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Medical Uses of Cannabis in California

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... caregivers from state laws prohibiting possession and cultivation of marijuana ' ... Exemption from marijuana law prosecution removes stressors. ... – PowerPoint PPT presentation

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Title: Medical Uses of Cannabis in California


1
Medical Uses of Cannabis in California
  • Tod H. Mikuriya, M.D.
  • President,
  • Classic Pharmaceuticals
  • Berkeley, California, U.S.A.

2
Introduction
  • The Compassionate Use Act of 1996 exempts
    patients and caregivers from state laws
    prohibiting possession and cultivation of
    marijuana
  • shall not apply to a patient or to a patients
    primary caregiver who possesses or cultivates
    marijuana for the personal medical purposes of
    the patient upon the written or oral
    recommendation or approval of a physician.

3
California Cannabis Use Summary
  • All are chronic conditions. (N4,928)
  • Self medication with cannabis is a safer and more
    effective drug in the management of chronic
    illness compared with prescription or OTC drugs.
  • Medical destigmatization de-alienates and
    therapeutically intervenes
  • Significant problems of implementation and
    compliance remain.

4
Pharmacologic Safety
  • Compared with opioids, steroids, NSAIDS,
    sedatives, tricyclics, and benzodiazepines
    cannabis has minimal to no side effects.
  • Critical difference in chronic condition coping.

5
Modes of Activity
  • Immunomodulator analgesic
  • Mood and affect modulator
  • Antispasmodic anticonvulsant
  • Harm reducing substitute
  • Hypothermogenic

6
Modes of Action Difficult to Categorize
  • Conditions have multiple manifestations. Or
    concurrent unrelated conditions may exist.
  • Glaucoma, prostatitis
  • Dyspepsia, back strain

7
Immunomodulator Analgesic (42)
  • A significant number presented with pain and
    dysfunction based upon localized tissue specific
    inflammation.
  • While many conditions are secondary to trauma,
    other etiologies are largely autoimmune or
    idiopathic.
  • Manifestations are organ system dependent and may
    be multiple.

8
Mood and Affect Modulator (27.2)
  • Controls emotional overreactivity and mobilizes
    affect.
  • Restores sleep without hangover or fogginess.
  • Improves attention and mental acuity by
    decreasing distraction.

9
Spasmolytic Anticonvulsant (25.9)
  • Cannabis relieves spasm and seizures from CNS,
    PNS, skeletal, and smooth muscle.
  • Appetite stimulation is secondary to smooth
    muscle relaxation in the GI tract.

10
Harm Reduction Substitution (4.2)
  • Alcoholism and alcohol abuse
  • Detox with high oral dose
  • And inhaled supplementary maintenance with lower
    dose
  • Minimize contact with other alcohol users

11
Modes of Action
12
Age Distribution of Patients
13
Psychiatric Conditions Treated
14
Percent Usage as Harm Reducing Substitute
15
Physiological Mechanisms
  • Increased cerebral perfusion
  • Eicosanoids, precursors to prostaglandins,
    mediator of inflammation
  • Similar in structure to cannabinoids
  • Lipophilic non-polar molecules not soluble in
    water
  • Psychological effects of cannabis blocked by
    indomethacin
  • Mild tachycardia
  • Decreased circulating glucocorticoids

16
Psychosocial
  • Exemption from marijuana law prosecution removes
    stressors.
  • Fear of loss of freedom, job, housing, custody,
    health services, compensation, and harmful
    contact with police, court, probation, social
    workers, etc.
  • Dealienation with improved self esteem,
    socialization, and health services access.
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