Alzheimer’s and Cannabis
Alzheimer’s disease can be a challenging diagnosis for both the patient and family. It is the most common cause of dementia, accounting for 60-80% of cases and is the 6th leading cause of death in the U.S. Alzheimer’s is also a leading cause of disability and poor health as disease progression occurs over time.
In 2020, Alzheimer’s and other dementias will cost the nation $305 billion – by 2050, these costs could rise as high as $1.1 trillion according to the Alzheimer’s Association statistics and facts. The population of Americans age 65 and older is projected to grow from 56 million in 2020 to 88 million by 2050 which is the age range of greatest risk of Alzheimer’s. Baby boomers have already begun to reach age 65 and older.
Alzheimer’s is a Type of Dementia
Dementia is a group of symptoms associated with declining memory, reasoning, or other thinking skills. Many different types of dementia exist such as Lewy Body, Vascular, Frontotemporal (Pick’s disease), Parkinson’s and Huntington’s disease. Alzheimer’s disease is the most prevalent of the types and is one of the biggest threats to our 65 and older population.
Alzheimer’s disease is a neurodegenerative disease caused by the buildup in the brain of extracellular plaques (made of a proteinaceous material called amyloid) and intracellular tangles (made up of tau protein). Alzheimer’s impacts the portion of the brain associated with learning, so a common early symptom is “trouble remembering”. As the disease progresses symptoms become more severe including disorientation, confusion, and behavior changes. Speaking, swallowing, and walking become difficult over time. There is no way to prevent, cure or even slow Alzheimer’s disease.
The rate at which Alzheimer’s progresses can vary. On average, a person with Alzheimer’s lives four to eight years after diagnosis, but can live 20 years, depending on other factors. Changes in the brain related to Alzheimer’s begin years before any signs of the disease are apparent which is also a challenge unless pre-screening becomes more of a standard in our healthcare system.
Current medications utilized today cannot stop the damage that Alzheimer’s causes to brain cells. These medications only lessen or stabilize symptoms for a limited time by affecting the chemicals involved in carrying messages among the brain’s nerve cells.
Can medical cannabis help patients with Alzheimer’s disease?
While research in the United States is still somewhat limited, there are promising results from recent studies in Australia, Spain, Israel, South Korea, and the UK indicating that it may.
There are two areas of inquiry:
- Can cannabis be used to treat the symptoms of Alzheimer’s and other dementias?
- Can cannabis products treat the disease itself, stopping or even reversing the actual disease process?
Alzheimer’s and Symptom Management
It is known that cannabinoids (both THC and CBD) can increase appetite, help with insomnia, and promote restful sleep, and that it can have psychological effects, including anxiety reduction and relaxation. Although research continues to definitively prove cannabis’s benefits with conditions such as depression and anxiety, there is promising preclinical research that it may help reduce agitation, aggression, and irritability in patients with Alzheimer’s as well. The pharmaceuticals currently used to treat these behaviors can have significant side effects, including cardiovascular issues, stroke, and even death. The potential to utilize cannabis as an alternative enhances quality of life.
The Alzheimer’s Society (www.alzheimers.org) references a 2018 study by Krista Lanctot, Ph.D. at Sunnybrook Research Institute which looked specifically at patients with moderate to severe Alzheimer’s. A 14-week trial used nabilone (a synthetic form of THC which is approved in Canada to treat chemotherapy-induced nausea) compared with a placebo to see if agitation was reduced without major side effects. The results showed that nabilone not only “significantly reduced agitation compared to the placebo, but it also improved behavioral symptoms overall.” The most common side effect seen was increased sedation.
A 2016 study published in The Journal of Alzheimer’s Disease has concluded that cannabis extract containing THC can relieve many of the debilitating symptoms of Alzheimer’s. Researchers from the Abarbanel Mental Health Center and the Sackler Faculty of Medicine at Tel-Aviv University, along with the Department of Psychology at Bar-Ilan University conducted the study, which was one of the first clinical studies observing the effects of cannabis on Alzheimer’s. The study observed the effects of medical marijuana on 11 people living with Alzheimer’s over the course of 4 weeks. 10 participants finished the trial. Despite the small size of the study, researchers concluded that “Adding medical cannabis oil to Alzheimer’s patients’ pharmacotherapy is a safe and promising treatment option.”
Alzheimer’s and Disease Progression/Treatment
There are currently no FDA-approved drugs on the market that change the course of the disease, however there is promising research showing that cannabis can slow the progress of the actual disease itself. One 2014 preclinical study in the Journal of Alzheimer’s Disease showed that small amounts of THC can slow, and in some cases even reverse, the progress and production of beta-amyloid protein. A 2014 study at the University of South Florida and a 2016 preliminary study from the Salk Institute in California also found that THC reduces beta amyloid proteins in the brain.
“Inflammation within the brain is a major component of the damage associated with Alzheimer’s disease, but it has always been assumed that this response was coming from amyloid plaques in the brain, not the nerves or nerve cells themselves,” states Antonio Currais, PhD, lead author of the 2016 study on THC and Alzheimer’s conducted through the University of California, San Diego. “When we were able to identify the molecular basis of the inflammatory response to amyloid beta protein, it became clear that THC -like compounds, that the nerve cells make themselves, may be involved in protecting the cells from dying.”
A comprehensive analysis in the February 2017 edition of Frontiers in Pharmacology summarized an Australian study of CBD’s effects on Alzheimer’s. The meta-analysis states that “CBD can affect the progression of Alzheimer’s by reducing cellular harm when the nervous system becomes damaged. CBD can also reduce neuro-inflammatory responses and promote neurogenesis, the growth and development of new nervous system cells.
Results of a 2019 South Korean literature review of studies of marijuana for Alzheimer’s disease focusing on CBD and THC and published in the Journal of Pharmacopuncture revealed the results of the surveyed studies “implied that the CBD components of cannabis might be useful to treat and prevent Alzheimer’s Disease [AD] because CBD components could suppress the main causal factors of AD. Moreover, it was suggested that using CBD and THC together could be more useful than using CBD or THC alone.”
As THC and CBD are also well-known anti-inflammatories, and as inflammation in the brain may cause or contribute to the progression of Alzheimer’s, the use of cannabinoids to reduce inflammation could also help slow the progression of the disease. In February 2020, MedPharm holdings, a Denver company, announced plans to apply for an R&D license to test THC, CBD and other cannabinoids’ effects on Alzheimer’s and dementia patients. MedPharm will also study how THC, CBD and other cannabinoids are absorbed and metabolized in the body. They plan to begin the first phase of double-blind testing in mid-2020.
Cannabis side effects:
The authors of the popular website, United Patients Group, state that, “According to an increasing number of studies, cannabinoid therapy appears to do what common pharmaceutical drugs cannot when it comes to dementia – recover, repair and heal the parts of the brain and nervous system that have been severely affected by the progression of this deadly and heartbreaking disease. And, when used at low doses and under the guidance of a caring professional, cannabinoid therapy can have annoyed therapy appears to be absent of the damaging side effects that inevitably come with hard pharmaceutical therapies.”
“The WHO (World Health Organization) states that, ‘No public health problems have been associated with the use of CBD,’ and there has been no known association with potential for dependence or abuse, unlike most formal alternatives. The most reported potential side effect of CBD usage was diarrhea and bloating, but with some patients also reporting nausea. About 3% of patients in studies reported liver problems and had to discontinue high-dose CBD use. Specifically, with dementia, some patients reported increased tremor with high doses of CBD. As with any new treatment, patients and caregivers should monitor effects and outcomes closely,” say the authors at www.dementiacarecentral.org.
Conclusion:
Alzheimer’s disease is a debilitating disorder that can have devastating effects for patients and caregivers. There is no known cure at this time, and the best that allopathic medicine has had to offer up until now is hit-and-miss management of the many debilitating symptoms that are a part of the disease.
Cannabis presents an entirely new way to potentially treat both the symptoms and the cause(s) of Alzheimer’s, and possibly other dementias as well. Not only can cannabinoids relieve many of the unpleasant and life-altering side effects, but it is showing great promise in treating the underlying structural causes and stopping the cellular damage seen in dementias.
Further research is needed, and unfortunately, until the DEA and the federal government stop stonewalling and start facilitating access and approvals to study this plant, reliance on other countries’ research and results is all that is available to U.S. patients.
About Kintsugi Solutions
Kintsugi Solutions was co-founded by Cynthia Northcutt and Darcey Trescone to support the growth of education, compliance, and safe access to medical cannabis within the industry. Cindy is a registered nurse and attorney at law. She has worked in the medical and legal fields for over 30 years as an educator and advocate and practices exclusively in the areas of cannabis law and education. Darcey is a registered nurse and graduate student in cannabis therapeutics, who has worked in the post-acute healthcare industry for over 20 years with a focus on regulatory compliance, technology, and marketing. Working with patients suffering debilitating diseases, they recognized years ago that cannabis could often provide relief, and now that times and tides are finally changing, they can openly advocate and educate about medical cannabis.