In The Netherlands, pharmaceutical-grade cultivated cannabis is distributed for medicinal purposes as commissioned by the Ministry of Health. Few studies have thus far described its therapeutic efficacy or subjective (adverse) effects in patients. The aims of this study are to assess the therapeutic satisfaction within a group of patients using prescribed pharmaceutical-grade cannabis and to compare the subjective effects among the available strains with special focus on their delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) content. In a cross-sectional and natural design, users of pharmaceutical-grade cannabis were investigated with questionnaires. Medical background of the patients was asked as well as experienced therapeutic effects and characteristics of cannabis use. Subjective effects were measured with psychometric scales and used to compare among the strains of cannabis used across this group of patients. One hundred two patients were included; their average age was 53 years and 76% used it for more than a year preceding this study. Chronic pain (53%; n = 54) was the most common medical indication for using cannabis followed by multiple sclerosis (23%; n = 23), and 86% (n = 88) of patients (almost) always experienced therapeutic satisfaction when using pharmaceutical cannabis.
People who smoke cannabis get satisfaction in control of pain, lack of sleep and spasms. The average consumption was 0.6g a day and the high dose stuff had about 20% THC (wow), the middle dose 12% THC and the so called low dose was 6% THC. The higher an middle dose of THC were better at stimulating the “munchies” and “anxiety”. These are mediated by cannabinoid receptors. Was CBD beneficial maybe maybe not as the cannabis with most CBD also had the lowest THC. There are differences in strains of cannabis in the their CBD content, it is say higher in Moroccan cannabis where as Mexican Cannabis may have little CBD. In the initial reports in surveys conducted in 1998 on both sides of the pond said cannabis alleviated their symptoms. To me this suggests that THC is the main active ingredient, not CBD.
Koppel BS, Brust JC, Fife T, Bronstein J, Youssof S, Gronseth G, Gloss D. Systematic review: Efficacy and safety of medical marijuana in selected neurologic disorders: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2014;82(17):1556-63. doi: 10.1212/WNL.0000000000000363
OBJECTIVE: To determine the efficacy of medical marijuana in several neurologic conditions.
METHODS: We performed a systematic review of medical marijuana (1948-November 2013) to address treatment of symptoms of multiple sclerosis(MS), epilepsy, and movement disorders. We graded the studies according to the American Academy of Neurology classification scheme for therapeutic articles.
RESULTS:Thirty-four studies met inclusion criteria; 8 were rated as Class I.
CONCLUSIONS:The following were studied in patients with MS: (1) Spasticity: oral cannabis extract (OCE) is effective, and nabiximols and tetrahydrocannabinol (THC) are probably effective, for reducing patient-centered measures; it is possible both OCE and THC are effective for reducing both patient-centered and objective measures at 1 year. (2) Central pain or painful spasms (including spasticity-related pain, excluding neuropathic pain): OCE is effective; THC and nabiximols are probably effective. (3) Urinary dysfunction: nabiximols is probably effective for reducing bladder voids/day; THC and OCE are probably ineffective for reducing bladder complaints. (4) Tremor: THC and OCE are probably ineffective; nabiximols is possibly ineffective. (5) Other neurologic conditions: OCE is probably ineffective for treating levodopa-induced dyskinesias in patients with Parkinson disease. Oral cannabinoids are of unknown efficacy in non-chorea-related symptoms of Huntington disease, Tourette syndrome, cervical dystonia, and epilepsy. The risks and benefits of medical marijuana should be weighed carefully. Risk of serious adverse psychopathologic effects was nearly 1%. Comparative effectiveness of medical marijuana vs other therapies is unknown for these indications.
So analysis of a load of studies said we think cannabis probably as some value in controlling pain and spasticity, which is what it is licensed for. But there are risks…yep you may get high,other drugs have a serious risk which is also 1% like PML, which can be fatal and cause irreversible damage.
CoI: We are trying to develop alternatives to Cannabis for symptom control