A Very Different Tumble Into the Weeds…

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Here I go again! Only this time, I’m eager to join the action…I think.

As you may know, in two previous posts, I’ve written about my ambivalence concerning the legalization of marijuana. Each time, I got new subscribers among the happy pot community, who somehow overlooked my ambivalence (or seized on my description of my single, and singular, pot experience) and adopted me as a kindred spirit.

That’s fine; I welcome anyone who’s interested in what I have to say—and I would be happy to have them join our dialogue, though so far they’ve merely silently “liked” my posts.

For the record, in researching a response to a comment after my second post on the topic, I came across an LA Times Op-Ed that stressed we know much less about the impact of marijuana than we might because the federal government has for so long forbidden its use—even for research.

I found that editorial persuasive, so I’ve moved from ambivalence to being cautiously OK with legalization. I am also bowing to the inevitable, and hoping legalization does all the good things proponents claim (like diminishing the racial injustice in prosecutions and reducing the power of drug lords).

But I still worry about young brains because that’s where the most deleterious effects of use occur. In fact, though many states have passed legislation legalizing marijuana for individuals age 21 or older, some experts say it should be 25 because the developing brain is still deeply affected until then.

That’s not my purpose here, however.

Today we’re talking CBD (cannabidiol), derived from the part of the marijuana/hemp plant that, unlike THC (delta-9-tetrahydrocannabinol), doesn’t create a high.

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Courtesy of Pixabay.com

Interestingly, though the federal government continues to consider marijuana illegal, it holds a patent for CBD; National Institutes of Health scientists found several decades ago that in test tubes, an in-depth Sunday New York Times Magazine article reported,

“…the molecule shielded neurons from oxidative stress, a damaging process common in many neurological disorders, including epilepsy.”

That finding has been validated, as described below.

And now there’s a federal law legalizing CBD products made from hemp, provided they contain 0.3 percent or less of THC.

Unless you’ve adopted a net-free existence on some desert isle, the chances are you’ve heard about CBD. It’s available everywhere, purportedly for everything that ails you, from back pain to anxiety to alleged cancer cures (the FDA cracked down on that one), to social phobia (that’s in the testing stage). My dentist is now selling it in his office, for goodness sake!

While CBD seems to have taken the country by storm, thus far its efficacy has been documented only in treating epilepsy in children; it’s FDA-approved for that indication.

But according to a Consumer Reports survey, 64 million Americans have tried CBD in the past year, and most said it was effective, particularly for anxiety. Almost three-fourths reported no side effects,

Based on anecdotal evidence and what I’ve read to date, I’ve been intrigued by the prospect that it might be helpful to me by a) reducing the frequency of my migraines; b) relieving my stomach issues that I know—as one of a long line of “gut” people—have an anxiety component; and c) alleviating my arthritic knee pain, thereby forestalling my need for a second knee replacement, which I most emphatically don’t want to have.

I discussed the possibility of my using CBD with my neurologist, a superb physician/researcher and compassionate soul.

He said he had no objection to my trying it, and it had, in fact, helped some of his migraine patients. However, he hasn’t sought a license to prescribe it because it isn’t evidence-based for migraines at this point. He referred me to a neurologist who does prescribe it.

I made an appointment. For a mere $750 initial visit (this doctor doesn’t accept Medicare), he would take my migraine history, give me a thorough exam, and hand me a prescription to a dispensary he deals with.

But when I looked over the forms I was to complete before seeing this new physician, I realized that none of the questions were relevant to me. I do get more migraines per month than my neurologist and I would like, but I don’t suffer from them. That’s due to the wonders of the pharmaceutical industry.

Yeah, they’re doing lots of awful things with pricing, and regulation is clearly needed. But I must acknowledge that the appearance of sumatriptan decades ago transformed my life.

Before it, I lost full days to intractable pain and nausea that made me think: If only the nausea would go away, I could tolerate the pain. Now, I feel a twinge, take a pill, and I’m good to go ten minutes later. So I didn’t need this new doctor’s extensive questioning, to which I would repeatedly respond with NA (not applicable).

I also didn’t need a thorough exam, as I’d just had one in the very capable hands of my neurologist’s fellow—under his guidance.

So the second thoughts arose, and not solely from my wallet, which was sending clear question marks to my prefrontal cortex, something along the lines of “Are you nuts? Paying $750 for a prescription to take to a pharmacy?”

I cancelled the appointment and sought my neurologist’s advice about how to proceed. He hadn’t known his colleague didn’t accept Medicare. When I explained why I cancelled, he said: “For you to spend $750 to get handed a prescription to take to a pharmacy is nuts!”

Most people buy CBD independently—without a doctor’s involvement. I felt concerns about that approach because this is an unregulated market. It’s caveat emptor: Let the buyer beware!

With the gold rush out there, the unsuspecting consumer may be buying a product that has too much or too little CBD, and/or it may be adulterated.

For example, The New York Times described a graduate student in Virginia who complained of a “heart-pounding, hallucinogenic high he had neither expected nor wanted to have.”

Testing revealed he had vaped a liquid containing CBD, but it also contained a synthetic compound, 5F-ADB, that the Drug Enforcement Administration has associated with anxiety, concussions, psychosis, and even death.

So I was concerned about quality and dosage. Actually, I was more concerned about dosage because I had located a few sources that seemed reasonable, including my dentist, who assured me he’d fully investigated the purity of the products he planned to sell.

I’m also considering two other possible sources: one is owned by a Florida pharmacist who developed the product and seemed very cautious when I heard her on an NPR discussion; another is being frequented by many parents of children with epilepsy, who spoke highly of it in that lengthy Sunday New York Times Magazine article.

That left the question of dosage, and my neurologist said he’d do some research and advise me about what would be appropriate.

So stay tuned for the next installment of “Annie Goes for the Gummies.” I’m not sure why, but one of the companies under consideration offers many of their products (for adults) in the form of Gummies. Should that send me a warning signal? I’m fine with a tincture under my tongue, as some friends have described, or a capsule, or a cream for my knee. But Gummies? (And yet, I occasionally indulge a strong desire for Swedish Fish, suspecting that my body sometimes has a weird need for red dye #whatever, so maybe the Gummies hold some promise…)

If you or someone you know has had experiences with CBD that you’re willing to share, I’d love to hear about them.

Annie