Tag: Healthcare

Endometriosis, often a silent yet profound disruptor in the lives of those it touches, warrants attention – not only for its prevalence – but also for the potential relief that unconventional treatments like natural therapies might offer.

Symptoms can occur as early as eight years old and it takes a long time for patients to acquire a diagnosis in Australia and around the world.

Learn more about endometriosis below and how natural therapies play a role in its management.  

Understanding Endometriosis: A Journey of Resilience

When someone has endometriosis, it means that some of their tissue resembling the womb lining ventures beyond its usual boundaries and often spreads to unexpected corners of the body. This is the reality of endometriosis—a disorder not confined to reproductive organs but capable of infiltrating areas as diverse as the bowel, bladder, and even the skin and brain. 

Endometriosis symptoms are diverse and often misunderstood and with an average timeline of diagnosis is 6.5 years in Australia. Six and a half years is also the world average diagnosis length – but there is a wide spectrum across the world with only a 0.5-year delay in Brazil and an incredible 27-year delay in the UK.

Endometriosis in Everyday Life: Pain Management & Symptoms  

For many, the persistent pelvic pain, especially around menstruation, becomes an unwelcome companion, disrupting daily activities and casting shadows over hopes for fertility.

For others, endometriosis symptoms include abdominal pain, pain during or after sex, pain going to the toilet, irregular bleeding, changes in toilet habits, and not being able to get pregnant (infertility). 

The journey to understand endometriosis, seek diagnosis and manage symptoms is a long one. Often it can be the related emotional and mental stress of managing symptoms and seeking the best individual healthcare support that can be the most overwhelming for patients. 

Embracing Natural Therapies: A Path to Empowerment

In the quest for relief, patients and healthcare providers alike are exploring unconventional treatments, and among them, medicinal cannabis stands out. While the research is ongoing and it might not be suitable for everyone, there is growing evidence suggesting its potential in alleviating symptoms associated with endometriosis. 

The cannabis plant, with its compounds like CBD and THC, has been noted for its analgesic and anti-inflammatory properties, which could offer respite from the debilitating pain and inflammation characteristic of the condition.

• In one study which included several hundred people with endometriosis across Australia and New Zealand, participants self-reported to using cannabis to manage symptoms – whether using a prescription or not. 
• A worldwide survey study with a 1634  participants managing endometriosis showed that 55% of respondents with endometriosis used cannabis specifically for symptom management onlyAnother study showed how cannabis appeared to  be effective for endometriosis associated pelvic pain, gastrointestinal issues and mood, with effectiveness differing based on method of ingestion. 
• Another survey showed that approximately 1 in 10 women with endometriosis self-managed their symptoms with cannabis. Self-reported effectiveness in pain reduction was high (7.6 of 10), with 56% also able to reduce pharmaceutical medications by at least half. Women reported the greatest improvements in sleep and in nausea and vomiting. Adverse effects were infrequent (10%) and minor.. Management strategies should be personalised for the individual and with some reported to include “heat packs (70%), dietary changes (44%), exercise (42%), yoga or pilates (35%) and cannabis (13%).”

Looking Ahead: Collaborating for Change around Endometriosis 

As Endometriosis Awareness Month unfolds, it becomes imperative to foster collaboration among patients, healthcare providers, and advocates. 

Organisations such as Endometriosis Australia play a pivotal role in raising awareness, driving research, and advocating for improved understanding and care. 

Initiatives like the EndoCannED study underscore the importance of exploring novel interventions like medicinal cannabis, providing hope to those seeking relief from the burdens imposed by endometriosis.

Joining the Movement: A Call to Action for Endometriosis 

For individuals living with endometriosis, there’s a palpable sense of solidarity and support permeating the atmosphere this March. 

If you’re over 20 and living with endometriosis in Victoria, you have a unique opportunity to participate in the EndoCannED study. 

In Sydney, the Endo Australia has organised a high tea with inspirational speakers who are paving the way in women’s health and advocacy. 

There are many other local and national groups to join if someone wants to participate and advocate for people living with endometriosis. Management apps like Qendo allow Australians to track their symptoms and record how they’re managing their endometriosis.

Endometriosis Awareness Month serves as a reminder of natural therapies as an option in managing complex conditions like endometriosis. 

Through collaboration, advocacy, and research, we can transform the landscape of endometriosis care, offering hope and empowerment to those affected. 

If you are  interested in learning more about natural therapies and endometriosis, book a free call with one of our Astrid nurses here. The Astrid healthcare team are experts in supporting patients through each individual’s wide ranging health and wellness journey. 

References:

https://www.nicm.edu.au/research/clinical_trials/endocanned_study

https://endometriosisaustralia.org/sydney-endometriosis-australia-high-tea-2024/

https://pure.york.ac.uk/portal/en/publications/understanding-diagnostic-delay-for-endometriosis-a-scoping-review

https://www.qendo.org.au/qendo-app

https://pubmed.ncbi.nlm.nih.gov/34978929/

https://pure.york.ac.uk/portal/en/publications/understanding-diagnostic-delay-for-endometriosis-a-scoping-review

Cancer is a significant health challenge worldwide and profoundly affects the Australian community.

Each type of cancer presents unique challenges, necessitating tailored treatment and care approaches. Living with cancer requires immense strength and resilience. The journey is often arduous, and the support of friends, family, workplaces, and the wider community becomes invaluable.

This blog explores the impact of cancer in Australia, listing the ten most common types of cancer and the importance of recognising symptoms early. We also delve into the essential role of comprehensive support services in managing the challenges of a cancer diagnosis and treatment.

By understanding the diverse aspects of cancer care, we can better support those affected and promote awareness about the importance of informed, compassionate care.

At Astrid, we aim to support our patients with their wellness and medical needs everyday. We’re a team of pharmacists, doctors, nurses and technicians passionate about what cannabinoids and natural medicines can do for our health. 

What is Cancer’s Impact in Australia?

Cancer significantly affects many lives around the world and within the Australian community. Cancer is the second-leading cause of death worldwide. In Australia, there were an estimated 160,000 diagnoses of cancer in 2022 – an estimated 0.5% of the population.

Each type of cancer presents its unique challenges and requires a tailored approach to treatment and care. 

Ten of the most common types of cancer in Australia – with the top five cancers accounting for 60% of all cancers in Australia: 

1. Prostate Cancer 
2. Breast Cancer 
3. Melanoma of the Skin 
4. Colorectal Cancer 
5. Lung Cancer 
6. Non-Hodgkin Lymphoma 
7. Kidney Cancer 
8. Pancreatic Cancer 
9. Thyroid Cancer 
10. Uterine Cancer

Living with cancer requires immense strength and resilience. The journey is often arduous, and the support of friends, family, workplaces, and the wider community becomes invaluable. For anyone concerned about their health or that of someone close to them, seeking advice from healthcare professionals is strongly advised. Recognising symptoms early and receiving informed care are essential steps in effectively managing the challenges of this journey.

What is the Role of Natural Therapists in Cancer Treatment?

In the realm of cancer treatment and care, natural therapies and cannabidiol (CBD) have emerged as a beacon of hope. 

Ongoing research highlights the role of cannabis in symptom relief, making it an essential component in the broader conversation about cancer treatment and care. 

As we take a moment to reflect on cancer awareness, it’s important to educate the public, healthcare professionals, and policymakers about the nuanced aspects of medicines in the context of cancer support. Alongside discussions on natural therapies, it’s also essential to underscore the importance of comprehensive support services for cancer patients.

Bodies are equipped with several intricate systems that are essential for regulating health and everyday functions. Among these systems is the endocannabinoid system (ECS), a vital system that plays a key role in maintaining homeostasis, or balance, within the body. The ECS is important as it has a wide ranging influence over various aspects of our well-being, including mood, memory, inflammation, hormone regulation, as well as appetite and metabolism. 

The ECS system functions through endocannabinoids, which are naturally produced by the body. These endocannabinoids travel between cells, binding to cannabinoid receptors located in cell membranes. This interaction between endocannabinoids and receptors triggers various physiological responses, contributing to the body’s overall balance and health. 

In relation to the ECS, CBD (cannabidiol) emerges as a significant compound. It is one of the most prevalent cannabinoids found in the cannabis plant, alongside Tetrahydrocannabinol (THC), which is known for its psychoactive properties. Unlike THC, CBD is non-psychoactive. Its interaction with the ECS, though not direct, influences the system in a way that may enhance the body’s use of its own endocannabinoids. This unique way that CBD interacts with the ECS has made people interested in its ability to help with symptoms of different health issues, including cancer. 

CBD may play a role in improving quality of life for patients, and especially for patients with cancer, as CBD can help with: 

• Symptom relief: CBD may help manage common side effects of cancer treatment, such as nausea and vomiting.
• Pain management: CBD’s potential anti-inflammatory properties may help to alleviate cancer-related symptoms or pain and reduce reliance on opioids.
• Improved sleep: Disrupted sleep is common among cancer patients. CBD’s calming effects may promote better sleep quality.
• Mental health support: The psychological stress of a cancer diagnosis can be overwhelming so CBD’s potential to ease anxiety and depression in some people may offer valuable support.

Definitive research is still emerging but there is growing recognition of cannabis and CBD’s potential in cancer management and treatments.

Australia has been a leader in some of the recent CBD research. 

• A study in Sydney found that oral THC:CBD could improve life quality for chemotherapy patients by reducing nausea and vomiting (in comparison to standard nausea medications), with manageable side effects like sedation and dizziness. And the US Food and Drug Administration (FDA) has approved cannabinoid drugs for chemotherapy patients who don’t respond to standard anti-nausea medications.
• More recent research also indicates that modified forms of medicinal cannabis (with low THC content) can potentially target cancer cells without harming normal cells.

Can a Healthy Lifestyle Help Prevent Cancer?

When managing cancer, it’s important for patients to identify treatment options that align with their needs and accessibility to them. 

Maintaining a healthy lifestyle is important for good wellbeing and illness prevention – and what a healthy lifestyle is can be different for different people. 

More than 40% of cancer-related deaths could be prevented through decreasing risks such as smoking, drinking alcohol, having a poor diet and lack of physical activity. 

At Astrid, we value considering each patient individually as each one of us is unique and we all have different endocannabinoid systems. We want to empower our patients to reach their full potential and we are looking forward to seeing more innovative treatments with cannabinoids offer new hope to those battling cancer. 

By promoting awareness about Astrid’s resources and support networks, we aim to contribute a more holistic understanding of the challenges associated with cancer, emphasising the need for both medical innovation and compassionate care.

If you have questions about natural therapies, contact the Astrid team.

References:

https://www.newcastle.edu.au/newsroom/featured/tests-show-potential-for-medicinal-cannabis-to-kill-cancer-cells

https://www.mdpi.com/2072-6694/12/4/1033

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326553/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604171/

https://www.tga.gov.au/resources/resource/guidance/guidance-use-medicinal-cannabis-treatment-palliative-care-patients-australia#references

https://www.canceraustralia.gov.au/impacted-cancer/what-cancer/cancer-australia-statistics

https://ncci.canceraustralia.gov.au/diagnosis/cancer-incidence/cancer-incidence

https://www.cancer.gov/about-cancer/treatment/cam/patient/cannabis-pdq

https://www.annalsofoncology.org/article/S0923-7534(20)39996-8/fulltext/

https://www.sydney.edu.au/news-opinion/news/2020/09/18/medical-cannabis-found-to-reduce-chemo-induced-nausea-vomiting.html

https://www.worldcancerday.org/understanding-cancer

This persistent discomfort not only affects daily activities but also creates challenges to work and enjoyment. The impact is profound, with the cost of chronic pain in 2018 reaching an estimated $139 billion in Australia, attributing to diminished quality of life and productivity losses. 

Managing chronic pain can be complex, demanding a comprehensive approach that integrates both pharmaceutical and non-pharmaceutical methods. 

In the following blog, we explore the potential of medicinal cannabis as a contributor to the treatment of chronic pain.

What is chronic pain?

Chronic pain is pain that lasts beyond normal healing time after injury or illness, generally lasting 3 to 6 months. It is a common and complex condition, and the pain experienced can be anything from mild to severe. The defining characteristic of chronic pain is that it is ongoing and experienced on most days of the week. 

New analysis in this report shows that compared with people without pain, people with chronic pain are more likely to:  

• be female and older
• have long-term conditions
• stay longer in hospital
• report limitations to daily activities.

There are two main types of chronic pain:

• Nociceptive pain: pain is caused by damage to body tissue and usually described as a sharp, aching, or throbbing pain and can be caused by a range of conditions or factors including injury, surgery, arthritis, osteoporosis or musculoskeletal conditions.
• Neuropathic pain: pain is a type of pain that occurs following damage to the nervous system itself. The sensations associated with this type of pain are described as burning or shooting pains. The skin can be numb, tingling or extremely sensitive.

Chronic pain commonly coexists with insomnia, anxiety, depression, post-traumatic stress disorder (PTSD), and substance use disorders such as opioid and alcohol misuse.

What is the role of medicinal cannabis in the treatment of chronic pain?

The use of medicinal cannabis for the treatment of pain can be traced back to over 5000 years ago when it was utilised in Chinese medicine to treat pain associated with childbirth, rheumatic pain, malaria, and even constipation.

Today, medicinal cannabis is considered to be an emerging therapy in the treatment of chronic pain as its use is the subject of ongoing research. 

The majority of the studies that have been done on the use of cannabinoids in pain have studied Delta-9-tetrahydrocannabinol (THC) or THC-rich extracts. Most studies looked at using cannabinoids as “adjuvant” or “add-on” treatments, used in addition to other pain medicines.

Research up until now has demonstrated a moderate benefit using medicinal cannabis in the treatment of chronic pain. There is evidence that medicinal cannabis may help manage comorbidities of chronic pain, such as sleep problems, anxiety, appetite suppression. It may also be effective in managing symptoms in some chronic conditions associated with pain, including HIV, multiple sclerosis, fibromyalgia, and arthritis.

Additionally, there is an interest at present as to whether the use of medicinal cannabis products for chronic pain can result in a reduction of use of strong opioids. 

If this were the case, deaths and incapacity from opioid overdoses could be reduced, given that cannabinoids have fewer adverse outcomes. 

It’s important to note that while some individuals with pain have reported that their use of opioids has been reduced through the use of medicinal cannabis, research is ongoing in this area. 

How does Medicinal Cannabis work in the treatment of Chronic Pain? 

Despite robust supportive data from animal models, current clinical trial evidence for THC and CBD efficacy in humans suffering from chronic pain is limited. The therapeutic effects of medicinal cannabis primarily arise from the cannabinoids Delta-9-tetrahydrocannabinol (THC) and/or cannabidiol (CBD) that are present in the Cannabis Sativa plant.

 Whilst the complete mechanism of medicinal cannabis in the treatment of pain is not fully understood, it is thought that it is mediated through the effects of THC and CBD on the Endocannabinoid System (ECS). 

Is Medicinal Cannabis suitable for all patients with chronic pain?

Current guidelines recommend that chronic pain management should follow a multidisciplinary ‘whole person’ approach to treatment that targets biopsychosocial factors. This means that a range of non-pharmacological as well as pharmacological strategies should be considered as a part of an individualised plan to manage chronic pain. 

Patients diagnosed with chronic pain that is not adequately controlled can talk to their doctor about the suitability of medicinal cannabis as a part of their treatment plan.

It is important to ensure that any measures taken as a part of a treatment plan for chronic pain are effective at reducing pain and positively impacting secondary outcomes such as improving sleep, mood and quality of life.  

It may be of benefit for individuals using medicinal cannabis in the treatment of chronic pain to keep a diary, which includes dosing information and monitoring for efficacy, effects on mood and function, and possible side effects. This aims to help slowly titrate cannabis to symptom control, while minimising adverse events. Generally, once individuals using medical cannabis are stabilised on an effective dose they do not require dose escalation over time.

More research is needed Medical Cannabis in the treatment of Chronic pain

The Australian Government’s National Strategic Action Plan for Pain Management recognises that the burden of pain in Australia is growing and pain is associated with comorbidities such as mental health and disability. The overarching aim of this plan is to “Improved quality of life for people living with pain and the pain burden for individuals and the community is minimised”.This plan supports the need for ongoing research and clinical guidance on the use of emerging pharmacological and non-pharmacological interventions, including medicinal cannabis. This must keep pace with rising consumer expectations and be accompanied by effective communication strategies.

Chronic Pain in Endometriosis: Potential for improved outcomes?

One area of growing interest is in the treatment of Endometriosis. Endometriosis affects roughly 10% (190 million) of reproductive age women and girls globally. It is a chronic disease associated with severe, life-impacting pain during periods, sexual intercourse, bowel movements and/or urination, chronic pelvic pain, abdominal bloating, nausea, fatigue, and sometimes depression, anxiety, and infertility. There is currently no known cure for endometriosis and treatment is usually aimed at controlling symptoms.

Endometriosis has significant social, public health and economic implications. It can decrease quality of life due to severe pain, fatigue, depression, anxiety and infertility. Some individuals with endometriosis experience debilitating pain that prevents them from going to work or school. Painful sex due to endometriosis can lead to interruption or avoidance of intercourse and affect the sexual health of affected individuals and their partners. Addressing endometriosis will empower those affected by it by supporting their human right to the highest standard of sexual and reproductive health, quality of life and overall well-being.

Women with endometriosis have a four times greater risk of chronic opioid use compared to women without endometriosis. Opioids may be ineffective in managing pain from endometriosis and the tolerance and dependence they are associated with naked opioids unsuitable for the long-term treatment required by those with the condition.

An online survey of women aged 18 to 45, living in Australia, and with surgically confirmed endometriosis sought to determine the prevalence, tolerability, and self-reported effectiveness of cannabis in women with endometriosis.The results indicated that women who utilised cannabis reported good efficacy in reducing pain and other symptoms of endometriosis. Despite this, there is still little evidence supporting its use in this setting and more research is desperately needed.

Currently, the potential use of medicinal cannabis for pain management in people with endometriosis is being explored by Victorian and NSW researchers in a study conducted by Deakin University and Western Sydney University.

To learn more about the role of medicinal cannabis in the treatment of chronic pain and conditions such as Endometriosis or ask any questions, please contact our team on (03) 9077 2446 or hello@astrid.health, or visit one of our dispensaries. 

References:

https://www.aihw.gov.au/getmedia/10434b6f-2147-46ab-b654-a90f05592d35/aihw-phe-267.pdf.aspx?inline=true

https://www.ncbi.nlm.nih.gov/books/NBK574562/

https://www.tga.gov.au/resources/resource/guidance/guidance-use-medicinal-cannabis-australia-patient-information#chronic

https://www.health.gov.au/sites/default/files/documents/2021/05/the-national-strategic-action-plan-for-pain-management-the-national-strategic-action-plan-for-pain-management.pdf

https://www.liebertpub.com/doi/pdf/10.1089/can.2021.0156

https://onlinelibrary.wiley.com/doi/10.1111/ijcp.13871

https://www1.racgp.org.au/ajgp/2021/october/medicinal-cannabis#:~:text=Pharmacologically%2C%20THC%20acts%20a%20partial,well%20as%20analgesia%20and%20sedation.

https://www.who.int/news-room/fact-sheets/detail/endometriosis#:~:text=It%20is%20a%20chronic%20disease,depression%2C%20anxiety%2C%20and%20infertility.

https://www.nps.org.au/professionals/chronic-pain

Sinclair J, Smith CA, Abbott J, Chalmers KJ, Pate DW, Armour M. Cannabis Use, a Self-Management Strategy Among Australian Women With Endometriosis: Results From a National Online Survey. J Obstet Gynaecol Can. 2019 Nov 7. pii: S1701-2163(19)30808-4. doi: 10.1016/j.jogc.2019.08.033. [Epub ahead of print]

It has been studied for a number of years and there is evidence supporting its use in the treatment of certain childhood epilepsies.

What is Epilepsy? 

Epilepsy is a brain disorder characterised by unprovoked seizures, which are sudden and unpredictable bursts of electrical activity in the brain. These seizures can happen at least 24 hours apart or may occur even with a single unprovoked seizure if there is a high chance of more seizures happening. It’s quite common, being the fourth most common brain disorder after migraine, stroke, and Alzheimer’s Disease. In Australia alone, around 142,740 people are estimated to have active epilepsy, costing billions due to its impact on lives.

About one in three people with epilepsy continue to have seizures despite taking regular medication. The frequency of seizures in these individuals may vary in frequency and severity, however any uncontrolled seizure can severely impact quality of life. Medicinal cannabis treatments may be of benefit in these patients. 

What is the role of medicinal cannabis in the treatment of Epilepsy?

Cannabidiol (CBD), the non-intoxicating molecule from cannabis plants has been tried as an add-on treatment in young people up to the age of 25 who have epilepsy. 

Some studies showed it made life better for both kids and adults with epilepsy, but there aren’t many studies on how well it works for adults. Right now, doctors only suggest medicinal cannabis or cannabinoids along with regular anti-epileptic drugs, not on their own. 

If a doctor thinks about prescribing cannabis treatment, they usually use it together with other medicines, and then see if it helps. In Australia, there’s one approved liquid medicine with CBD(100mg/ml) that is prescribed for this purpose.

Is medicinal cannabis suitable for all patients with Epilepsy?

Medicinal cannabis or cannabinoids might help some people with epilepsy, especially children and young adults, by reducing how often they have seizures. However, this treatment doesn’t work the same for everyone, and it’s crucial to consult your doctor and neurologist before trying it. 

The main goal of epilepsy treatment is to decrease the number of seizures, ideally aiming for no seizures at all. If a patient experiences a 50 percent or more reduction in seizures with medicinal cannabis and doesn’t have significant negative side effects, it might be considered effective. 

Doctors usually suggest trying CBD for about twelve weeks to see if it helps, and ongoing research is being conducted to find out the best dosage and effectiveness of CBD in treating common types of epilepsy in adults.

What are some of the side effects of medicinal cannabis used in the treatment of Epilepsy?

All medications can have potential side effects. The majority of patients treated with CBD report it is well tolerated. Usually, adverse events (AEs) are mild and only observed in the first month. In patients being treated with CBD for the treatment of epilepsy, some of the reported side effects include:

• Diarrhoea 
• Drowsiness
• Changes in appetite (increased or decreased)
• Worsening of seizures
• Fever 
• Convulsion
• Fatigue
• Gastrointestinal problems 
• Irritability 
• Changes in weight (gain or loss)
• Nausea 
• Behavioural difficulties 
• Vomiting 
• Elevations of liver enzymes (can improve with continued use or dose reduction)

The most frequent AEs are drowsiness, reduced appetite, diarrhoea, vomiting, fatigue, and fever. More serious side effects have also been reported rarely. These include ‘Status epilepticus’, experiencing a seizure lasting more than 5 minutes, or having more than 1 seizure within a 5 minutes period, without returning to a normal level of consciousness between episodes.

Are all medicinal cannabis products suitable in the treatment of Epilepsy?

The cannabis sativa plant has been utilised since ancient times to treat seizures. The active ingredients of this plant include delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). 

In more recent times, there have been studies that have demonstrated there is evidence  that supports the use of cannabidiol (CBD) in the treatment of some patients with epilepsy. Most of this evidence indicates that CBD alone is well tolerated and may be effective in reducing seizures in specific patient groups. 

There is less evidence to support the use of THC containing products. THC is generally not recommended in the treatment of epilepsy as the effect on seizure control is uncertain and they have psychotropic effects that CBD alone is not associated with.

In summary, Cannabidiol (CBD) is the substance in medicinal cannabis that has the most published evidence as an epilepsy treatment. Australian guidelines support using CBD as an add-on to treatment in certain patients when conventional treatments have not adequately controlled seizures. The strongest evidence for the use of CBD is in paediatric and young (under 25 years old) patients. In these populations CBD appears to be well tolerated and reduced seizures by 50% or more in over half the patients studied. Several studies have also demonstrated an improvement in quality of life for both paediatric and adult patients.  

Further research is needed to fully understand the role of other medicinal cannabis products and the role of CBD in the treatment of Epilepsy in adult patients. 

To learn more about the role of medicinal cannabis in the treatment of Epilepsy or ask any questions, please contact our team on (03) 9077 2446 or hello@astrid.health, or visit one of our dispensaries. 

References:

Devinsky O, Cilio MR, Cross H, Fernandez-Ruiz J, French J, Hill C, Katz R, Di Marzo V, Jutras-Aswad D, Notcutt WG, Martinez-Orgado J, Robson PJ, Rohrback BG, Thiele E, Whalley B, Friedman D. Cannabidiol: pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders. Epilepsia. 2014 Jun;55(6):791-802. doi: 10.1111/epi.12631. Epub 2014 May 22. PMID: 24854329; PMCID: PMC4707667.

https://pubmed.ncbi.nlm.nih.gov/24854329/

https://www.epilepsy.org.au/about-epilepsy/medicinal-cannabis/

https://www.tga.gov.au/resources/resource/guidance/guidance-use-medicinal-cannabis-treatment-epilepsy-paediatric-and-young-adult-patients-australia#role

https://www.hopkinsmedicine.org/health/conditions-and-diseases/status-epilepticus#:~:text=If%20you%20have%20epilepsy%2C%20you,episodes%20is%20called%20status%20epilepticus.

Zaheer S, Kumar D, Khan MT, Giyanwani PR, Kiran F. Epilepsy and Cannabis: A Literature Review. Cureus. 2018 Sep 10;10(9):e3278. doi: 10.7759/cureus.3278. PMID: 30443449; PMCID: PMC6235654.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6235654/

O’Brien TJ, Berkovic SF, French JA, et al. Adjunctive Transdermal Cannabidiol for Adults With Focal Epilepsy: A Randomized Clinical Trial. JAMA Netw Open. 2022;5(7):e2220189. doi:10.1001/jamanetworkopen.2022.201

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2794028

https://www.tga.gov.au/resources/resource/guidance/guidance-use-medicinal-cannabis-australia-patient-information

https://epilepsyfoundation.org.au/wp-content/uploads/2022/06/Medicinal-Cannabis-Position-Statement-June-2022.pdf

https://epilepsyfoundation.org.au/wp-content/uploads/2020/02/Economic-burden-of-epilepsy-Final-Report-Feb-2020.pdf

What are the benefits and risks? 

Both smoking and vaporisation are methods of inhaling natural-therapies medicine that involve heating of the cannabis flower to create a vapour which is then inhaled. 

When medicinal cannabis is in dried form, the compounds that elicit an effect in humans, or cannabinoids, are inactive. Heating the dried flower at high temperatures by combustion (smoking) or vaporisation results in a process called decarboxylation which transforms the inactive compounds in medicinal cannabis into an active forms, namely into cannabidiol (CBD) and tetrahydrocannabinol (THC).

Smoked medicinal cannabis results in a rapid onset of action (usually within minutes), higher blood levels of THCand CBD and a shorter duration of effect as compared to ingested cannabis. Peak concentrations are reached within 30 minutes and the effects may last for two to four hours. 

Smoking has traditionally been the most common route of administration for recreational cannabis use, however it was found to have considerable individual variability because of the unknown concentration of THC in the products being consumed. At least 40% of the THC dose in the medicinal cannabis is lost in side stream/combustion when smoked, making it difficult to predict a therapeutic outcome. For this reason, and due to the well-documented evidence that smoking in general is harmful, smoking of medicinal cannabis products is not supported by the current legislation.

Vaporising medicinal cannabis results in a similar rapid absorption and high blood concentrations as smoking it. Medicinal cannabis is heated just at the right temperature, which is considerably lower than smoking temperature, hence combustion does not take place. If there is no combustion, fewer toxins and no side stream “smoke” are produced, making passive exposure less of a problem. First effects occur within 90 seconds and reach a maximum after 15 to 30 minutes, before wearing off after two to four hours. 

Vaporising heats the medicinal cannabis at a lower temperature without burning it and releases the cannabinoids and terpenes in the form of a vapour, which is then inhaled. The terpenes are responsible for the aroma characteristics of cannabis.

Given the rapid onset of action, vaporising medicinal cannabis products might be more suitable for symptoms or conditions where rapid relief is required. The amounts of THC and other cannabinoids delivered by the vaporiser are dependent on the temperature, the duration of the vaporisation and the volume in the vaporiser. 

When new to vaporising or making the change from smoking, starting with a low dose is important. Studies suggest that vapourising medicinal cannabis delivers a higher amount of active ingredients than smoking, which may increase the likelihood of adverse effects.

What are the benefits of vaporisation vs smoking? 

Vaporising prescribed natural-therapies medicines has many benefits. As well as a reduction in exposure to toxins such as tar and carbon monoxide, it is associated with a reduction in respiratory symptoms such as cough, phlegm, and chest tightness and less wastage. Additionally, vapourisation of natural-therapies medicines produces less odour compared to smoking. 

When is vaporisation not recommended?

Whilst vaporisation is considered safer than smoking, there are still risks associated with vaporising and inhaled forms of medicines are not recommended for anyone with known respiratory tract or lung conditions. 

What temperatures are used to vaporise natural medicines? 

Different cannabinoids and terpenes are released at different temperatures. Many vaporiser devices give you control over the temperature at which the flower is heated. This can result in variations in therapeutic effects. Generally speaking, when vaporising at lower vs. higher temperatures a difference in therapeutic effects may be noticed.

Common practice is to start at lower temperatures and to increase or decrease slowly until optimal therapeutic effect.The ideal temperature may vary depending on the variety of the dried flower or depending on the situation and symptoms, for example some patients may choose lower temperatures during the day and higher temperatures in the evening. Some dried flowers will have a recommended vaporising temperature based on the properties of the medicinal cannabis flower that has been prescribed.

In summary, vaporising and smoking dried herb are two methods of inhaling medicinal cannabis, both involving heating the cannabis flower to create a vapour for inhalation. Smoking results in a rapid onset of action with higher blood levels of cannabinoids but is discouraged due to variable THC concentrations and health risks associated with smoking. Vaporizing offers similar rapid absorption, fewer toxins, and less odour, more cannabinoids, making it a safer option, especially for those needing quick relief, but requires careful temperature control to optimise therapeutic effects and reduce the risk of adverse effects.

There are a variety of ARTG listed medical vaporizers available in Australia that our team of Pharmacists are happy to provide advice on. To learn more about medicinal cannabis or ask any questions, please contact our team on (03) 9077 2446 or hello@astrid.health, or visit one of our dispensaries.

References

https://www.tga.gov.au/resources/resource/guidance/guidance-use-medicinal-cannabis-australia-overview

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8975973/

This understanding of the ECS builds on a history that dates back to 2800 BC when plant-based remedies, including those derived from the cannabis plant, were already being employed to address a wide range of health issues. Our contemporary comprehension of how medicinal cannabis operates within the body has only emerged relatively recently, thanks to our deepening understanding of the endocannabinoid system.

What is the ECS?

The endocannabinoid system (ECS) system is a biological system that was identified in the early 1990s by researchers exploring the effects of ∆9-tetrahydrocannabinol  (THC), a well-known cannabinoid from cannabis plant.

The ECS is made up of internally produced cannabinoids (endocannabinoids), receptors (cannabinoid receptors)  and enzymes. It is a system that helps regulate and maintain homeostasis (more commonly known as balance) within your body.

Experts are still trying to fully understand the ECS. But so far, we know it plays role in regulating a range of functions and processes, including:

• sleep
• mood
• appetite
• memory
• reproduction and fertility

The ECS exists and is always active in your body even if you aren’t a patient using natural-therapies medicines. 

Endocannabinoids

Endocannabinoids, also called endogenous cannabinoids, are molecules produced in the body. Experts have identified two key endocannabinoids so far:

• anandamide (AEA)
• 2-arachidonoylglyerol (2-AG)

These help keep internal functions running smoothly. Your body produces them as needed, making it difficult to know what typical levels are for each. Enzymes are responsible for making and breaking down the endocannabinoids in the body.

Endocannabinoid receptors

Endocannabinoids work by interacting with endocannabinoid receptors. These receptors are found throughout your body. When endocannabinoids interact with them it signals that the ECS needs to take action.

There are two main endocannabinoid receptors:

• CB1 receptors, which are mostly found in the central nervous system and brain
• CB2 receptors, which are mostly found in your peripheral nervous system, especially immune cells

Endocannabinoids can bind to either receptor. The effects that result depend on where the receptor is located and which endocannabinoid it binds to.

Enzymes

Enzymes are chemicals that are responsible for making and also breaking down endocannabinoids once they’ve carried out their function.

How do natural therapies medicines interact with the ECS?

Phytocannabinoids are cannabinoids derived from plants. The phytocannabinoids are most concentrated in the glandular trichomes (hairy outgrowths) of the flowering heads of the female plant. There are over 100 phytocannabinoids in the cannabis plant as well as hundreds of non cannabinoid compounds.

Phytocannabinoids have a similar chemical structure to our endocannabinoids and can interact with the endocannabinoid receptors to elicit a response and result in the therapeutic effects of natural-therapies medicines. 

The most abundant phytocannabinoids found in the cannabis plant are ∆9-tetrahydrocannabinol (THC) and cannabidiol (CBD). 

THC is responsible for the psychoactive, intoxicating effects of cannabis, whereas CBD is non-psychoactive.

THC and the ECS

Tetrahydrocannabinol (THC) is one of the most prevalent phytocannabinoids found in the cannabis plant. It can bind to both CB1 and CB2 receptors and can have psychoactive properties which are associated with some of the side effects of natural medicines such as increased anxiety, slower reaction times and impaired memory when taken too frequently or at too high a dose. It is also associated with beneficial effects, such as pain relief. It may improve cancer-related symptoms like increasing appetite and reducing nausea and vomiting, and improving sleep.  

CBD and the ECS

The other major cannabinoid is cannabidiol (CBD). Unlike THC, CBD isn’t psychoactive/intoxicating and is generally well tolerated.

Experts aren’t completely sure how CBD interacts with the ECS. But they do know that it doesn’t bind to CB1 or CB2 receptors the way THC does.

While the details of how it works are still under debate, research suggests that CBD can help with pain, nausea, and other symptoms associated with multiple conditions.

The ECS consists of endocannabinoids, receptors, and enzymes, which work together to help maintain stability in processes such as temperature, sleep, and mood.

In summary, the ECS is a biological network discovered in the 1990s through THC research. It regulates functions like sleep and mood and consists of endocannabinoids, CB1 and CB2 receptors, and enzymes.

Endocannabinoids like anandamide and 2-arachidonoylglyerol interact with CB1 and CB2 receptors, signalling the ECS. Cannabis-derived phytocannabinoids can also bind to these receptors. THC, a common phytocannabinoid, is psychoactive and relieves pain but can cause anxiety and memory issues. CBD, another major cannabinoid, isn’t psychoactive and may help with pain and nausea. The ECS stabilises processes like temperature and mood.

To learn more about natural therapies or ask any questions, please contact our team on (03) 9077 2446 or hello@astrid.health, or visit one of our dispensaries.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3997295/

https://www.sydney.edu.au/lambert/medicinal-cannabis/history-of-cannabis

https://www.health.harvard.edu/blog/the-endocannabinoid-system-essential-and-mysterious

https://ajp.psychiatryonline.org/doi