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Seniors + Cannabis

Cannabis Should Be Considered a First-Line treatment in seniors.

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I was asked what makes seniors different from any other adult when it comes to medical cannabis? I thought about this for a while. Seniors (not just our children) should be considered our future, especially when it comes to accepting cannabis as medicine. Seniors have the good fortune of having life experiences. Some experiences make them question current thoughts and conventional wisdom. This is especially true when it comes to their health and healthcare. Many seniors have serious repercussions from their past choices, even if they were told by conventional teachings that their choices were good ones. They are now paying a heavy price in the form of poor health. Seniors spend their hard earned and well-deserved time, energy, and money going from doctor to treatment facility to consultant to pharmacy only to continue to experience poor health and a poor quality of life they did not count on. In the US, people over the age of 65 are taking an average of 5 different prescription medications a day. This does not include the over-the-counter medications that are also being used. This is a staggering statistic! These medications are not without risks. Side effects from pharmaceuticals are well-reported, and often, patients are prescribed other medications to counteract the side effect of a medication, only to require another medication to counteract the side effect of the drug used to counteract the side effect of the initial drug. By the way, there are no double blind randomized trials studying the safety or efficacy or dose effects of multiple pharmaceutical drugs taken by a single person. How can this be? The FDA only approves single molecules for single indications. No one has ever questioned or examined what happens when a human body is given a panoply of pharmaceuticals in perpetuity. We just assume that it is okay. This is the common practice of modern medicine and when written here in black and white seems absurd. 

Frustrated, many seniors are open to new methods of regaining health beyond the traditional pharmaceutical route. This means embracing a lifestyle method that focuses on health and well-being by putting themselves and their healthcare first. This method is described as the therapeutic order of healthcare. Imagine the therapeutic order as a pyramid (think of the old food pyramid) where the base of the pyramid consists of lifestyle elements that include nutrition—especially plant-based eating—exercise, socialization, and sleep. If injury or illness occurs after a proper foundation is established then the next step up the pyramid is discovering the root cause, and then addressing the cause with the least invasive and least risky therapies first. So this next step on the pyramid includes for example: physical therapy, psychological therapy, meditation, acupuncture, massage, and herbal remedies. The remainder of the pyramid includes, in a stepwise manner, the traditional medical therapeutic modalities starting with over-the-counter medications, then pharmaceutical drugs and finally surgical interventions. As you can see in this model, the traditional medical treatment options should be the last considerations and not the first line treatment. 

It should be considered a first-line therapy along with other herbal treatments and before pharmaceuticals.

So where does medical cannabis fit into the therapeutic order pyramid? It should be considered a first-line therapy along with other herbal treatments and before pharmaceuticals. How can this be? Cannabis has been illegal for decades and is still federally illegal. It is a schedule 1 drug, which means it is in a category of drugs that are considered highly addictive and have no medicinal value. Sadly, cannabis has been vilified for social and economic reasons, and the schedule 1 designation has nothing to do with whether or not it has medicinal value. In fact, cannabis has been used safely and effectively as a medicine for thousands of years. Cannabis medicines were even included in the US Pharmacopeia until 1941 when cannabis prohibition replaced alcohol prohibition. This means that up until 1941, pharmacists and physicians would have the option to treat patients with cannabis medicines for all kinds of indications. Our US government even has a patent on cannabinoids as antioxidants and neuroprotectants that was issued in 2003 (patent number US6630507B1). So clearly, cannabis does have medicinal value. We humans (and almost every other living creature) have a biological system in our bodies called the endocannabinoid system (ECS). The ECS governs every other biological system in our body, and its purpose is to maintain a physiologic balance. The word endocannabinoid is a combination where “endo” means from within and “cannabinoid” refers to the chemicals our own body makes—which are similar to the chemicals that the cannabis plant makes. The ECS gently tries to keep everything in check. When injury or illness strikes, supplemental help is in order; that’s where cannabis comes in. The chemicals in the cannabis plant interact with our ECS to help regain and maintain that physiological balance. Cannabis medicines and its interactions with the ECS can be a beneficial treatment for a whole host of medical indications. Using cannabis as a first-line treatment may prevent having to take many pharmaceuticals or reduce or replace them entirely.

Does that mean seniors have to smoke something or feel intoxicated or high in order to use this herbal remedy? Absolutely not! Cannabis is different from most traditional pharmaceutical remedies in that there are many ways to take it and there are different amounts of cannabis chemicals and combinations that make up cannabis medicine. Inhalation is the most commonly thought of method, but it is certainly not mandatory. In fact, surveys report that most people over the age of 40 prefer methods other than inhalation. The medical issue and patient and physician preference will help guide the best method of administration. Topicals or under the tongue preparations are popular methods of administration. As an example, for a localized pain, topical cannabis creams and ointments can be used effectively. Because it stays on the skin there is no intoxication or feeling “high.” The under the tongue preparations, like tablets or tinctures, allow the medicine to be absorbed quickly with a fast onset of action without having to smoke. These types of preparations are easily titrated so you can start at low doses and see the effects within 30 minutes and take more only if needed and without risking intoxication or that feeling of being high. 

So, can cannabis be used freely without concern? The answer is no. Just like with all medicines, cannabis and its constituents is a medicine. Medical cannabis can interact with other medications, especially if you are a patient taking many different pharmaceutical medications. Although cannabis has been shown to be a much safer medicine than traditional pharmaceutical drugs, and with less toxic side effects, cannabis including CBD must be used with care. My recommendation is to talk to your physician or healthcare provider and discuss your interest in taking cannabis medicine. Request that they help guide you so you can maximize the potential benefits of cannabis medicine for your specific condition. The goal is always to do no harm, to improve health, and embrace a better quality of life. Seniors deserve to maximize their valuable time pursuing the things they want to do without being side-lined by their conditions or the treatments. Cannabis can help achieve this goal.

Be well,
Dr. Deb

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GRAM Mag Sets NOW AVAILABLE!

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GIVE THE GIFT OF GRAM

You can now order sets of our
printed magazines. Give the gift of
knowledge this year to your friends,
family, or yourself and only pay
the shipping and handling.

What a deal!

Set includes 9 vintage GRAM Mags
(2019-2020)

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Turmeric

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Turmeric is a root vegetable commonly used as a spice in various Indian and other cultures’ dishes. Turmeric is in the zingiberaceae family, as is ginger. The turmeric plant is native to the southeastern region of Asia and commonly harvested in places like India, Sri Lanka, China, Indonesia, and Taiwan. It is responsible for curry’s signature orange color, and its vibrant pigment will give essentially any meal an orange hue. 

Turmeric contains a substance called curcumin, and curcumin has been shown through research to offer anti-inflammatory and other therapeutic benefits. The scientific name for the turmeric plant is Curcuma Longa, and likely where the name curcumin comes from. When people are talking about the health benefits of turmeric, they are referencing curcumin so you may hear the two names used interchangeably. Curcumin is part of a group called curcuminoids, with curcumin being the most active and the most beneficial for health. Flavonoids are another substance found in various plants and give these plants their color. Curcumin is a flavonoid and is responsible for providing that bright orange color to turmeric. In addition to providing aesthetic value, flavonoids are also strong antioxidants with anti-inflammatory and immune-boosting properties.

The Journal of Biological Chemistry published a study done by Sanjaya Singh and Bharat B. Aggarwal of the Cytokine Research Laboratory at the world-renowned cancer hospital, M.D. Anderson. The study found that curcumin suppressed NF-κB, a protein complex responsible for controlling inflammatory responses. In other words, turmeric shuts off the body’s inflammatory response. Anti-inflammatories can be beneficial for many different ailments, including chronic pain and digestive disorders. A lot of CBD companies even put curcumin in their products because of its benefits. It is believed to be a synergistic pair with complementary therapeutic properties. The thought is that the two plant medicines are powerful on their own; as a combination, they can deliver even more anti-inflammatory and medicinal benefits. 

Many people simply add turmeric to their dishes as a way to easily incorporate it into their daily routine. It is pretty mild in flavor and can be added to many dishes without changing the overall taste too drastically. Some say that turmeric isn’t strong enough on its own to receive the anti-inflammatory properties that curcumin provides, and therefore recommend a curcumin supplement. Research varies on that, so in the end it is just up to personal preference and your doctor’s approval. Curcumin supplements come most available in capsules. Pregnant women can safely use turmeric as an addition to their food, but should avoid taking high-dosage supplements. Those who are interested in supplementing with curcumin products should talk with their doctor first. 

M.D. Anderson Cancer Center did another study in 2007 exploring curcumin for cancer treatment. The study found that curcumin inhibits ovarian cancer growth and angiogenesis (the development of new blood vessels). It does this by targeting and manipulating the NF-κB pathway, the same protein complex responsible for controlling inflammatory response. According to a report published by the National Center for Biotechnology Information, “The nuclear factor NF-κB pathway has long been considered a prototypical proinflammatory signaling pathway, largely based on the role of NF-κB in the expression of proinflammatory genes including cytokines, chemokines, and adhesion molecules.”  

The trend with curcumin seems to be it’s ability to control inflammatory responses in the body. It does this by multiple pathways, but a commonly researched one is the NF-κB protein complex. Because this pathway is able to be manipulated by curcumin to encourage anti-inflammatory expressions, its potential for successfully treating various ailments is there.

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Psilocybin + Magic Mushrooms

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When many think of plant medicine, specifically those plants with psychoactive effects, they think of “magic mushrooms,” or fungi containing psilocybin and psilocin that can cause hallucinations depending on the dosage consumed. In many states, there are active efforts to decriminalize these otherwise scheduled substances, lowering penalties for their use and possession. But what value do psilocybin-containing mushrooms offer? New research suggests a range of therapeutic and psychological value ranging from the treatment of substance abuse to anxiety and depression management.  

What are Magic Mushrooms?

Magic Mushroom use dates back to 10,000 BCE and references continue throughout the era. Their modern popularity began when the term “magic mushroom” was coined by two etnomycologists who learned of a Harvard study on local doctors in Mexico using these substances, noting the substance’s ability to affect the nervous system. These findings were eventually published in Life magazine in 1957, and the term became the universal reference for psychoactive fungi and truffles, specifically those containing high concentrations of psilocybin and psilocin.

Psilocybin & Psilocin: The “Magic” in Magic Mushrooms

Psilocybin and psilocin are part of a family of psychedelic compounds found in magic mushrooms. Psilocin is pharmacologically active, and psilocybin is converted into psilocin when consumed or activated. Similar in structure to serotonin, there are more than 50 species of mushrooms and a variety of truffles that produce both the precursor, psilocybin, and the psychoactive compound, psilocin. Unlike LSD, magic mushrooms do not affect dopamine receptors, solely targeting serotonin sites

How are Magic Mushrooms used?

Magic mushrooms are often used for recreational, therapeutic and medicinal reasons. “Effects range from mild feelings of relaxation, giddiness, euphoria, visual enhancement (seeing colors brighter), visual disturbances (moving surfaces, waves), to delusions, altered perception of real events, images and faces, or real hallucinations.” Recreationally, this is often known as “tripping.” As an alternative health option, these fungi are being used for anxiety, depression, PTSD, and trauma, as well as psychological disorders such as substance abuse disorders, and science is beginning to back the potential for these applications.

Research on Mushrooms

Evaluations of currently available scientific studies suggest a growing number of therapeutic benefits and treatment options. “In the past few years, a growing number of studies using human volunteers have begun to explore the possible therapeutic benefits of drugs such as psilocybin…looking at psilocybin and other hallucinogens to treat a number of otherwise intractable psychiatric disorders, including chronic depression, post-traumatic stress disorder, and drug or alcohol dependency.”

Magic mushrooms have been respected as a “safe & natural healing sacrament for millennia throughout Mexico, Central America and the world,” and are known to be beneficial for depression, recidivism (the tendency to repeat past transgressions), and encourages openness, creativity, as well as personal and spiritual growth. UCLA and NYC have done studies on the applications of magic mushrooms in the treatment of end-of-life anxiety and other studies have backed up the use of psilocybin and psilocin in the treatment of substance use disorders, depression (especially in cases of terminal conditions like cancer as well as treatment-resistant depression), and reducing depression and anxiety overall.

Best way for people to consume?

When it comes to the consumption of mushrooms, advice on dosage is about as specific as it was with cannabis under prohibition. Consumers must purchase on the black market and are subject to whatever may be available. 

“Recreational doses range from 1–5 grams of dry mushrooms depending on the species and individual strength of the specimens… After ingestion, the psilocybin is enzymatically converted to psilocin. Absorbed from the gastro-intestinal tract, hallucinogenic effects usually occur within 30 minutes of ingestion with a duration of effect of 4–6 hours.” 

My recommendation as someone who has used magic mushrooms both for recreational and therapeutic purposes, is to grind the mushrooms into a fine powder and either encapsulate them in small increments and/or combine with lemon juice. Capsules will allow you to titrate your dosage as needed with a recognizable increment, while lemon juice will expedite onset time.  

The Legality of Magic Mushrooms

In the United States, psilocybin is a Schedule I controlled substance, with no accepted medicinal value and a high potential for abuse. In contrast, the Drug Policy Alliance states that “Physically, psilocybin mushrooms are considered to be one of the least toxic drugs known.” With that being said, local efforts such as Decriminalize Nature – Oakland and Decriminalize Denver have pushed for and successfully passed initiatives and legislation to reduce penalties and make enforcement a low priority, as was done in the early days of cannabis activism. This has spurred multiple local and international efforts to “Decriminalize Nature,” efforts that we learn more about in this month’s feature.

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