by Hepsharat Amadi, M.D.
Cannabis has a long history of medicinal use. As early as 2900 B.C., Emperor Fu of China and many Chinese people of that time used marijuana for medicinal purposes, for example, treating headache and nausea and as an aphrodisiac.
The two types of cannabis species most commonly known are cannabis sativa, or marijuana, and cannabis indica, or hemp. Marijuana is the species that contains the phytochemical tetrahydrocannabinol (THC) which is known for its euphoric effects (“getting high”), and hemp is primarily known for the strength of its plant fibers which were used in making rope and other articles of clothing. Hemp contains tiny amounts of THC, but not enough to produce the effects that THC in cannabis sativa can.
Both species of cannabis also contain a phytochemical known as cannabidiol (CBD oil). CBD is a natural anti-inflammatory and especially protective to the nervous system but has no euphoric properties. These are just two of the more than 400 different phytochemicals that have already been discovered in cannabis, with more presumably waiting to be discovered.
A key distinction between medical marijuana and “street” marijuana is that medical marijuana carefully regulates the ratios of CBD and THC present in the extracts that are dispensed to a patient. As CBD is anti-inflammatory but produces no “high”, it might be present in higher ratios in a medicine that is used during the day so as to allow people to function normally, working or even driving. Plain CBD by itself is legal in all 50 states and can be sold without a medical prescription. It is the admixture of even a small amount of THC that renders it a substance that cannot be consumed without a permit from the state for medical marijuana.
Because of its anti-inflammatory properties, many people have benefited from just plain CBD oil (without any THC) for combating musculoskeletal injuries and pain. However, the addition of just tiny amounts of THC creates an “entourage effect”, allowing the CBD to penetrate and perform its amazing effects even better. Often, the amount of THC that is needed to produce the entourage effect is so low, there is no associated euphoria from consuming it. Nevertheless, any amount of THC present in a compound classifies it as medical marijuana.
One of the most fascinating things I have learned about cannabis is that the human body contains an entire system of receptors for these molecules—the endocannabinoid system. Just like the system of opioid receptors the human body also contains, which renders it susceptible to the effects of plant opioids such as derived from the opium poppy, the human body contains a wide distribution of these endocannabinoid receptors, not only in the brain, but also in the gut and many other tissues.
Although consistent use of marijuana can build a tolerance to its effects, it is not physically addictive in the same way that opiates can cause addiction. And unlike opioid withdrawal, which can be very dangerous if not done in a supervised way with medical support, there are no harmful effects from just stopping marijuana use “cold turkey”. No one has ever died from an overdose of marijuana or from withdrawing from marijuana, unlike the case with opioid overdoses.
There are many different diseases and syndromes that medical marijuana is currently used to treat. Some examples are: chronic pain, persistent muscle spasms, seizures, migraines, anxiety and depression, PTSD, glaucoma, Parkinson’s disease, multiple sclerosis, autoimmune disorders, irritable bowel disease and more.
The Second Century Fayyum Medical Papyrus is believed to be the earliest known record of cannabis being used in ancient Egyptian cancer medications, and cancer is one of the other qualifying conditions for which medical marijuana can now be prescribed or “recommended.” (Doctors are not allowed to say they are prescribing a substance that is still illegal under Federal guidelines as cannabis is still categorized a Schedule I substance, in the same class as heroin, under current DEA guidelines.)
The process for obtaining permission from the State of Florida to use medical marijuana requires that a person first see a doctor to determine if their condition qualifies them as being a candidate. Once the doctor determines that they do qualify, basic patient information such as name, DOB, SSN, address, phone and email are entered by the doctor into the Medical Marijuana Registry.
Entering the patient in the database generates two emails that are sent to the patient which contain links to an online application for the medical marijuana card from the State of Florida, requiring a fee of $75 sent in the mail as a check or money order as well as a photo ID which can either be attached to the online application or mailed in with the fee and printout of the application. Once the state receives, reviews and approves the application (a process that is now taking about two to three weeks from the time the state receives the application), the applicant is sent an email informing them that they have been approved and their official medical marijuana card arrives in the mail. This card serves to identify to law officers that a person is entitled to consume medical marijuana, and also provides job protection in that a person cannot be discriminated against in their employment for consuming cannabis products.
Currently in Florida, medical marijuana is not available as leaves to be smoked. What is available are extracts of marijuana oil which can be consumed in the form of drops, and also the oil can be vaporized and inhaled, which looks like smoking but is not really smoking in that there is no ash in the content of the vapor and the vapor is not heated. Contrary to tobacco smoking, smoking marijuana has no increased risk for lung cancer. The other form available in Florida is “ingestible” or “edible” which is typically a sweet with the oils in it, having a longer onset and duration of action than the oral oils or the vaped forms.
I believe, as time goes on, the use of medical marijuana will become much more common as word about its benefits spreads. It is possible to wean people off harmful-in-the-long-run opioid medications, muscle relaxants, sedatives and medications for anxiety and depression using cannabinoid such as CBD and THC in precise ratios depending on the condition. I see doctors who are helping people to wean off medications which could kill them in the short and long run by using medications which have never killed anyone, anywhere, as performing a brave public service to the extent that one never knows when federal law making cannabis use illegal will take precedence over state law in which medical use is now legalized.
Only certain doctors can recommend medical marijuana to patients—those who have chosen to take the online course (and pay the extra fee for doing so); these doctors are responsible for recommending cannabis for their own panel of patients as well as keeping quarterly reports on these patients in a database run by the University of Florida for research purposes. If a patient wants to change doctors, they have to get the first doctor to “deactivate” them from his/her database before they can be activated in a different doctor’s database.
I see this development as offering hope to many, particularly veterans and elderly, who often suffer from symptoms of pain and anxiety, muscle spasm and depression, not to mention insomnia, in being able to have these problems addressed with herbal derivatives that are pure, contain no synthetic drugs that build up in the liver and kidneys, and that produce no lasting irreversible side effects.
As of yet, no insurance company is allowed to pay any cost of the visit for a patient to obtain recommendation for medical marijuana and no insurance will pay for a patient’s supply of medical marijuana, so the cost of this whole avenue of treatment is strictly out-of-pocket. However, many are opting to choose a more natural approach to their health challenges even if they have to pay as they are finding it more effective and easier to take while still working than the drugs that are made available to them through their insurance.
Dr. Hepsharat Amadi is a wholistic family physician, functional medicine doctor and herbalist whose approach to treating patients focuses on natural therapies while minimizing the use of synthetic pharmaceuticals. She practices quantum bio-feedback, offers bio-identical hormone replacement and is certified to recommend patients for medical marijuana. Her office is located at 10189 W. Sample Rd., Coral Springs 33065. For more information and to make an appointment, call 954-757-0064, email [email protected] or visit DrAmadi.com.