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Deborah Leader, RN

Cannabinoids as Treatment for COPD?

By March 26, 2013

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The use of the cannibis plant for therapeutic purposes reaches as far back as the beginning of recorded history. Many people, however, would never dream of lighting up a joint to treat their COPD symptoms; afterall, smoking marijuana, for pleasure or for medicinal reasons, is highly controversial and some people just aren't comfortable going there. But what if you could derive the medicinal benefit from marijuana without having to smoke it? Would you consider it a viable treatment option for lung disease?

There have been numerous studies done about the benefits of medical marijuana, but few have focused on marijuana, in other forms, as treatment for COPD. One such study, published in Chronic Respiratory Disease, hypothesized that cannabinoids, a class of chemical compounds found in marijuana, have the ability to ameliorate the sensation of breathlessness, without depressing the respiratory drive.

Nine subjects (four with COPD and five with normal lung function) participated in a double blind, randomized, placebo-controlled crossover study over two test days. The subjects received either sublingual (under the tongue) cannabis extract or a placebo.  Subjects in the cannibinoid group were given a maximum dose of 10.8 mg of THC and 10 mg of cannabidiol.

Measurements were taken of breathlessness, mood and activation, end-tidal carbon dioxide tension and ventilatory parameters before the patients were given the drug/placebo administration and then 2 hours afterward.

Normal and COPD subjects showed no differences in breathlessness (VAS) scores and respiratory measurements before and after placebo or drug. However, after receiving cannibinoids, subjects with COPD chose 'air hunger' breathlessness descriptors less frequently compared to placebo. The study demonstrated that breathlessness descriptors may detect an amelioration of the unpleasantness of breathlessness by cannabinoids without a change in conventional breathlessness ratings (VAS).

The Tashkin et al. study involving a small group of asthmatic patients, compared the effects of smoked cannibis and oral THC (the primary psychoactive ingredient in cannibis) to the bronchodilator, isoprenaline 0.5%. They discovered that significant brochodilator effects were achieved with smoked cannibis and oral THC that were clinically significant to isoprenaline 0.5%, and that these effects lasted at least two hours after smoking/ingesting the drugs. Additionally, experimentally-induced bronchospasm was reversed in three subjects after smoking cannibis.

Williams et al. showed that aerosol THC administered via nebulizer significantly improved ventilary function is asthmatic patients. And, although salmeterol was superior to THC in achieving maximum bronchodilator effect at 5 and 15 minutes respectively, after that,  both drugs were equally effective.

The National Cancer Institute reports that cannibinoids have significant analgesic and anti-inflammatory properties, without the psychoactive high produced by THC. Because inflammation is at the root of many chronic diseases, COPD included, the anti-inflammatory properties of cannibinoids may be beneficial in the treatment of COPD, especially in the advanced stages of the disease.

In 2012, the Journal of the American Medical Association, reported that occasional, low cumulative marijuana use over a 20 year period was not associated with any adverse effects on lung function. In fact, at low levels of exposure, FEV1 increased by 13 mL/joint-year (95% CI, 6.4 to 20; P < .001) and FVC by 20 mL/joint-year (95% CI, 12 to 27; P < .001). At higher levels of exposure, however, these effects were leveled and sometimes, reversed.

A study preceding the JAMA report suggested that smokers of both marijuana and tobacco had an increased risk of respiratory symptoms and COPD, while smoking marijuana alone, was not associated with these adverse effects.

The point of this post is to help people make a decision as to their treatment options for COPD. I am in no way advocating for, or denouncing, the use of marijuana for medicinal purposes. I believe everyone has a choice. If it can help improve symptoms and is not abused, I cannot honestly say I see a problem with it. Besides, there are many ways to ingest cannibinoids -- sublingually, buccally, orally, even rectally -- that may be more tolerable and individually acceptable than smoking cannibus.

Doctor's have been prescribing drugs like Marinol for many years as treatment for nausea and vomiting associated with chemotherapy. It is also used to increase appetite in AIDS  patients. Perhaps it's about time that cannibinoids, as a legitimate treatment option for COPD, be studied more extensively in order to further research and potentially help people suffering from this dreadful disease.

Sources:

Pickering et. al.Cannabinoid effects on ventilation and breathlessness: A pilot study of efficacy and safety. Chronic Respiratory Disease. May, 2001. Vol. 8 no. 2, 109-118. Published online before print March 24, 2011, doi: 10.1177/1479972310391283.

National Cancer Institute. Cannibis and Cannabinoids. Updated 2/21/2013.

Pletcher, et. al. Association Between Marijuana Exposure and Pulmonary Function Over 20 Years. JAMA. January 11, 2012. Vol. 307, No. 2.

Tan, et. al. Marijuana and chronic obstructive lung disease: a population-based study. CMAJ. April 14, 2009. Vol. 180, No. 8. doi: 10.1503/cmaj.081040.

Tashkin et. al. Effects of Smoked Marijuana in Experimentally Induced Asthma. American Review of Respiratory Disease. Volume 112, 1975.

Williams, et. al. Bronchodilator effect of 1-tetrahydrocannabinol administered by
aerosol to asthmatic patients. Thorax (1976), 31, 720.

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Comments
March 28, 2013 at 2:48 pm
(1) Lesley Carol Prince says:

Thank you for this interesting and promising information on the efficacy of marijuana as an alternative treatment for the breathlessness of COPD. This could be an option for some persons and might save them from arms and hands bruised from steroid inhalers.

March 28, 2013 at 3:04 pm
(2) Bob Beckner says:

I would rather take it orally either in pill or power form, or lozenger form! I don’t think that I would want to smoke it; as smoking cigarettes are what gave me the desease in the first place! At this point I would try about anything!!!!!!!!Robert E. Beckner

March 28, 2013 at 3:21 pm
(3) Darin says:

I’ve been using Marinol for about 18 months. It is great. It comes in 5 Mg, 10Mg, and 20mg capsules that must be refrigerated. Doctors seem very reluctant to prescribe it, but with a little prodding they come around. When I started with it I was in the worst of an exacerbation, and weighed in at 142 lbs on my 6 foot 2 inch frame. The Marinol mellowed me down, and gave me an appetite. I now weigh in at an all time high of 182 lbs. incidentally when younger I had a long and friendly history with Marijuana so I had no fear of the Marinol. I take the 2Mg daily dose with a clear head.

March 28, 2013 at 6:54 pm
(4) Jackie says:

I’ve used cannabis for my COPD and as a pain reliver for arthritis. Don’t know how many people know this but the United States government has a cannibinoid patent. Not sure if it’s ok to post a link but here is a link to United States Patent #6630507. If the link doesn’t make it just google it.

http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&Sect2=HITOFF&d=PALL&p=1&u=%2Fnetahtml%2FPTO%2Fsrchnum.htm&r=1&f=G&l=50&s1=6630507.PN.&OS=PN/6630507&RS=PN/6630507

March 28, 2013 at 7:23 pm
(5) Mike GT says:

Dear Ms. Leader, unfortunately for me and many others, we did not have the education and awareness that we have today to let us know how bad smoking was. I grew up when smoking was allowed in restaurants and the work environment. Today, dealing with a respiratory condition, I would not use anything that requires smoking as a form of medication, and not to mentioned the change in behavior as it affect the mind.
This article is confusing as it talks about studies, however as most studies and surveys, the question is “What is their interest?”, is the study conducted by a neutral party?
My interpretation is that this article does promote the use of marijuana. In my view, medications used to control COPD should not have anything to do with smoking. Thank you for the opportunity to comment. . . .

March 29, 2013 at 3:46 am
(6) Deborah says:

Mike,
Please reread the article. Cannibinoids are not smoked. They are taken orally, sublingually, or buccally. I state this from the beginning of the blog post. You have misinterpreted the entire post. I am not promoting smoking of anything. Again, please reread it.

March 29, 2013 at 4:00 am
(7) copd says:

And….don’t forget rectally, as I mention in the post.

March 30, 2013 at 9:37 am
(8) Tom says:

GW Pharmaceuticals have already applied for a Patent for Cannabinoids in the treatment of C.O.P.D.

10 Dec, 2005: http://worldwide.espacenet.com/publicationDetails/biblio?DB=EPODOC&II=27&ND=3&adjacent=true&locale=en_EP&FT=D&date=20070419&CC=WO&NR=2007042811A1&KC=A1

“The present invention relates to the use of a combination of cannabinoids for the treatment of Chronic Obstructive Pulmonary Disease (COPD) . Preferably the combination of cannabinoids are cannabidiol (CBD) and delta-9- tetrahydrocannabinol (THC) . More preferably the cannabinoids are in a predefined ratio by weight of approximately 1 : 1 of CBD to THC.”

Of course, if you take it any other way than GW’s ‘Sativex’ (oral form), then you’re a criminal here in the U.K.

April 2, 2013 at 10:27 pm
(9) Bro. Michael Baldasaro says:

Marijuana oil, unlike the nicotine in tobacco, is water soluble.
It has been my experience that the oils in marijuana when smoked, lubricates my lungs and improves breathing overall.

After some 40 years of smoking a whole lot, almost daily, of Gods Tree of Life, Marijuana, my lungs are fine after being tested and x-rayed.
I have no difficulty breathing unless exposed to second hand tobacco smoke.

Fear of marijuana is unfounded, however one must realize that any plant may cause some people have allergies to some plants. Unlike many over the counter prescription and legal drugs, alcohol and tobacco, deaths attributed to marijuana use remain at 0.

Be well and prosper.
Bless us all!

April 4, 2013 at 2:45 pm
(10) Joan says:

Will taking this pill change personalities as does the smoking of marijuana? I would hate to see people taking this pill and driving. What effect will the pill have?

April 7, 2013 at 7:46 am
(11) Deborah says:

Joan,

Good question. The article states that:

The National Cancer Institute reports that cannibinoids have significant analgesic and anti-inflammatory properties, without the psychoactive high produced by THC.

So, I gather from this that cannibinoids, when taken in the form that the article is talking about, don’t get you high. But, not really sure based on just one statement. More research would have to be done and of course, you would have to discuss with your doctor.

August 8, 2013 at 11:55 pm
(12) DrSteven says:

CBD, cannabidiol, is in both marijuana and hemp (also cannabis).
Hemp is legal to possess in ALL 50 states.
Legal states are noticing that half of all sales are for edibles and extracts! The premier company in the legal state of Colorado is Dixie Botanicals and DIxie Elixers, two companies owned by MJNA.
MJNA is the alpha source of CBD from legal hemp through their other company RSHO (Phytosphere)!
MJNA, a stock traded on the stock market is about to rocket up!
As well for those that want CBD they can order it from ANY state legally from MJNA (phytosphere) or from Dixie Botanicals!
Invest in the “Green Rush”! MJNA is the ALPHA company to invest in!
Investing in MJNA is investing in America!
Help the sick and take cannabis away from the overseas cartels by investing in MJNA!

February 3, 2014 at 1:00 pm
(13) James says:

I was diagnosed “severe COPD” over 2 years ago, and it has progressed towards “end stage”. My nebulizer works okay with Budesonide & Ipratropium, but Thrush is a huge problem for me, even with rinsing, plus the effects don’t last very long. My bronchi get very tight & produce such thick mucus, it is so hard to clear this up & allow the nebulizer treatments to get deep enough into my lungs to have anything but a superficial effect.

I do smoke high grade marijuana. When I do, the smoke enters my lungs & expands & opens those airways. It induces aggressive coughing fits that medical professionals would term as “productive”, clearing large amounts of mucus from my airways. It feels so good to have air able to reach deep into my lungs…then I hit them with the Budesonide. OMG, what sweet relief. Seriously, I would recommend smoking it to anyone with severe COPD. It may be harsh to those not used to it, but you will just feel so relieved.

February 4, 2014 at 2:58 am
(14) James says:

Oh, and the effects are longer lasting than pharmaceutical inhalants alone. This combination lasts longer and affords a larger window for maintenance treatments. Personally, if I take a few puffs every 2-3 hrs, it gives the deeper set mucus & tight airways a chance to loosen up & expell with each treatment.

Marijuana has many more effects that are beneficial to this disease, the 4th leading cause of death in the US, kinda need something to take the edge off that realization. All natural; Non-Addictive; Revenue & employment generating; Save taxes on prisons; O2 Green friendly; Way too many positives to list. I was told all the Dr’s can hope to do is afford me comfort measures… Yup, Marijuana has got that.

February 6, 2014 at 6:12 pm
(15) Deb says:

James, you and Deborah hit the nail on the head. And quite eloquently, I might add. You both mention comfort measures. I find it interesting that Morphine, which is an opiate, can have adverse side affects like nausea, constipation, and dyspepsia. Yet it is highly accepted as a comfort measure in our society. Marijuana has many benefits without so many potential side affect. IMHO, it has been given a bad rap, and I hope that one day it will find wide acceptance as adding relief and comfort for those of us who suffer from COPD and other illnesses.

April 15, 2014 at 10:00 pm
(16) Marek Zielinski says:

After third heart attack, developed COPD and emphysema, received and still on some conventional meds, never had so good results, relieves alike after smoking Cannabis.
When British Government will change the law concerning use of the medical marijuana?,

“When medical marijuana is available to everyone, we will look back on these days and marvel at the ignorance of marijuana prohibition and the damage it did to so many.”
I agree.
;~)

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