It’s been close to two years since cannabis has been legalized in Canada. It’s time we got the real dope on the effects cannabis can have on our families’ health. We reached out to Dr. Alan Bell, a family doctor who has been prescribing cannabis since it was legalized for medical use in 2002, to help us understand the science behind its use. Once you get the dope on cannabis, you can decide if it can play a role for you or your family.
Let’s start at the beginning. Cannabis has two main active components – cannabidiol (CBD) helps with pain, anxiety, depression, and seizures, while tetrahydrocannabinol (THC) is what gets you high (but also has medicinal effects). Both are useful to help what hurts…it’s all about the right ratio of the two and the right dose for each person.
CBD-only products are often highly effective and you’re not getting high on it, according to Dr. Bell, but most benefit from having some THC in the mix. Although he says more research is needed, he’s seeing a lot of evidence that shows many of us can benefit from cannabis as a second, or third line of treatment, especially when other meds haven’t worked well or are causing side effects.
For anyone in the family who is dealing with pain, sleep disorders, mental health issues, or experiencing seizures, medical cannabis may save the day. It can also work well to help with arthritis, fibromyalgia, cancer complications including nausea and vomiting from chemotherapy, epilepsy, spinal cord injury, and multiple sclerosis. It can reduce pain and muscle spasm and can also work for sleep disturbance, depression, anxiety, loss of appetite – basically overall quality of life. (Probably not what you were thinking about back when you were hiding in your basement, passing around a bong, right?)
Yes, Dr. Bell will prescribe cannabis for you or even your kid if medically appropriate, but don’t expect a prescription to smoke a joint. Most patients are prescribed capsules or oil that you swallow. Keep in mind that where you fill your prescription is key. Forget walking over to your local weed shop to pick your favorite strain. Dr. Bell stresses the importance of getting medical cannabis through a licensed producer who understands how to get you the exact dose of THC and CBD he prescribes. When you get it right, your symptoms can get a lot better, and you avoid side effects like getting high or, in doctor-speak, “euphoria”. Don’t trust the local dealer to get you the right stuff. This is medicine people!
Also, be aware that each of us responds to cannabis differently. While it seems like a “miracle drug” for some, for others it just won’t work or it causes side effects you don’t want. Dr. Bell says you can largely blame your DNA for how you metabolize and respond to it. Your unique genetic makeup impacts what dose and strain would work best for you, and can even affect how cannabis interacts with other medications. It’s why some of us feel hyper or dozy when we take it and why some of us get really high from the effects of TCH while others stay straight. Our DNA can even help warn us if we’re candidates for addiction or dependency on the drug.
Whether you use cannabis to heal or get high, you should know about pharmacogenetics. It’s an exciting new science that studies how genetics plays an important role in how we respond to different drugs based on our unique DNA. There’s an innovative Canadian company, Inagene Diagnostics, that has developed a cutting-edge DNA test you can do at home with a simple cheek swab. Within one or two weeks, you receive results that spell out how your body reacts to recreational and medical cannabis, whether you are more likely to get some side effects or have interactions with other meds than most people, and get advice on the best ratio and dose for you, based on your genes. The test also includes a breakdown of your likely reactions to 120 “conventional” pain and mental health medications. Dr. Bell considers the Inagene DNA test an “extremely useful treatment roadmap.” Based on the test results, he will know in advance how his patient will metabolize cannabis, allowing him to side-step a lot of the frustrating “trial and error” cycle of finding the right dose of THC vs CBD. The Inagene test also flags patients with a higher likelihood of developing a dependence on cannabis, so he would avoid prescribing cannabis in those situations.
While Dr. Bell is a strong advocate of medical cannabis, he worries about teens using pot recreationally. Their brains are still developing well into their early 20’s and THC can cause “functional and structural changes to the growing brain.” If your teen gets high a lot, here’s what can happen: increased mental illness, depression, anxiety, and psychosis. Cannabis is also known to trigger early schizophrenia. Plus, based on their genetic makeup, they could be at increased risk of these things or be candidates for addiction. Scary stuff but better to know, right?
While research shows that regular use of the “Mary Jane” can be harmful for teens, Dr. Bell has no particular medical concerns with healthy moms and dads getting high - except if you’re pregnant or breastfeeding. Keeping in mind that some of us won’t react well to THC because of our genes, if you want to be sure you’re safe getting high, invest in a pharmacogenetic test. “I don’t think there should be a stigma around it,” says Dr. Bell. “If you use recreational cannabis responsibly, it’s no different than enjoying a beer or cocktail.”
Photo By: Tim Mossholder courtesy of Unsplash