Why medical cannabis should be covered by plans and payers

With cannabinoid-based medicines, clinicians can often wean multiple other meds - which not only has a powerful effect on patients' well-being - but also a huge cost-saving effect. I'll be publishing some data on this soon - but if any of you have further evidence to illustrate this, please reach out. We'd love to get more people involved in the #CoverCannabis Project. Once the provinces & payers understand the cost-benefit, hopefully there will be more coverage for medical cannabis - especially for our most vulnerable patients. Check out more of my thoughts on this in this article.

CBD Reduces Plaque, Improves Cognitive Function in Model of Familial Alzheimer's

There is a dire need for novel therapies to improve outcomes for patients with Alzheimer’s Disease, which is considered one of the fastest-growing health threats of our time. 

In a promising new study published in the Journal of Alzheimer’s Disease, investigators reported that a two-week course of high dose CBD helped reduce plaque and improve cognitive function in an experimental model of early onset familial AD.

Familial disease is an inherited version of Alzheimer’s in which symptoms typically surface in the 30s and 40s and occurs in about 10-15% of patients.

Next steps include determining optimal doses and giving CBD earlier in the disease process. They also are exploring delivery systems including the use of an inhaler that should help deliver the CBD more directly to the brain. 

See article below for more information. https://www.sciencedaily.com/releases/2021/03/210309192548.htm 

Citation for journal article, available here https://pubmed.ncbi.nlm.nih.gov/33612548/

Reefer MEDness Podcast - Discussing Dementia & Autism Spectrum Disorder

It’s always such a privilege to be invited onto any podcast to share my experience...but I have to say this was a uniquely awesome experience to be welcomed onto one founded by a nurse and pharmacist, that is dedicated to furthering the conversation around medical cannabis, AND is grounded in science. 

In this episode we talked about the challenges of managing dementia in long-term care, as well as managing behaviours associated with autism, where other treatments have failed. We don’t have a lot of good options in our standard medicine toolbox for either of these - but I’m seeing results with cannabinoid-based medicine.

Thanks so much to Trevor and Kirk at Reefer MEDness for such a great conversation. 

Full episode available here.

New Warnings About Benzodiazepine Use and Dementia Risk

There have been several studies that have indicated that have linked benzodiazepine use to an increased risk for Alzheimer's disease (AD).

This is one out of Finland is one of the largest. 

Lead author Vesa Tapiainen, MD, PhD, said: “These drugs are often used to treat sleep problems, but their efficacy for this indication diminishes over time, whereas the risks for adverse events remain.”

In addition to insomnia, benzodiazepines and other so-called "Z" drugs, such as zolpidem (multiple brands) and zopiclone (Lunesta, Sunovion), are used to treat other neuropsychiatric symptoms of dementia, such as anxiety.

Commenting on the study’s findings, David S. Knopman, MD (Mayo Clinic, Alzheimer's Association Medical and Scientific Advisory Council), noted that many studies have suggested that patients who are exposed to certain psychoactive drugs, such as those with cholinomimetic properties, are at increased risk for dementia.

"I therefore find it plausible that benzodiazepines and related drugs could carry the same risks," he said. 

The "bottom line" for Knopman is that use of certain psychoactive drugs seems to increase the risk for dementia. However, it is unclear whether the drugs are temporarily worsening cognition or symptoms are being treated with these drugs, said Knopman.

"In other words, the direction of causality from drugs to dementia could go in either direction, and this study that used administrative data can't determine the direction of causality," he said.

Nevertheless, a take-home message is that benzodiazepines and related sleep medications should be avoided "if at all possible" in older individuals, said Knopman.

Similar to benzodiazepines and “Z” drugs, cannabinoid-based medicines have anxiolytic, anticonvulsive and relaxing effects. When dosed low and slow by an experienced healthcare practitioner, cannabinoids can be equally or more effective than these medications in managing symptoms, but with a far superior side-effect profile. 

Read the full study here.