important that during heating, no toxic substances are released (e.g. carcinogenic compounds or tar substances) that are formed during the combustion process. The optimal vaporization temperature is between 180-200 degrees C, usually it is 186 degrees C. In specific cases the temperature may be lower or higher.

The first effects of medicinal marijuanaapplied by vaporization are quick- after 5-10 minutes the patient feels its therapeutic effect, which is possible thanks to the omission of the digestive system - active compounds pass through the lungs directly into the blood. The effect lasts for the next 2-4 hours.

As the drug explains. Albert Jeznach,During the first month of treatment, the dose ofmust be determined using a technique called titration, which involves slowly increasing the dose until it is optimal for the patient. It is a compromise between the action of the drug and side effects.

The patient receives recommendations on how to gradually increase the dose of the drug and what to pay attention to, as well as how to independently divide the dried hemp so that it does not lose its properties. Titration allows the determination of the minimum effective or maximum tolerated dose of the drug. After the end of this period, the effectiveness of the treatment can be initially assessed. A full evaluation of the treatment effectiveness is possible after three months of using the full dose.

Principles of medical marijuana treatment

How does a doctor schedule medical marijuana treatment? Do I need to do any additional tests before starting treatment? As the drug explains. Albert Jeznach,there are no studies dedicated to the use of medical marijuana , but before starting therapy, the doctor should be able to see the results of morphology, liver enzyme tests and kidney function tests, including creatinine.

- The most important thing is the history and diagnosis of the underlying disease. On this basis, it is possible to determine what is the greatest problem for the patient - whether pain, nausea and anorexia resulting from chemotherapy, or sensory disturbances, or neuropathy. Life-saving chemotherapy or radiation therapy can damage nerves, and sometimes I have patients who have already been cured of their cancer but are still in my care because we need to take care of their pain. - says the drug. Albert Jeznach.

- You also need to determine whether the patient wants to be calmer, calm, or whether he wants to be professionally active as long as possible and be able to work even during oncological treatment. Depending on the patient's needs and expectations, I can choose a variety that has either the advantage of the sativa phenotype, which is more stimulating, or the indica phenotype, which is more calming and relaxing. It would be best to start treatment with a hybrid variety that has both CBD and THC, but unfortunately there is no such variety in Poland. - explains the expert.

It is worth knowing thatmedical marijuana cannot be the drug of first choice,nor the only treatment method . Therapy is started with low doses, which the doctor then increases. Every patient treated with medical marijuana must give their informed consent.

Medicinal marijuana and possible drug interactions

Medical marijuana therapy must be carried out under the supervision of a specialist , and the doctor must be aware of all other medications the patient is taking. As the drug explains. Albert Jeznach, like many other drugsmedical marijuana can interact with drugs, weakening or intensifying their effects , which in some cases may be toxic and be dangerous to the patient's he alth, and in others result in a reduction in the effects of the basic treatment. These interactions are mutual, i.e. both groups of drugs affect each other's action.

  • Some chronic medications and herbal substances can affect THC levels . Drugs that may increase the level of this substance include some antidepressants, proton pump inhibitors, antifungal drugs, macrolide antibiotics or HIV protease inhibitors.
  • Drugs and substances thatcan reduce the effects of THCinclude St. John's Wort, as well as some semi-synthetic antibiotics, carbamazepine and phenobarbital.
  • In turn, cannabinoids can, among others, intensify the effects of drugs affecting the nervous system - including hypnotics, antiepileptics, sedatives, anti-repressants, benzodiazepines and barbiturates.

Contraindications for medical marijuana treatment

Medical marijuana is considered a safe drug, but it should not be used in all cases.

Medicinal marijuana - contraindications:

  • cannabis allergy
  • pregnancy and breastfeeding
  • age under 25 (relative contraindication)
  • arrhythmia and cardiovascular diseases
  • uncontrolled hypertension
  • respiratory problems
  • unstable depression, schizophrenia, mania
  • suicidal thoughts
  • alcohol and drug abuse

Can you become addicted to medicinal marijuana?

What is the risk of becoming addicted to medical marijuana? Bow. Albert Jeznach explains that slight - similar to caffeine.Medical marijuana is not physically addictive- but you can become addicted to the well-being that occurs after the application of the drug.

Therefore, therapy can be administered during an exacerbation of the disease intermittently during remission, with generally no risk ofwithdrawal symptoms, although this can occur if cannabis is stopped too quickly after long periods of treatment. The patient may then experience symptoms such as sleep fluctuations, mood swings, irritability, and appetite disorders - they are mild and usually disappear after 1-2 weeks.

Side effects of medicinal marijuana use

Like any drug, medicinal marijuana can have some side effects, the nature of which depends on the variety of cannabis. They are mild and should disappear over time.

The most common medicinal marijuana side effects are:

  • euphoria and agitation
  • disorders of psychomotor coordination and psychomotor functions
  • sleepiness, fatigue
  • dizziness
  • reducing attention and focus
  • appetite increase
  • impairment of short-term memory and information processing
  • possibility of fainting.

As the drug explains. Albert Jeznach, some of these side effects may in some cases be desired - for example, impairment of short-term memory helps to obliterate migraine pain or the worsening of cancer pain.

Howeverpeople treated with medical marijuana cannot drive a caror other motor vehicles for some time after application due to the risk of collision or accident. As the expert explains, in accordance with the Canadian guidelines developed by the College of Family Physicians of Canada (Polish guidelines do not exist yet), you must give up driving for 4 to 8 hours after taking the drug. However, a treatment plan can be set in such a way that the patient could commute to work during the treatment.

Can you overdose on medicinal marijuana?

Like any drug, medicinal marijuana can also be overdosed.The most serious symptom of overdose is a comawhich can last up to two to three days. There are no cannabinoid receptors in the brainstem responsible for basic vital functions, such as breathing, so overdosing will not lead to death from suffocation. In this part of the brain, however, there are opioid receptors, so an overdose of opioids can lead to death.

As the drug emphasizes. Albert Jeznach, the estimated lethal dose for medical marijuana varieties that are currently used in Poland, is about 100 g in a single admission. Considering that the usual single dose is about 100-150 mg, taking 100 g seems impossible.

Worth knowing

CBD oil is not the same as medicinal marijuana

It is good to know that available in storesin herbal medicine and on the Internet, CBD oils are not a substitute for medical marijuana. Bow. Albert Jeznach emphasizes thatmedical marijuana has a clearly defined composition - other than CBD oil,because it contains THC, which cannabis oil cannot contain. - In addition, the status of these products is unclear: it is not known whether they are novel food, or insects, or an aromatherapy product or a dietary supplement. As of today, there is no CBD oil in Poland that would obtain the status of a dietary supplement. The quality of these products varies greatly, often unknown. There is no validation, so we do not know if their composition is repeatable. - says the expert.

- CBD is quite safe, it is hard to poison it, but it is a biologically active substance and has specific effects on the body, both positive and negative. May help with some diseases, has anti-inflammatory effects. But it is important to know that CBD is metabolized by the liver like most drugs and can both weaken and intensify the effects of some drugs. There is a real danger thatenhances the effect of anticoagulantsand a patient who uses such drugs simultaneously with CBD oil may suffer from hemorrhage, e.g. from the gastrointestinal tract. It is a potential threat to life and he alth. If someone already wants to use CBD, it is safer to do so after consulting a doctor. - he adds.

Where to buy medicinal marijuana and how much does treatment cost?

Medical marijuana is prescribed by prescription and is available from select pharmacies (usually the same pharmacies that sell opioid painkillers). Although the prescription for medicinal marijuana can now be issued by any doctor, the patient treated in this way must be under the constant care of a specialist.

As the drug explains. Albert Jeznach, for medical marijuana, the same rules apply as for opioid drugs: they should only be used by a doctor who has experience. In Poland, the therapy is performed mainly by doctors from pain treatment clinics. In other countries, such as Canada, there are already official cannabis treatment guidelines for GPs.

Currently, medical marijuana is not reimbursed in Poland. The cost of treatment varies from patient to patient as the doses of medicinal marijuana are selected according to the needs and symptoms. The approximate cost of the therapy ranges from PLN 600 to PLN 1,200 per month. In addition, you need to add the expense for a herb grinder, as well as an inhaler which is a medical device, which costs about PLN 1,200.

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