Over the past two decades, medical cannabis has become an alternative treatment option for many medical patients across the globe.
While medical studies in this area are by no means complete, there have been many promising findings both in the medical lab and outside of it, which may be indicators of future treatments that could be based on medical cannabis. A disease called Parkinsons disease has recently moved to the forefront of medical investigation involving medical cannabis treatments.
Parkinsons disease is a neurodegenerative brain disorder that occurs when there is a slow reduction in the amount of dopamine produced in the human brains nerve cells. Dopamine is the brain chemical that allows coordinated and smooth muscle movements in the body.
Because the disease affects a persons movements and begins gradually, and because there is no laboratory test for the disease, it can be difficult to spot early on. Through a thorough examination of a patients medical history and repeated neurological exams, most cases can be diagnosed. Parkinsons disease is not generally diagnosed in younger people; age 60 is the age when it usually begins to affect a patient. For the disease to affect a patient noticeably, 60-80 percent of a patients nerve cells must be affected. Early warning signs of Parkinsons disease include:
While Parkinsons disease is not fatal, complications from it can be, and there is no cure. The goal of treatment is to provide the most high-quality life possible once the disease has been diagnosed.
There are four main stages of Parkinsons disease, all accompanied by their own symptoms. Stage one involves mild symptoms that do not interfere with normal, everyday activities of patients tremor and other movement symptoms occur, but only on one side of the body. Changes in posture, walking, and facial expressions may become apparent to friends or family at this stage.
In stage two, tremors and rigidity may appear on both sides of the body, and walking and posture issues are obvious. Daily tasks may become more difficult or take longer, but the patient should still be self-sufficient. Stage three often includes loss of balance and slower movements, possibly with frequent falls. Independence is still possible, but dressing and eating may become more and more difficult at this stage.
In stage four, symptoms of Parkinsons disease may require help from a walker and help with daily tasks this usually results in a loss of independence. Help from family, a friend, or a nurse that either visits daily or lives with the patient may now be required. In stage five, leg stiffness may prevent the patient from walking, and require 24-hour nursing care. Although most symptoms of Parkinsons disease are commonly associated with physical issues, the following non-motor symptoms are also common, particularly in stage five:
Among the types of medical treatment that have been shown to decrease symptoms of Parkinsons disease are surgery, deep brain stimulation (DBS), and various prescribed medications (most common are carbidopa/levodopa, Sinemet, Azilect, Mirapex, ropinirole, and Requip). In DBS, surgically implanted electrodes in the brain block electrical pulses from nerve cells that cause unwanted movements, stopping tremors and other Parkinsons disease symptoms.
A doctor may use magnetic resonance imaging (MRI) or computed tomography (CT) scans to identify parts of the brain producing unwanted movements prior to surgery. DBS uses surgical insertion of a neurostimulator (similar in size to a stopwatch or heart pacemaker) which delivers to electrical stimulation to targeted brain areas. DBS usually involves the thalamus, subthalamic nucleus, and the globus pallidus. DBS is used only for patients who do not respond to other medications and treatments, and is an invasive procedure. Medical cannabis could help prevent such a procedure, and provide an option that Parkinsons disease patients could use in the privacy of their own homes.
The National Parkinsons Foundation acknowledges the current medical cannabis investigations occurring for Parkinsons disease patients, noting that several anecdotal reports show reduced tremors in Parkinsons patients. Ride with Larry is a three-part documentary involving Larry, a man with severe Parkinsons disease who chose to consume medical cannabis to help with his tremors and other symptoms. Because medical cannabis can interact with neurological cannabinoid receptors (CB1 and CB2), it affects the brain and can calm tremors in some patients.
In general, people with Parkinsons disease have fewer CB1 receptors than people without it; boosting CB1 receptors with medical cannabis seems to alleviate dyskinesia and reduce tremors. The difficulty of conducting medical cannabis trials for Parkinsons disease has been and is still affected by national and international laws regarding the use of medical cannabis, as well as the difficulty of conducting a double-blind, placebo controlled trial with medical cannabis. However, some patients are positive that medical cannabis helps their tremors, and have posted videos of the treatment working on websites such as YouTube. In one pilot study, nabilone (a cannabinoid receptor agonist) significantly reduced dyskinesia in seven patients with Parkinsons disease. Several other studies have shown different results, including tic benefits but no dyskinesia benefits.
A more recent study conducted in Europe has demonstrated that some Parkinsons patients enjoy both pain relief and improved motor function following medical cannabis treatments. Parkinsons disease patients in areas of the world where medical cannabis is legal have the option to discuss this form of treatment with their doctors or healthcare professionals if they are not responding to medications or DBS, but more clinical trials are needed to find reliable results for this treatment.
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