By MICHAEL C. PATTERSON
A recent study published by the US National Institutes of Health (NIH) and Frontiers of Psychiatry found that the use of a synthetic cannabinoid medicine (dronabinol) decreased Neuropsychiatric symptoms (NPs) in a clinical study of a female patient with severe Alzheimer’s Disease (AD). The link to the study is here:
Alzheimer’s Disease is a debilitating neurogenerative disease that affects approximately 17 percent of people in the world from ages 75-84. Neuropsychiatric symptoms (NPS) such as delusions, agitation, anxiety, and hallucinations are present in up to 95 percent of patient in all stages of dementia. As someone with a tremendous amount of experience as an occupational therapist working in an Alzheimer’s nursing home for 3 years and treating Alzheimer’s patients for over 20 years, I can tell you that it is one of the worst diseases for humanity I have ever encountered.
Currently, there is no prescription drug that has been approved specifically for the treatment of NPs. The clinical case study involved is from a female patient diagnosed with AD with continuous cognitive decline and dementia related behavioral symptoms. Between 2008 and 2019, the patient was examined every 6 months at the memory clinic of the Medical University in Innsbruck, Austria. During each visit, the patient’s cognitive state and pharmacological treatment were evaluated via the neuropsychiatric inventory (NPI). In 2018, the patient progressed to severe AD stage and presented with progressive NPs (anxiety, delusions, agitation, aggressive behavior, and suspected pain due to long immobility).
At this time, off label treatment with low-dose dronabinol (synthetic THC) was initiated. Once low-dose dronabinol use commenced, the patient’s emotional state improved, while disruptive behavior, aggression, and sedation decreased significantly. Furthermore, the patient was decreased from 6 psychotropic drugs to 3 after starting dronabinol due to no longer requiring the added psychotropic drugs.
Analysis
The results in this case study are consistent with anecdotal results seen in patients all over the world using THC or synthetic THC medical cannabis. There is evidence that cannabinoid therapy can break up amyloid plaques in the brain (which are caused by AD), and therefore decrease NPs of Alzheimer’s. Cannabis and cannabinoid therapy are becoming more mainstream within the medical community due to their extremely low side effects and positive results in relieving symptoms of many different diagnoses.
More research will continue to be done on AD using cannabinoid therapy. The early results are extremely positive, which can increase AD patient and caregiver physical and emotional health, increasing overall quality of life, and a decrease in AD related health care expenses related to severe AD (falls, fractures, decrease in poly-pharmacy by taking less prescription medication, 24/7 supervised care)
Medical Cannabis Does Not Create Cognitive Decline in Seniors
A recent study published in the September 2020 edition of the Drug and Alcohol Review, determined that the use of medical cannabis does not create a cognitive decline in senior citizens. The link to the study is here:
https://onlinelibrary.wiley.com/doi/10.1111/dar.13171
The study was performed by Sharon R. Sznitman PhD, Senior Lecturer, Simon Vulfsons MD, Director, David Meiri PhD, Lecturer, Galit Weinstein PhD, Senior Lecturer at Israel’s Haifa University School of Public Health. The study included 125 cannabis users who were 50 years and older. Out of the 125 study participants, 63 had Israeli government permission to use cannabis and 62 did not have permission.
Each participant was put through a multitude of tests consisting of CogState computerized brief battery used to assess cognitive performance of psychomotor reaction, attention, working memory and new learning. Regression models and Bayesian t‐tests examined differences in cognitive performance in the two groups. Furthermore, the associations between medical cannabis use patterns (dosage, cannabinoid concentrations, length and frequency of use and hours since last use) with cognition were assessed among medical cannabis licensed patients.
Patients were tested before use of medical cannabis and after use of medical cannabis. The result of the study showed no detectable difference in cognitive ability before or after use of medical cannabis.
Dr. Sharon Sznitman and Dr. Galit Weinstein noted that the results of the study do not show any widespread change on cognition in older chronic pain patients. Considering use of medical cannabis is increasing in older populations, this study could be a first step toward a better risk-benefit assessment of the use of medical cannabis with Seniors. The researchers also noted that “previous studies have shown that medical cannabis can have long-term effects on the brain when consumed at a young age. Those affects are not necessarily the same when consumed in old age.”
Analysis
Senior Citizens are the fastest growing demographic of users of medical cannabis in the United States. With over 435,000 medical cannabis patients in Florida and the average age of a medical cannabis patient over 50 years old, many Seniors are currently using medical cannabis. However, these numbers could be considered the “tip of the iceberg.” As more senior citizens become comfortable using medical cannabis for their diagnoses with less side effects and more relief than traditional pharmaceutical medications, we will see many more seniors starting to use medical cannabis into 2021 and beyond.
Physicians and health care organizations need to educate seniors on the benefits of medical cannabis and begin to track the data related to outcomes of seniors who take cannabis as a medicine. Not only is medical cannabis safer than traditional pharmaceuticals (for most patients), but it is also more cost effective for health care organizations (ACOs) for cost of care per patient. The evidence is in the data. As more ACOs and health care entities start to track the data around use of medical cannabis and see better outcomes and decreased cost of healthcare within their system, you will see more acceptance of medical cannabis as a medicine within the current healthcare community.
Michael C. Patterson, founder and CEO of U.S. Cannabis Pharmaceutical Research & Development of Melbourne, is a consultant for the development of the medical marijuana industry nationwide and in Florida. He serves as a consultant to Gerson Lehrman Group, New York and helps educate GLG partners on specific investment strategies and public policy regarding Medical Marijuana in the U.S. and Internationally. He can be reached at mpatterson@uscprd.com
