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Medical Marijuana and Parkinson’s: How Can It Help?


Parkinson’s disease counts as a qualifying medical condition in most states with medical marijuana. Learn what the science says about cannabis for Parkinson’s now.

Medical Marijuana and Parkinson's Disease

What’s the connection between medical marijuana and Parkinson’s disease?

With several states now making medical marijuana legal for patients with qualifying diseases like PD, researchers are allowed to conduct more studies to determine the real benefits of this new form of therapy.

After all, few can forget the jaw-dropping transformation of Larry, a retired police captain and PD sufferer, as he tries medical marijuana for the first time in the feature documentary Ride with Larry:

In less than five minutes, Larry goes from having severe tremors and being barely able to talk to an almost complete turnaround of both those symptoms -- and more.

So it’s no surprise others with PD want to know if medical marijuana is right for managing their symptoms too.

Since medical marijuana is currently only legal in 29 states, researchers are just now beginning to understand why cannabis for Parkinson’s might be so successful.

Here’s what we know so far:


What is Parkinson’s Disease and How Does It Affect Those With It

An estimated 60,000 Americans are diagnosed with PD each year, and nearly one million Americans will have Parkinson's by 2020 [1].

Parkinson’s disease is a neurological disorder which affects your motor system. It’s believed to be caused by a severe drop in dopamine levels in your brain.

Since the nerve cells responsible for producing dopamine get destroyed in PD, your brain loses its ability to produce this essential neurotransmitter.

Dopamine is a chemical messenger which helps your nerve cells talk to each other. Low levels mean messages from your brain don’t quite reach your muscles as they should.

Over the long term, this is thought to lead to cognitive decline and symptoms such as:

  • Tremors and shaking

  • Muscle rigidity and stiffness of limbs

  • Bradykinesia, or slowness of movement

  • Impaired balance and coordination loss

There’s no known cure for PD, and since the disease is progressive, it can also get worse over time.

Medications have been shown to slightly improve a few of these symptoms, though not without their unpleasant side effects.

Since several studies show your body’s natural endocannabinoid system is involved in certain neurodegenerative processes, cannabinoids found in medical marijuana may be worth exploring for PD symptoms.

How Does Medical Marijuana and Parkinson’s Work?

So what is your body’s endocannabinoid system?

Basically, your brain has tons of cannabinoid receptors all over the place. It produces its own cannabinoids (endo- means internal) but outside sources can also dock in these receptors too.

Here’s what’s so special about the endocannabinoid system and PD: these receptors are highly concentrated in an area specifically affected by Parkinson’s.

Known as the basal ganglia, this powerhouse contains the globus pallidus and the substantia nigra pars reticulata, which are really complicated names for saying it’s a cannabinoid receptor-packed house.

This area is home to the most densely packed cannabinoid receptors you’ll find anywhere else in your body.

So wouldn’t it be great if you could find a drug to specifically work in this area and hopefully influence these receptors to counteract the symptoms of PD?

Cue medical marijuana.

See, there are over 100 different cannabinoids found in cannabis.

The two main cannabinoids are:

  • THC, known more formally as tetrahydrocannabinol. This is responsible for the “high” you feel with marijuana.

  • CBD, or cannabidiol, which lacks all the psychoactive effects of THC yet has been studied extensively for its therapeutic use in diseases such as cancer, epilepsy, Alzheimer’s, and more [2][3].

THC Physicians

When the American Academy of Neurology (AAN) conducted an overview of 34 studies on medical marijuana for neurological disorders, they learned spasticity, central pain syndromes, and bladder dysfunction seemed to be improved after marijuana use [4].

Since many of these symptoms overlap with those of Parkinson’s, patients and their caregivers have been curious if cannabis will help them too.

What does the science say?


Medical Marijuana for Parkinson’s Motor Symptoms

During a study on patients with PD later published in Movement Disorders Journal [5]:

  • 39 patients (45.9%) described mild or substantial alleviation of their PD symptoms in general after using marijuana

  • 26 (30.6%) showed improvement of resting tremors

  • 38 (44.7%) had improvement in bradykinesia

  • 32 (37.7%) alleviated muscle rigidity

  • 12 (14.1%) improved L-dopa-induced dyskinesias

Further, using cannabis for Parkinson’s for at least three months generated “significantly more alleviation of Parkinson’s disease symptoms in general” among participants.

THC Physicians

Another trial of 22 patients attending a motor disorder clinic were evaluated at baseline and again 30 minutes after smoking cannabis.

Researchers learned the participants [6]:

  • Boosted their total score on the motor Unified Parkinson Disease Rating Scale significantly from 33.1 at baseline to 23.2 after cannabis consumption -- a 10 point improvement.
  • Significantly improved specific motor symptom scores after treatment in tremor, rigidity, and bradykinesia.
  • Significantly improved their sleep and pain scores.
  • And most important, no significant adverse effects of the drug were observed.

Medical marijuana for Parkinson’s may not only improve the physical symptoms of the disease, but also the ones harder to discuss and heal too.


Cannabis for Parkinson’s Patients with Anxiety and Depression

Along with the struggles of PD also comes a high prevalence of anxiety and depression [7].

“At least half of all Parkinson's patients may suffer from clinical depression at some point during the course of their disease,” estimates from the Michael J. Fox Foundation point out, and sometimes depression manifests even before motor symptoms [8].

Depression in PD is thought to be connected to the neurotransmitter disturbances in that area of the brain, and most specifically with monoamine neurotransmitters.

But low dopamine levels, which are characteristic of PD, also contribute to depression in the form of apathy and a loss of motivation.

Yet in self-reported data collected by the app Strainprint, which helps users of medical marijuana track their symptoms after using different strains, medical cannabis users perceived [9]:

  • 50% less depression
  • 58% less anxiety and stress

After reviewing the data, there was an association between high CBD (>9.5%)/low THC (<5.5%) strains and the largest changes in depression ratings.

This information may be used to help those with PD find relief without adding another prescription pill to their daily cocktail.

Another symptom of PD affecting a patient’s quality of life is their sleep cycle.


Fewer Sleep Disturbances

CBD has been studied for its potential role improving sleep-related behaviors associated with rapid eye movement sleep behavior disorder (RBD) in PD patients.

RBD causes patients with PD to have nightmares and active behavior during their REM sleep cycle. So instead of dreaming away soundly, sleep is disrupted and the health consequences of disturbing this healing time are profound.

In one small study, researchers treated four PD patients with CBD, the main non-psychotropic component of cannabis, and they noticed a “prompt and substantial reduction” in the frequency of these RBD-related events -- and there were zero side effects [10].

For more information, check out this article on medical marijuana for sleep next.

People with Parkinson’s may also come to rely on harmful and addictive opiates to manage their pain as well.


Cannabis for Parkinson’s Pain Management

Many PD patients report either musculoskeletal pain and/or central nerve pain.

In one study, researchers watched 2,736 patients over the age of 65?begin medical cannabis treatment. Over 65% of the participants were using medical marijuana for pain management.

After six months of medical cannabis treatments [11]:

  • 93.7% of participants reported improvement in their condition

  • On a 0-10 scale, the median level of reported pain went from an eight to a four.

  • More than 18% of patients either reduced or stopped taking their opioids for pain in lieu of the medical marijuana treatments.

Though studies like this demonstrate therapeutic uses of medical cannabis are safe and effective -- and can reduce opioid dependency -- there still needs to be more research done to improve the quality of life of people with PD.


Medical Marijuana Can Improve Quality of Life

When an anonymous questionnaire was sent out to people with PD attending the Prague Movement Disorder Centre, 25% of 339 respondents admitted to taking cannabis and 45.9% of them found some form of benefit from doing so [12].

And in another study, researchers observed a “statistically significant difference” between baseline and final assessment in the overall PD questionnaire score between a placebo and those taking CBD, which suggests there might be a possible effect of CBD on improving quality of life [13].

Plus, the risk of serious psychoactive incidents, like hallucinations or manic episodes, is less than 1% with medical marijuana.

Though more research will be needed to understand exactly how best to safely prescribe medical cannabis based on each patient and their specific PD symptoms, the early results seem promising.

 

Expert Advice About Medical Marijuana for Parkinson’s

According to a report from Parkinson.org, you should follow these tips if you’re trying cannabis for Parkinson’s [14]:

  • Never substitute medical marijuana for your PD medications and always work with your doctor as there may be potential drug interactions.

  • Understand that cannabis remains unregulated and the effects can vary by strain. Try to stay consistent when you find one you like and buy from the same source.

  • You may also want to experiment with patches or cannabis-infused creams for relief of localized pain on your body.

Medical marijuana in Florida has been legalized for “debilitating medical conditions” and Parkinson’s disease is included.


Trying Medical Marijuana for Parkinson’s

If you’re interested in trying medical marijuana for PD or are inquiring for a loved one, you should first seek out your local laws to determine the legality of the drug in your state, the types of medicine you can use, where to get it, and how much you need.

If you are located in Florida, check out THC Physicians for your medical evaluation, which is the first step in getting a Florida Medical Marijuana Card.


References:

  1. Understanding Parkinson’s: http://parkinson.org/Understanding-Parkinsons/Causes-and-Statistics/Statistics

  2. Cannabinoids in health and disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202504/

  3. Cannabidiol: a promising drug for neurodegenerative disorders? https://www.ncbi.nlm.nih.gov/pubmed/19228180

  4. Systematic review: efficacy and safety of medical marijuana in selected neurologic disorders: report of the Guideline Development Subcommittee of the American Academy of Neurology: https://www.ncbi.nlm.nih.gov/pubmed/24778283

  5. Survey on Cannabis Use: https://pdfs.semanticscholar.org/a569/1349d19c96cccace47d4db3efa5295069440.pdf

  6. Cannabis (medical marijuana) treatment for motor and non-motor symptoms of Parkinson disease: an open-label observational study: https://www.ncbi.nlm.nih.gov/pubmed/24614667

  7. Depression and Parkinson’s Disease: Current Knowledge: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878671/

  8. Anxiety and Depression with Parkinson's Disease: https://www.michaeljfox.org/understanding-parkinsons/living-with-pd/topic.php?emotions-depression

  9. A naturalistic examination of the perceived effects of cannabis on negative affect: https://www.jad-journal.com/article/S0165-0327(18)30310-0/fulltext

  10. Cannabidiol can improve complex sleep-related behaviours associated with rapid eye movement sleep behaviour disorder in Parkinson's disease patients: a case series: https://www.ncbi.nlm.nih.gov/pubmed/24845114

  11. Epidemiological characteristics, safety and efficacy of medical cannabis in the elderly: https://www.ncbi.nlm.nih.gov/pubmed/29398248

  12. Survey on cannabis use in Parkinson's disease: Subjective improvement of motor symptoms: https://onlinelibrary.wiley.com/doi/abs/10.1002/mds.20111

  13. The Health Effects of Cannabis and Cannabinoids: The CurrentState of Evidence and Recommendations for Research: https://fhop.ucsf.edu/sites/fhop.ucsf.edu/files/custom_download/NAP_2017_CANNABIS_RESEARCH.pdf

  14. Parkinson’s Report: http://parkinson.org/sites/default/files/attachments/ParkinsonReport-Summer-2018.pdf