It is known that 42, 249 people died in the United States in 2016 due to overdosing on opiods, as reported by Centers for Disease Control and Prevention (CDC). It began in 1990s with the popularity of prescription pills. In the early 2000s was with the rise in the use of heroin while the previous years have seen the use of fentanyl.
It is sad to know that people are not open to communicate about the opioid addiction so that they get the help they need. Breaking the stigma can support in overcoming the crisis. Moreover, doctors should take extra care while prescribing medications and making the patients aware about the side effects of these drugs as well as looking into alternative forms of medicine.
Cannabis is such an alternate medicine and an excellent natural herb which can help in relieving pain, anxiety, etc. There are various products available in the market, ranging from cannabis seeds to cannabis strains (like laughing buddha cannabis strain), CBD oil etc. Cannabis infused products can prove to be highly beneficial to people suffering from chronic illnesses.
While several countries are far from even considering legalization of medical cannabis, currently 29 states and Washington DC have permitted its legal use.
Most treatments are meant to heal, but some are for palliative care (end of life care) in terminally ill patients. Palliative care is to provide symptomatic relief from a chronic and serious illness, and to reduce the risk of developing co-morbidities and also to improve the patient’s quality of life. The aim of the palliative care is not to treat or cure the underlying disease, but to treat the bothersome symptoms of the disease. Some of the illnesses that may utilize palliative care treatments include cancer, HIV/AIDS, ALS, multiple sclerosis, etc.
Finding a proper and safer course of treatment (long-term drug safety) is one of the main challenges being faced by palliative care practitioners. The goal of the drug regimen is to alleviate the symptoms as well as to mitigate the adverse events of these drugs. For palliative care of cancer patients, opioid analgesic is the prime choice of physicians, but it can cause serious harm – or even fatal events – in the long run.
The therapeutic potential of cannabinoids to treat sleep problems, pain and anorexia might play an important role in palliative care. Cannabinoids promote analgesia and inhibit inflammation via endogenous signaling, along with other benefits such as neuroprotection and anti-cancer activity, which are significant for terminally ill patients. In cancer patients, exogenous cannabinoids act synergistically with endogenous opioids and provide pain relief, opioid-sparing benefits and reduce opioid dependence and tolerance threshold. Cannabinoids may have palliative benefits not only for cancer patients, but also in neurodegenerative, HIV/AIDS and chronic pain patients. Despite these benefits, the use of cannabinoids in critical and palliative care patients remains controversial.
According to DEA classification, cannabis is a Schedule I drug that is hazardous and without any medicinal value. Most cannabis strains do not exceed 20% THC, whereas prescription drugs, such as Dronabinol, has a 100% THC-like substance, which has been classified as Schedule III drug. Naturally occurring cannabis has several ingredients that augment the treatment benefits and negate the adverse events. However, this is not applicable in synthetic, single compound cannabinoid formulation. To reduce opioid-related morbidity/mortality and improve palliative care in terminally ill patients, considering the cannabinoids as a mainstay pain management drug is the critical need at the moment.
The risk-benefit profile of cannabinoid-based medicine greatly depends on the drug formulation and route of drug delivery.
Problems Associated with Palliative Care
Opioid overdose-related deaths are rising across the world and in the United States. Increased availability of synthetic opioids worsens the overdose mortalities, and most of the cases are due to misuse or accidental exposure. The widespread expression of mu-opioid receptors in the brainstem leads to increased binding of opioids, which also controls the respiration and is the cause of opioid overdose mortality. Overdose opioids bind with these mu-opioid receptors, which results in the suppression of breathing and death. Long-term opioid treatment also leads to development of tolerance, and the patient often requires incremental dose increases for better pain management. Although, mu-opioid antagonists, such as naloxone, are available to reverse overdose, it must be administered within few minutes of overdose crisis, which is not always possible. In addition to opioid tolerance, opioid dependence or addiction can develop during palliative care. Opioid addiction is a serious, relapsing and chronic neuro-psychiatric illness that requires long-term treatment for recovery.
The complete symptom burden of palliative care patients is poorly understood and opioid treatments may add up to other problems, such as severe constipation and prescription of laxatives to relieve constipation. According to a large assessment study that involved 50,600 Caucasian cancer patients who were on opioid therapy as palliative care, approximately 12% of patients reported moderate or severe constipation at the first assessment, and nearly 19% patients reported the same during the last assessment. All patients were on opioid therapy that resulted in moderate to severe constipation. Prescription of laxatives to treat the constipation is likely in these patients. The goal of the palliative care treatment is to relieve the symptoms, if not to mask the agonizing pain in palliative care patients including terminally ill cancer patients. Opioid therapy appears to be worsening the problems by causing/increasing distressing symptoms that require further treatments, which is undesirable and reflects the complexity and quality of palliative care treatment.
Why Cannabinoids Are Better Than Opioids In Palliative Care
While healthcare practitioners are in dilemma about prescribing medical cannabis for illnesses, the use of medical marijuana for palliative care is trending upward. Medical cannabis significantly reduces the use and dependence of opioids and also opioid overdose-related death. According to a study by RAND Corporation, there is a plausible link between the legal medical marijuana dispensaries and a reduction in opioid-related deaths in those areas. The study compared the rate of opioid-related deaths in states with and without legal marijuana dispensaries. As reported by the study, a lower rate of opioid-related mortalities (16-31%) and fewer reports of hospitalizations (28-35%) for related treatments were observed in states with medical cannabis dispensaries, compared to states without medical cannabis dispensaries. Patients who obtained treatment without legal intervention (penalized due to illegal substance use), further decreased the rate of hospitalization (up to 53%). The duration of the presence of legal marijuana dispensaries were also found to be related with the decline in opioid-related morbidities and mortalities.
Palliative care patients can easily obtain prescription medical cannabis from these legal dispensaries to reduce their reliance on opioids, prevent the opioid-related problems and also for better management of their symptoms. According to Nora Volkow, Director of the National Institute of Drug Abuse, the evidence about the efficacy of cannabinoids is strong and cannabis could ‘provide a powerful new tool’ to combat opioids and their related problems.
According to a comprehensive literature review of available studies, patients reported improvement in quality of life, and the improvements were considered as a therapeutic outcome by the patients. However, the healthcare providers raised concerns, and were in a dilemma about supporting the therapeutic cannabis use, as the used cannabis was illegally obtained.
A Norwegian study concluded that cannabinoids possess therapeutic effects in neuropathic pain, as well as moderate anti-emetic and appetizing effects in certain groups of patients. Due to non-availability of randomized clinical trials, the study authors were unable to recommend the medical use of cannabis. All of these symptoms and indications are applicable for palliative care cancer patients. To treat vomiting, anorexia and pain, a regimen of at least three drugs should be administered, and the patient must go through the side effects of these medicines. Instead of three drugs, cannabinoids as a monotherapy can be considered to treat all three symptoms, which are common in terminally ill cancer patients. Hence there are grounds to employ medical cannabis as a palliative care drug.
Analgesia is a common benefit shared by opioids and cannabinoids. However, cannabinoids differ from opioids in anti-nociception by the involvement of endocannabinoid system. Further studies suggested the additive effects of cannabinoids and opioids in pain modulation. Medications being prescribed to augment the opioid effects and to reduce the opioid doses are called opioid-sparing drugs. Cannabinoids can greatly increase the analgesic potency of opioids and thus relieve pain in lower doses of opioids. According to studies, cannabis greatly reduced the need for opioids, or even complete eliminated the need for opioid use. Additionally, the cannabinoids work synergistically in alleviating some of the symptoms of terminally ill patients, such as pain in end-stage cancer patients.
Clinical trial evidence found that oral cannabinoids (Sativex) provided better pain relief in opioid-refractory cancer pain than long-acting opioids. The treatment was well-tolerated by the palliative care patients. According to three randomized control studies, cannabis use significantly improved the appetite, weight gain and stabilized body weight in AIDS wasting syndrome. These benefits might be helpful for terminally ill patients suffering from cancer-associated cachexia.
Conclusion
Most of the systematic review studies that are inconclusive or even against the use of medical cannabis have assessed the randomized clinical trials of synthetic cannabinoids such as Dronabinol but not plant-derived cannabinoids. Even some of the studies that assessed the natural cannabinoids lacked adequate statistical power due to flawed clinical trial design. Assessing these studies cannot provide a definitive conclusion.
Conventionally, palliative care management for most of diseases – including cancer – is opioids. Due to inevitable risk of tolerance, the patient has to take more and more narcotics, even if the drug provides little relief. Higher doses can make the patients become more confused and lethargic, with the risk of developing depression, anorexia, nausea and vomiting.
Cannabis could definitely reduce the dosage of these narcotics and also improve the symptoms by its synergistic actions. For terminally ill patients, marijuana could reduce the anguish, improve the quality of life and may also add days to their life.
A tincture brought relief to 92-year-old Raymond Hayley, which also made things a little easier for his son and caretaker, William
Raymond Hayley enjoyed a day trip to Granville Island with his son, Will, in June 2017.
[B]efore passing away suddenly in September 2016, Doreen Hayley made her son swear not to put his father, Raymond, in a care home.
The “normal bachelor life” William Hayley had been living in Vancouver was about to come to a halt: with his mother gone and his 92-year-old father suffering from Parkinson’s disease, he was thrown into the position of caretaker without an instruction manual.
At the time, he had no idea how big a role cannabis would play in easing his father into the final stage of life.
Among Raymond’s favourite places to take in the sights and sounds of Vancouver were the docks of Granville Island. It was there on a summer day in late June that the Straight first met the Hayleys.
Diagnosed with Parkinson’s disease in his 70s, Raymond had spent the better part of 20 years suffering from the degenerative disorder that caused uncontrollable shaking and rigidity. As it progressed, Parkinson’s came with its own brands of dementia and anxiety, and Raymond would experience a symptom called “sundowning” almost daily.
Each afternoon like clockwork, William said, his father’s agitation and confusion became otherworldly.
“He’d get into these states—the closest thing I could relate it to is a possession,” he said. “The look on his face would change, things didn’t make sense to him; he would moan, and sometimes he’d hit himself or a chair.”
With his father waking up hourly, sleep escaped William, too. Their health suffered, and William developed anemia as Raymond’s condition deteriorated.
At his wits’ end and with no option from doctors but powerful antipsychotics, William watched a Facebook video of a man with Parkinson’s disease whose tremors subsided after he took Phoenix Tears, a highly concentrated cannabis extract.
“I thought, ‘Rather than having him come to this terrible crashing end like a plane cartwheeling down a runway, what if we could soften the landing for him?’ ”
William consulted with his father’s physician before visiting local dispensary the Village Bloomery, where he opted for a four-to-one CBD-to-THC tincture, a ratio that would minimize psychoactivity while decreasing anxiety. He said the effects on his father were almost immediate.
“Within 30 minutes, he went from eating cookies to stacking them up and building with them. He was calm, he wasn’t moaning, and he wasn’t shaking,” William remembered.
He also said that when the tension in Raymond’s body stopped, it opened the doorway to sleep—something he hadn’t done for more than 40 minutes at a time in almost five years.
“All of a sudden, six hours became eight, and eight became 10,” William said. With his father able to sleep, William could do the same. Physically, Raymond had some control of his body back, and mentally, the symptoms of his dementia began to subside, according to William. He added that the sundowning stopped and there was light in his eyes again.
“I’ve got it down to a routine where I put it in his dentures,” William said as we circled Granville Island. “He likes it, he wants it, and he knows that it’s working.”
Raymond passed away peacefully in his son’s arms on August 21, 2017. Today, William says that not only did cannabis give him his father back; it gave his father the ability to grieve, something dementia had robbed him of.
“He was married for 69 years—some people don’t live that long,” William said in a follow-up interview. “When he became lucid enough to realize his situation, that his wife had passed away and everything was gone, he was actually able to grieve. At least with cannabis, I could talk to him about it.”
It’s the type of bittersweet story known well by Selena Wong, a Vernon-based cannabis consultant who specializes in end-of-life care.
Calling cannabis her “saving grace”, Wong said that when she realized that cannabis could have value for her grandparents, it was a game changer. But she noted that there are a few things to consider when administering cannabis to an elderly person.
“I’m really mindful that the people I work with have a positive experience with cannabis,” she said. “Seniors are people, and just like you and I want to know what we’re taking, so do they.”
Topical lotions or CBD products are good starting points, she said, because they won’t cause euphoria. A tincture is also a great option for seniors who might have trouble swallowing capsules.
“Because of the conditioning they’ve experienced, it helps them to reframe that relationship with the plant without having a negative experience.”
Looking back, William says that without cannabis, he’s not sure how well he would have coped with his father’s illness, but he’s happy to have kept his promise to his mother.
“A year is a long time to give up,” he says, “but I’d give $10 million just for another 10 minutes with him.”
The medicinal use of marijuana is now legal in a growing number of U.S. states, and other states might eventually join this list. Some patients, however, might be unable to smoke medical marijuana because of their illness, disease, symptoms, treatments and/or other factors. This article explores the alternatives to smoking marijuana that might prove healthier or more viable for patients who’ve received a prescription for medical marijuana.
Marijuana Use for Medicinal Purposes
Requiring a doctor’s prescription and secured from legal vendors, medical marijuanacan help relieve numerous symptoms, such as pain, glaucoma, migraine headaches,nausea and weight loss.
While there are various pros and cons to using medical marijuana, it’s important to understand that the use of marijuana is not without potential side effects. For example, conventional or “street” marijuana might contain harmful fungus and/or pesticides, which can prove especially dangerous for patients with a compromised immune system.
Moreover, the fact that marijuana is usually smoked — either in cigarette form, or through the use of tobacco or water pipes — introduces additional concerns. Burning marijuana leaves and buds, for example, can produce 50% to 70% more carcinogens versus traditional or “analog” tobacco cigarettes. In addition, patients who have never smoked before, or those receiving other treatments that can interfere with their ability to smoke, might find smoking marijuana difficult or simply impossible.
I found that to be a case with a patient with whom I once worked:
Mr. C was a 79-year-old man suffering from lung cancer and COPD. He suffered from chronic bone pain, nausea and severe weight loss. He asked his doctor about medical marijuana and received the necessary prescription. When I came to see him, he held a joint, but he didn’t know how to use it. It was immediately clear that because of his inexperience, and because he was using oxygen and was already suffering from a forceful cough, smoking a marijuana cigarette would not be the best method for him.
Alternative Non-Smoking Medical Marijuana Options
It’s important to again stress that medical marijuana is a physician-prescribed treatment and should only be used according to a doctor’s instruction. If you, or someone you care for, receives a prescription for medical marijuana use but cannot smoke marijuana, your non-smoking options might include:
Edible Marijuana: Medical cannabis can be heated and made into oils, butters and tinctures. Many “cannabis clubs” sell pre-made cookies, brownies, lollipops and teas. Savvy patients — those willing to take the time to empower themselves through research and knowledge — can also find recipes to make their own marijuana tincture, oil or butter.
Eating or drinking marijuana’s main or active ingredient tetrahydrocannabinol (THC) is certainly preferable to many patients rather than smoking it, but these alternative methods can also create problems. When consumed via food or drink, THC does not absorb into the bloodstream as quickly as when it is smoked.
This can make it more difficult to control the effectiveness of the drug or how much is consumed. In addition, patients who suffer from decreased appetite or nausea might not tolerate eating or drinking marijuana.
Vaporizers: Another option is to inhale marijuana using a vaporizer. This method involves heating the marijuana to a high enough temperature to vaporize the THC but not burn the plant. Patients can then breath in the vapor from a bag without inhaling the harsh and potentially toxic smoke.
Vaporizing marijuana is much healthier for your lungs and also produces the highest THC content of any smoking-related method. This allows patients to use a smaller quantity of marijuana at a time, which can potentially save money.
Vaporizers range from battery-powered, handheld devices to larger plug-in units. The quality and prices of marijuana vaporizers vary widely, so it is wise to shop around and read user reviews online before purchasing one.
Ultimately, my patient found a healthier alternative to smoking marijuana, too:
Mr. C experimented with edible marijuana. He found he enjoyed the marijuana brownies he was able to get at a cannabis club, but as his appetite waned, he found it difficult to stomach the rich chocolate taste. He didn’t want to invest in a vaporizer because his life expectancy was short. However, through the people he met at the cannabis club, he was able to strike a deal with another medical marijuana patient and split the cost of a vaporizer — with the agreement that the other patient would inherit the device after Mr. C’s death. It was an unusual arrangement, to be sure, but it allowed Mr. C to continue using medical marijuana for several more weeks.
Is medical cannabis the answer to lowering prescription drug costs and reducing opioid-related overdose deaths?
By Sean Williams
This could potentially be a groundbreaking year for the marijuana industry.
In November, residents in up to a dozen states could be voting on whether or not to legalize recreational or medical marijuana. This comes after Pennsylvania and Ohio passed laws legalizing medical marijuana in their legislatures this spring. As it stands now, half of the country has legalized the use of medical marijuana, and four states (plus Washington, D.C.) allow for the sale of recreational marijuana to adults ages 21 and up.
Arguably just as exciting is the possibility that the U.S. Drug Enforcement Agency could reclassify medical marijuana in a matter of weeks. The Food and Drug Administration has already submitted its opinion to the DEA, with the DEA now conducting its own investigation into the safety of medical marijuana. If the agency were to reclassify medical marijuana as anything other than schedule 1, which means an illicit drug, medical marijuana could be prescribed by physicians, and insurers may even begin covering the substance.
But that isn’t all. The good news just keeps streaming in for the cannabis industry.
Cut Medicare’s expenditures with… medical marijuana?
Last week, Ashley Bradford and David Bradford, both of the Department of Public Administration and Policy at the University of Georgia, published findings that examined a possible correlation between medical marijuana prescription use in legal states between 2010 and 2013 and Medicare prescription use under Part D over the same timeframe. The authors’ work can be found in the online journal Health Affairs.
What the study authors found was a correlation between medical marijuana prescription use and lower prescription drug use under Medicare for ailments commonly treated by medical marijuana in states where medical marijuana is legal. For instance, medical marijuana is often prescribed to treat anxiety, depression, nausea, seizures, sleep disorders, and spasticity associated with multiple sclerosis. In states where medical marijuana is legal, the authors found a marked reduction in Part D expenses for FDA-approved drugs to treat these ailments. Prescription drug use under Medicare Part D for ailments that medical marijuana isn’t used for did not see a drop in these same medical marijuana-legal states.
What’s more telling is the amount of money the authors calculated that medical marijuana saved Medicare Part D in 2013. Per their estimates, it was about $165 million. According to the authors’ extrapolated estimates, they believe a nationwide legalization of medical marijuana would result in about $470 million saved annually by Part D.
One final positive is that no marijuana overdoses have led to any deaths. The same can’t be said for opioids, which are commonly prescribed as painkillers. Opioid overdoes, which include heroin, killed more than 28,000 people in 2014, and at least half of all of these deaths involved a prescription opioid, according to the Centers for Disease Control and Prevention. Thus, it’s possible that if cannabis were incorporated into the care regimen for seniors, or all patients for that matter, it could reduce the costs for Medicare and Medicaid, as well as prevent unnecessary opioid-related overdose deaths.
Hold your horses
But before you get too excited that medical marijuana will save Medicare and Medicaid, keep a few things in mind.
First, saving money is great for Medicare Part D, but we’re talking about $470 million in savings on an estimated $88 billion in drug spending for 2016, per the Kaiser Family Foundation. Don’t get me wrong, saving money would be a good thing for the Medicare program, with the Hospital Insurance Trust expected to deplete its spare cash reserves by 2028. But we’re really only talking about one-half of one percent based on 2016’s spending estimates. With prescription drug costs seemingly rising by a mid-to-upper single-digit percentage each year, medical marijuana isn’t going to be Medicare’s white knight.
Secondly, we have no clue what the DEA is going to do with marijuana when it makes its ruling in the coming weeks. The DEA could decide to do nothing and leave it as an illicit schedule 1 substance. It could also de-schedule the drug completely, putting it on par with tobacco and alcohol, which seems like a longshot.
More reasonably, the DEA could reschedule medical cannabis as a schedule 2, 3, 4, or 5 drug, implying that a medical benefit exists, but suggesting that addiction to the substance exists, too. Labeling cannabis as a schedule 2 drug could prove to be a nightmare for the industry, with regulatory costs soaring. Schedule 2 means the FDA coming in and controlling package labeling, ensuring that manufacturing standards remain consistent, and potentially requiring medical marijuana companies to run clinical studies to support their claims that cannabis treats certain ailments. A rescheduling may be a victory in name only for the cannabis industry.
Finally, we still have federal restrictions on the cannabis industry, which are making life tough, if not impossible, for investors trying to take advantage of marijuana’s growth. Lawmakers on Capitol Hill don’t look anywhere near ready to change their tune on marijuana, which means inherent disadvantages for businesses involved in the cannabis industry will continue for the foreseeable future.
For starters, access to basic financial services is hit-and-miss. Only 3% of the nation’s roughly 6,700 banks are currently willing to work with cannabis-based companies for fear of federal prosecution down the line. This means few businesses have access to business checking and savings accounts, or lines of credit to buy product and expand.
Additionally, marijuana businesses get the short end of the stick come tax time. IRS tax code 280E, in its simplest form, disallows businesses that sell illegal substances from taking normal business deductions. As long as the marijuana plant is considered an illicit substance on Capitol Hill, cannabis companies will be paying tax on their gross profits instead of net profits, thus forking over far more than they should in taxes. It’s simply not an investor-friendly environment.
Although things appear to be moving in the right direction for cannabis, you’d be wise as an investor to avoid the industry altogether until these inherent disadvantages disappear.
The Georgiadis’s dog, Bernie, who hasn’t had a seizure in four months.
Bernie, a 130-pound Swiss mountain dog, began having grand mal seizures when he was six months old. About once a week he would violently convulse, foam at the mouth, and urinate on himself for several minutes before recovering an or so hour later. The medication he was given seriously disoriented him, was harmful to his liver and for the most part didn’t work.
At the end of their rope, Bernie’s parents decided to put him on a pet supplement derived from cannabis. Gradually, his seizures became less severe and less frequent, before disappearing altogether.
Despite a large amount of promising anecdotal evidence like Bernie’s story, and a growing industry of cannabis-based pet products, many people have a hard time taking medical marijuana for pets seriously.
“It sounds ridiculous, until you experience it yourself,” said Bernie’s owner, Anthony Georgiadis, who says his dog hasn’t had a seizure in four months.
Living in Florida, where medical marijuana is illegal, Georgiadis orders Bernie’s supplement online from a California company called Treatibles. He is allowed to do this because Treatibles products are derived from legal hemp and contain little to no THC (the intoxicating ingredient in marijuana).
Many pet products are not made from hemp, though, but rather straight marijuana containing trace amounts of THC. So anyone wanting these products for their animal’s chronic pain, anxiety, inflammation, appetite stimulation, or epilepsy have to live in a state where medical marijuana is legal – and even then, they need to have a prescription for themselves just to enter a dispensary.
Last year, Tick Segerblom, a Nevada state senator, introduced a bill to create a medical marijuana registry for pets.
“They thought it was a joke,” Segerblom said of his senate colleagues. “It was the talk of the country for a while.”
“Look at this moron!” Dennis Miller screamed on the O’Reilly Factor, deriding the senator’s bill, calling it “the end of culture as we know it”.
“I have fish at home that want medical marijuana,” O’Reilly joked. “I’m not exactly sure how to deliver that to them, because if you put the cigarette in there it all gets wet.”
Despite the public ridicule, Segerblom said, he had been looking forward to the issue being debated in a hearing, but that hearing never happened. In the end, he said, “it went to a committee headed by a person who hates marijuana, and he made sure that it died”.
Amanda Reiman, manager of marijuana law at the Drug Policy Alliance, said that today’s battle over animal medical marijuana mirrors the clash over human medical marijuana in 1990s California.
“When we first started talking about the idea of using marijuana as a medicine, people laughed about it,” she said. “But they’ve come around, because when you know someone who was helped by cannabis it’s not funny anymore.”
n 2013, Reiman’s cat, Monkey, was diagnosed with terminal intestinal cancer. The chemotherapy and medication caused Monkey to lose her appetite, not sleep and become lethargic. The situation reminded Reiman of the countless scenarios she’d encountered with humans after a decade of working in medical marijuana, so she decided to mix a very small amount of cannabis oil in Monkey’s food.
In 2013, Reiman’s cat, Monkey, was diagnosed with cancer.
“It brought her energy back, she was eating and playing – she was actually acting healthier than she had been before she was diagnosed with cancer,” Reiman said. “I knew it wasn’t a cure for her, and in the end she passed away several months later. But I really do feel it gave her a quality of life at the end; instead of just fading away, she stayed strong right up until the end.”
Veterinarians caution against pet owners taking matters into their own hands, because finding the correct dose can be tricky. While many pet medicines are just human drugs in different doses, the weight ratios between humans and animals can make it easy to accidentally give your pet an overdose. And pets overdosing on cannabis is already a serious problem in states where marijuana is legal.
As with children, it’s common for pets to stumble upon a high potency marijuana edible, eat it, and become incredibly ill and intoxicated.
“We’ve seen some serious poisonings of animals [from marijuana] and even a couple of deaths,” says the medical director at the ASPCA Animal Poison Control Center, Dr Tina Wismer.
When it comes to pet meds, Wismer says it’s not uncommon for a human medication to be applied to animals purely on the basis of anecdotal evidence. She believes more studies need to be done on the therapeutic use of cannabis on animals to find the right dose.
Dr Sarah Brandon, a veterinarian and cofounder of Canna Companion, a hemp-based pet supplement company, says that over the last 18 years, she has administered cannabis to more than 4,000 animals, and is currently analyzing data before offering it to the medical community.
“Right now, veterinarians have no guidance on this,” she says. “There’s a lot of fear out there, and they are scared to come out and recommend [cannabis]. A veterinarian can recommend a hemp-based product as a supplement, but they cannot encourage them to use marijuana.”
Dan Goldfarb, owner of Seattle-based Canna-Pet, describes the differences between hemp and marijuana: “It’s like dog breeds: you can have a chihuahua or a great dane, both of which are dogs but are bred to exude very different characteristics.”
Canna-Pet, Treatibles and Canna Companion are all strictly hemp-based, so they are allowed to sell their products outside of marijuana dispensaries – even online to states where marijuana is illegal – without the need of a prescription. This also affords them deniability when people like Dennis Miller say they just want to get their pet stoned. But there are a handful of companies who use straight marijuana in their pet products, who say that hemp is too limited.
“We’ve seen better results with a little THC,” says Alison Ettel, founder of Treat Well, who has been using cannabis on a variety of animals for ten years and was recently invited to treat seals at the Marine Animal Center in Sausalito, California. She says that hemp works for some ailments like anxiety, but doesn’t contain a number of medicinal properties that marijuana does, like appetite stimulation, and that hemp can be harmful to an animal with a compromised immune system. “We believe hemp can have more negative effects than positive.”
Ettel adds that while her products contain psychoactive properties, if used in the right dosage in proportion to the animal’s size, there is no reason they should ever become intoxicated by it.
Brian Walker’s California company, Making You Better Brands, offers a marijuana based doggie shampoo for pain relief (along with similar products for horses). Walker says that the marijuana is never activated with heat, a process necessary for making the plant psychoactive.
But his company is still regulated like any other in the cannabis industry, meaning pet owners can only buy it in a dispensary with a (human) prescription, and can’t take it out of state. Walker said the lack of information available about the differences between hemp, active cannabis and inactive cannabis has prevented acceptance among veterinarians of medical marijuana.
“They picture a dog eating a brownie and being high for two days,” he said. “But with non-active cannabis they’re not going to get high – they’re going to get well.”
