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Tue Jul 23, 2013, 10:58 PM

Marijuana Causes Remission in Crohn's Disease

http://www.ncbi.nlm.nih.gov/pubmed/23648372

METHODS:
We studied 21 patients (mean age, 40 14 y; 13 men) with Crohn's Disease Activity Index (CDAI) scores greater than 200 who did not respond to therapy with steroids, immunomodulators, or anti-tumor necrosis factor-α agents. Patients were assigned randomly to groups given cannabis, twice daily, in the form of cigarettes containing 11.5 mg of tetrahydrocannabinol (THC) or placebo containing cannabis flowers from which the THC had been extracted. Disease activity and laboratory tests were assessed during 8 weeks of treatment and 2 weeks thereafter.

RESULTS:
Complete remission (CDAI score, <150) was achieved by 5 of 11 subjects in the cannabis group (45%) and 1 of 10 in the placebo group (10%; P = .43). A clinical response (decrease in CDAI score of >100) was observed in 10 of 11 subjects in the cannabis group (90%; from 330 105 to 152 109) and 4 of 10 in the placebo group (40%; from 373 94 to 306 143; P = .028). Three patients in the cannabis group were weaned from steroid dependency. Subjects receiving cannabis reported improved appetite and sleep, with no significant side effects.

CONCLUSIONS:
Although the primary end point of the study (induction of remission) was not achieved, a short course (8 weeks) of THC-rich cannabis produced significant clinical, steroid-free benefits to 11 patients with active Crohn's disease, compared with placebo, without side effects. Further studies, with larger patient groups and a nonsmoking mode of intake, are warranted.


This article reporting the study claims complete remission, but the study is more conservative in its claims. It is true that nearly half the patients in the study were in complete remission, but the sample size is very small.

But, interestingly, 10 out of 11 patients in the study using cannabis, rather than the placebo, demonstrated a "clinical response" to the cannabis. Out of those 10, 5 were in complete remission.

http://www.medicaldaily.com/articles/17529/20130718/medical-marijuana-crohns-disease-remission-anti-inflammatory-drug-inflammatory-bowel-disease.htm

Often mischaracterized as an autoimmune disease, Crohn's disease is in fact an immune deficiency state. Arising from a host of genetic, environmental, and immunological factors, the disease causes a chronic inflammatory disorder that attacks the person's gastrointestinal tract anywhere from the mouth to the anus in order to fight the body's antigens that otherwise do no harm. Symptoms of the disease range from mild abdominal pain to more severe cases of bloody diarrhea, nausea, vomiting, weight loss, and fevers.

There is no cure for Crohn's; however, various methods are aimed at limiting flare ups and keeping the disease in remission. Treatments, like disease severity, fall on a spectrum depending on the person. Simple dietary changes suffice for some, while invasive surgery to remove the affected area may be needed for others. Corticosteroids and other medications are also prescribed for less severe cases.

The disease affects around 400,000 to 600,000 people in North America, although many people do not get diagnosed until they've had the disease for years, simply because no symptoms were present.

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Response to RainDog (Original post)

Tue Jul 23, 2013, 11:21 PM

1. k and r--thank you for posting this. as I have several friends with crohn's--will definitely be

keeping an eye on any further research in the area.

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Response to niyad (Reply #1)

Wed Jul 24, 2013, 04:49 AM

6. And all of these patients had severe, intractable Crohn's

that had not responded to traditional therapeutic treatments.

this is an important study.

hopefully one of many to come.

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Response to RainDog (Original post)

Wed Jul 24, 2013, 12:38 AM

2. Thanks for posting this.

Will forward to friend with crohn's, and recommend he move to a state where med mj is legal...

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Response to RainDog (Original post)

Wed Jul 24, 2013, 01:16 AM

3. I'd be interested in seeing a larger sample size

And perhaps oral administering.

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Response to Fearless (Reply #3)

Wed Jul 24, 2013, 04:56 AM

7. Yes. But another study noted smoking is an effective delivery system

http://www.democraticunderground.com/11701225

Smoking cannabis provides rapid and efficient delivery of THC to brain. THC can be detected immediately in plasma after the first puff of a cigarette; peak concentrations occur within 10 minutes, then decrease to approximately 60% of peak by 15 minutes and 20% of peak by 30 minutes, but there can be wide inter-individual variation in concentrations achieved . Rapid onset and predictable decay means that self-titration of dosing is attainable.


However, in the case of Crohn's Disease, I would definitely want to try some sort of edible version because the cannabinoid receptors that are put to use for this inflammation are in the digestive system.

Also would be interesting to do a study with cannabis with various levels of CBD cannabinoids noted, since CBD, not just THC, has a strong anti-inflammatory effect - and the two work in tandem, based upon other research, to boost the qualities of the other.

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Response to RainDog (Reply #7)

Wed Jul 24, 2013, 03:44 PM

10. Exactly!

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Response to RainDog (Original post)

Wed Jul 24, 2013, 01:19 AM

4. This is the NIH, not a study sponsored by High Times.

While a larger sample size would be interesting, one cannot dismiss the fact that this is a legitimate study reported at the federal level.

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Response to AllyCat (Reply #4)

Wed Jul 24, 2013, 04:57 AM

8. The research was done in Israel

...where a lot of research on cannabis is done.

and, yes, this is an important peer-reviewed study, even tho the sample size is small.

evidence is incontrovertible that cannabis has medical value.

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Response to RainDog (Original post)

Wed Jul 24, 2013, 01:43 AM

5. Pot is the only thing that makes you want to eat when you're on chemo.

Yes, there are lots of prescription anti-nausea drugs, but none of them make you want to eat, they just keep you from puking.

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Response to RainDog (Original post)

Wed Jul 24, 2013, 09:28 AM

9. The mammalian endocannabinoid system is the key to good immune health.

And yet because of prohibition, most people don't even know that they have an endocannabinoid system. It is every bit as important as any other system in our body, maybe more so.

Doctors and drug dealers.. I mean drug companies certainly aren't telling anyone.

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Response to tridim (Reply #9)

Wed Jul 24, 2013, 10:26 PM

11. Bio. Prof. Dr. Robert Melamede thinks so

http://www.harmreductionjournal.com/content/2/1/17

He calls the cannabinoid system "nature's method of harm reduction."

Evolution of Endocannabinoids

The cannabinoid system appears to be quite ancient [13,14], with some of its components dating back about 600 million years to when the first multicellular organisms appeared. The beginnings of the modern cannabinoid system are found in mollusks [15] and hydra [16]. As evolution proceeded, the role that the cannabinoid system played in animal life continuously increased. It is now known that this system maintains homeostasis within and across the organizational scales of all animals. Within a cell, cannabinoids control basic metabolic processes such as glucose metabolism [17]. Cannabinoids regulate intercellular communication, especially in the immune [18] and nervous systems [19]. In general, cannabinoids modulate and coordinate tissues, organ and body systems (including the cardiovascular [20], digestive [16], endocrine [21], excretory [22,23], immune [18], musculo-skeletal [24], nervous [19], reproductive [25], and respiratory [26] systems). The effects of cannabinoids on consciousness are not well understood, but are well known, and underlie recreational cannabis use. These effects also have therapeutic possibilities [27].

Cannabinoids: Homeostatic Regulators

The homeostatic action of cannabinoids on so many physiological structures and processes is the basis for the hypothesis that the endocannabinoid system is nothing less than a naturally evolved harm reduction system. Endocannabinoids protect by fine-tuning and regulating dynamic biochemical steady states within the ranges required for healthy biological function. The endocannabinoid system itself appears to be up- or down-regulated as a function of need. As will be detailed later in this article, endocannabinoid levels naturally increase in the case of head injury and stroke [28], and the number of cannabinoid receptors increases in response to nerve injury and the associated pain [29]. In contrast, the number of cannabinoid receptors is reduced when tolerance to cannabinoids is induced [30].

...Evolution has selected the endocannabinoids to homeostatically regulate numerous biological phenomena that can be found in every organized system in the body, and to counteract biochemical imbalances that are characteristic of numerous damaged or diseased states, in particular those associated with aging. Starting from birth, cannabinoids are present in mother's milk [135], where they initiate the eating process. If the activity of endocannabinoids in the mouse milk is inhibited with a cannabinoid antagonist, the newborn mice die of starvation. As life proceeds, endocannabinoids continuously regulate appetite, body temperature, reproductive activity, and learning capacity. When a body is physically damaged, the endocannabinoids are called on to reduce inflammation, protect neurons [136], regulate cardiac rhythms [137] and protect the heart form oxygen deprivation [20]. In humans suffering from colorectal cancer, endocannabinoid levels are elevated in an effort to control the cancer [74]. They help relieve emotional suffering by reducing pain and facilitating movement beyond the fears of unpleasant memories [119].

While this review is far from complete, it attempts to provide a conceptual overview that supports the endocannabinoid system as being nature's method of harm reduction. There is a pattern to all the cannabinoid-mediated activities described. Many of the biochemical imbalances that cannabinoids protect against are associated with aging. Aging itself is a system-wide movement towards chemical equilibrium (away from the highly regulated far-from-equilibrium state) and as such is an imbalance from which all living organisms suffer. In contrast, the harmful consequences of cannabis use, however exaggerated they often appear to be, are likely to represent significant potential risk for a minority of the population for whom reduced cannabinoid levels might promote mental stability, fertility or more regulated food consumption.

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