Monday, December 4, 2017

Medical Cannabis Benefits: Treating Glaucoma




Glaucoma is an eye condition characterized by abnormally high pressure in the eye, which gradually causes damage to the optic nerve. According to Mayo Clinic, glaucoma is one of the leading causes of blindness in the United States.

The vision loss caused by glaucoma cannot be recovered and the most common form of glaucoma has zero warning signs. The damage to the optic nerve is so gradual that most don’t notice the change in vision until the condition is at an advanced stage. Early detection through regular eye exams and a test that measures eye pressure are necessary for glaucoma to be diagnosed early enough before permanent damage can be done. Those who are diagnosed with the condition will need regular treatment to lower eye pressure for the rest of their lives.

The elevated eye pressure is the result of a buildup of fluid called aqueous humor that flows throughout the eye. The fluid normally drains, but when it’s overproduced or doesn’t drain properly, pressure builds.

There are two types of glaucoma conditions, including open-angle glaucoma and acute angle-closure glaucoma. Open-angle glaucoma is the most common form of the condition. Acute angle-closure glaucoma can be accommodated with severe headache, eye pain, and nausea and vomiting.

Since glaucoma isn’t curable, treatment focus is on keeping the pressure lower in the eye through medications.

FINDINGS: EFFECTS OF CANNABIS ON GLAUCOMA
Over multiple decades, scientific research has proven that cannabinoids are effective at decreasing intraocular pressure. In addition, the compounds found in cannabis feature neuroprotective and vasodilation properties, which further assist in the conservative treatment of glaucoma. The cannabinoids found in cannabis, including tetrahydrocannabinol (THC), activate endocannabinoid receptors CB1 and CB2. These endocannabinoid receptors are located in the structures of the eyes and are responsible for the formation and outflow of aqueous humor.

Studies have demonstrated cannabinoids have efficacy at lowering intraocular pressure. One study found that smoking cannabis lowered blood pressure, which led to a decrease in intraocular pressure, within 60 to 90 minutes of inhalation.

For patients interested in avoiding the psychoactive effects of smoking cannabis, topical cannabinoid applications have also proven effective at decreasing ocular pressure. In one study, applying THC oil directly to the eyes of participants with high blood pressure resulted in the lowering of systolic blood pressure, which researchers concluded may lead to a decrease in intraocular pressure. In another, applying cannabinoid directly to the eye decreased intraocular pressure within the first 30 minutes with maximal reduction being reached in 60 minutes. One study that applied cannabinoids directly to the eyes of rabbits recorded decreased intraocular pressure within 1.5 hours of administration and the effects lasted for more than 6 hours. In addition, the eye to which the cannabinoid had not been administered also experienced a decrease in intraocular pressure, but the effect lasted for 4 hours.

STATES THAT HAVE APPROVED MEDICAL CANNABIS FOR GLAUCOMA
Currently, 26 states have approved medical cannabis for the treatment of glaucoma. These states include: Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Hawaii, Illinois, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, North Dakota, Ohio, Pennsylvania, Oregon, Rhode Island, Vermont and Washington.

Several states have approved medical cannabis specifically to treat “chronic pain,” a symptom commonly associated with glaucoma. 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.”

In Washington D.C., any condition can be approved for medical cannabis as long as a DC-licensed physician recommends the treatment.


Beneficial Cannabinoids and Terpenoids Useful for Treating Glaucoma

The following chart denotes which cannabinoids and terpenoids work synergistically with each other for significant 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, GastroIntestinal Disorders, Movement Disorders, HIV/AIDS, and conditions related to Aging. (About Americans For Safe Access)

A Patient's Guide to Medical Cannabis



This guide for patients who use medical marijuana (cannabis) covers everything you need to know. Created by Americans for Safe Access (ASA), a non-profit advocacy organization, this publication will help individuals who are using or considering cannabis treatments to better educate themselves, their families and their physicians. ASA has been developing information resources about medical marijuana (cannabis) for patients, their families, doctors, and elected officials for over a decade.

Aging



Cannabis has been found to help many patients suffering from conditions that afflict older patients, including arthritis, chronic pain, cancer, Alzheimer’s disease, diabetes, and spasticity associated with such diseases as Parkinson’s.


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


References

Understanding medical cannabis.Elemental Wellness Center, 2014 Jul.

Chien, F.Y., Wang, R.F., and Mittag, T.W. (2003, January). Effect of WIN 55212-2, a Cannabinoid Receptor Agonist, on Aqueous Humor Dynamics in Monkeys. Archives of Ophthalmology, 121(1), 87-90. Retrieved from http://jamanetwork.com/journals/jamaophthalmology/fullarticle/415023.

Colasanti, B.K., Craig, C.R., and Allara, R.D. (1984, September). Intraocular pressure, ocular toxicity and neurotoxicity after administration of cannabinol or cannabigerol. Experimental Eye Research, 39(3), 251-9. Retrieved from http://www.sciencedirect.com/science/article/pii/0014483584900137.

Facts About Glaucoma. (n.d.). National Eye Institute. Retrieved from https://nei.nih.gov/health/glaucoma/glaucoma_facts.

Glaucoma. (2015, September 15). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/glaucoma/basics/definition/con-20024042.

Jarvinen, T., Pate, D.W., and Laine, K. (2002, August). Cannabinoids in the treatment of glaucoma. Pharmacology & Therapeutics, 95(2), 203-20. Retrieved from http://www.sciencedirect.com/science/article/pii/S0163725802002590.

Merritt, J.C., Crawford, W.J., Alexander, P.C., Andruze, A.L., and Gelbart, S.S. (1980, March). Effect of marihuana on intraocular and blood pressure in glaucoma. Ophthalmology, 87(3), 222-8. Retrieved from http://www.aaojournal.org/article/S0161-6420(80)35258-5/abstract.

Merritt, J.C., Olsen, J.L., Armstrong, J.R., and McKinnon, S.M. (1981, January). Topical delta 9-tetrahydrocannabinol in hypertensive glaucomas. Journal of Pharmacy and Pharmacology, 33(1), 40-1. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.2042-7158.1981.tb13699.x/pdf.

Naveh, N., Weissman, C., Muchtar, S., Benita, S., and Mechoulam, R. (2000, April). A submicron emulsion of HU-211, a synthetic cannabinoid, reduces intraocular pressure in rabbits. Graefe’s Archive for Clinical and Experimental Ophthalmology, 238(4), 334-8. Retrieved from http://link.springer.com/article/10.1007%2Fs004170050361.

Nucci, C., Bari, M., Spano, A., Corasaniti, M., Bagetta, G., Maccarrone, M., and Morrone, L.A. (2008). Potential roles of (endo)cannabinoids in the treatment of glaucoma: from intraocular pressure control to neuroprotection. Progress in Brain Research, 173, 451-64. Retrieved from http://www.sciencedirect.com/science/article/pii/S007961230801131X.

Porcella, A., Maxia, C., Gessa, G.L., and Pani, L. (2001, January). The synthetic cannabinoid WIN55212-2 decreases the intraocular pressure in human glaucoma resistant to conventional therapies. European Journal of Neuroscience, 13(2), 409-12. Retrieved from http://onlinelibrary.wiley.com/wol1/doi/10.1046/j.0953-816X.2000.01401.x/full.

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