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Medical and Marijuana for Pain and Symptom Management

In states where medical marijuana is legalized, mesothelioma patients are starting to use the plant to help with pain, symptoms, and side effects associated with cancer and treatment. Marijuana or ‘cannabis’ refers to a type of flowering plant in the Cannabaceae family that can have altering effects on those who smoke or consume it.

Marijuana can be manipulated into many forms that patients ingest to help with pain management. There isn’t concrete data, however, supporting the use of medical marijuana for anything other than palliative care, like curing the disease. Standard mesothelioma treatments like surgery, chemotherapy, radiation, and targeted treatments are still the primary methods for fighting mesothelioma. Marijuana should never replace primary treatments and should only be used as a complementary therapy if approved by a doctor.

Recreational Vs. Medical Marijuana

To have access to medical-grade marijuana, a patient must get approval from a doctor and sign up for a medical card. This card will grant the patient access to stores called dispensaries that sell medicinal cannabis. In other states where recreational and medicinal weed are both available, patients don’t have to get a medical card but legally need to be 21 years of age or older and should verify with their physician beforehand. Medical cards can be available to patients under 21 with approval from a doctor. Although medical cannabis is sometimes cheaper in price for a higher dosage, both medical and recreational marijuana are pretty much the same thing and have been known to help manage symptoms of cancer and anti-cancer treatments when used properly.

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What’s In Cannabis?

There are over a hundred components in marijuana and they’re called cannabinoids. Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are the main cannabinoids a person will notice when they ingest or smoke cannabis. THC is psychoactive, meaning that it gives users the feeling of being “high”. CBD is nonpsychoactive, so it doesn’t make the person feel intoxicated in any way, but it can still have relaxing and soothing effects on the body. It should be noted, however, that CBD products need a very small amount of THC in order to be effective, but what’s needed is so small patients don’t notice any changes.

Commercially, the number of cannabinoids in marijuana plants are listed as percentages and can range anywhere from under one percent to over thirty percent. Some concentrates have percentages of over seventy. These numbers depend on the type of strain, how it’s grown, nutrients used in soil, and several other factors. Percentages are listed so patients know how potent the product is before purchasing.

Hemp

Hemp and marijuana are actually the same species of plant. Hemp is just one of the many different names used to refer to cannabis even though it’s still a flowering herb from the Cannabaceae family. While botany may not see a huge difference in hemp and marijuana, the law still does. Legally, the major difference between the two is how much THC content is in each. Hemp is used to refer to all cannabis that contains less than 0.3 percent of THC. While this number was chosen randomly, it’s now used in the legal definition of hemp as referenced in the Agricultural Act of 2018.

Synthetic THC and CBD

Scientists have put together synthetic versions of cannabinoids found in the marijuana plant. Synthetic THC and CBD are currently the only FDA-approved supplements regarding cannabis. Two primary synthetics are called Dronabinol and Nabilone and they’re made in both pill and liquid form. In 2018, the first FDA-approved CBD product was put on the market, called Epidiolex. There’s also a mouth spray called Nabiximols that has both, with a one-to-one mix of synthetic THC and CBD.

While these modified versions of plant-based cannabis do contain synthetic THC or CBD, that’s all they contain. Marijuana plants host several other components that also contribute to its effects.

Benefits and Side Effects

Scientists have been studying the effects of medical marijuana on cancer patients for decades and usually observe positive health benefits with continued use. They do this by conducting several group studies on volunteers in clinical trials in order to assess efficacy.

Some benefits researchers have seen in previous patients when combining THC and CBD include relieving or reducing the following symptoms and side effects of cancer and related treatment:

  • Anxiety/depression
  • Insomnia
  • Loss of appetite
  • Muscle loss
  • Nausea/vomiting
  • Pain

As with all treatments and therapies, there’s always some risk of side effects. Side effects associated with medical marijuana are usually mild compared to other treatments like chemotherapy. Still, some patients don’t experience much or any side effects at all. The method of consumption also matters. Some report that eating cannabis edibles may have a stronger effect on the body than smoking. It’s important to consume carefully and only what the doctor recommends.

Side effects may include:

  • Dry mouth and eyes
  • Dizziness or feeling lightheaded
  • Drowsiness
  • Fatigue
  • Increased appetite

Less common side effects include:

  • Increased heart rate
  • Disorientation
  • Hallucinations
  • Headaches

The severity of side effects also hinges on the strain of the plant and whether it’s a Sativa, Indica, or hybrid (among other factors). Each patient will react differently, so what may make one person feel dizzy, may not affect the other person at all.

Other Things in Marijuana That Can Help

Besides THC and CBD, researchers have observed other cannabinoids and organic compounds in medical marijuana that can help manage symptoms of illness or treatment.

CBN

Also known as Cannabinol, CBN has been known to relieve neurological conditions like chronic muscle stiffness, epilepsy, and seizures. It may also help with insomnia or be helpful as a mild sedative. Other reports have stated CBN can relieve inflammation and pain. CBN is created when THC-A oxidizes.

THC-A

Tetrahydrocannabinol acid (THC-A) is like THC, but minus the psychoactive ability. Patients may prefer this sometimes because it doesn’t alter the state of mind. THC-A has been correlated to health benefits like minimizing inflammation and reducing neurological pain.

CBG

Cannabigerol, or CBG, is a nonpsychoactive cannabinoid that may help with anxiety and depression. There have also been reports on it reducing tumor growth, inflammation, or pain, but there are no conclusive statements.

Terpenes

Terpenes are organic compounds found in several types of plants as well as cannabis. Their primary purpose is to produce a specific aroma that people may react to when inhaled. Some have noticed therapeutic benefits when terpenes are paired with THC and CBD. They work by binding to similar endocannabinoid receptors found in the brain and body. This is also a component to why some people may feel different effects with one strain than another person. Whichever receptors the terpenes bind to help determine the effect of the strain, and this differs with each individual.

Terpenoids

Like terpenes, only terpenoids have already been oxidized. This can happen when the plant is dried out, burned, or by using chemicals. The terms are sometimes interchangeable.

Sativa, Indica, and Hybrid Strains

When thinking of Sativa, Indica, and hybrid in terms of medical marijuana, you’re thinking of whether it will have uplifting or relaxing properties. Is it an upper or downer? Sativa strains are known for more of a “head high” encouraging an energizing and euphoric effect that may reduce stress while boosting focus and creativity. Indica provides more of a full-body change, potentially reducing anxiety while helping the user relax, eat, and sleep better. Hybrid is a combination of the two, but usually hybrid strains will lean more towards either Sativa or Indica.

Ways for Patients to Consume Medical Marijuana

There’s a variety of ways cannabis can be consumed, each with varying strengths and side effects. Besides inhaling it through smoke or vapor, patients can eat, drink, or apply it to the skin as a cream, spray, or patch. Your doctor may recommend a method based on your condition and related symptoms. Here are the specific forms of marijuana that can be found at a dispensary:

Edibles

When someone infuses cannabis in food, they’ve created an edible. There are many ways to make edibles, each with varying levels of potency. The most common method for incorporating medical marijuana in food is to infuse oil or butter with cannabis and use it in cooking food or making a drink.

Vapes

They look like electronic cigarettes, only instead of tobacco, there’s a liquid compound of THC and/or CBD that can be heated up, vaporized, and then inhaled. This method of ingesting cannabis is much healthier than lighting flower and smoking since with a vaporizer there’s no combustion or smoke, only vapor. This is good for patients with respiratory problems either from illness or preexisting.

Flower

Also called ‘bud’, flower refers to the actual cannabis plant. Buds contain trichomes, (small growths that look like tiny hairs), which contain concentrated amounts of cannabinoids like THC. When a person ignites the flower, their trichomes will break open and release oils called resin that a person will inhale after it’s turned to gas from lighting it.

Extract

May also be referred to as concentrates, cannabis, or hash oil, an extract is exactly what the name implies. The marijuana plant is dipped in a liquid compound that will extract a concentrated oil that contains high amounts of THC. Usually, the use of an oven or heating element is needed, but there are other methods of extraction that involve different elements. Concentrated oil can then be put in a vaporizer or heated up on a specialized tool in a process known as ‘dabbing’. The oils can also be put in creams and other topicals and patches. In the past, butane was the primary compound used to extract the hash oil (known as BHO), but scientists are developing cleaner methods to make concentrates.

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Is It Legal?

Cannabis wasn’t always legal, only in the past decade has the plant been decriminalized and in some states legalized medicinally and/or recreationally. It is still federally illegal. With each year, more and more states are turning to the legalization of cannabis, with medical marijuana usually being the first. Always make sure you know and understand the laws in your state before consumption, as each state’s regulations differ.

Talk to Your Doctor

Ultimately, your doctor or oncologist will be the final say on whether you should use any complementary treatments, especially medical marijuana. Adhere to their dosage recommendations and what type they suggest for best results. Additionally, never replace primary treatments with complementary ones. If you want to stop standard anti-cancer treatments, talk to your doctor about what other options you may have.

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