Trade In your Ibuprofen for Cannabis
BY BONNI GOLDSTEIN, MD ON AUGUST 15, 2018 (UPDATED ON MAY 6, 2019)
More than 17 million Americans take NSAIDs on a daily basis for inflammation
Pain from inflammation can and will likely affect all adults at some point in their lives, and for some, become chronic conditions that interfere with a normal quality of life.
Over-the-counter (OTC) and prescription anti-inflammatory medications are easily available, readily prescribed, and very commonly used. The most common anti-inflammatory medications are called NSAIDs: non-steroidal antiinflammatory drugs. Based on consumer survey responses, more than 17 million Americans take NSAIDs on a daily basis, with more than 70 million prescriptions and more than 30 billion OTC NSAID tablets sold annually in the United States.
OTC NSAIDS include aspirin, ibuprofen, naproxen and prescription NSAIDs include celecoxib, diclofenac, etodolac and ketoprofen. NSAIDs work by blocking enzymes called COX-1 and COX-2. These enzymes produce a group of compounds that our cells make called prostaglandins. Prostaglandins made by COX-1 enzymes activate your platelets (for blood clotting) and protect the lining of your stomach and intestines. Prostaglandins made by COX-2 enzymes are made in response to injury or infection, regulating inflammation. Most NSAIDs work non-selectively on both enzymes (except for celecoxib which is a COX-2 inhibitor). This lack of selectivity becomes an issue because pain and inflammation relief from NSAIDs come from blocking COX-2, but unfortunately COX-1 is also blocked, causing unwanted adverse side effects.
26% percent of NSAID users have adverse drug reactions. Complications include upper gastrointestinal bleeding and ulcers, heartburn, ringing in the ears, headaches, dizziness, liver or kidney problems, leg swelling, high blood pressure, heart attack, heart failure, stroke, and death.
Side effects and complications of NSAIDs are common and serious. In one study, the risk of NSAIDs adverse drug reactions was found to be 26%.2 Complications include upper gastrointestinal bleeding and ulcers, heartburn, ringing in the ears, headaches, dizziness, liver or kidney problems, leg swelling, high blood pressure, heart attack, heart failure, stroke, and death. In June of 1999, The New England Journal of Medicine estimated that 16,500 NSAID-related deaths occur among Americans with rheumatoid arthritis and osteoarthritis every year.1 Over 100,000 NSAIDs users are hospitalized per year for gastrointestinal complications A review of 17 studies found that 11% of preventable drug-related hospital admissions could be attributed to NSAIDs. In 2005, U.S. Food and Drug Administration issued a public health advisory warning people of the increased cardiovascular risks of NSAIDS, and again in 2007 they published a medication guide for NSAIDs recommending the lowest dose possible for patients using these drugs. In January 2016, the FDA strengthened the existing label on all NSAIDs to warn that there was an increased chance of heart attack and stroke. Some NSAIDs, such as rofecoxib (brand name Vioxx) and valdecoxib (brand name Bextra) have been taken off the market due to their risks clearly outweighing their benefits and pharmaceutical company “misrepresentation.”
As a cannabis physician, I find these statistics and multiple FDA warnings appalling. Using dangerous drugs instead of a healing and non-toxic plant is simply ridiculous.
Over the past two decades, multiple studies have proven the anti-inflammatory benefits of phytocannabinoids and terpenoids, compounds that abound in the cannabis plant. The plant cannabinoids have many different mechanisms of action in their anti-inflammatory properties, including the blockage of pro-inflammatory compounds that are made in the body as a result of injury or illness. CBDA, cannabidiolic acid, the raw non-psychoactive cannabinoid precursor to CBD, showed significant COX-2 enzyme blockage when compared to placebo, two NSAIDs and other cannabinoids.10 Dr. Ethan Russo and Dr. Geoffrey Guy, in their excellent 2005 study, report that the phytocannabinoids work synergistically (the “entourage effect”) to provide balanced and nontoxic medicinal effects when compared with single molecule anti-inflammatories.8
“Over the past two decades, multiple studies have proven the anti-inflammatory benefits of phytocannabinoids.”
Patients suffering with inflammation have many choices when it comes to cannabis medicine. Along with the ability to choose “non-smokable” delivery methods, such as tinctures, edibles, topical balms and vaporizers, patients now have many choices of which combination of cannabinoids to use. For instance, one can take cannabis medicine that is THC-rich, CBD-rich, combination CBD+THC, THCA, CBDA and/or CBG. Some cannabis medicine suppliers are combining raw and heated cannabinoids in tinctures to increase the anti-inflammatory benefits. Many patients are benefitting from drinking the juice of raw cannabis plants. In my medical practice, I have seen thousands of patients eliminate or reduce the need for NSAIDs, reducing their risks of side effects and possibly even death, with the use of cannabis.
The Endocabinoid System
Cannabis has been at the center of one of the most exciting—and under reported—developments in modern science. Research on marijuana’s effects led directly to the discovery of a hitherto unknown biochemical communication system in the human body, the Endocannabinoid System, which plays a crucial role in regulating our physiology, mood, and everyday experience.
The discovery of receptors in the brain that respond pharmacologically to cannabis—and the subsequent identification of endogenous cannabinoid compounds in our own bodies that bind to these receptors—has significantly advanced our understanding of human biology, health, and disease.
It is an established scientific fact that cannabinoids and other components of cannabis can modulate many physiological systems in the human brain and body. Cannabinoids are chemical compounds that trigger cannabinoid (and other) receptors. More than 100 cannabinoids have been identified in the marijuana plant. Of these marijuana molecules, tetrahydrocannabinol (THC) and cannabidiol (CBD) have been studied most extensively. In addition to cannabinoids produced by the plant, there are endogenous cannabinoids (such as anandamide and 2AG) that occur naturally in the mammalian brain and body, as well as synthetic cannabinoids created by pharmaceutical researchers.
Extensive preclinical research—much of it sponsored by the U.S. government—indicates that CBD has potent anti-tumoral, antioxidant, anti-spasmodic, anti-psychotic, anti-convulsive, and neuroprotective properties. CBD directly activates serotonin receptors, causing an anti-anxiety effect, as well.“Cannabidiol offers hope of a non-toxic therapy that could treat aggressive forms of cancer without any of the painful side effects of chemotherapy,” says McAllister.
In recent years, scientists associated with the International Cannabinoid Research Society (ICRS) have elucidated a number of molecular pathways through which CBD exerts a therapeutic impact. For example, a preclinical study by Dr. Sean McAllister and his colleagues at the California Pacific Medical Center in San Francisco report on how CBD destroys breast cancer cells by down-regulating a gene called ID-1, which is implicated in several types of aggressive cancer. Silencing the ID-1 gene is, thus, is a potential strategy for cancer treatment.
“Cannabidiol offers hope of a non-toxic therapy that could treat aggressive forms of cancer without any of the painful side effects of chemotherapy,” says McAllister.
The images above are from an experiment by McAllister testing how CBD can stop the invasion of cancer cells in human cell lines. Compare the untreated breast cancer cells on the left to the breast cancer cells destroyed by CBD on the right. Photo credit: The California Pacific Medical Center
CBD AND THC SYNERGY
According to McAllister’s lab, the best results were obtained when CBD was administered along with THC. Several studies underscore the therapeutic advantages for combining CBD and THC—particularly for treating peripheral neuropathy, a painful condition associated with cancer, multiple sclerosis (MS), diabetes, arthritis, and other neurodegenerative ailments. Clinical research conducted by with GW Pharmaceuticals, a British company, has also shown that CBD is most effective as an analgesic when administered in combination with whole plant THC.
Our Guide to choosing a high quality CBD product.
Choose a company that sources their hemp from within the United States bonus if it also comes from a fully legal state they have higher growing standards. Colorado, Oregon, Washington, California, Nevada, Michigan, Maine, Vermont, and Massachusetts.
There are several methods CBD companies can use to extract the oil from the plant. Some methods use toxic solvents they are typically the much cheaper route therefore result in a cheaper product. A much safer option is to choose a company that uses cold CO2 process using this method ensures that the product maintains it purity throughout the extraction process.
"Full-Spectrum" or "Whole Plant" Label:
Finding a company that uses the whole plant will ensure the product also contains all aspects and components necessary in a high quality product. Be cautious of products labeled as isolate or hemp oil. Isolate products are lacking a variety of beneficial components. Hemp oil is mainly used in beauty products or as an omega 3 supplement.
Third Party Lab testing:
One of the most important aspects when choosing a quality product is to verify the lab test results. This is one of the only ways to be entirely sure the product you're buying is what it's being advertised to be. For example a product may be labeled as containing 1000mgs of CBD being able to see the lab results can verify the total mgs in a particular bottle.