Friday, December 1, 2017

Medical Cannabis Benefits: Treating Dystonia





Dystonia is a neurological movement disorder in which the sufferer’s muscles contract abnormally and involuntarily; when sustained it can be painful. It can affect one muscle, an entire muscle group, and even the entire body. Symptoms of Dystonia can be very mild to very severe, and they include: cramping, a dragging leg, involuntary pulling of the neck, uncontrollable blinking, and speech difficulties.

Dystonia appears to be related to problems in the basal ganglia (a central part of the brain) and the disorder may be hereditary, or caused by other factors such as birth related complications, physical trauma, infection, or even poisoning. There is no known cure for Dystonia, and treatment has been experimental and limited.

Using Cannabis to Treat Dystonia


Cannabis is a complex medicinal plant that may actually be used to treat a variety of debilitating symptoms caused by a surprisingly large number of ailments. It’s usefulness as a non-lethal medicine (you cannot die from an overdose of cannabis) cannot be overstated and it’s versatility in terms of how it can be consumed and as to how it can be useful for so many illnesses is something to be excited about. However, it is important to remember that consulting with your primary care physician should be your first priority when considering incorporating cannabis into one’s medical regiment and that cannabis is to be used as an adjunct therapy and not a replacement. It is also your responsibility to communicate with your doctor as to how your use of cannabis has affected your health and of your progress with utilizing medical cannabis.

With that said, it may be helpful for individuals looking to treat Dystonia with medical cannabis to know that there are several small case studies and investigations throughout the last decade that suggest cannabinoids may be a viable option to help reduce the symptoms and pain caused by the disorder.

Exciting studies have shown that cannabis may be quite useful for treating individuals suffering from Dystonia for the following reasons: to reduce muscle tension and involuntary, painful muscle contractions; reducing possible nausea; reducing possible anxiety and or depression; and to significantly reduce the pain caused by the contractions.

FINDINGS: EFFECTS OF CANNABIS ON DYSTONIA
Research suggests that cannabis improves dystonia. Cannabinoids found in cannabis interact with the CB1 and CB2 receptors of the endocannabinoid system, which in turn regulate the excitatory and inhibitory neurotransmitters necessary to curtail spasticity and muscle tremors (Pertwee, 2002). Studies support that medical cannabis offers significant improvements in muscle spasticity, both in mice trials and in human subjects (Borgelt, Franson, Nussbaum & Wang, 2013) (Baker, et al., 2000).

Numerous case studies have supported cannabis’ dystonia-curtailing benefits. In one, a 52-year old woman with multiple sclerosis experienced a decreased frequency of dystonia in response to cannabis-based medications. She also reported improvements in sleep quality and anxiety (Deutsch, et al., 2008). In another, a 42-year-old chronic pain patient reported an improvement in dystonia following cannabis inhalation (Chatterjee, Almahrezi, Ware & Fitzcharles, 2002). Smoking cannabis also caused a marked improvement in dystonia in a patient with Wilson’s disease (Uribe Roca, Michelli & Viotti, 2005). A 38-year-old pianist saw an improvement in motor control following THC intake, causing the researchers to conclude that THC significantly improves focal dystonia (Jabusch, Schneider & Altenmuller, 2004).

Along with pain, muscle spasm is the most common reason that medical cannabis is recommended and prescribed by medical professionals (Borgelt, Franson, Nussbaum & Wang, 2013).

STATES THAT HAVE APPROVED MEDICAL CANNABIS FOR DYSTONIA
Currently, only the states of Illinois and New Mexico (cervical dystonia) have approved medical cannabis for the treatment of dystonia. 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, various other states will consider allowing medical cannabis to be used for the treatment of dystonia 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”).

Sixteen states have approved medical cannabis for the treatment of spasms. These states include: Arizona, Arkansas, California, Colorado, Delaware, Florida, Hawaii, Maryland, Michigan, Minnesota, Montana, Nevada, New Hampshire, Oregon, Rhode Island and Washington.

Several states have approved medical cannabis specifically to treat “chronic pain,” which can develop in some cases of dystonia. These states include: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New Mexico, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, and West Virginia. The states of Nevada, New Hampshire, North Dakota, Montana, Ohio and Vermont allow medical cannabis to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania, Washington, and West Virginia have approved cannabis for the treatment of “intractable pain.”

RECENT STUDIES ON CANNABIS’ EFFECT ON DYSTONIA
Spasms that had previously proven to be untreatable by traditional efforts were significantly reduced after four weeks of cannabis treatment.
A double-blind, randomized, placebo-controlled, parallel-group study of Sativex, in subjects with symptoms of spasticity due to multiple sclerosis.
(http://www.tandfonline.com/doi/pdf/10.1179/016164109X12590518685660?needAccess=true)


Beneficial Cannabinoids and Terpenoids Useful for Treating Dystonia

The cannabis plant offers a plethora of therapeutic benefits and contains cannabinoids and terpenoid compounds that are useful for treating a number of ailments and disorders, and recent case studies have shown that both Tetrahydrocannabinol (THC) and Cannabidiol (CBD) may be beneficial for improving motor control and reducing the pain caused by the spasms.

With that said, the following chart also denotes which cannabinoids and terpenoids work synergistically with each other for possible therapeutic benefit. It may be beneficial to seek out strains that contain these cannabinoids and terpenoids.




Americans For Safe Access Condition-based Booklets
These booklets summarize the history of medical cannabis and the recent research used to treat a variety of conditions, including Cancer, Multiple Sclerosis, Chronic Pain, Arthritis, Gastro-Intestinal Disorders, Movement Disorders, HIV/AIDS, and conditions related to Aging. (About Americans For Safe Access)

Movement Disorders



The therapeutic use of cannabis for treating muscle problems and movement disorders has been known to western medicine for nearly two centuries.


Article: "How to Qualify for Medical Cannabis in New Mexico"



References

Understanding medical cannabis.Elemental Wellness Center, 2014 Jul.

Current status of cannabis treatment of multiple sclerosis with an illustrative case presentation of a patient with MS, complex vocal tics, paroxysmal dystonia, and marijuana dependence treated with Dronabinol.Deutsch, Stephen I, et al.

CNS Spectrums: The International Journal of Neuropsychiatric Medicine, 2008 May, 13(5): 393-403.

Cannabis sativa and dystonia secondary to Wilson’s disease.Roca, Urive, et al.

Movement Disorder Society, 2004 Jan, 20(1): 113-115.

Effects of pharmacological manipulations of cannabinoid receptors on severity of dystonia in a genetic model of paroxysmal dyskinesia.Richter, A, et al.

European Journal of Pharmacology, 2002 Nov 15, 454(2-3): 145-151.

A dramatic response to inhaled cannabis in a woman with central thalamic pain and dystonia.Chatteree, Avijit, et al.

Journal of Pain and Symptom Management, 2002 Aug, 24(1): 4-6.

Randomised, double-blind, placebo-controlled trial to assess the potential of cannabinoid receptor stimulation in the treatment of dystonia.Fox, SH, et al.

Movement Disorders: Official Journal of the Movement Disorder Society, 2002 Jan, 17(1): 145-149.

Cannabis in movement Disorders.Muller-Vahl, K.R., et al.

Forschende Komplementarmedizin (Research in Complementary Medicine), 1999 Oct, 6(3): 23-27.

(+)-WIN 55,212-2, a novel cannabinoid receptor agonist, exerts antidystonic effects in mutant dystonic hamsters.Richter, Angelika, et al.

Open label evaluation of cannabidiol in dystonic movement disorders.Consroe, Paul, et al.

International Journal of Neuroscience, 1986, 30(4): 277-282.

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