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Anorexia Nervosa

Anorexia nervosa is an eating disorder characterized by abnormally low body weight and body dysmorphia, a distorted body image. Individuals suffering from anorexia are stuck in a repeating cycle of self-starvation or purging food because they have an extreme fear of gaining weight. Their obsession with their weight, and what they eat disrupts their life and negatively affects their health. This distorted body image also has a negative effect on the person’s self-esteem.

Anorexia is a psychological eating disorder caused by a mix of genetic, environmental, and psychological factors. Anorexia may be associated with a stressful life event, a lack of support, or weight-based teasing that the individual has experienced. A perceived lack of control in one’s life may be a trigger, so an anorexic may assert control in their life through the controlling of food intake. Trying to maintain weight for a sport or activity may be a trigger for athletes that become anorexics. The rising numbers of female patients with anorexia may, in part, also be due to the constant exposure to societal or Hollywood beauty standards which utilize heavy filters, which drive need to achieve an unrealistic ideal of the female body type.

There are two types of Anorexia: restriction of how much one eats, and bulimic, where food is binge eaten and then purged. The restrictor individuals starve themselves primarily by limiting their intake of food and missing meals. The unrealistic perception of their body image may also drive them to exercise too frequently. The bulimic individuals induce vomiting to purge any food eaten, use laxatives, as well as appetite suppressants to curb appetite in order to keep their weight in check.

Anorexics are predominantly grossly underweight with respect to their age and gender, but they consider themselves to be fat or overweight. Although men and women of any age can suffer with anorexia, it’s most common in young women and typically starts during adolescence. Youth with anorexia may not meet developmental weight gain milestones so their height and weight will be below normal; and adults will have an uncharacteristically low BMI, Body Mass Index.

The extreme weight loss can create a cascade of physical problems. Long-term starvation depletes the body of its essential nutrients, so the first organ to be affected is the brain. Anorexics may be fatigued, lethargic, and irritable. They may have difficulty sleeping which may lead to erratic thoughts, and an inability to concentrate. After depletion of the body’s fat stores, patients begin to waste as muscle is broken down for energy. The malnutrition will affect growth; therefore, these patients have a frail, thin appearance with thinning hair which may fall out. Hormonal imbalance is common in chronic anorexics, with adolescent girls even missing their period.

The constant vomiting leads to gastroesophageal reflux, persistent stomach discomfort, and bacterial infections. The induced vomiting can erode teeth and the lining of the esophagus causing bleeding. Anorexia may even damage the heart. The starvation can create dehydration, electrolyte imbalances, and irregular heart rhythms which may cause dizziness and fainting spells. Intolerance of cold can be a symptom of low blood pressure common in this disease.

Typical symptoms of those suffering from Anorexia include:

•  A refusal to eat or denial of hunger
•  Skipping meals
•  Developing feeding rituals
•  Obsession with food preparation
•  Spitting food out after chewing
•  Repeatedly stepping on the scale to check weight
•  Lying about the amount of food eaten
•  Hiding food

How can Medical Marijuana Help Patients with Anorexia Nervosa?

Cannabis may be an effective treatment option for treating the psychological symptoms of Anorexia Nervosa. A study published in the Israel Journal of Psychiatry studied the effects of marijuana on the psychological symptoms of Anorexia Nervosa, and concluded that THC significantly improved self- reported body care, sense of ineffectiveness, and depression.

Research discovered that the endocannabinoid system in women with anorexia and bulimia was significantly underactive. THC, the psychoactive component of cannabis, has many physiological effects on the body, one of which is increased appetite. Cannabis may be used to treat anorexia patients because THC stimulates the brain’s endocannabinoid system to trigger heightened feelings of hunger.

References:
Allison, S., Warin, M., Bastiampillai, T., Looi, J. C. L., & Strand, M. (2021). Recovery from anorexia
nervosa: the influence of women’s sociocultural milieux. Australasian psychiatry: bulletin of
Royal Australian and New Zealand College of Psychiatrists, 29(5), 513–515.
https://doi.org/10.1177/10398562211010796

Avraham, Y., Latzer, Y., Hasid, D., & Berry, E. M. (2017). The Impact of Δ9-THC on the Psychological
Symptoms of Anorexia Nervosa: A Pilot Study. Israel journal of psychiatry, 54(3), 44–51.

Cachexia

AKA: Wasting Syndrome

Cachexia is a condition in which a patient will undergo excessive weight loss, muscle loss and fat loss.  This condition is often secondary to another disease like Anorexia, HIV/AIDS and cancer.  Cachexia can occur in elderly patients with no known underlying causes.  The effects of cachexia include inability to concentrate, fatigue, depression and overall diminished quality of life.

How can Medical Marijuana Help Patients with Cachexia?

The primary use of Medical Marijuana in treating Cachexia is its ability to stimulate appetite, resulting in increased caloric (food) intake.  It can also reduce vomiting and nausea and improve the effects of depression.  Higher THC strains of Medical Marijuana will tend to be the best options for treating patients with Cachexia. 

Glaucoma

Glaucoma is an eye disease that results in damage to the optic nerve causing vision loss.  Glaucoma can be broken down into two different types. Open-angle, which is the most common type, is caused when the drainage angle for fluid within the eye remains open.  This type of glaucoma happens over time and does not cause pain.  Peripheral vision will begin to decrease followed by central vision resulting in blindness if left untreated.  Closed-angle glaucoma can happen gradually or without warning. This type of glaucoma can cause severe pain, blurred vision, redness, dilated pupils and nausea. The risk factors include age, family history and prolonged steroid use.  Higher eye pressure has been shown to be connected to an increase in the tendency to develop glaucoma as well.  Glaucoma is the second leading cause of blindness.

How can Medical Marijuana Help Patients with Glaucoma?

Several studies have shown smoking marijuana can result in a decrease in eye pressure.  This is precisely the purpose of prescription medications given to those who suffer from glaucoma.  This makes medical cannabis a wonderful adjunct to traditional medicine or useful in cases where patients cannot tolerate traditional treatment.  The studies have shown the decrease in eye pressure can last on average 3 to 4 hours.  Future studies are looking at the effectiveness of edible forms to reduce eye pressures for longer durations.  Even further down the road will be research to understand what elements of medical cannabis result in the reduction of eye pressure. 

Epilepsy and Seizure disorders

Epilepsy is a seizure disorder – the severity of the condition can vary.

Epilepsy is a seizure disorder; the severity of the condition can vary from patient to patient.  A seizure occurs in a patient when the body experiences an abnormal electrical storm in the brain.  This electrical storm causes the individual to experience changes in consciousness and sensation.  It manifests outwardly in a number of different ways including small eye flickers on the mild end to full body convulsions on the more severe end. 

How can Medical Marijuana Help Patients with Epilepsy and Seizure disorders?

THC and CBD, cannabinoids abundant in marijuana, exert their effects on both central and peripheral nervous systems. CBD specifically has shown promise in early research studies to have anti-seizure potential.   

Multiple Sclerosis

A degenerative disease of the central nervous system

Multiple Sclerosis (MS) is a degenerative disease of the central nervous system affecting the brain, spinal cord, and nerves. Symptoms of MS vary in range from a single symptom to multiple symptoms and mild in intensity to severe. Symptoms can include pain, fatigue, muscle stiffness or spasms, tremors, inflammation, depression, loss of muscle coordination or bladder control.

MS is an autoimmune disease in which the body’s own immune system attacks the protective covering called myelin, that insulate nerve fibers. This myelin sheath enables the brain to communicate with the rest of the body by allowing electrical impulses to travel along the nerve fibers quickly and efficiently. When myelin is damaged, electrical impulses or communication from the brain to the body is slowed or blocked causing MS symptoms.

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How can Medical Marijuana Help Patients with Multiple Sclerosis (MS)?

Much of the data or research collected on the effects of medical marijuana on MS symptoms come from patient surveys, self-reported assessments and observational studies. Two active compounds found in medical marijuana that have been studied in the management of MS include tetrahydrocannabinol (THC) and cannabidiol (CBD).  According to a study published in American Academy of Neurology among patients from the University of Rochester MS Center, results found majority of subjects found medical marijuana helpful in managing symptoms such as spasticity and pain.  The study also reported more than half the subjects felt their quality of life improved with the use of medical marijuana. Another promising study published in 2016 in European Neurology studied patients with treatment-resistant MS spasticity.  Real-life data from the study confirmed that adding THC:CBD oromucosal spray was an effective and well-tolerated treatment option for those patients.

Post-Traumatic Stress Syndrome

A mental health disorder that develops after you experience a traumatic, life-threatening, or highly stressful event.

Post-traumatic stress disorder (PTSD) is a mental health disorder that develops after you experience a traumatic, life-threatening, or highly stressful event.  Examples include sexual assault, war, death of someone close, or a natural disaster.  This is an anxiety disorder that can make it difficult to function to have a “normal” life.  It can last from months to years effecting social relationships, the ability to work and carry out daily tasks like going to the grocery store.  Common symptoms include overwhelming feelings of fear, sadness, anger, hopelessness, or irritability, nightmares, negative outbursts, and being on guard. 

In PTSD, the part of the brain responsible for the “flight-or-fight” response, called the amygdala, becomes overactive. Its job is to heighten our senses to be ready to act during perceived threat.  Another part of the brain that assesses the threat and brings the “flight-or-fight” response down when there is no actual threat is called the prefrontal cortex, and it becomes under-active.

How can Medical Marijuana Help patients with PTSD?

Many patients have reported medical marijuana to help in PTSD. According to an article published by Alcohol and Drug Abuse Institute at University of Washington, anecdotal and case-reports showed evidence marijuana decreased flashbacks, nightmares, anxiety and hyperarousal in PTSD.  A recent trial showed canniboids, an active compound found in medical marijuana, lowered the amygdala’s response and increased the prefrontal cortex response to threat.  Other research has noted participants re-experienced the trauma decreased and had less avoidance of situations that reminded them of the trauma.  These continued reports make medical marijuana an effective treatment for PTSD.

Medical Marijuana As An Alternative Treatment

The Ohio, Pennsylvania, Missouri and Oklahoma Medical Marijuana programs all recognize Spasticity as a qualifying condition for medical marijuana treatment. Emerging research suggests that many patients with conditions such as Cerebral Palsy (CP) or Multiple Sclerosis (MS) might consider cannabis to help relieve symptoms related to spasticity; it’s thought that medical marijuana might calm muscle spasticity. 

What is Spasticity?

Spasticity is a condition associated with damage to the brain, spinal cord or motor nerves, or neurological conditions. Spasticity is increased, involuntary, velocity-dependent muscle tightening that causes resistance to movement. The condition is typically a result of insult to the central nervous system or motor neurons. It may occur as a primary condition such as with degenerative conditions or as a result of secondary causes such as spinal cord injury, trauma to the brain, or inflammatory conditions such as multiple sclerosis.

Spasticity can range from mild feelings of muscle tightness to painful, uncontrollable spasms of extremities, often in the legs, around the joints, and in the lower back. Spasticity patients may experience  symptoms such as: 

• Abnormal posture
• Carrying a shoulder, arm, wrist, and finger at an abnormal angle due to muscle tightness
• Exaggerated deep tendon reflexes (knee-jerk or other reflexes)
• Repetitive jerky motions, especially when touched or moved
• Pain or deformity of the affected area of the body

Spasticity may also affect speech. Severe, long-term spasticity may lead to contracture of muscles. This can reduce range of motion or leave the joints bent.

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Chronic Pain

Pain or related symptoms lasting more than 3 months.

Any condition that results in pain, or related symptoms, that lasts more than 3 months may be considered a qualifying condition under chronic pain. The intensity of the pain as well as other symptoms resulting from the painful condition such as anxiety, depression and sleeplessness can be considered in the overall assessment by our physicians when conducting a patient interview. Furthermore, the cause of the chronic pain condition can be fairly broad and can include the following commonly encountered “head to toe” every day problems:

Headaches

Migraines, tension headaches, cluster headaches

Neck Pain

Muscle strains, herniated disks, and arthritis related conditions

Shoulder Pain

Labral tears, rotator cuff injuries, arthritis related conditions

Chest Pain

Rib and muscle injuries, chronic pain secondary to pulmonary and respiratory issues, heartburn and acid reflux

Arms/Hands

Muscle or tendon injuries, prior broken bones, Carpal Tunnel Syndrome, any type of arthritis, vascular disease and Reynaud’s Syndrome/Disease.

Abdominal Pain

Inflammatory bowel disease, hernias, prior organ injuries or surgeries involving the liver, spleen or kidneys, mesenteric ischemia, Herpes Zoster and shingles

Pelvic Pain: Male

Kidney stones, Varicoceles, Prostrate related pain, testicular pain, inguinal hernias, pelvic nerve compression and SI joint pain

Pelvic Pain: Female

Menstrual cramps, Polycystic Ovarian Syndrome (PCOS), Endometriosis/Endometritis, Pelvic Congestion Syndrome, pain during sexual intercourse, Pelvic Inflammatory Disease, pelvic nerve compression and SI joint pain

Legs

Hip and Knee pain or prior injuries, muscle or tendon strains, pulls, or tears, any broken bones, vascular pain secondary to poor circulation, Charley horse and cramps that become painful while walking or at night, restless leg syndrome

Neurological

Peripheral or diabetic neuropathy, sciatica, shingles, Lyme’s Disease, Multiple Sclerosis, Parkinson’s, Epilepsy and Seizure disorders

Any Cancer or Surgical Related Pain

Any pain from cancer or surgical procedures

Foot and Ankle

Any type of tendon or bone injury, plantar fasciitis, Achilles tendon injury, bunions, ankle sprains and strains, prior foot surgeries, burning pain secondary to diabetic neuropathy

How Medical Marijuana Helps Patients with Chronic Pain

Medical Marijuana helps to control or block the pain associated with the possible causes listed above. If you have one or more of these Chronic Pain conditions, you may qualify for treatment with medical marijuana.

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