Cannabis And Mental Health: Dementia

Can you help treat dementia with cannabis?
Cannabis and Mental Health: Dementia
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A new case of dementia is diagnosed every three seconds.  

Dementia is an all too common syndrome that is not at all a normal part of aging, according to the World Health Organization. The WHO reports that 47 million people in the world had dementia as of 2015. Of those, 63% live in middle-to-low-income countries. The WHO expects this number to rise to 71% by 2050.

Dementia is a term that describes symptoms of a loss in specific functions in the body: communication, daily performance and memory. The syndrome, not a disease, is most commonly associated with the elderly with its likelihood increasing as a person ages. 

While some conflate dementia with Alzheimer’s disease, it is important to note the distinction that Alzheimer’s is a specific disease grouped under dementia. 

The damage caused by dementia often extends beyond the patient and into the lives of their  family members. While we attempted to contact families affected by dementia, none were able to provide High Times with their personal accounts.  However, one personal blog published their family’s story, outlining  some of the difficult decisions a family might have to make concerning their loved ones. 

“When Mom’s Alzheimer’s progressed to the point that she became combative and personal hygiene became an issue, my brother planned to put her in a nursing home, but I quit my job to look after her. I moved her to Portland with me and took over her care, to focus on the quality of her remaining life,” the post says.

The account went on to list the numerous medications the writer’s mother was on before switching to cannabis. They included five over-the-counter drugs and three inhalers, as well as medications for asthma, seizures, allergies, and other ailments.

In addition to personal blogs, treating dementia with cannabis garnered national attention is the case of the Spier family. Alexander Spier, the family patriarch, was a Holocaust survivor who became a business owner in the United States. The two years leading up to his death from Alzheimer’s-related conditions in 2017 were, predictably, painful for him and his family, and  involved episodes like leaving his nursing home twice, requiring Spier’s family to move him to Florida to a dedicated care facility. 

Today, the family operates the Spier Family Foundation, which offers support to several hospitals and their medical research efforts. 

Dr. Rahul Khare is a doctor working on such efforts. The founder and CEO of Innovative Express Care & Innovative Ketamine Care said his work includes studying the therapeutic uses of medical cannabis and CBD for several mental and physical conditions. 

The Chicago-based physician has used CBD, THC, and other compounds in the plant’s profile to address patients’ symptoms and conditions. He said that cannabis may be best suited to treating a patient’s aggressive behavior. Dr. Khare explained that, traditionally, a patient would be given a benzodiazepine, like Ativan or Valium, to address such behavior. The end result is a person who is out of commission for four to six hours.

Instead, the physician recommends a cannabis tincture in the gums or a nasal spray. “Patients are much more likely to be compliant when using cannabis due to the lower side effect profile than other drugs in managing these aggressive symptoms of dementia,” explained Dr. Khare.

In February 2019, a THC/CBD oral spray mentioned by Dr. Khare, Sativex, was part of the first major trial to determine the effects of cannabis on dementia patients. The drug had previously been approved for patients with multiple sclerosis.

Others believe cannabis can be a treatment option in cases where drugs are required if other methods fail to produce results. Dr. Krista Lanctôt is a University of Toronto professor and senior scientist with the Hurvitz Brain Sciences Research Program at Sunnybrook Health Sciences Centre. In July 2018, she wrote how agitation issues should first be treated with non-drug solutions, though some conditions require medication, including cannabis. Dr. Lanctôt went on to compare standard medical solutions and cannabinoids. 

She wrote, “In fact, the medications that tend to be the most effective can sometimes lead to stroke, or even death. Cannabinoids, on the other hand, interact with the body differently, which means they could be safer and more effective overall for someone experiencing agitation.”

The doctor added, “Some of [the] effects [of cannabis] are even thought to help reduce brain cell death.”

While not enough to prove beyond a shadow of a doubt, studies over the years have concluded that cannabis does have the potential to aid in addressing many adverse side effects brought on by dementia. This includes a 2019 open study which found that cannabis may improve the behaviors of dementia patients. A 2016 open study also found cannabis “significantly decreased” symptoms including delusions, aggression, irritability, sleep and apathy—resulting in lower levels of caregiver distress as well.

Despite the findings from individual studies, a positive association between cannabis and dementia treatment cannot be made at this time. While some doctors like Dr. Khare believe CBD can help calm a patient, and THC can act as a quick sedative, others worry about the patient’s overall cognition. Associate scientist at Sunnybrook Health Sciences Centre in Toronto Dr. Nathan Herrmann was one to think this.”There is good reason to be concerned that cannabinoids could make cognitive function worse, either by direct effects or by causing excessive sedation,” he once said.

Dr. Herrmann and his team cited a lack of studies, many pointing to little to no positive effects. The researchers aimed to provide further clarity with an analysis of their own. The findings from their first clinical trial using synthetic cannabinoids as an Alzheimer’s treatment were released in July 2018. The results stated that the drug Nabilone can help improve a patient’s symptoms. The team hopes to conduct a more extensive study to confirm its conclusions on agitation while determining if Nabilone can improve patients’ appetites and lower pain levels.  

As always, consult with a medical professional before treating dementia or any related conditions with cannabis.

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