Written by Andrew Zimmerman
Parkinson’s Disease (PD) is the 14th-leading cause of death in the United States. It is the second most common neurodegenerative disease after Alzheimer’s, and effects nearly one million Americans and 10 million people worldwide.
Medical marijuana has become better known for its medicinal properties than ever before and is now legal for medical use in over 30 states. This is the first time in the 62 year history of the Parkinson’s Foundation that they are talking openly about medical marijuana as a treatment for the symptoms of Parkinson’s.
Led by James Beck, PhD, who has led the Parkinson’s Foundation’s scientific programs since he joined the organization in 2008, the effort has a goal of establishing a consensus as to its use with PD patients. So in Denver, CO, on March 6-7, 2019, a conference was held which brought together various experts from all over the world to discuss the implications and recommendations of medical marijuana use for people with Parkinson’s.
You may be wondering why now? Well, it turns out that the Parkinson’s Foundation teamed with Northwestern University (a Parkinson’s Center of Excellence) to conduct a 73-item, online survey regarding the use of medical marijuana and Parkinson’s, as they studied the attitude towards marijuana at 40 Parkinson’s Centers of Excellence via the survey – the results are overwhelming and unexpected:
- 95% of neurologists polled have been asked to prescribe medical marijuana to PD patients.
- 80% of patients with PD have used cannabis.
- 23% of doctors received formal education on medical marijuana.
The study results also included:
- The fact that only 23 percent of physicians had any formal education on the subject of cannabis, thus 93 percent of physicians polled want cannabis treatment taught in medical school.
- Only 10 percent of physicians have recommended the use of cannabis to patients with PD.
- Regarding patient memory: 75 percent of physicians felt that cannabis would have negative effects on short-term memory and 55 percent felt that cannabis could have negative effects on long-term memory.
- Only 11 percent of physicians have recommended the use of cannabis in the last year.
An additional outcome of the study revealed that cannabis can allegedly reduce tremors for PD patients. Researchers are speculating that cannabis might be “neuroprotective” as it saves neurons from the damage caused by Parkinson’s.
The findings also stated that there is considerable risk in using marijuana with PD, as PD patients already have impaired “executive function,” which are thinking processes that help us make safe decisions. As marijuana has a psychoactive effect on users, it is possible that this could further impair a PD patient, so caution should be used and each case evaluated for risks and benefits.
The study also spoke to the risks and benefits concerning the use of marijuana for people with PD should be reviewed and considered. Possible benefits include improvements in anxiety, pain management, sleep dysfunction, weight loss and nausea. Potential risks include impaired cognition, dizziness, blurred vision, mood and behavioral changes, loss of balance and hallucinations. Chronic use of marijuana can increase risk of mood disorders and lung cancer (if smoking).
A final outcome of the study was that physicians would be more likely to prescribe marijuana in general if it was approved through regulation as opposed to legislation.
For medications to be approved, they need to undergo a science-based evaluation that proves their effectiveness, overseen by the U.S. Food and Drug Administration. As marijuana has been approved through legislation as opposed to regulation, there are no common labels, dosage recommendations or timing guidance that physicians can use as reference.
Ultimately, it will be up to individuals and their families and caregivers to determine if marijuana is an option for them and managing their Parkinson’s.
More on Parkinson’s Disease
Parkinson’s disease (PD) is challenging to live with, as it causes progressive changes to motor function as well as many other non-motor symptoms, including depression, sleep problems, pain, and cognitive dysfunction. PD is a neurodegenerative disorder that mostly affects the dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called substantia nigra. Symptoms generally develop slowly over years. The assessment of Parkinson’s is governed by a rating scale that will assess any motor symptoms, including movement and tremors, as well as non-motor symptoms, such as loss of smell.
There are 5 stages of Parkinson’s Disease:
Mild symptoms such as tremors along one side of the body may be present at this stage. Often the symptoms are mild enough not to interfere with daily life, but slight changes in walking, posture, or facial expressions may be noticed by those around them.
Both sides of the body may be affected by slightly worsened tremors or rigidity. Issues with posture and walking may become quite noticeable and everyday activities may be harder to achieve but patients will still be able to do things for themselves.
As motor symptoms become worse, patients may begin to experience loss of balance leading to falls and movement can become very slow. Although many patients can still live independently they may have difficulty in everyday activities such as eating or dressing.
In this later stage, symptoms are now extremely limiting. Many patients can still stand without assistance but movement is greatly impaired. Most will need help with everyday activities and will not be able to look after themselves.
This is the most advanced stage of the disease and most patients will experience difficulty in walking and standing, often requiring a wheelchair. Assistance will be needed in all areas of daily life as motor skills are seriously impaired. In addition, people with advanced Parkinson’s disease may also begin to suffer hallucinations.
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