Pros and Cons of Medical Cannabis use by People with Chronic Brain Disorders

Abstract

Background: Cannabis is the most widely used illicit drug in the world and there is growing concern about the mental health effects of cannabis use. These concerns are at least partly due to the strong increase in recreational and medical cannabis use and the rise in tetrahydrocannabinol (THC) levels. Cannabis is widely used to self-medicate by older people and people with brain disorders such as amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), Alzheimer’s disease (AD), Parkinson’s disease (PD), bipolar disorder, and schizophrenia.Objective: This review provides an overview of the perceived benefits and adverse mental health effects of cannabis use in people with ALS, MS, AD, PD, bipolar disorder, and schizophrenia.Results: The reviewed studies indicate that cannabis use diminishes some symptoms associated with these disorders. Cannabis use decreases pain and spasticity in people with MS, decreases tremor, rigidity, and pain in people with PD, and improves the quality of life of ALS patients by improving appetite, and decreasing pain and spasticity. Cannabis use is more common among people with schizophrenia than healthy controls. Cannabis use is a risk factor for schizophrenia which increases positive symptoms in schizophrenia patients and diminishes negative symptoms. Cannabis use worsens bipolar disorder and there is no evidence that bipolar patients derive any benefit from cannabis. In late stage Alzheimer’s patients, cannabis products may improve food intake, sleep quality, and diminish agitation.Conclusion:Cannabis use diminishes some of the adverse effects of neurological and psychiatric disorders. However, chronic cannabis use may lead to cognitive impairments and dependence.

Neuroprotection or Neurotoxicity of Illicit Drugs on Parkinson’s Disease

“…In countries where cannabis is legal, marijuana is used recreationally to self-medicate symptoms of disorders such as PD, multiple sclerosis, amyotrophic lateral sclerosis and schizophrenia [129]. About 44% of the population with PD is currently using marijuana [130].…”

“…About 44% of the population with PD is currently using marijuana [130]. In addition to cannabis, three cannabis derived products are also in use: dronabinol, nabiximols and nabilone [129]. Despite the lack of solid scientific evidence, PD patients using cannabis mention a positive impact on mood, memory, fatigue, obesity, sleep, pain, tremor, rigidity and bradykinesia after its consumption.…”

Disease-modifying and symptomatic treatment of amyotrophic lateral sclerosis

“…In general, most anti-spastic drugs might cause fatigue and nausea and therefore have to be increased very carefully to ensure compliance. There are several reports in the literature about anti-spastic and possible other beneficial effects of cannabis in ALS, 69 but there are no systematic approaches.…”

Pros and Cons of Marijuana in Treatment of Parkinson’s Disease

“…It is estimated that the number of individuals with PD is expected to increase to nine million by 2030 in fifteen of the most populous countries worldwide [2]. About 3% to 5% of the world’s population is known to use marijuana, making it the most popular illicit substance [3].…”

“…In the United States, about 20 million people are marijuana users, estimated to 12.3% of its total population, with about 1.2 million individuals using medical marijuana. As many as 23 states, as well as District of Columbia (DC), have legalized medical marijuana, and four states have legalized its recreational use [3]. The use of marijuana has increased four times in individuals aged 55 to 59 years and doubled among the elderly population aged 60 to 64 years, between 2002 and 2012 [3].…”