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IMAGE: Dr. Deborah Malka
Dr. Fred is one of those warm, gifted doctors that you’re lucky to find in times of illness. Pragmatic and compassionate, he helped many families to feel more at ease before the surgery of a loved one. As an anesthesiologist, he traveled across India performing free operations on children and even got to sit down with the Dalai Lama. After a lifetime devoted to healing, Dr. Fred recently retired ahead of schedule because of his diagnosis of amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease.
The curse of ALS, the most common adult motor neuron disease, is that the mind stays clear while the muscles gradually stop responding. Dr. Fred must watch as his body loses the ability to drive – and then to walk – and then to talk. We possess only vague guesses at its cause and there’s no definitive clinical tests – only the symptoms of weakness, difficulty swallowing and the wasting muscles that result from a mass extinction of motor neurons in the brain and spinal cord. Death comes, on average, in about five years as the lungs stop inflating and the patient suffocates. To slow the progression, the FDA has only approved one drug (Riluzole) but the benefits are paltry at best. Only one medicine works to decrease Dr. Fred’s muscle spasticity but it’s illegal to dispense: cannabis.
Despite extensive preclinical evidence that cannabis delays the symptoms of ALS, a call to arms for clinical trials has been ignored despite the scientist’s obvious incredulousness that cannabis somehow treats the five different “abnormal physiological processes [that] occur simultaneously in this devastating disease.” Outspoken patients like Cathy Jordan, a 15 year survivor and the poster child for cannabis and ALS, gets raided by the local sheriff instead of being an object lesson in exciting new medicines for an intractable illness.
That’s because the War on Weed is actually a War on the Elderly. Prohibition causes millions of our parents and grandparents to die earlier and in more pain because they have no knowledge or access to one of mankind’s oldest safest medicines. I’m a scientist currently doing research for a graphic novel about the human endocannabinoid system. It took me a year and a half in the scientific literature before I realized the truth: cannabis is the closest medicine humans have to a panacea for the many diseases of aging.
Anyone reading this article understands the criminal stupidity of denying the medical benefits of cannabis. However, few of us realize the extent of this injustice against the elderly. The sheer expanse of diseases is astounding and the mountains of evidence overpowering. Cannabis helps with so many basic problems of aging: it lowers inflammation across the body, lessening aches, migraines and arthritis. By itself, it’s helpful against pain and it enhances the other painkillers so a patient needs less addictive opiates with just a few puffs of pot. It eases nausea from chemotherapy, treats sleep apnea, raises bone density for osteoporosis and protects the GI tract. It prevents heart attacks and lessens the neurotoxicity of strokes if applied immediately (the federal Health & Human Services even has a patent for this cannabinoid neuroprotection. This makes it even more ironic when the DEA claims ‘no medical benefit’). For as yet unknown reasons, cannabis works especially well for movement disorders like Parkinson’s and the self-attacking autoimmune disorders like Crohn’s disease. Cannabis slows the viruses of herpes and HIV, the prions of Mad Cow disease and even destroys the MRSA bacteria in a test tube (this drug resistant staph infection now kills more people than HIV every year and we have no new antibiotics left to kill it – except for the cannabinoids from that wicked weed). Our brain overflows with cannabinoid receptors that protect against MS, epilepsy and Alzheimer’s. Cannabis attacks and prevents cancer by several different pathways and it often eases depression. As the colorful Colorado activist Bill Althouse says, “If you’re over 50 years old and you don’t have 50 mg of CBD in your system every day, you’re an idiot.”
Ingestion Guide: Dosing Grandma
If the War on Weed is a War on the Elderly, then the Revolution is the Dispensary. For the afflictions of age, the medical dispensary changes everything because cannabis has always been a tricky medicine. The variability of effect between individuals and the difficulty in producing a standardized product caused its decline in medical use even before the 1930’s and Anslinger’s Reefer Madness hysteria. With cannabis, a patient must be willing to figure out what works for them out of the bewildering array of options. Progress is watching a feisty old lady walk into a dispensary and declare that she takes one quarter sativa brownie in the morning for her tremors, one third of an indica brownie at night to help her sleep and as needed throughout the day, small hits of high CBD oil from her vape pen. She said it took her some months and the advice from her budtender and doctor to find a balance between motor control and getting “too damned stoned to play bridge.”
Luckily, Dr. Fred enjoys getting high. He used to take golf trips to Scotland with his wife and they’d always stop in Amsterdam to stock up for the links. This makes him an anomaly among elderly patients who usually have never tried cannabis before. For our grandparents, one experience of getting too stoned can turn them off forever. Dr. Fred says, “I like getting high but I want to choose when it happens. I can’t spend the rest of my time in a constant fog.” That’s why the emergence of high CBD products is one of the most important stories to come out of the dispensaries.
The plant contains 80 different cannabinoids but only two are well studied. If THC is the ‘stoning’ molecule of cannabis, then CBD is the healing molecule that lowers inflammation, lessens anxiety and acts as a general homeostatic agent for the body. Since CBD is hardly psychoactive, Dr. Fred can ingest more medicine without getting high. It’s not a replacement for his other medications but an additional tool to help them work better. Some older patients may be able to replace their pharmaceuticals with cannabis but for most, we just need to make them aware of cannabis as an another option to help. Especially the high CBD products that provide the healing but not the stoning.
For a patient like Dr. Fred battling a multi-headed hydra like ALS, he needs many different forms of cannabis. When his muscle spasticity begins, Dr. Fred still prefers a trusty joint of Blue Dream. However, he observes that “cannabinoids dramatically decrease my spasticity but they also decrease my muscle control. The overall effect is one that makes me less stable on my feet.” He finds positive benefits on his mood and GI tract but he’s still experimenting to find the ingestion methods that serve him best.
The two main factors to consider when dosing Grandma is the strain of cannabis and the method for ingesting it. It’s all about finding something that works and sticking with it.
For strains of cannabis, most people understand the difference between the more energetic sativa strains and the sedative indicas. By the way, one of the major reasons that many people don’t smoke cannabis is because it puts them to sleep. But throughout the Prohibitionistic parts of the country, the bud tends to be heavy indicas that knock people out. They don’t realize that some sativa strains might turn them into a chipper squirrel who cleans the house instead of getting locked up on the couch. It’s a vast improvement when going from your local dealer who – if you’re lucky – might have a few strains and vague ideas about their effect to a dispensary with dozens of strains, labels of potency and budtenders to provide advice.
But then you must figure out how to get the cannabis into Grandma’s system. Patients often need two ingestion methods: a slow form for all day protection and a fast method for instant relief.
(When I give this talk about the “War on the Elderly & the Revolution of the Dispensary,” I show off a grab bag of the pot products below. In backwards places like the medical marijuana wasteland of New York City, the naked display of cannabis products always titillates the audience but it’s the array of options that should be exciting them)
Vaporization – Perhaps the safest fast ingestion method is vaporizing cannabis. It raises the temperature to where the cannabinoids boil off but the plant material does not burn. No smoke and almost no smell. That means Dr. Fred can duck into the bathroom of a restaurant when his motor control starts to slip and take one quick puff off a vape pen and return to the table, able to handle his fork again.
Caution should be taken with vaporization and the elderly. Just like with alcohol, there’s a lower tolerance. Also because the smoke is so light, it doesn’t feel like you’re inhaling anything and it’s easy to take too much. But the portability and cleanliness make vaporization an important option
Edibles (eating) – The most widespread method for long lasting relief. Here’s where the greatest creativity of the dispensaries unleashes: cookies, hard candies, soft drinks, gummies, honey, tea, pizza and premade cannabis butter so Grandma can bake her medicine into anything she desires.
Eating cannabis is also where the most care needs to be taken because the effects may take up to two hours depending on the contents of the stomach. Start especially small with edibles.
Sublingual (under the tongue) – Dispensaries now provide high CBD oils that can be dropped into the mouth, sublingual tabs that melt under the tongue and CBD lozenges
Topicals (on the skin) – cannabis can be absorbed through the skin. Lotions made from cannabis help with skin conditions and there’s even pain sprays that provide instant relief. For cancer patients and other compromised immune systems, skin application is one of the safest methods for cannabis ingestion
And many more – There’s also old methods like juicing the whole plant or the Egyptian trick of menstrual cramp relief by applying honey hash to the vagina and there’s new methods like the dabbing of hash oil or the direct injection of THC microspheres into cancerous tumors.
After seeing the power of cannabis on Dr. Fred’s ALS, I believe we owe it to our grandparents to let them know about this nontoxic medicine to treat their aches and pains. After 100 years of Prohibition and a lost century in human health, the awesome power of American research and ingenuity will finally be unleashed on this important old medicine. Our study of cannabis and our methods of ingestion will be a boon to our grandparents and ourselves.