The Role of Cannabis in Treating Long COVID

During a recent (and highly important) call with one of my publishers, I put the call on mute whenever I wasn’t speaking so I could projectile vomit. I was having a migraine, but the call was too important to reschedule. Unfortunately, while they may work for some, Sumatriptan, along with Topamax, Nurtec, and every other migraine medication doctors prescribed me, play into the accompanying nausea and I throw it up before any pain relief for my head (which hurt so badly I wanted to put a bullet through my brain) could set in. While I’m going to continue to see neurologists and (when I can get in, the waitlists are nuts) a long-term COVID specialist, the next time a migraine strikes, I’m sticking with THC gummies, honey. Thank god cannabis is also good for nausea.

I didn’t have migraines before I had COVID, which I got in 2020 from a friend, shortly after restaurants opened up but before there was a vaccine. I figured if restaurants could open, I could risk this respiratory disease; after all, I’m young, healthy, and never smoked tobacco, I even stick primarily with edibles when it comes to cannabis. What I, and the general public didn’t know, is that COVID affects the brain, too. According to The Washington Post, the blood vessels of our brains are lined with endothelial cells, which have angiotensin-converting enzyme 2 (ACE2) receptors, a type of protein that the coronavirus latches onto. This causes such cells to become inflamed, which harms the blood-brain-barrier, inducing swelling and resulting injury. As a result, me, and many others, now have what’s called long COVID, symptoms or effects of the disease that last weeks, months, or as I can attest to, even years after first exposure.

“Primarily, what we’re seeing is long-term cognitive consequences,” says cannabis clinician Dr. Mikhail Kogan, who is part of the George Washington University faculty and the author of Medical Marijuana: Dr. Kogan’s Evidence-Based Guide to the Health Benefits of Cannabis and CBD. “Patients present with cognitive decline, and more severe cases present with outright dementia.” He says that common symptoms of long COVID include mood disorders such as depression, anxiety, insomnia, and pain, such as my migraines (which don’t help with anxiety, depression, or insomnia, you can imagine). Hair loss, brain fog, and changes in taste and smell are also common. For some folks, long COVID symptoms are totally out of the blue, but for others, it’s almost as if the SARS CoV-2 virus triggers latent conditions, or health problems they were predisposed to and the infection activated. “What happens a lot is that we uncover other problems when we start working with long COVID patients because we find that they’ve had other problems going on for a long time, but they were very mild, so nobody paid enough attention.”

Thankfully, as The Washington Post points out, while there are instances of older people getting dementia after exposure, these neurological injuries usually take place in younger folks, between the ages of 20 and 50, who never needed hospitalization. Eventually, the symptoms resolve for some people. But for others, they’re still reeling from the ongoing destruction.

David, 30, out of Enfield Connecticut, and his partner of 10 years first got COVID in late January of 2020. First, his partner picked it up after traveling across several states to pick up the couple’s new rescue dog, Ellie. David got COVID shortly thereafter. “Fast forward a tad I also get sick, we are bed bound, I needed to use walls and my bed frame to even hold myself up. It was like the flu, mixed with food poisoning, vertigo, and so much more. Jump ahead to 2021, we caught Delta in September,” David says.

Since then, after they got over “having COVID,” and were no longer contagious, the health problems persisted. “Over the past three years, we have realized a large accumulation of things wrong with us that just weren’t issues before. I have trouble breathing in intense heat and cold and I have a lot of coughing fits. Early results are pointing towards lung scarring. I also have Sleep Apnea, and my brain feels like it [has] aged 10-20 years. I have a horrible short-term memory now. I hurt a lot and am often exhausted,” David says. He adds that his partner has a similar list of symptoms, except more severe, in addition to POTS (Postural orthostatic tachycardia syndrome) and Fibromyalgia. “Saying I am ‘better’ than my partner would be like saying if they were given a knife in a gunfight, but I was lucky because I got two knives in a gunfight,” David says. “I hope that makes sense.” It does. 

It’s not a happy story. David’s partner lost their job at a farm due to their long COVID symptoms, and he was no longer able to continue his job in consumer and fan services at LEGO mostly because of long COVID brain fog. “My work output was absolutely awful. If it weren’t for my job there, though, I wouldn’t have the healthcare we had access to for the past two plus years with my work insurance. To say that we would be in a worse position without that insurance would be an understatement. Long COVID has taken away A LOT from us,” David wrote to High Times.

He currently has been able to pick up one-off gigs in the video game industry. David has also found hope somewhere fun other than the video game industry: cannabis. “It helps keep me focused or at least my mind off negative thoughts brought on by long COVID. For me, but much more so for my partner, it helps settle nausea. My partner literally wouldn’t be able to hold down the first meal of the day for a time without taking an edible to help settle their stomach. And sleep, oh do I enjoy actually getting to sleep again since becoming a heavier cannabis user,” David says.

Cannabis is one of the few long COVID treatments that covers a plethora of symptoms rather than one. “Almost no patients present with one symptom, everybody presents with a package. And that package will usually include three to five symptoms. Cannabis is almost the only treatment I can think of that targets all of the symptoms. If a patient comes in with migraines, insomnia, anxiety, and nausea, it’s four medications versus cannabis,” says Dr. Kogan. He says CBD is the first line, but for most pain you want a little bit of CBG in the mix. Noting that this is based on experience, and more research is needed, he adds that CBG is very effective for chronic neuropathic pain when it’s specifically in the settings of anxiety and depression.

Unfortunately, this is tough to study. Not only are doctors still learning more about long COVID everyday, and only have a few years to work off of, but trying to get funding for cannabis research sucks until the Feds finally remove the Schedule I label. But don’t worry. As always, the science nerds find a way. In February of 2022, the UK’s NHS Research Ethics Committee and Medicines and Healthcare products Regulatory agency approved one of the world’s first scientific studies on the efficacy of cannabis to treat long COVID. The study is being done by the NGO Drug Science, founded by neuropsychopharmacologist David Nutt, infamous (but correct?) for stating that horseback riding was more dangerous than taking ecstasy.

Drug Science recently wrapped up their Phase 2 trials. “It’s a feasibility study and we’re half-way through it so I can’t give you any results, but what I can tell you, is that those patients seem to be responding pretty well. There’s no drop out, which is great for a feasibility study. We now have over 3,000 patients who are submitting their data every month to us. What we see through that is that there is a statistically significant improvement in people’s health outcomes since they’ve been prescribed medical cannabis,” Drug Science’s CEO, David Badcock, told High Times over Zoom. They’re giving patients a full-spectrum high-CBD oil, with a small amount of THC, but not enough to produce a high, supported by the company BOD Australia.

According to Dr. Mikhail Kogan, “Most of our patients recover. And the reason they recover is that we don’t look at this the way medicine does. We don’t just prescribe particular treatment, what we say is let’s try to find out why you have these conditions. Let’s try to fix what’s underneath the symptoms.” The brain’s known for its neuroplasticity, or ability to adapt, change, and heal, so while there are plenty of horror stories, there’s no reason patients shouldn’t hope to get better over time.

“Cannabis helps elevate me to a place where I can just say, ‘You know what, your whole life has been trauma after trauma; just give this one the bird and help the two of you love and appreciate each day as best as you can,” David says.