Monday, October 2, 2017

Cannabis is Sports Medicine:

Concussions, CTE and Traumatic Brain Injury

Currently, there is no effective drug for the treatment of traumatic brain injury, CTE and concussions. In the U.S., there are nearly 52,000 deaths and roughly 80,000 cases of severe disability related to traumatic brain injury every year. There are more than 5.3 million people in the U.S. living with disabilities related to traumatic brain injury — numbers far greater than those for multiple sclerosis, Parkinson's disease and Alzheimer's disease.

What is the most common sport causing head injury?
Football accounted for 47,000 of those head injuries, and baseball played a role in 38,394. Cycling was also the leading cause of sports-related head injuries in children under 14, causing 40,272 injuries, roughly double the number related to football (21,878).  

Concussions are also sometimes referred to as mTBI (Mild Traumatic Brain Injury). Concussions are injuries to the head which cause a temporary lapse in the normal operation of brain function. Concussions have many symptoms which could be displayed in a physical, psychological or emotional manner.

In recent years, the clear link between playing football and traumatic brain injuries has been prevalent in the sporting world news.  After a  2013 NFL settlement of $765 million for concussion-related injuries, and new lawsuits springing up as more research comes out, it is more clear than ever that action needs to be taken against such brain injuries.

In 2015, concussion-related injuries were in the spotlight, primarily as a result of the major motion picture – “Concussion”. The movie, based on a true story, highlights the findings of Nigerian-born forensic neuropathologist, Dr. Bennet Omalu, who researched the connection between concussions and what is now known as chronic traumatic encephalopathy (CTE).  His research created an onslaught of scrutiny toward the NFL and has been the catalyst for a class-action lawsuit between the National Football League and thousands of former players.

CTE is a progressive degenerative disease caused by repetitive trauma to the brain. Symptoms include memory loss, migraine headache, confusion, impaired judgment, paranoia, impulse control problems, aggression, depression, and progressive dementia. The brain degenerates even after the trauma has ended and can appear months or years after the trauma has ended. Because of the feelings of depression that are linked to CTE, those afflicted may experience thoughts of suicide.

In recent years, too many professional athletes have already been lost to this, who have committed suicide and were suffering from CTE.  In 2013, former NFL star and Pro Football Hall of Fame Inductee, Junior Seau, took his own life with a self-inflicted gunshot wound to the chest. It was later discovered that he suffered from CTE. Football players are not the only athletes that experience thoughts of suicide due to traumatic brain injuries. BMX pro — the world’s most well known cyclist and X Games Superstar, Dave Mirra, also ended his life by suicide. Those close to him were shocked by his actions and it was found that CTE played a role, as reported by ESPN earlier this year.

Dr. Dustin Sulak, DO, says, “Cannabis could potentially be beneficial to all sports, but especially those with high risk for head injury, because it can likely protect participants from the long term consequences of concussion and brain trauma.”

THC and other naturally occurring cannabinoids act on brain injury as a general neuroprotective agents with antioxidant properties, which can have crucial roles in treatment of Concussions, CTE and Traumatic Brain Injury.  Post-concussion syndrome is symptoms that can linger following a concussion. Studies have shown cannabis reduces damage caused from brain injuries and can help athletes manage the symptoms of the syndrome.

By definition, neuroprotection is an effect that may result in salvage, recovery or regeneration of the nervous system, its cells, structure and function. It is thought that there are many neurochemical modulators of nervous system damage. An antioxidant is a molecule that inhibits the oxidation of other molecules. Oxidation is a chemical reaction that can produce free radicals, leading to chain reactions that may damage cells. Antioxidants such as thiols or ascorbic acid (vitamin C) terminate these chain reactions. That’s right, just like vitamin C - THC and CBD all do the body good.

These cannabinoids as antioxidants and neuroprotectants are also why the U.S. Patent Office issued patent #6630507 to the U.S. Health and Human Services Department. The patent lists the use of certain cannabinoids found within the cannabis plant as useful in additional neurodegenerative diseases such as Alzheimer's, Parkinson's, and HIV dementia.

Since cannabis contains compounds recognized and endorsed by an agency of the U.S. government- Why is it that cannabis remains on the Federal Schedule One list of drugs?
As this patent is a direct contradiction of the government’s own definition for the classification of a Schedule I drug and it should provide the professional sports world reason enough to allow for the use of cannabis.

The non-psychoactive part of cannabis known, as CBD, also has the potential to treat and even prevent concussions. The NFL should set an example by investing in cannabis research to see how it can help improve the health of its players. The new studies have found that certain properties in cannabis can help shield the brain from injury. Like all cannabinoids, CBD helps the body by imitating the endocannabinoids produced in the body as part of the endocannabinoid system, and has also been found to have the potential to reduce inflammation in the brain when brain trauma occurs.

Former Super Bowl champions Marvin Washington, Scott Fujita and Brendon Ayanbadejo helped start a conversation two years ago,  calling on the NFL to incorporate medical cannabis in their strategy for treating and preventing concussions. Eugene Monroe continued the debate earlier this year when he became the first current player to call on the NFL to look at the benefits of medical cannabis. He has since been joined by Derrick Morgan.  The NFL has a strict no-drug policy but the program is often not taken seriously by its players, ironically the league’s selection for the yearly drug policy’s mandated test starts on April 20th.

Currently, only the state of Illinois has approved medical cannabis for the treatment of post-concussion syndrome. However, in Washington D.C., any condition can be approved for medical cannabis as long as a DC-licensed physician recommends the treatment. In addition, a number of other states will consider allowing medical cannabis to be used for the treatment of post-concussion syndrome with the recommendation from a physician. These states include: California (any debilitating illness where the medical use of cannabis has been recommended by a physician), Connecticut (other medical conditions may be approved by the Department of Consumer Protection), Massachusetts (other conditions as determined in writing by a qualifying patient’s physician), Nevada (other conditions subject to approval), Oregon (other conditions subject to approval), Rhode Island (other conditions subject to approval), and Washington (any “terminal or debilitating condition”).

Also many states have approved medical cannabis specifically to treat “chronic pain,” which can develop from post-concussion syndrome. These states include: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New Mexico, Ohio, Oregon, Pennsylvania, Rhode Island and Vermont. The states of Nevada, New Hampshire, North Dakota, Ohio and Vermont allow medical cannabis to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania and Washington have approved cannabis for the treatment of “intractable pain.”

Athletes and professional sports leagues in general have a large influence on our culture, as of 2012 Americans spent $25.4 billion directly on professional sports.  And if these leagues change their policies on cannabis, they can make a major league impact to help change the way people think about cannabis, how it is used and the people who use it.  If the NFL were to finance this research into cannabis for Concussions, CTE and Traumatic Brain Injury -the potential impact reaching into future generations is tremendous. Not only would the league attempt to cure a major medical question that plagues modern sports, but it could potentially set a precedent in professional sports world,  pushing cannabis research forward to fully discover the whole plant’s potential.

The looseness of the NFL’s current cannabis policy, as well as Commissioner Goodell’s recent statement that the league is willing to support research into cannabis for medical uses specific to football injuries, suggest that this possibility is becoming a viable future option.

We need to continue developing our understanding of cannabinoid neurobiology in order to most effectively utilize the numerous therapeutic properties of cannabis. We can then unleash the full spectrum of benefits cannabinoids, the therapeutic effects and synergistic terpenoids are able to provide and discover innovative new treatments that could quite possibly help the millions of people who continue to suffer from Concussions, CTE, and Traumatic Brain Injury.