By Amanda Jowsey
DENT Neurologic Institute recently found that medical cannabis shows promising results as an effective treatment for Parkinson’s disease.
CannaBuff, a new magazine about the current and future industry of recreational and medical marijuana in Buffalo, recently published an article by Laszlo L. Mechtler, medical director of DENT Neurologic Institute Headache Center, Neuro-Oncology Center and Cannabis Clinic.
Mechtler is also the chief of neuro-oncology at Roswell Park Cancer Institute.
In the article, Mechtler explained about PD and the research so far on medical marijuana as an additional treatment option for patients.
PD affects around a million people in the US. There are 60,000 new cases diagnosed each year. There is no cure and its underlying causes are not yet fully understood. It primarily affects those older than 55. It currently costs the healthcare industry $52 billion a year and is projected to cost $79 billion per year by 2037 in the US alone.
“PD is classified as a common chronic neurodegenerative disorder characterized by motor dysfunction including bradykinesia (slowness of movement), rigidity, tremor, dyskinesia (involuntary muscle movements) and dystonia (involuntary muscle contractions),” Mechtler said.
In one DENT study, 87% of patients with a diagnosis of PD due to secondary conditions observed improvement in at least one symptom after initiating MC therapy. The three symptoms that demonstrated the most improvement were pain (61%), spasticity (58%) and tremor (48%).
Another study found a 22.2% reduction “in total on-period dyskinesia after receiving a synthetic cannabinoid similar to THC.”
THC (tetrahydrocannabinol) and CBD (cannabidiol) are the two main cannabinoids in marijuana. Another study with patients receiving only CBD found significant improvements in sleep, hallucinations and illusions and delusions.
“A survey assessing the impact of MC on 47 PD patients found overall symptomatic improvement in 82% of patients, including improvement in tremors, muscle stiffness, pain, insomnia and/or mood,” he said.
Another survey-based study including nine PD patients who used cannabis “found patient-reported improvements in mood, sleep, motor symptoms and quality of life.”
DENT also found an additional benefit to medical marijuana: it helps patients reduce or end their reliance on opioid medications. In those patients with PD due to secondary conditions, “50% of patients using opioid pain medications were able to reduce their dose or discontinue treatment” using MC.
PD is caused by “a degeneration” in the substantia nigra, a part of the brain responsible for producing dopamine. It affects many aspects of the central nervous system, including movement, cognitive executive function, and the fight or flight response.
Most of the PD medications used currently are to replenish this dopamine and improve symptoms like rigidity and tremor.
“The problem is it’s not a cure. It’s like giving insulin to a diabetic to maintain their sugar control,” Mechtler said.
These medications are also not without their side effects.
When used as an additional treatment, medical marijuana significantly improves patients’ quality of life.
“[MC] helps not to cure the disease but helps with the symptomatology. Most patients tolerated it extremely well and most came back and said, ‘My quality of life has improved.’ And at the end of the day, when you’re a physician, and you hear these words: ‘I feel better. I sleep better. I have less anxiety, less stiffness. Then that’s a win-win situation,” Mechtler said. “Any time you treat a neurodegenerative disorder, a disorder that is progressive in nature, quality of life becomes of paramount importance.”
Experts are divided on its efficacy; but Mechtler emphasized the importance of continuing studies like the ones being done at DENT.
He would like to do prospective, randomized studies on MC and other chronic diseases, but the legal restrictions placed on cannabis present what feel, in today’s day and age, like unnecessary roadblocks to life-changing information.
“As with most MC research, the overall number of studies evaluating its effects on Parkinson’s patients remains relatively low, due in part to cannabis’ classification as a schedule 1 controlled substance under federal law,” he said. “There is a need for large, randomized placebo-controlled, clinical trials to fully understand the efficacy and long-term effects of MC on PD before it can be officially validated as a treatment option.”
37 states have legalized medical marijuana. Medical marijuana has been legal in New York since 2014. As of 2021, New York joined the list of the 19 others that have legalized recreational marijuana. Its federal classification still lays out numerous barriers for clinical studies.
“For that reason, cannabis has not been accepted in the medical community because of the lack of quality research and that needs to change. I’m surprised it hasn’t changed.” Mechtler said.
These studies would help pave the way for additional research on medical marijuana, the benefits of which extend far beyond helping just those with Parkinson’s.
“Cannabis is not a treatment for all disorders,” Mechtler said, but the facts are there, and the numbers don’t lie.
“Does it improve quality of life? Unequivocally. Does it improve anxiety, sleeping patterns, pain and chronic inflammation? Yes,” he added.
The fact that it has shown a significant decrease in the reliance on opioids, in an opioid epidemic, is also a gift.
“Then you look at the other side of the coin: side effects. The side effects [of medicinal marijuana] become minimal compared to the usual medications we take on a daily basis, which have a laundry list of side effects that are real,” Mechtler said.
In his experience, Mechtler has seen significant improvement in patients’ symptoms, not just in Parkinson’s, but in those who suffer from chronic illnesses like fibromyalgia, chronic migraines and even irritable bowel syndrome.
Mechtler continues to explore research under a hypothesis called endocannabinoid deficiency syndrome, studied by Ethan B. Russo, a board-certified neurologist, psychopharmacology researcher and author.
The endocannabinoid system exists naturally in everyone’s body and, from a very basic standpoint, serves to stabilize stressors from life and maintain emotional, physical and mental homeostasis. The CED hypothesis suggests that deficiencies in this system can cause several chronic, “treatment-resistant” diseases, as described in one of Russo’s studies.
By taking the cannabinoids from the marijuana plant and using them medicinally to supplement this deficiency, symptoms improve greatly, the same way that Parkinson’s medications are used to supplement dopamine.
Mechtler hopes that this continued research will help to further legitimize marijuana in the medical community so that its benefits can be fully understood and utilized in addition to traditional treatments offered.