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.
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.