Medical Marijuana Update

Medical Marijuana Update

As we enter a new era in Canada, it’s important to look at what’s happening in other places.  Medical marijuana is legal in the majority of states in the USA.  It is also legal in Australia although it is much more difficult to get.  The supply is limited and there are no dispensaries.  Medical marijuana in general doesn’t make it accessible to most people.  Finding a doctor who will prescribe it isn’t always easy.  Only a limited number of conditions are approved.  What medical marijuana does is increase quality because the product is lab tested.

Recreational use is legal in Canada and in nine states of the US.  This designation makes it much easier to obtain and quality can be determined by the consumer.  In these states we find labs creating cleaner products that are free of fungus, pesticides, bacteria and chemicals.  We can also get specific amounts of CBD:THC which allows is important for targeting specific symptoms.  I’m looking forward to these kinds of labs emerging in Canada.  At this time we can’t import across the border safely.  It can be hit or miss what you get from a dispensary.

CBD For Pain

Medical marijuana is antispasmodic.  Women who experience intractable pain during their cycle, CBD can help relax the muscles.  It also dampens the communication from the pain receptors to the brain.  What people report is still feeling the pain but it doesn’t bother them in the same way.  This is important because the body can begin to heal when the pain response is lower.

Medical marijuana is anti-inflammatory.  Therefore we see an improvement other symptoms as well.  The side effects of other anti-inflammatories and pain medications can be severe.  Not to mention that many of the stronger pain killers are habit forming and can result in overdose.  I had a patient yesterday with a severe back spasm.  The hospital denied him pain medication.  NSAIDs don’t work for him because they are hard on the gut.  He suffers from gastritis.  He has no history of addiction to opiods.  So why was he denied?

Another patient of mine had suffered with endometriosis for years.  CBD was the only pain medication that helped her function.  Once her pain was down she was able to make important decisions about her health, her career and her family.

Why does it work? How to take it?

The endocannabinoid system is part of our body. It’s a modulatory system that affects brain, endocrine, and immune tissues. Our body has endocannabinoid receptors.  We produce chemicals naturally that are very similar to the chemical cascade of what occurs when we take CBD.

Smoking causes harm.  Vaporization is a good alternative as are oils or tinctures.  Suppositories can be excellent for severe abdominal and pelvic pain. Women who suffer from pain during intercourse are experiencing relief.  But again we need to have standardized products.  I have had two patients who experienced high anxiety and paranoia using products from a dispensary.

Women’s Health

Endocannabinoids appears to play a very important regulatory role in the secretion of hormones related to reproductive functions and response to stress.

Women are using CBD for symptoms associated with PMS including painful periods, anxiety and insomnia.  During perimenopause and menopause women are experiencing relief by using CBD particularly for insomnia and anxiety.

Pregnancy and Breastfeeding

There are only a few small studies on the subject of use in pregnancy.  The results show a propensity towards pre-term labour and delivery.  They also showed use over 20 days during pregnancy may result in lower birth weight.  It is difficult to do clinical trials during pregnancy but this limited evidence shows that caution is warranted. Use during breastfeeding exposes the infant so the benefits need to be weighed carefully against the benefits.

One circumstance where more research could be valuable is when nausea/vomiting during pregnancy are extreme.  Given that malnutrition of both mother and fetus is a concern, careful administration of CBD likely offers less risk than other medications that are used in this circumstance.

Dr. Rachna Patel is an expert in use of medical marijuana.  Her website is an excellent resource.

 

 

Getting to the Root of Postpartum Depression

Getting to the Root of Postpartum Depression

Sleep in pregnancy is important. It’s often the last uninterrupted sleep for months or even years. In counselling psychology, the cause of most postpartum depression is understood as a insomnia combined with anemia. This makes a lot of sense. In acupuncture theory we know that anemia can be the root of both insomnia and depression.

The second and third trimester is when iron levels tend to drop. This is in part due to an increase in fluid volume but also because the fetus is growing rapidly.   Low iron stores aren’t seen seen as a problem unless there are symptoms associated. Insomnia is not necessarily one of those symptoms. A midwife at my clinic was intrigued when I explained the connection.    

The amount of blood required to nourish a pregnancy and new-born is massive. Combine this with loss of blood at birth, low levels to begin with and a diet that is not nutrient dense to result in many health concerns. This is the perfect storm resulting in a tired mother who can’t sleep even when her baby is.  Early diagnosis and prevention can limit suffering. 

Research shows that postpartum depression isn’t limited to the first year of after birth. In fact onset is most common later, around the time a child is 4 years old. The number of lost nights of sleep is countless by then.   I often refer to motherhood as a high intensity endurance challenge. If this is so then preparing for it makes a lot of sense.

Patients who are ready to have children come to see me. Ideally both parents want to optimize their health prior to conception. I resolve any gut issues because we know this can contribute to a heightened stress response. We look at nutrient status and rule out any absorption issues.

We talk about stress management and hormone balance.   Onset of autoimmune driven thyroid disease occurs after pregnancy in the majority of cases. Preventing this by looking a specific markers and ensuring that triggers are removed is a first step.   Looking at the long-term health of the parents is the best way to support the child. Fertility, pregnancy or breastfeeding all require similar diet and lifestyle strategies.

Patients have told me they didn’t know they were depressed until they begin feeling better and are able to reflect.   Compound work, relationship, physical, mental and emotional stress along with a new baby means extra care and attention are needed.  Keep in mind that postpartum depression is a type of clinical depression affecting both sexes. Symptoms include sadness, low energy, changes in sleeping or eating patterns, reduced desire for sex, anxiety and irritability.  In severe cases in can include panic attacks, social withdrawal, addiction and psychotic episodes.