Medical Marijuana

The more we learn, the more we confirm that medicinal herbs used in ancient healing traditions are, indeed, healing.

Medical Marijuana

Plant Based Medicine

Plants provided our first medicines. Evidence from pre-historic sites suggest and written records confirm that plants have been used medicinally for thousands of years.

Historical Discoveries

Through discoveries made after the science of chemistry began in the 1800s, certain medicinal alkaloids were isolated from their source plants, including morphine, quinine and caffeine. Although many modern medicines are based on plant constituents, a rift between chemical pharmacology and the practice of traditional herbal medicines developed. The separation grew stronger over time, until recent interest in integrative medicine began to bridge the divide.

Contributing Factors

One of the factors that contributes to the new interest in medicinal herbs is the growing awareness that isolated constituents extracted from herbal plants are often less effective than they are when consumed simultaneously with all the other constituents present in the whole plant.

Living Plant

A living plant is a complex system with thousands of interacting chemicals, and many of them work together in synergy – creating a greater impact than the effect of consuming isolated components in single molecule pharmaceuticals.

Constituents

The constituents of a whole plant, or whole plant extract, influence each other in a number of ways that effects their impact on the consumer. There are several different ways they may work in synergy. They may help stabilize each other, potentiate or enhance each other, or modify the impact of certain elements. They may help make a constituent more water soluble or protect it from stomach acids. All of these are ways that the synergies created in taking in a whole plant can produce radically different results than taking the chemically isolated ingredients.

Plant Extracts

Whole herbs or whole plant extracts are best for retaining the overall medicinal effectiveness. They provide not only the presence of each active constituent but also the relative concentration of the constituents, preserving the profile of the herb and supporting its intended action.

St. John’s Wort, for example, known for its soothing effects, acts on enzymes in the brain that influence serotonin levels. Chemists isolated the “active ingredient,” only to discover that another ingredient was also “active,” and then another. In fact, the plant has a complex chemistry, including constituents that render the active ingredients more water soluble – more accessible and therefore more easily absorbed and effective.

Disease States

Louisiana law allows for any condition considered debilitating to an individual patient to be treated with medical marijuana. The list below shows common conditions that can often be effectively treated with medical marijuana. Click on each condition for additional information and links to scholarly articles. This list is not intended to be all inclusive.

Intractable Pain

Malignant Disease – Pain

Study – Pharmacotherapeutic considerations for use of cannabinoids to relieve pain in patients with malignant diseases
– M Darkovska-Serafimovska 2018 (1:1 Sativex) View Article

Chronic Pain

Systematic reviews on therapeutic efficacy and safety of Cannabis (including extracts and tinctures) for patients with multiple sclerosis, chronic neuropathic pain, dementia and Tourette syndrome, HIV/AIDS, and cancer receiving chemotherapy
– L Amato 2017 (1:1 Sativex) View Article

Neuropathic Pain – MS

A double-blind, randomized, placebo-controlled, parallel-group study of THC/CBD oromucosal spray in combination with the existing treatment regimen, in the relief of central neuropathic pain in patients with multiple sclerosis
– RM Langford 2013 (1:1 Sativex) View Article
Oromucosal delta9-tetrahydrocannabinol/cannabidiol for neuropathic pain associated with multiple sclerosis: an uncontrolled, open-label, 2-year extension trial
– D Rog 2007 (1:1 Sativex) View Article
Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis
– D Rog 2005 (1:1 Sativex) View Article

Non-cardiac Chest Pain

Dronabinol increases pain threshold in patients with functional chest pain: a pilot double-blind placebo-controlled trial
– Z Malik 2016 (THC – Dronabinol) View Article

Chronic Spinal Cord Injury

Effect of Cannabinoids on Spasticity and Neuropathic Pain in Spinal Cord Injured Persons
– K Ethans 2015 (THC – Dronabinol) View Article

Pancreatitis – Abdominal Pain

Δ9-THC (Namisol®) in Chronic Pancreatitis Patients Suffering From Persistent Abdominal Pain
– H Van Goor 2014 (THC – Namisol) View Article

Neuropathic Pain – MS

Efficacy and Safety of the Pain Relieving Effect of Dronabinol in Central Neuropathic Pain Related to Multiple Sclerosis
– S Schimrgk 2010 (THC – Dronabinol) View Article

Neurological Pain

A Study to Evaluate the Effects of Cannabis Based Medicine in Patients With Pain of Neurological Origin
– W Notcutt 2002 (THC – Marinol) View Article

Cancer Pain

Cancer – Pain

Results of a Double-Blind, Randomized, Placebo-Controlled Study of Nabiximols Oromucosal Spray as an Adjunctive Therapy in Advanced Cancer Patients with Chronic Uncontrolled Pain
– A Lichtman 2018 (1:1 Sativex) View Article
Medical Marijuana Use in Oncology A Review
– G Wilkie 2016 (1:1 Sativex) View Article
Multicenter, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study of the Efficacy, Safety, and Tolerability of THC:CBD Extract & THC Extract in Patients w/Intractable Cancer-Related Pain
– J Johnson 2010 (1:1 Oro-mucosal spray) View Article

Adv Cancer – Pain

An open-label extension study to investigate the long-term safety and tolerability of THC/CBD oromucosal spray and oromucosal THC spray in patients with terminal cancer-related pain refractory to strong opioid analgesics
– J Johnson 2013 (1:1 Sativex) View Article

Opiod-Refractory Cancer Pain

Nabiximols for opioid-treated cancer patients with poorly-controlled chronic pain: a randomized, placebo-controlled, graded-dose trial
– RK Portenoy 2012 (1:1 Sativex) View Article

Cancer - Chemotherapy-induced nausea & vomiting

Cancer – Childhood Chemo Nausea Vomiting

Antiemetic medication for prevention and treatment of chemotherapy induced nausea and vomiting in childhood
– R Phillips 2016 (THC – Cannabis) View Article

Chemotherapy Induced Nausea

Dronabinol for chemotherapy-induced nausea and vomiting unresponsive to antiemetics.
– M May 2016 (THC-Dronabinol) View Article

Cancer – Nausea and Vomiting

Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy
– LA Smith 2015 (THC-Cannabis Exacts) View Article
Regulation of nausea and vomiting by cannabinoids and the endocannabinoid system
– KA Sharkey 2014 (THC-Dronabinol, 1:1 Sativex) View Article
Efficacy of dronabinol alone and in combination with ondansetron versus ondansetron alone for delayed chemotherapy-induced nausea and vomiting
– E Meiri 2007 (THC-Dronabinol) View Article

AIDS/Positive HIV status-Adjunctive-treatment for side effects

HIV/AIDS – Morbidity and Mortality

The medical use of cannabis for reducing morbidity and mortality in patients with HIV/AIDS.
– EE Lutge 2013 (THC-Cannabis) View Article

Cachexia or Wasting Syndrome

Lung Cancer – Anorexia

The effect of nabilone on appetite, nutritional status, and quality of life in lung cancer patients: a randomized, double-blind clinical trial
– JG Turcott 2018 (THC-Nabilone) View Article

Anorexia and Weight Loss

Dronabinol oral solution in the management of anorexia and weight loss in AIDS and cancer
– M Badowski 2018 (THC-Dronabinol) View Article

HIV-Wasting Syndrome

A Phase I/II Study to Evaluate Single Agent and Combination Therapy With Megestrol Acetate and Dronabinol for the Treatment of HIV-Wasting Syndrome
– G Galetto 2008 (THC-Dronabinol Megestrol) View Article

Cancer – Anorexia

Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a North Central Cancer Treatment Group study
– A Jatoi 2002 (THC-Dronabinol) View Article

Seizure Disorders

Refer to Epilepsy Category

Epilepsy

Epilepsy – Children

Efficacy of CBD-enriched medical cannabis for treatment of refractory epilepsy in children and adolescents – An observational, longitudinal study
– M Hausman-Kedem 2018 (20:1) View Article

Epilepsy

Epilepsy and Cannabis: A Literature Review
– S Zaheer 2018 (CBD:THC and CBD) View Article
Cannabinoids and Epilepsy
– EC Rosenberg 2015 (CBD) View Article
Epilepsy Cannabinoids for epilepsy
– D Gloss 2014 (CBD) View Article

Epilepsy – Pediatric

CBD-enriched medical cannabis for intractable pediatric epilepsy: The current Israeli experience
– M Tzadok 2016 (20:1) View Article

Multiple Sclerosis

Evidence for the efficacy and effectiveness of THC-CBD oromucosal spray in symptom management of patients with spasticity due to
multiple sclerosis
– U Zetti 2016 (1:1 Oro-mucosal spray) View Article
Tetrahydrocannabinol:Cannabidiol Oromucosal Spray for Multiple Sclerosis-Related Resistant Spasticity in Daily Practice
– P Vermersch 2016 (1:1 Sativex) View Article
Sativex(®) and clinical-neurophysiological measures of spasticity in progressive multiple sclerosis.
– L Leocani 2015 (1:1 Sativex) View Article
Advances in the management of multiple sclerosis spasticity: recent clinical trials.
– O Fernandez 2014 (1:1 Sativex) View Article
A double-blind, randomized, placebo-controlled, parallel-group study of Sativex, in subjects with symptoms of spasticity due to multiple sclerosis
– C Collin 2010 (1:1 Sativex) View Article
Randomized controlled trial of cannabis based medicine in spasticity caused by multiple sclerosis
– C Collin 2007 (1:1 Oro- mucosal spray) View Article
Do cannabis-based medicinal extracts have general or specific effects on symptoms in multiple sclerosis? A double-blind, randomized, placebo-controlled study on 160 patients
– D Wade 2004 (1:1 Sativex) View Article

MS-Neurologic Disorders

Systematic review: Efficacy and safety of medical marijuana in selected neurologic disorders
– B Koppel 2014 (1:1 Sativex) View Article

Spasticity

Spasticity

Clinical and Preclinical Evidence for Functional Interactions of Cannabidiol and Δ9-Tetrahydrocannabinol
– D Boggs 2018 (1:1 Sativex) View Article

Chronic Spinal Cord Injury

Delta-9-tetrahydrocannabinol-cannabidiol in the treatment of spasticity in chronic spinal cord injury: a clinical experience
– C Grao-Castellote 2017 (1:1 Sativex) View Article

Spasticity – MS Induced

Evidence for the efficacy and effectiveness of THC-CBD oromucosal spray in symptom management of patients with spasticity due to multiple sclerosis
– U Zetti 2016 (1:1 Oro-mucosal spray) View Article
Tetrahydrocannabinol:Cannabidiol Oromucosal Spray for Multiple Sclerosis-Related Resistant Spasticity in Daily Practice
– P Vermersch 2016 (1:1 Sativex) View Article
Sativex® and clinical-neurophysiological measures of spasticity in progressive multiple sclerosis.
– L Leocani 2015 (1:1 Sativex) View Article
Advances in the management of multiple sclerosis spasticity: recent clinical trials.
– O Fernandez 2014 (1:1 Sativex) View Article
A double-blind, randomized, placebo-controlled, parallel-group study of Sativex, in subjects with symptoms of spasticity due to multiple sclerosis
– C Collin 2010 (1:1 Sativex) View Article
Randomized controlled trial of cannabis based medicine in spasticity caused by multiple sclerosis
– C Collin 2007 (1:1 Oro-mucosal CBM) View Article
Do cannabis-based medicinal extracts have general or specific effects on symptoms in multiple sclerosis? A double-blind, randomized, placebo-controlled study on 160 patients
– D Wade 2004 (1:1 Sativex) View Article

Chronic Spinal Cord Injury

Effect of Cannabinoids on Spasticity and Neuropathic Pain in Spinal Cord Injured Persons
– K Ethans 2015 (THC-Dronabinol) View Article

Spasms – ALS

Randomized Placebo-Controlled Crossover Trial With THC (Delta 9-Tetrahydrocannabinol) for the Treatment of Cramps in Amyotrophic Lateral Sclerosis (ALS)
– M Weber 2009 (THC-Dronabinol) View Article

Severe Muscle Spasms

Refer to Spasticity Category

Parkinson’s Disease

MS, Autism, Parkinsons, Alzheimers, Tourette’s, Huntington’s, Epilepsy

Neurological Disorders in Medical Use of Cannabis: An Update
– R Solimini 2017 (THC, CBD, plant) View Article

Parkinsons

The Therapeutic Potential of Cannabinoids for Movement Disorders
– B Kluger 2015 (THC-Nabilone) View Article
Cannabis for dyskinesia in Parkinson disease A randomized double-blind crossover study
– CB Carroll 2004 (Extract-Oral Cannabis) View Article
Cannabinoids reduce levodopa-induced dyskinesia in Parkinson’s disease: a pilot study
– KA Sierdzan 2001 (THC-Nabilone) View Article

PD-Neurologic Disorders

Systematic review: Efficacy and safety of medical marijuana in selected neurologic disorders
– B Koppel 2014 (THC, plant) View Article

Glaucoma

Glaucoma

Marijuana and Glaucoma
– T Graul 2018 (THC) View Article

Retinal Hemodynamics

Dronabinol and retinal hemodynamics in humans
– N Plange 2007 (THC-Dronabinol) View Article

Interocular Pressure

Effect of sublingual application of cannabinoids on intraocular pressure: a pilot study. [CBD shown to cause adverse events.]
– I Tomida 2006 (Sublingual THC & CBD) View Article

PTSD

PTSD

Cannabinoids and post-traumatic stress disorder: clinical and preclinical evidence for treatment and prevention
– M Zer-Aviv 2016 (THC-Nabilone) View Article
Preliminary, open-label, pilot study of add-on oral Δ9-tetrahydrocannabinol in chronic post-traumatic stress disorder
– P Roitman 2014 (Oral THC) View Article

PTSD – Nightmares

The efficacy of nabilone, a synthetic cannabinoid, in the treatment of PTSD-associated nightmares: A preliminary randomized, double-blind, placebo-controlled cross-over design study
– R Jetly 2015 (THC-Nabilone) View Article

PTSD – Nightmares, Insomnia, Chronic Pain

Use of a Synthetic Cannabinoid in a Correctional Population for Posttraumatic Stress Disorder–Related Insomnia and Nightmares, Chronic Pain, Harm Reduction, and Other Indications
– C Cameron 2014 (THC-Nabilone) View Article

Autism Spectrum Disorder

Autism

Cannabidiol Based Medical Cannabis in Children with Autism- a Retrospective Feasibility Study
– A Aran 2018 (20:1) View Article
Oral Cannabidiol Use in Children With Autism Spectrum Disorder to Treat Related Symptoms and Co-morbidities
– D Barchel 2018 (20:1) View Article

Crohn’s Disease

Crohns

Cannabis finds its way into treatment of Crohn’s disease
– R Schicho 2014 (THC, plant) View Article
Side effects, health risks, and a short duration of action limit the usefulness of this drug
– T Naftali 2013 (THC) View Article

Muscular Dystrophy - Pain

Malignant Disease – Pain

Pharmacotherapeutic considerations for use of cannabinoids to relieve pain in patients with malignant diseases
– M Darkovska-Serafimovska 2018 (1:1 Sativex) View Article

What forms of Medical Marijuana are allowed in Louisiana?

The acceptable forms of medical marijuana in Louisiana, approved by the legislature, are oils, extracts, tinctures, sprays, capsules, pills, solutions, suspension, gelatin-based chewables, lotions, transdermal patches, suppositories, and metered-dosed inhalation.

What are Medical Cannabis Tinctures?
Medical cannabis tinctures are packaged in a 30 mL glass bottle with a dropper. Tincture dosages are easy to self-titrate and measure. Tinctures are easily absorbed by the liver, so the effects are felt more quickly than in pill or gelatin based chewable form. Because of this, tinctures represent an effective method of consumption for precise dosing.

Tinctures are administered either: (click here)

Orally

You place the instructed dosage into your mouth and swallow. You should start to feel the effects coming on between 30 to 90 minutes, with a peak maximum effect reached after two to three hours, and last for about 4 to 12 hours, depending on the dose.

Sublingually

You place the instructed dosage under your tongue and hold for 30 seconds and then swallow. This helps get the medicine into your bloodstream quicker and is a preferred method that will allow you to feel the effects coming on faster and stronger.

Oils

Oil is a concentrated extract derived from the marijuana plant. Oils can be consumed in many ways, but the most common are placing under your tongue via a dropper or through a vaping device. Depending on how the oil was consumed, it typically will take up to 20 minutes to start feeling the effects.

Extracts

Extracts are a type of concentrate created using solvents (alcohol, carbon dioxide, etc.) that essentially wash the trichomes off the cannabis plant, collecting them for further refinement. All having similar effects, cannabis extracts can come in many different forms, like oils, lotions, sprays, and more.

Sprays

Cannabis sprays are another form of tincture. Sprays come in small bottles, that allows you to consume the oil. Usually used by spraying inside mouth onto cheeks and under the tongue, the effects can take approximately 30 minutes.

Capsules

Capsuled cannabis comes in a small pill-like form, allowing the patient to ingest orally. Researchers say that a capsule pain-relieving effect may last longer throughout the day.

Solutions

Medical marijuana solutions are mixtures that dissolve thoroughly, allowing each ingredient to be equally distributed. Some cannabis solutions can include lotions.

Suspensions

In a medical marijuana suspension, there are usually two main ingredients that are unable to dissolve with one another. Therefore, there are small particles that remain intact. Most cannabis suspensions include oils.

Gelatin-Based Chewables

Gelatin-based chewables are another option for patients who choose not or does not want to consume capsule forms of medical marijuana. When consuming chewables, the cannabis enters the bloodstream and is further digested. This then is broken down by the stomach and absorbed by the intestines. These chewables take typically 30 minutes- 1 hour to reach the maximum effect.

Lotions

Medical marijuana comes in topical forms, such as creams and lotions. This allows the patient to rub on the lotion at any point where they may be experiencing discomfort or pain. Lotions are known to help over-worked muscles, patients with eczema and psoriasis, or any kind of aches and pains.

Since the rate of absorption of the skin is slow, this allows the therapeutic relief to last longer, while avoiding the altered mental states from developing.

Transdermal Patches

Transdermal patches are an easy and effective way to receive pain relief throughout the day. These medical marijuana patches allow an immediate infusion into the bloodstream allowing all day relief. Transdermal cannabis patches range in dosages and are very user friendly: it’s as simple as unwrapping and sticking it to the desired area.

Suppositories

Over the past few years the use of these medical marijuana suppositories has risen. After entering the rectal mucosa, the healing components of the plant-based medicine quickly spread to the organs and into the bloodstream. Unlike pills or any oral consumption of medical cannabis, suppositories do not allow the patient to experience a “head high”. These are also easy to use at home and offers just as many benefits as any other product.

Metered Dose Inhalation

Charged with natural extracts of cannabis, the aerosol sprayed from a metered dose inhaler is coarser than smoke yielding more cannabinoids per dose. Very little of the product (~5%) dissipates or is exhaled, allowing you to medicate without exposing others to significant second hand aerosol.

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Medical Marijuana