Survey Reveals Risks, Rewards of Cannabis Use
Some people with Parkinson’s disease find that using cannabis products helps to ease certain symptoms, according to results from a survey.
The findings notably suggest that cannabis products with high levels of the chemical THC are more likely to induce both positive and negative effects in Parkinson’s patients.
“These survey results offer a broad overview of real-world cannabis use patterns and experience among a large group of people living with [Parkinson’s] and provide initial results regarding the differential symptomatic effects of” different cannabis products, researchers wrote.
Findings were published in the study, “Higher risk, higher reward? Self-reported effects of real-world cannabis use in Parkinson’s disease,” in Movement Disorders.
Cannabis has two main active components: tetrahydrocannabinol (THC), which is the main chemical that induces a “high,” and cannabidiol (CBD), which doesn’t induce a “high” but may have numbing or anti-inflammatory properties.
Cannabis has not been rigorously studied in Parkinson’s, but many patients are interested in its potential benefits, and with increasing availability of a number of cannabis-based products, many have tried them. In lieu of scientific studies, learning from these patients’ experiences could help patients and clinicians to understand the potential benefits and risks of using various cannabis products for Parkinson’s patients.
To this end, researchers at the University of Colorado conducted a survey through Fox Insight, an online platform run by the Michael J. Fox Foundation for Parkinson’s Research.
The survey was answered by 1,881 people with Parkinson’s who reported having used cannabis products since they were diagnosed. Most respondents were men (58.5%), and more than half had been diagnosed with Parkinson’s for less than three years. The vast majority were white (97.9%), and the respondents generally were highly educated, with nearly two-thirds having at least a college degree and 33.6% with graduate or professional degrees.
Most of the respondents (73%) said the main reason they used cannabis was medicinal; 7.3% reported recreational use, and 19.7% said they used cannabis both medically and recreationally. A little more than half had been using cannabis for six months or less, while about a third had been using for longer than a year.
Notably, nearly one of three respondents (31.8%) said they had not talked to their healthcare providers about their use of cannabis. Based on this finding, the researchers recommended that clinicians should bring up the topic of cannabis use with Parkinson’s patients “in a standardized, nonjudgmental manner” during visits.
The majority of respondents said they consumed oral cannabis products — a food, drink, edible oil, or sublingual (under-the-tongue) tincture, and 37.5% of respondents reported consuming cannabis by smoking or vaping. Almost all of the patients knew generally what type of product they had (e.g., high or low THC/CBD), and most knew exact levels from product labels. More patients used products with higher CBD (54.6%), while 30.2% used higher THC, and 15.2% took similar amounts of THC and CBD products.
The most common improvements noted with using cannabis (of any kind) —  reported by more than half of respondents — were better sleep, less agitation and anxiety, and less pain. Some participants reported having stopped taking other medications — for pain (26.8%), anxiety (18.6%), sleep (16.9%), Parkinson’s symptoms (13.9%), or depression (11.9%) — since they started using cannabis.
“I think these results reflect what I generally see in my patients. Overall, medical marijuana seems to help with symptoms as reported in this survey: anxiety, sleep and pain,” Katherine Amodeo, MD, a movement disorder specialist at Westchester Medical Center in New York, who was not involved in the study, said in a press release.
The most common adverse side effects of cannabis, reported as worsening by more than one in 10 patients, were dry mouth, dizziness, cognitive impairment, increased appetite or weight, daytime sleepiness, imbalance, fatigue, palpitations, apathy, and hallucinations.
In general, the overall magnitude of both positive and negative effects was small, the researchers noted. Notably, patients who took a product with high THC were generally more likely to experience an effect — whether positive or negative.
“Use of higher THC products was associated with more frequently reported symptomatic benefits for pre-existing [Parkinson’s]-related symptoms, especially for nausea, depression, tremor, poor sleep, agitation, decreased appetite, anxiety, sexual dysfunction, and pain,” the researchers wrote.
However, they added, “higher THC products were also associated with more frequent symptomatic worsening, most notably dry mouth, dizziness, cognition, and balance.” As such, the team noted that high THC products appear to be a “high-risk, high-reward” in terms of Parkinson’s symptoms.
The researchers called for further studies to evaluate cannabis in Parkinson’s.
“These survey results are completely in line with my experience so far,” said Katherine Leaver, MD, a neurology professor at Mount Sinai Beth Israel in New York, who was not involved in the study.
“Medical marijuana doesn’t help everyone with Parkinson’s or every symptom of Parkinson’s. But it is a useful tool in the toolbox of treatments for the disease. And, as in this study, I’ve seen benefits for sleep, pain, anxiety and, sometimes, for motor symptoms.”
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