Medical Marijuana for Pain How Does Cannabis Work on Your Body? - - PowerPoint PPT Presentation
Medical Marijuana for Pain How Does Cannabis Work on Your Body? Jeremy Spiegel, MD Medical Director - Casco Bay Medical Westbury, Long Island, New York Intro Brief History of Cannabis Physiology of Cannabis Pain studies
Jeremy Spiegel, MD Medical Director - Casco Bay Medical Westbury, Long Island, New York
➔ Brief History of Cannabis ➔ Physiology of Cannabis ➔ Pain studies ➔ Ehlers-Danlos Syndrome ➔ Cannabis in Clinical Practice
“My doctor is old school, he doesn’t go in for medical marijuana.”
“My doctor is old school, he doesn’t go in for medical marijuana.”
“My doctor is old school, he doesn’t go in for medical marijuana.”
It was on the US Formulary until 1942 -- Removed AGAINST the advice of the AMA.
Reefer Madness
Harry Anslinger was a government official - the US’s first commissioner
Narcotics.
Reefer Madness
Harry Anslinger was a government official - the US’s first commissioner
Narcotics.
Chronic pain may
generally, or from the brain or spinal cord. The brain changes over time in patients with chronic pain.
Chemical compounds called
cannabis flowers providing relief from pain, nausea, and have anti-inflammatory properties.
Tip
Don’t wait till the end of the presentation to give the bottom line. Reveal your product or idea (in this case a translation app) up front.
Tip
Don’t wait till the end of the presentation to give the bottom line. Reveal your product or idea (in this case a translation app) up front.
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Phytocannabinoids are ligands
Ligand binding to a receptor protein
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Phytocannabinoids are agonists (and partial agonists,
antagonists, inhibitors) Agonist is a
ligand that binds, alters the function of the receptor, and triggers a physiological response.
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Our Bodies Naturally Produce Cannabinoids
Anandamide and 2-AG regulate brain and mood, eating, pain, immune function, sleep.
➔ We have receptors on our cells in our brain and nervous system (CB1) and other parts of our body (CB2)
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Phytocannabinoids are li
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CB1 and CB2 are G-Protein coupled receptors in the cell membrane
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Our Bodies Naturally Produce These
Anandamide and 2-AG regulate brain and mood, eating, pain, immune function, sleep.
➔ We have receptors on our cells in our brain and nervous system (CB1) and other parts of our body (CB2)
THC binds to CB1 in the brain, where CBD binds to CB2 elsewhere in the body.
Parkinson’s patients I have treated demonstrate improvement in tremor and muscle rigidity with the use of MMJ. Onset of improvement may be quite rapid.
This is helpful for those suffering with PTSD -- Post Traumatic Stress Disorder, who benefit from an ability to let go of strongly recalled traumatic memories (recalled both mentally and physically).
Attention Deficit Disorder responds nicely to MMJ, with greater focus, concentration and productivity.
Pain is reduced. Things taste
become more vivid.
With proper dosing and repeated use, an innocuous pleasant feeling
reductions in pain sensation and
It is a strong anti-nausea
diseases benefit from THC as there are cannabinoid receptors in the gastrointestinal tract.
Arthritis symptoms improve, as do the neurodegenerative disorders such as multiple sclerosis, with reduced spasticity of muscles.
Pain Tracts
Pain travels through nerves, special tracts, the lateral spinothalamic tract carries pain and temperature.
Pain Tracts
Pain travels through nerves, special tracts, the lateral spinothalamic tract carries pain and temperature.
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Delta-9 THC is a multitarget ligand
Δ9-THC has also been proposed to be a serotonin 5HT3A receptor antagonist and an allosteric modulator of the opioid receptors TRP (Transient Receptor Protein) Channels modulate ion entry mediating neuronal signaling: PAIN and PRESSURE perception, temperature, smell, taste vision.
➔
Phytocannabinoids are ligands
Ligand binding to a receptor protein
➔
Phytocannabinoids are agonists (and partial agonists,
antagonists, inhibitors) Agonist is a
ligand that binds, alters the function of the receptor, and triggers a physiological response.
functions
AND CB2 RECEPTORS
neurotransmitters such as anandamide and adenosine
activates a SEROTONIN receptor 5HT-1A implicated in: Anxiety, addiction, sleep, pain perception, nausea and vomiting
BLOCKS GRP55 Signaling GRP 55 signals
reabsorbs bone. Therefore: Putatively REDUCE OSTEOPOROSIS and JOINT PROBLEMS by antagonizing this process.
➔
Phytocannabinoids are ligands
Ligand binding to a receptor protein
➔
Phytocannabinoids are agonists (and partial agonists,
antagonists, inhibitors) Agonist is a
ligand that binds, alters the function of the receptor, and triggers a physiological response.
your choice of MMJ
your choice of MMJ
you will have milder effects -- elimination of nausea without full blown “munchies”.
your choice of MMJ
you will have milder effects -- elimination of nausea without full blown “munchies”.
your choice of MMJ
you will have milder effects -- elimination of nausea without full blown “munchies”.
subluxation, strain, dislocation, hyperextension
University of Michigan researchers found a 64% decrease in users
Beware opioids
Increased cannabis use for chronic pain may reduce addictions and deaths related to opioid painkillers
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CB1 Receptors are virtually nonexistent in the brainstem, medulla, thalamus.
So we don’t get the life-threatening effects on vital physiological functions
These active molecules are among the 500 different compounds found in cannabis, of which there are 85 different cannabinoids.
I perform these either: In-Person in Westbury
Online via videochat
(We can help you with this.)
(We will give you a list of conveniently located dispensaries.)
➔ Chronic Pain >= 3 months duration ➔ Post Traumatic Stress Disorder ➔ Cancer ➔ ALS ➔ HIV/AIDS ➔ Inflammatory Bowel Disease
➔ Epilepsy ➔ Huntington’s Disease ➔ Parkinson’s Disease
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Spinal Cord Injury
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Multiple Sclerosis
www.cascobaymedical.com
990 Westbury Road Suite 204 Westbury NY 11590
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“Molecular Targets of the Phytocannabinoids: A Complex Picture”Prog Chem Org Nat Prod. 2017; 103: 103–131.
➔ “The Endocannabinoid System, Cannabinoids, and Pain” Rambam Maimonides
Med J. 2013 Oct; 4(4) ➔
National Academies of Sciences, Engineering, and Medicine. 2017. The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for
National Academies Press.
➔ Annals of Internal Medicine, 2017. Benefits and Harms of Plant-Based Cannabis for Posttraumatic Stress Disorder: A Systematic Review. ➔ Cannabis Pharmacy: The Practical Guide to Medical Marijuana by Michael Backes ➔ Leafly.com ➔ CannaSOS.com