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What Can Cannabis Do for Patients with ALS?

Part of a group of rare degenerative neurological conditions, amyotrophic lateral sclerosis (ALS) causes muscle stiffness and cramping that can be extreme. Difficulty swallowing, slurred speech, and muscle twitching are also markers of this progressive disease, often named for New York Yankees baseball player Lou Gehrig, who infamously had his career cut short in 1939 following his diagnosis. The condition also is known as motor neuron disease (MND) for the way it kills neurons that control voluntary muscle movement

Fifteen people each day are diagnosed with the incurable disease, according to the ALS Association . Treatments include prescription medications as well as holistic options, such as speech therapy, breathing exercises, and medical marijuana.

The prognosis for ALS is poor and few patients live beyond five years with the disease, although there are notable exceptions. Physicist Stephen Hawking lived for more than half a century with ALS, but his case was an anomaly.

What has current research told us about how cannabis may be able to improve the quality, or even the quantity, of life for patients with ALS?

Research Overview

Research has been encouraging in the treatment of ALS with cannabis with a number of studies and clinical trials leading the way.

(Photo via Andrei_R/Shutterstock)

The Studies

A 2010 study published in the American Journal of Hospice and Palliative Care found that cannabis was effective in addressing issues associated with ALS. Researchers described the powerful antioxidative, anti-inflammatory, analgesic, appetite-stimulating, muscle relaxing, and neuroprotective properties of cannabis. All of these properties could pertain to symptom management of ALS, according to the authors of the study. In addition, delayed onset and slower disease progression were observed in mice with ALS. Based on all these findings, researchers made a strong recommendation for clinical trials of cannabis to treat ALS.

In 2016, a literature review published in the journal Neural Regeneration Research expanded on the claims of the 2010 study. The authors of the review concluded that “there is a valid rationale to propose the use of cannabinoid compounds in the pharmacological management of ALS patients. Cannabinoids indeed are able to delay ALS progression and prolong survival.” However, they did note the need for studies performed on humans and targeted clinical trials.

One such clinical trial is presently under way at the Gold Coast Hospital and Health Service in Queensland, Australia. The trial involves 30 participants with ALS or MND. The patients will alternately be treated with CBD oil or a placebo and the study is estimated to wrap up in January 2021.

These research studies and trials have paved the way for some ALS patients to integrate cannabis into their therapeutic treatments.

Patient Perspectives

Just before his 40th birthday, Sam Jundef of Marlboro, New Jersey, was diagnosed with ALS. In the four years since his diagnosis, the once-athletic father of two cannot move, speak, or breathe without assistance. Sam has gained some relief from vaping marijuana, but the process is arduous and involves disconnecting his ventilator.

Because of these challenges, Sam and his wife, Jessica, have been fighting for access to transdermal medical marijuana patches in New Jersey. Jessica lamented to New York City’s WPIX-TV in 2018 that, “He’s 43 years old. He can’t walk. He can’t talk. He can’t eat. He can’t breathe on his own and, like, why can’t we provide things for him that are going to make his life easier? Why should my husband, who has ALS, who’s dying, whose every day is precious, why should he have to suffer a minute?”

There may be good reason why ALS patients and their loved ones are battling for legal access to cannabis medicine. Cathy Jordan, a retired resident of Parrish, Florida, has been living with ALS since 1986. With an average survival rate for ALS patients falling between two and five years, Cathy’s longevity is exceptional. She credits medical marijuana with stopping ALS in its tracks. Cathy chronicled her journey in Florida Food & Farm in 2017: “I turned 36 on New Year’s Day 1986. But during that first week, I knew I had ALS. I was hoping beyond hope I didn’t have ALS. I started choking on my own saliva. I didn’t want to end my life like that.”

Then, in 1989, Jordan turned to medical marijuana and her life changed: “I smoked my first Myakka Gold. I’m convinced that whatever was in that pot stopped my disease.”

Jordan’s survival story is an unusual one but may provide hope to some ALS patients who have tried other treatments that have failed. What do the experts have to say about cannabis as a treatment for ALS?

(Photo via bubutu/Shuttershock)

What the Experts Say

Dr. Dale J. Lange, Chairman of Neurology, Neurologist-in-Chief, and Professor of Neurology at Weill Medical College of Cornell University in New York, has initiated a clinical trial to test the effects of cannabis on ALS. Lange told HuffPost in 2015: “I am very interested in looking into the effects of high CBD/low THC in patients with ALS and UMN predominant motor system disease.”

That eminent professionals in the field such as Lange are probing the possibilities is a hopeful sign, but there is much more work to be done to ensure legal access for patients in need.

The Bottom Line

A burgeoning body of evidence indicates that cannabis could work as part of a comprehensive treatment plan for patients with ALS.

Featured Image illustrated by Allena Braithwaite/Weedmaps

What Can Cannabis Do for Patients with ALS? Part of a group of rare degenerative neurological conditions, amyotrophic lateral sclerosis (ALS) causes muscle stiffness and cramping that can be

Here’s How Getting Stoned Affects Your Body

In an ideal world, with rigorously regulated dispensaries and organic pot at shoppers’ disposal, would a healthy person be healthier if she used marijuana?

Balancing 24 credits, marching band, sorority council meetings, and a part-time job was taking a toll on Cali G., then a 21-year-old University of Missouri student. Overwhelmed, she turned to alcohol to mellow out.

“My responsibilities became unbearable. I would come home from class, grab a beer, and chug my way into a fog,” she says. After one particularly brutal hangover, Cali swore off hard drinking. Then, on a camping trip with friends, she had a pot epiphany.

“My friends told me that smoking weed is safer for your lungs than cigarettes,” says Cali, who is now 24 and living in southern California. “After learning how to do it, I sank into a state of relaxation I’d rarely felt before. It was like I’d been wearing a weighted vest but now it was lifted off.”

The next morning, Cali watched as campers who had gotten drunk staggered out of their tents. “I was munching on Goldfish crackers, thinking, Damn, I’m glad I missed out,” she recalls. “That went against what I’d believed before: Weed is bad, and alcohol is legal. There’s a reason for that, right?”

Long-held beliefs about pot are shifting fast. Fifty- three percent of Americans (and 68 percent of millennials) support legalization, according to a March 2015 survey by the Pew Research Center. It’s already fine to use medicinally in 23 states and DC—prescribed for pain, nausea, insomnia, PTSD, and more—and you can light up recreationally in Colorado, Washington, Oregon, and Alaska. Which means plenty of people may be wondering the same thing as Cali: Might pot be better for you than alcohol?

In the Pew survey, about 7 out of 10 respondents said drinking is the more damaging habit.

They seem to be right. Last year, researchers compared the deadliness of 10 substances for a study published in Scientific Reports. Booze and tobacco were among the top four. Alcohol abuse is linked to 1 in 10 deaths among 20- to 64-year-olds annually, including car accidents, homicides, and suicides. Smoking cigarettes kills more than 200,000 women each year from heart attack, stroke, lung cancer, and emphysema. Marijuana, meanwhile, was last on the list—about 114 times less fatal than alcohol.

“In modest amounts, marijuana doesn’t cause terrible harm to anyone’s health,” says Igor Grant, MD, director of the Center for Medicinal Cannabis Research, at the University of California at San Diego. Still, he and other experts argue that more research is needed before we endorse pot as a health positive. But because the federal government categorizes marijuana in the most dangerous class of drugs, it’s incredibly difficult to get the approval and supplies necessary to conduct a gold-standard study that might show weed’s benefits. Pot may turn out to be a more virtuous vice than booze, but that doesn’t mean getting baked is good for you.

It’s no news flash that marijuana use affects coordination, time perception, and memory. It can hinder your ability to pay attention and alter your judgment, says Nora Volkow, MD, director of the National Institute on Drug Abuse. “Sometimes, I do get to that point where I can’t focus and realize I’ve smoked too much,” says Annie D., 25, who works in e-commerce in Washington. Teens and young adults, in particular, may not be able to learn as much while high, Dr. Grant says. And Dr. Volkow points out that the brain is still developing until age 24 or 25.

Marijuana can affect mood disorders and mental health too. In some, it can cause or exacerbate anxiety and depression. And those with a genetic predisposition might be at risk of developing schizophrenia if they use pot, a 2012 study in Biological Psychiatry concluded. Longtime users may experience withdrawal symptoms like unease, restless- ness, and irritability if they quit.

Scary, yes, but such effects aren’t that different from what drinkers experience. A few drinks can impair memory, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) states. And withdrawal symptoms from heavy, long-term alcohol use are much more alarm- ing: hallucinations or delusions.

There’s some evidence pot may have negative effects on your heart, including case reports of heart attacks and strokes among recent or heavy users. But little is known about the link, says David Goff, Jr., MD, PhD, dean of the Colorado School of Public Health at the University of Colorado at Aurora. One study from 2013 shows that pot may decrease fertility, because it can lower levels of the luteinizing hormone, needed for ovulation. And smoking pot isn’t great for your lungs. It can’t compare to the health effects of tobacco, partly because, as Dr. Goff notes, “people don’t smoke a pack of joints a day.” Still, he says, “voluntarily putting smoke into your lungs is dumb.” Dr. Grant adds, “When you smoke marijuana, you bring in tars that can cause lung cancer.” Using a vaporizer may reduce your tar exposure.

Pot & Your Safety

Tori C., a student at a large southern university, skips alcohol and smokes pot usually. She feels it keeps her safer. In the fall of 2014, she was sexually assaulted after a party where she and her attacker had been drinking.

It happens way too often: More than 690,000 college students are assaulted each year by someone who has been drinking, NIAAA statistics estimate. The annual number of victims of alcohol- related sexual assaults, specifically, is 97,000. Pot, meanwhile, tends to lessen aggressive behavior. Moderate and high doses may even suppress violence and reduce irritability and hostility in group settings, according to a review of research in Addictive Behaviors.

Evidence of this is emerging outside the lab. Compared with the first six months of 2013, the murder rate in Denver, Colorado, dropped by 38 percent in 2014, the first year you could lawfully buy pot. The rate of forcible sex offenses dropped by almost 19 percent. Critics caution, however, that it may be a case of correlation, not causation.

Tori knows the only person to blame for her rape is her rapist. Still, she says, “I was too drunk to fight back. Drinking inhibits my ability to function more than pot. When I smoke, I stay in control.”

She feels the same way about driving high. She tries not to drive under the influence of anything, she says, “but if I had to, I could drive stoned. There’s no way I could operate a vehicle drunk.” She’s not way off base. A 2010 study published in the American Journal
on Addictions found that drivers under the influence of alcohol underestimate how impaired they are, while participants who smoke pot drive cautiously to compensate. Drunk drivers also have more trouble keeping a car in its lane than marijuana users do.

None of which endorses drugged driving. Pot-related
road fatalities appear to be rising: About 12 percent of U.S. drivers in fatal accidents in 2010 had cannabinoids in their system,
up from 4.2 percent in 1999. “If you’re high, you shouldn’t be driving,” says Dr. Grant. “One could argue that drunk driving is worse, but that doesn’t mean pot is safe.”

Pot & the Bottom Line

This debate is far from over, so maybe take it slow. Legalization opponents worry there isn’t enough education and regulation to keep users safe. Denver has seen a rise in ER visits after people ingested large amounts of pot- laced goodies, which can cause anxiousness and hallucinations. In one tragic case, a visiting college student jumped off a balcony and died. “When I bought weed from a dispensary, I asked, ‘What are the side effects? What’s the correct dose?'” says Carla Lowe, founder of Citizens Against Legalizing Marijuana. They were very unhelpful and blasé, she says.

Most states have agencies intended to provide some level of oversight on how dispensaries operate, but Paul Armentano, deputy director of the National Organization for the Reform of Marijuana Laws, notes that there are no agreed-upon safety regulations of any kind: no supervision of testing facilities, and tests for contaminants aren’t standardized. “People are used to buying weed on the black market with no idea about quality,” he says. “As consumers get more sophisticated, they’ll demand higher quality and better testing.”

So in an ideal world, with rigorously regulated dispensaries and organic pot at shoppers’ disposal, would a healthy person be healthier if she used marijuana? Probably not. Studies show the most support for marijuana’s ability to relieve pain and muscle spasms, per a review published in the Journal of the American Medical Association in 2015. Evidence of other benefits is unclear. And if weed has protective qualities that might help healthy women, it remains to be seen. It’s still illegal for recreational use in nearly every state, of course. In those places where it is legal, it’s up to individuals to decide if pot is lifting them up or holding them back.

For Tori C., marijuana became a crutch instead of a cure. After the trauma of her sexual assault, she admits she abused pot for months, getting high several times a day to “be numb.” Her best friend set her straight: “She told me to stop smoking all the time and do my homework. I found a therapist, and my grades got better. Smoking so much just put a Band-Aid on what was really bothering me.”

This article was originally published as “Should Everybody Just Get Stoned?” in the January 2016 issue of Cosmopolitan . Click here to get the issue in the iTunes store!

In an ideal world, with rigorously regulated dispensaries and organic pot at shoppers' disposal, would a healthy person be healthier if she used marijuana?