APRIL 2018 Return to April 2018 e-Journal The Value of Medical Marijuana and CBD for Disorders of Aging Jeff Morris  Over the past decade, the medical use of marijuana, CBD, and other derivates of cannabis has increased exponentially in the U.S. Currently, 29 states and the District of Columbia have enacted laws in some form to allow physicians to prescribe marijuana medically—and by 2021, all 50 states may have laws allowing medical marijuana in some capacity. This trend should be of particular interest to practitioners of age management medicine, because disorders associated with aging are particularly appropriate for treatment with medical marijuana and CBD.

In the simplest of terms, we know that inflammation is at the root of most, if not all, of the conditions that afflict patients as they get older. The primary bioactive compounds of cannabis, THC and CBD, are both known to have anti-inflammatory effects throughout the body. The match of problem and solution would seem to perfect.

Such alignment is one of the reasons AMMG added a full-day preconference track on this very topic at their spring conference. The speakers included such experts as Greg Gerdeman, Ph.D., and David Bearman, M.D., and others with extensive knowledge and insights into the history and proper medical usage of cannabis. As they are quick to point out, cannabis has actually been used medicinally worldwide for thousands of years. It is, in fact, only within the past 100 years or so that cannabis took on the stigma from which it is just now starting to emerge. Indeed, it was not until 1972 that marijuana was classified as a Schedule 1 drug by the DEA, a move that, as Dr. Bearman describes it, was entirely political and in direct opposition to all of the scientific recommendations that had been made.

Ironically, most of the medical evidence today that supports use of cannabis is a direct result of the campaign against it. It was through research that was initiated to prove that cannabis was toxic and led to abuse and addiction, that the existence of the body's endocannabinoid system was discovered. The endocannabinoid system (ECS) consists of receptors, neurotransmitters and enzymes. CB1 Receptors are found largely in the brain, while CB2 Receptors are found in the immune system and the periphery. Dr. Gerdeman notes that ECS is a “master regulator” of human physiology. He calls endocannabinoids the "guardians of the nervous system," and points out that physical trauma or seizure activity rapidly and significantly elevates endocannabinoids in the brain.

Dr. Bearman, who is Executive Vice President of the American Academy of Cannabinoid Medicine, says the ECS is also composed of neurotransmitters: Anandamide (AEA); 2-arachydonyl glycerol (2AG); and enzymes: FAAH - enzyme that metabolizes anandamide; MYGYL - enzyme metabolizes 2AG.

Studies have shown that administering endocannabinoids to animals attenuates many kinds of chemically or electrically induced seizure activity. It also reduces the extent and severity of brain injury following experimentally inflicted head wounds, and reduces the severity of inflammation that naturally follows brain injury, which has enormous clinical consequence for recovery. Dr. Gerdeman further cites studies showing that ECS regulates the neurobiology of pain, with endocannabinoids used by cells to fine-tune their own synaptic input. Cannabinoids, he says, are also intrinsic regulators of the neurobiology of fear, stress and anxiety.

Dr. Bearman lists these Therapeutic Applications Of Cannabis:

• Anti-nauseant/Anti-emetic
• Appetite stimulant
• Analgesic
• Anti-epileptic
• Anti-inflammatory
• Anxiolytic
• Anti-spasmodic
• Anti-depressant
• Sleep Aid
• PTSD treatment
• ADD/ADHD treatment

He says the top conditions or symptoms it can treat are pain, sleep difficulties, nausea, arthritis & connective tissue disorders, migraine, and anxiety. 

Dr. Gerdeman says the non-neuronal actions of CB2, CB1 and other cannabis targeted receptors (TRPV1, PPAR-γ) regulate all the following, and more:

Inflammation: