Marijuana and Epilepsy 1

Marijuana and Epilepsy

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The subject of marijuana being used to treat Epilepsy has caused an uproar in the medical and political worlds’ in recent years.

Although the subject remains taboo, for some the outlook is starting to look different. What is more important, in my opinion, is that these changes are the result of a social phenomena where people are standing together to defend what they believe is a vital cause.

The Facts

Marijuana and Epilepsy
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Epilepsy is a disorder that is recurrent in nature and is characterized by the occurrence of unpredictable seizures. Most often, these seizures lead to severe side effects and the apparition of novel health problems. The source of the problem originates from the human brain, however the seizures can be experienced in any part of the body.

During a seizure,  abnormal electrical activity is triggered by changes in chemical composition of brain cells. These impulses activate or prevent other cells from communicating properly, thereby leading to an overflow or a lack of cellular communication. There are several types of seizures depending on how and where they begin. There are also epileptic syndromes which are characterized by certain medical events usually occurring together, 21  are recognized by the Epilepsy Foundation.

Currently an average of 2.2 million people are affected by epilepsy in the United States alone. On average 150,000 Americans develop epilepsy every year, notably 48 per every 100,000 people. This incidence has been found to be higher in young children and elderly. Worldwide, it is estimated that there is around 65 million people currently affected with epilepsy. One third of these people have no existing cure working for them.

The Consequences

The side effects of epilepsy can be devastating depending on the type and the condition. While some may have occasional seizures, others may completely be immersed in the condition that persist in a quasi-vegetative state. Some of the impacts can be described by the following:

  • Social impact: not doing well in social environments such as school and work
  • Learning disabilities
  • Cognitive disabilities
  • Behavioral changes, anxiety and mood variance
  • Unexplained injuries from seizure ( falls, stiffness, illnesses)
  • Osteoporosis
  • Reproductive health deterioration
  • Risk of death

The Treatment

Marijuana and Epilepsy
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Currently, different treatments are available depending on which epileptic syndrome one is presented with. While for some a combination of one or two types of medication is sufficient, for others a cocktail of pharmaceuticals is required. Often, these medications come with unbearable side effects or simply reduce the seizures by putting the patient in a vegetative state.

In syndromes such as the Dravet Syndrome, which usually begins in the first year of life, seizures tend to respond poorly to medical treatment or dietary changes. Moreover, seizures tend to be frequent in timing, occurring one after the other. This is extremely detrimental since it directly affects the development of the child.

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In situations where no medication seems to be efficient, parents are often left wondering what there is to do. For them, it is a question of saving their loved ones from an invasive condition that deteriorates a quality of life.

Medical Marijuana for Epilepsy

Marijuana and Epilepsy

Thanks to a word of mouth phenomenon, the use of Medical marijuana for epilepsy treatment has become the miracle medicine everyone is talking about. The case Charlotte Figi has started a wave that is only gaining magnitude. Charlotte’s mother, desperate to find a solution for her little girl’s condition, stumbled on a low-THC medical marijuana strain that has shown to  successfully help control her Dravet Syndrome. The Stanley brothers (growers of medical marijuana), who have previously experimented with such a strain, decided to put it on the market and name it Charlotte’s Web. Following the success story of Charlotte, more families started reaching out for the product.

Watch Dr. Sanjay Gupta’s MD report (CNN) about Epilepsy and Charlotte’s Web:

The problem is the prohibition surrounding medical marijuana. In Colorado and certain states the use of marijuana is legal. However, in the majority of places, marijuana is still considered to be an illicit drug with no medicinal value. This causes parents to go as far as moving or illegally ‘smuggling’ the product in order to treat their children. You can read more about cases like Charlotte and the whole marijuana for epilepsy movement in the Medical Marijuana for Children article.

The second concern that arises when it comes to using marijuana for epilepsy is the lack of research on the safety of the plant. Science has not yet come to an understanding of the drug’s mechanism of action. While the willingness to understand this plant is there, research can only go as far as federal laws allow it. The truth is that certain state laws are contradictory to federal laws when it comes to medical marijuana, thus putting physicians in a delicate position.

What We Know So Far

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Since Cannabis has been classified as a Substance I drug by the Controlled Substance Act, its availability for the treatment of a magnitude of diseases was revoked. With this came a war on drugs that sparked fears and assumption, which soon became common agreement in society. While human trials became unattainable, some researchers continued their work on marijuana.  In the case of Marijuana for Epilepsy, the most concrete demonstration of the anticonvulsant effects of cannabis came from Dr. Carlini (1973), a specialist in Neurology.

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By administering an epileptic mouse with CBD, Carlini was able to show that the product was more successful than THC in protecting the mice from leptazole-induced seizures. This was an interesting finding since the worries about marijuana were revolving around its ‘hallucinogenic’ effects which are associated mostly with THC rather than CBD. In 1975, the prevention of seizures by THC was also demonstrated in baboons and cats by researcher Juhn Wada. In 1980, Carlini went on to demonstrate the usefulness of CBD in human epileptic volunteers, and its effects on healthy volunteers. The results were promising: 4 out of 8 volunteers had an almost complete remission form the convulsive state, 3 out of 8 showed partial remission, and one subject quit the study due to the medication being ineffective.

GW Pharmaceuticals recently released Epidiolex, a CBD oil developed for the treatment of epilepsy. However access to the product remains very controlled despite the numerous clinical trials conducted. Currently there are seven doctors approved to prescribe Epidiolex. Five of those physicians have 25 patients and the others only have two. This is a frustrating situation when people affected with epilepsy are losing their ability to follow a normal development everyday.

While Epidiolex is advertised as being completely THC free, Ethan Russo, GW Pharma’s senior medical advisor is actually reviewing the evidence stating that THC and CBD can actually work synergistically in order to suppress the seizures. Dr. Goldestein who does research in the use of marijuana for epilepsy also pointed out the importance of the whole plant in medicine:

“All these compounds working together create an ‘entourage effect…’ I’m in favor of the whole plant. By pulling things out of it we may be losing some of the synergies. It will be great to do studies comparing whole plant extracts to single compounds.” – Dr. Goldstein

The Dangers

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The dangers around medical marijuana seem to be unsupported and blown out of proportion. We are talking about a plant with more than 5,000 years of documented medical history. The way we treat this medicine now is absurd, in my opinion and that of others like Dr. Abrams, Chief Hematology/Oncology :

“I do research in medical cannabis applications. If cannabis were discovered in an Amazon rainforest today, people would be clamoring to make as much use of it as they could… Unfortunately, it carries with it, you know, a long, maybe not so long, history of being a persecuted plant.” – Dr. Abramsi

Currently, the prescription drugs that are on the market are known to cause dependence and allow the possibility of overdose. With medical marijuana it is known that there is no such risk as explained by Dr. Goldstein:

“There is no fatal overdose because there are no receptors in the area of the brain where respiration is controlled…The CB2 receptors are mainly in the immune system: spleen, white blood cells, the GI system, the peripheral nervous system, bone, reproductive organs, heart.” – Dr. Goldstein

The real danger, it seems to me, is that such a cheap natural product is a threat for the pharmaceutical industry.  There’s no doubt about it, medical marijuana for epilepsy has a true potential, but the plant can also heal a vast variety of diseases including cancer.

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When you have people experiencing hundreds or thousands of seizures a day, and their learning abilities are hindered, we can’t sit there too long wondering if marijuana might have side effects in ten years. The truth is that if these people are left to their conditions, they will probably not even have ten years. If they do live those years, they will probably not lead a conscious and normal life like the majority of us. There is an importance balance between quality of life and long term risk that needs to be assessed here.

How Can We Bring Change?

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While some of us feel like there is not much we can do, it is important to realize how powerful we are when we come together. The story behind medical marijuana for epilepsy treatment is the perfect example of the importance of social phenomena. We need to stand together and inform ourselves; It took angry parents to allow some changes to occur around the case of medical marijuana for epilepsy. Things are starting to move, people are speaking up, politicians are being pressured and as long as there is persistence, things will keep changing.

Imagine the possibilities if everyone with an ill loved one who could be treated with medical marijuana, no matter the condition, would stand together. The more we learn, the more we search for answers, the more we educate one another, the more we will eventually realize the strength of our voice we have together. Sometimes a little bit of disorder is the only way to make order, and care and support are all that are required.

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