Category: Medical

cannabis & epilepsy

Medical Marijuana and Epilepsy

Does Medical Cannabis & Epilepsy go together? Epilepsy Ireland describes epilepsy as a neurological disorder which affects the brain. It is a tendency to have repeated seizures. This tendency can be long term, but the seizures can be controlled meaning that a person can have epilepsy but may not have active seizures. Seizures can start in a part of the brain or happen on both sides of the brain at once. Approximately one-third of patients with epilepsy have seizures that are resistant to antiepileptic medications.

Read more here: https://www.epilepsy.ie/content/epilepsy-explained

What is Medical Cannabis?

Medical cannabis is a broad term for cannabis-based medicine that is used to relieve symptoms of certain conditions. The cannabis plant contains more than 100 different chemicals named cannabinoids, with each one producing a different effect on the endocannabinoid system in the body. Delta-9 tetrahydrocannabinol (THC) and cannabidiol (CBD) are the two main cannabinoids used in medicinal cannabis in Ireland. Medical cannabis and epilepsy have a long history, with some evidence to suggest it was used in medieval times as a treatment. Medical cannabis is available in Ireland for treatment-resistant epilepsy. 

You can find out all about Medical Cannabis here.

An Overview of Cannabis & Epilepsy Research

One of the first successful trials for cannabis and epilepsy was conducted in 1978 by Mechoulam and Carlini. Patients were given 200mg of CBD daily for three months. The findings of the study show that half of the patients had no seizures during the three months of the trial, with no side effects reported. 

In 1980 Cunha et al conducted a further study on the relationship between cannabis and epilepsy. Patients were given 20-300mg of CBD daily for up to 18 weeks. Half of the patients remained seizure-free during the trial, with the remainder of patients finding they had a partial improvement in their symptoms. 

In 2016 Devinsky focussed on the treatment-resistant condition Dravet Syndrome. Dravet syndrome is a complex childhood epilepsy disorder that is associated with drug-resistant seizures and a high mortality rate. 120 children and young adults were part of this trial and received CBD Oil for epilepsy at a dose of 20 mg per kilogram of body weight per day. The study concluded that among patients with Dravet syndrome, cannabidiol resulted in a reduction in convulsive-seizure frequency, with 5 % becoming seizure-free. 

There are many forms of treatment-resistant epilepsy that can be helped with medical cannabis. Lennox-Gastaut Syndrome is a rare form of epilepsy that affects 2 per 100,000 people. Affected children experience several different types of seizures most commonly atonic, tonic, and atypical absence seizures. Children with Lennox-Gastaut syndrome may also develop cognitive dysfunction, delays in reaching developmental milestones and behavioural problems. Lennox-Gastaut syndrome can be difficult to treat because it is resistant (refractory) to many kinds of antiseizure medications. Devinsky enrolled 225 patients to receive cannabidiol oral solution at a dose of either 20 mg or 10 mg per kilogram of body weight or a placebo over the course of 14 weeks. The study showed those receiving 10 or 20 mg doses had a reduction in the frequency of seizures vs. the placebo group. The study concluded that among children and adults with Lennox-Gastaut syndrome cannabis, in particular, CBD oil was effective at reducing seizure frequency in the treatment of epilepsy. 

How does a person qualify for the use of Medical Cannabis? 

To qualify for the Medical Cannabis Access Programme for cannabis treatment for epilepsy, a person must suffer from severe, refractory (treatment-resistant) epilepsy. A patient will be permitted to access cannabis treatment for epilepsy when the patient has failed to respond to standard treatment.  You can take our eligibility checker to see if you are eligible to qualify for the Medical Cannabis Access Programme. 

Medical Cannabis Access Programme 

On 26th June 2019, the Minister for Health signed legislation to allow for the operation of the Medical Cannabis Access Programme (MCAP) on a pilot basis for five years.

The MCAP enables a medical consultant to prescribe a cannabis-based treatment for a patient under his or her care for the following medical conditions, where the patient has failed to respond to standard treatments:

You can read all about the Medical Cannabis Access Programme here.

Register as a Patient Today.

Types of Epilepsy 

Epilepsy can be classified into four main categories: focal, generalised, combined focal and generalised, and unknown. If a patient experiences two or more unexplained seizures, a doctor will typically make the diagnosis of epilepsy.

The majority of individuals with epilepsy receive medication, and as a result, two-thirds of them live seizure-free lives. For one-third of adults, medication is ineffective in managing their seizures. Although it is rare for epilepsy to go away on its own, seizures can be controlled with the right treatment. Epilepsy does not have to prevent you from leading a normal, fulfilling life.

Marijuana and Epilepsy 

According to the research, Tetrahydrocannabinol (THC), the most well-known active component of cannabis, is just one of a number of compounds that have been found to have medical properties. Cannabidiol (CBD), another compound non-psychoactive, is becoming one of the most well-known compounds in the treatment of epilepsy. 

How does THC affect people with Epilepsy? 

Both THC and CBD are in a group of substances called cannabinoids. They bind to receptors in the brain and are effective at managing conditions such as epilepsy and multiple sclerosis. While there is a mounting consensus among people with epilepsy that medicinal cannabis is effective, like all medications there can be side effects. 

CBD for Epilepsy 

Beyond seizure management alone, CBD medicines have the potential to address problems of the nervous system that cause seizures. According to the studies above, CBD has resulted in patients becoming seizure-free or drastically reducing the frequency of seizures leading them to live a full and normal life.  

How to take Cannabis for Epilepsy 

Working with a doctor when using medical cannabis to treat seizures is very important. Your doctor can help determine if medical cannabis will interact with any of your current medications and if it best suits your condition. 

Are there any side effects? 

Side effects might also depend on how the drug is taken. Smoking it would pose a risk to the lungs while eating it would not. Talk to your doctor if you are suffering from epileptic seizures and are not responding to traditional treatments. They can explain your options and provide information about medical cannabis treatment for epilepsy. The most common side effects of CBD include:

  • sleepiness
  • drowsiness
  • diarrhoea
  • loss of appetite

Is Medical Cannabis legal? 

Medical cannabis is available for treatment-resistant epilepsy under the Medical Cannabis Access Programme. You may be open to prosecution if you obtain cannabis without a valid prescription. 

Read more on: Is Medical Cannabis Legal in Ireland

Conclusion 

Medical cannabis and epilepsy have a long history together. In more recent years research has unlocked its potential as an epilepsy treatment. Studies have shown medical cannabis can result in patients living seizure free life, or drastically reducing their seizures resulting in a better quality of life.  If you suffer from treatment-resistant epilepsy you may qualify for medical cannabis under the MCAP programme. 

prescription for medical cannabis

Medical Cannabis Ireland: All about Medical Marijuana

Medical cannabis is a broad term for cannabis-based medicine that is used to relieve symptoms of certain conditions. The cannabis plant contains more than 100 different chemicals named cannabinoids, with each one producing a different effect on the endocannabinoid system in the body. Delta-9 tetrahydrocannabinol (THC) and cannabidiol (CBD) are the two main cannabinoids used in medicinal cannabis in Ireland.

How is Cannabis used Medically?

There is evidence to suggest medical cannabis can be helpful in the management of chronic pain, including neuropathic pain; spasticity; nausea and vomiting, particularly in the context of chemotherapy; and in the management of anxiety.

Further evidence also moderates evidence that medical cannabis can be beneficial in treating sleep disorders; appetite stimulation in the context of chemotherapy; fibromyalgia; post-traumatic stress disorder; and for some symptoms of Parkinson’s disease.

How does it help?

Medical cannabis treatment may help in several areas:

 

https://pubmed.ncbi.nlm.nih.gov/24778283/

https://bedrocan.com/wp-content/uploads/adding-medical-cannabis-to-standard-analgesic-treatment-giorgi_2020.pdf

Medical Cannabis Access Programme

In June 2019 the Minister for Health launched the Medical Cannabis Access Programme to be operational on a pilot basis for five years. The programme will help facilitate access to medicinal cannabis for suitable candidates.

The programme makes it possible for a consultant to prescribe medicinal cannabis for a number of conditions, where a patient has failed to respond to traditional pharmaceutical treatments.
Currently, three conditions qualify under the Medicinal Cannabis Access Programme.

The Medicinal Cannabis Access Programme is currently under review by the Department of Health.

Register as a Patient Today.

Difference between Marijuana and Medical Cannabis

Medical cannabis is prescribed by a consultant doctor who understands which product would be most medically beneficial for their patient. Marijuana or cannabis bought from unlicensed sources without a prescription is currently illegal in Ireland.

Hemp Vs. Marijuana Vs. CBD

Hemp , Marijuana and CBD all come from the same species, the Cannabis Sativa plant although variations can exist. The defining difference is their THC content. Hemp has a low THC volume, commonly below 0.3% THC meaning it does not produce the same psychoactive effect.

Hemp is ordinarily used for industrial purposes such as textiles but also produce CBD. Marijuana on the other hand is a high-THC variation of the Cannabis Sativa plant.

What are the common uses of Medical Cannabis?

The most common uses of medical cannabis in Ireland are limited to the three conditions listed above. Namely, Epilepsy, Multiple Sclerosis and nausea and vomiting due to chemotherapy.

Intractable nausea and vomiting associated with chemotherapy
Nausea and vomiting due to chemotherapy are common side effects of treatment. Medical cannabis for cancer patients has been shown to alleviate these symptoms. Considerable evidence demonstrates that manipulation of the endocannabinoid system regulates nausea and vomiting in humans. According to randomised research, medicinal cannabis is more effective than traditional medication for treating nausea and vomiting due to chemotherapy.

Severe, refractory (treatment-resistant) epilepsy.
Approximately one-third of patients with epilepsy have seizures that are resistant to antiepileptic medications. Traditionally CBD was seen as the most effective cannabinoid for drug-resistant epilepsy, although recent studies have found that for medical cannabis treatment for epilepsy “whole-plant medical cannabis products are superior to isolated CBD products in patients” and can result in a reduction in the frequency of seizures.

Spasticity associated with multiple sclerosis
60-84% of multiple sclerosis patients experience spasticity. When severe, it can be extremely challenging in terms of mobility. Studies have shown that cannabis treatment for multiple sclerosis can show an improvement in spasticity measures in over half of the patients treated. Research conducted with 279 people with MS in the UK showed the relief from muscle stiffness for those people taking the medical cannabis extract was “almost twice as high than with placebo.

Can I get a prescription for Medicinal Cannabis in Ireland?

Medical cannabis prescriptions are available in Ireland. To obtain a prescription, under the Medical Cannabis Access Programme, a consultant with specialist training in a specified medical condition may prescribe medicinal cannabis to their patient. Cannabis for medical use will only be prescribed once other treatments have failed. The Health Service has issued clinical guidelines to inform consultants.

How do I get a medical cannabis card?

Oleo launched its Medical Cannabis Card in November 2022. The Oleo Medical Cannabis Card will be the same size as other cards in your wallet. It will contain your photo and the details of your medical cannabis prescription including your Cannabis for Medical Use Register (CMUR) number. You can find all the details about the card and how to apply here.

How much Medical Cannabis will I be provided?

We cannot determine how much medicinal cannabis will be provided to the patient. This will be dependent on the patient’s condition and the severity of their symptoms. This aspect is best discussed with your consultant.

Different methods to consume Medical Marijuana

Depending on the medical marijuana product you are prescribed there are multiple ways to administer medicinal cannabis.

  • Inhalation: Inhaled cannabis may be the most well-known method of administration for medical cannabis flowers. The main benefit of inhaled cannabis is that the onset of action is practically quick, making it simple for a patient to titrate the dosage for maximal benefit. At Oleo we have developed our Panacea Inhaler which is available to patients prescribed medical cannabis under the Medical Cannabis Access Programme and is also available to buy on Amazon.
  • Sublingual: Sublingual delivery is another option for the administration of oil-based medical cannabis. Medical cannabis oil can have a rapid onset of action by being administered under the tongue or in the oral cavity. The patient feels the effects after a few minute. Other cannabis products may come in a spray bottle that can be sprayed directly into the mouth.
  • Tablet/ Pill format: Cannabinoids are soluble in fat, their absorption through the gut is slower and less predictable, depending on both the metabolism of the individual and the contents of the stomach. Determining an effective dose is more challenging, especially for the inexperienced patient, because the onset of the effect may take up to an hour to occur.

What will be the effects of Medical Cannabis?

Medical cannabis may aid with pain relief, nausea and vomiting control, inflammation reduction, and inflammation depending on the condition you are trying to treat. Medical cannabis may also interact with other treatments. It is best to discuss this with your Consultant.

Are there any side effects of Medical Cannabis?

Medical cannabis, like all medications, poses a risk of side effects. The type of medical cannabis product, the active chemicals (such as CBD, THC, or a combination), and individual differences can all have a significant impact on side effects. THC-containing products can impair driving and cognitive performance and produce sedation, anxiety, dizziness, appetite stimulation, and other symptoms. Although CBD rarely has significant negative effects on its own, it can change the effects of other prescribed drugs.

Will it Make me feel high?

In many cases, the answer to this is: only if you want to unless the dosage you need is quite high. The doses needed for medical purposes are often significantly lower than what is used recreationally. The most commonly reported adverse reactions in the first four weeks of exposure were dizziness, which occurs mainly during the initial period, and fatigue.

These reactions are usually mild to moderate and resolve within a few days even if treatment is continued.

What is THC? And how is it different from CBD?

THC, known by its scientific name, Tetrahydrocannabinol is the principal psychoactive constituent of cannabis and one of at least 113 total cannabinoids identified on the plant.

CBD, also known as Cannabidiol, is the second most common cannabinoid found in the cannabis plant. CBD does not produce any psychoactive effect.

Both CBD and THC are chemically similar to your body’s endocannabinoids. This allows them to interact with your cannabinoid receptors. Although CBD and THC have similar chemical structures, they don’t both have the same psychoactive properties. While CBD is psychotropic, it does so differently than THC. It doesn’t result in a THC-related high. The brain’s cannabinoid 1 (CB1) receptors bind with THC. It results in a high or euphoric feeling. According to research, this high can be more intense if the THC is inhaled as opposed to consuming.

Is Using Medical Cannabis Legal in Ireland?

Prescribed medical cannabis is legal in Ireland. Cannabis obtained without a valid prescription will fall under the Misuse of Drugs Act 1977 and will be deemed illegal. You can view a breakdown of the laws relating to illegal cannabis here.

Read our similar blog on: Is Medical Cannabis Legal in Ireland

Medical Cannabis Ireland

The availability of medical cannabis prescriptions is relatively new in Ireland. Nonetheless even in its infancy medical cannabis and related research have shown the potential benefits of medical cannabis for alleviating patients’ symptoms across a range of conditions.

The Medical Cannabis Access Programme is currently under review by the Department of Health. The Department of Health has commissioned an evidence review to access scientific research on the efficiency and safety of cannabis-based treatments for a range of conditions The initial stage of the review has been completed. A clinical group will now be convened to access this evidence and provide guidance on any amendments to the Medical Cannabis Access Programme. This is expected early in the new year.

 

Medical Cannabis Access Programe

Dublin man becomes first patient in Ireland to be prescribed medicinal cannabis

In November 2021, Ryan Gorman (26) was the first patient in Ireland to be granted a prescription for medical cannabis through the Medical Cannabis Access Programme (MCAP).  Ryan has an aggressive form of epilepsy as well as Autism Spectrum Disorder.  He received the high CBD, low THC formula which is approved by the Primary Care Reimbursement Service (PCRS), making it free of charge.

Ryan’s father and full-time carer, Brendan Gorman spoke with BusinessCann and shared his joy on this major milestone:

“For those people out there that have been waiting so anxiously to see when I’m gonna get access to it, finally the day has arrived. It can only be described as wonderful news, and hopefully, the benefits will be there for everybody,” he said.

“It’s not about being first or being last or in the middle. What is important is that if it becomes accessible, and the barriers are broken down, it’s almost like the Berlin Wall, one goes through then the rest will follow.”

Health Minster Stephan Donnelly announced in July 2021 that medical consultants can register themselves and their patients to the MCAP through the HSE.  Patients will need to be registered before they can be prescribed cannabis-based products.  Minister Donnelly said when announcing the start of the programme:  “Today is a significant step forward in the ongoing delivery of the MCAP.

“This step forward will greatly assist patients who, under the supervision of their consultant, need to avail of medicinal cannabis products to alleviate the effects of their severe medical conditions.

“I now hope the programme continues to go on and grow and expand further, to best meet the needs of patients and families around Ireland.”

Under MCAP only a consultant can prescribe medical cannabis where conventional treatment has failed.  A poll carried out by Red C on behalf of The Journal early last year found that only 4 per cent of people were opposed to the use of medical cannabis.  Almost 1,000 adults across Ireland took part in the survey,  they weighted to be an accurate profile of the population.

The programme is only available to patients with the following medical conditions: spasticity associated with multiple sclerosis, intractable nausea and vomiting associated with chemotherapy and treatment-resistant epilepsy.

 

The endocannabinoid system and the revolution of one | Rachel Knox | TEDxPortland

DR. RACHEL KNOX, MD, MBA

Dr. Rachel Knox, MD, MBA is a cannabinoid medicine specialist and clinical endocannabinologist who received her medical and business degrees from Tufts School of Medicine after completing her undergraduate studies at Duke. She trained in family and integrative medicine before pursuing additional study in the areas of functional medicine, cannabinology, and endocannabinology.

Along with her family, Dr. Rachel founded Doctors Knox, Inc., American Cannabinoid Clinics, and Pivital Edu to advance education in cannabinoid medicine and in the clinical care of the endocannabinoidome.

Dr. Rachel is also a policy and regulatory consultant on cannabis and psychedelics, and her commitment to reform extends into educating communities of color about the roles cannabis, psychedelics, and other plant medicines can play in addressing the Minority Health Disparity Gap, and the broader way in which these plants can impact the total wellbeing of these communities through health equity.

She is co-founder and president of the Cannabis Health Equity Movement™ (CHEM), and chair of the Association for Cannabis Health Equity and Medicine (ACHEM) and CHEM Allyance. She serves her home state of Oregon as the immediate past chair of the Oregon Cannabis Commission, member of Portland’s Cannabis Policy Oversight Team, member of Oregon’s Psilocybin Advisory Board, and board member for NuLeaf PDX; and also sits on several national boards including Cannabis Regulators of Color Coalition (CRCC), Doctors for Cannabis Regulation (DFCR), Minority Cannabis Business Association (MCBA), American Academy of Cannabinoid Medicine (AACM), and US Cannabis Council.

 

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