Medical Marijuana
Marijuana was legalized for medical use in Oklahoma in 2018. Details about legal use of medical marijuana is available at the Oklahoma Medical Marijuana Authority (OMMA) Uses
- Pain
- Depression
- Seizures
- Anxiety
- Insomnia
Adverse effects
Cannabis Hyperemesis Syndrome
Arrhythmia
Data from MESA (Multiethnic Study of Atherosclerosis), a longitudinal study of U.S. adults of representative races, a subset of whom underwent ECG monitoring from 2016 to 2018 was reviewed. Multiple linear regression was used to evaluate the associations between marijuana use and log-transformed outcomes of premature atrial contractions (PACs), premature ventricular contractions (PVCs), supraventricular tachycardia (SVT), and nonsustained ventricular tachycardia (NSVT). Results showed of 1485 patients, 140 patients (10%) reported marijuana use, with 61 reporting frequent (≥3 times per week) use. Users were younger, male, weigh more, and were more likely to smoke cigarettes. Compared with never-users, participants reporting current use of marijuana had more runs of SVT per day (fully adjusted geometric mean ratio [GMR], 1.42; 95% CI, 0.87 to 2.32), more PACs per hour (GMR, 1.22; 0.72 to 2.13), and more runs of NSVT per day (GMR, 1.28; 0.95 to 1.73) in the fully adjusted model. Past use was associated only with more PVCs. More frequent use was associated with more runs of NSVT per day and possibly more SVT per day. Results were similar when excluding patients with preexisting heart disease. Conclusion was that current marijuana use may be associated with a greater burden of arrhythmias. [1]
Is marijuana addictive?
Medical marijuana and psoriasis
National Psoriasis Foundation published an inteveiwe with Jason E. Hawkes, M.D., MS, from the University of California, Davis and Adam Friedman, M.D., FAAD, from the George Washington University School of Medicine and Health Sciences. . Dr. Friedman explained that cannabis is the plant, and cannabinoids are the molecules that affect the body. THC and CBD are the main phytocannabinoids derived from the plant. But Dr. Friedman points out that our own bodies produce cannabinoids, called endocannabinoids, such as anandamide (AEA), that regulate several different biologic processes. In addition, synthetic cannabinoids can be made in a laboratory with aspects of both phytocannabinoids and endocannabinoids. Dr. Friedman explains that some cannabinoids, like THC, interact with the CB1 receptor, which is present in the brain and nervous system and is generally responsible for the “high” that people associate with cannabis use.
The upside
Other cannabinoids, like CBD, interact with the CB2 receptor, which is present in the immune system, including the skin.While there is still much to be learned, Dr. Friedman says it has been shown that cannabinoids can reduce inflammation and can help resolve the effects of previous inflammation. “So, it's not just about stopping inflammation, but actually resolving it and dampening it down to then allow for proper healing,” says Dr. Friedman. They have even been shown to affect the production of interleukin 17 (IL-17), IL-23, and TNF alpha, all of which are important to the pathogenesis of psoriasis. “The cannabinoids have the potential to hit multiple different facets of inflammation and induce repair, which will benefit not just psoriasis, but any inflammatory disease, making it a very exciting area for discovery to go after many different disease states, even beyond dermatology,” says Dr. Friedman. Dr. Hawkes explains that the medical use of cannabis products, or products that contain cannabinoids, is generally considered to be safe, but there are several factors that can affect potential safety of use, including the dose, method of delivery, duration of use, and the specific ingredients. “The potential benefits of cannabis use for inflammation, itching, anxiety/depression, pain, and insomnia, for example, will be of significant interest to health care providers and patients.
The Downside
Conversely, we are aware of problems with overuse or the abuse of cannabis products such as worsening of anxiety/depression/paranoia, obesity, weight gain/metabolic syndrome, and cardiovascular disease,” says Dr. Hawkes. He adds that because people with psoriatic disease are already at higher risk of these conditions, or comorbidities, this should be taken into account when considering use of cannabis products. There are additional safety aspects to take note of when utilizing cannabis products, including the non-cannabis ingredients. Dr. Friedman says that there have been reports of allergic reactions to topical cannabis products, likely because of additives in the formulation. This is particularly important for products sold outside of dispensaries, as they are subject to fewer regulations. The delivery method of cannabis products is also something to keep in mind, as it can significantly affect the amount of cannabinoid absorbed by the body. “For example, as much as 35% of a cannabis-based product may be absorbed when ingested via an edible compared to less than 10% of a product delivered topically,” says Dr. Hawkes. He explains that delivery methods include smoking, vaping (smokeless inhalation), capsules, edibles (food or drink-based products), tinctures (sublingual absorption), and topicals. Cannabis products can interact with other medications you may be taking. “Cannabis products may also amplify the side effects of other concurrent oral medications, such as drowsiness, increased heart rate, or elevated blood pressure,” says Dr. Hawkes. “As we begin to tease out the specific biologic properties of cannabis strains and their ingredients as well as their potential therapeutic use for specific symptoms,” says Dr. Hawkes, “we are approaching a consumer landscape that could allow for a highly personalized, customizable shopping experience based on an individual’s symptoms or medical conditions.”
