Interview highlights with Ben Hartman of Cannigma & Dr. Dave Gordon (Leaf411 Advisory Board Member) regarding COVID-19 and Cannabis use:
1) Have you heard from medical cannabis patients who are dealing with anxiety and isolation because of COVID-19 lockdown/outbreak?
Dr. Dave: "...Anxiety is one symptom for which patients consistently use cannabis and there is currently a surge in fear and anxiety. For most patients products that are lower in THC and higher in CBD are effective for anxiety...Many use cannabis to enhance their enjoyment of various activities, and when your stuck around the house, things can get mundane. The euphoria THC produces can make meals, games, and media more enjoyable."
2) What do you recommend for patients with these symptoms, in order to find relief?
Dr. Dave: "For anxiety...CBD dominant, often a 10:1 ratio or higher. That means 10mg CBD to every 1mg THC."
3) If people are concerned, they won't be able to renew their cannabis prescription because of the lockdowns, how do you recommend they make their medicine last longer? Or are there alternatives to cannabis you recommend?
Dr. Dave: "By law, you have to have an in-person visit to receive certification in Colorado...Unfortunately, the lack of Tele-medicine access for medical certification is just another hurdle that pushes patient to the recreational market and thus limits their getting quality medical information prior to purchasing. It is important to remember that Tele-medicine consultation is available for anyone, in any state, for cannabis guidance and education by a physician (www.4pillarsdenver.com) or Nurses (www.leaf411.org).
4) Are patients concerned about smoking their cannabis, due to the fact it's a respiratory illness?
Dr. Dave: "The impact on cannabis and it's various methods of administration on lung health, and viral risk is extremely complex. There is most definitely NOT a black and white answer here and anyone that claims there is simply does not know the data. Smoking (combustion) is no doubt a respiratory irritant and can impair barrier function in the lungs, thus potentially increasing your risk of acquiring an infection...Regardless of how you consume cannabis, there are a variety of potential impacts on COVID-19 infection. Cannabis compounds are extremely effective anti-inflammatory medications which means they reduce our immune system response. That immune response is how we initially fight off viruses. Thus, in theory, cannabinoids could increase risk of acquiring infection. Alternatively, an overactive immune response is what causes most of the damage during viral infection, and it appears that this is true for COVID-19. Thus, IN THEORY, cannabinoids could cause an infection already present to be less severe and reduce the risk of life-threatening complications...Increased anxiety and stress results in increased cortisol levels...Activating our endocannabinoid system with cannabis, especially at low-dose, has been shown to lower cortisol levels so there may be beneficial effects there."
5) Elderly patients are in the high-risk group, what fears or anxieties have you heard from patients in this age group so far?
Dr. Dave: "Elderly patients and those with chronic medical conditions are undoubtedly concerned about COVID-19, as disease severity is much more significant in that population....Anxiety levels and forced isolation are even more prevalent among the elderly. For that reason, we should ensure access to cannabis products AND education is available to elderly so they can continue or start using cannabis in a safe and effective manner.
Dr. Dave's take home points...
- "During this period of increased anxiety and isolation, calming and euphoric effects of cannabis can be both valuable and patients can often achieve both these effects simultaneously with appropriate dosing and products."
- "Tele-medicine consultation is available for anyone, in any state, for cannabis guidance and education by a physician (www.4pillarsdenver.org) or nurses (www.leaf411.org), even if formal certification may require an in-person visit."
- "For those that prefer inhalation, its a great time to utilize cleaner methods....as more toxic inhalation methods could increase risk of viral acquisition, or lung inflammation."
- "...as always there are always pros and cons of every therapy and its the job of the patients and practitioners to work together to find the ideal product, ideal dose, and ideal route of administration to achieve safe and effective therapy.
- "For anxiety, low dose THC is typically best, often combined with higher amounts of CBD."
- "The specific effects of cannabis on COVID-19 are not studied and based on other virus research not directly cause and effect - there are aspects of cannabis use which could be detrimental and other aspects that are beneficial - education and guidance by cannabis-trained professionals are the best way to maximize the benefits and minimize detriments."
- Dr. Dave Gordon (Advisory Board for Leaf411): https://4pillarsdenver.com/
- CANNABIS, CBD & COVID-19: https://www.projectcbd.org/medicine/cannabis-cbd-covid-19?utm_source=Project%20CBD%20Mailing%20List&utm_campaign=220a9c98c2-EMAIL_CAMPAIGN_2020_02_26_07_50_COPY_01&utm_medium=email&utm_term=0_ea5031784e-220a9c98c2-11562609
- Cannabinoids, Influenza, and Coronavirus: https://www.safeaccessnow.org/cannabinoids_influenza_and_coronavirus
- COVID-19 Recommendations for Patients: https://www.safeaccessnow.org/covid-19_patient
- How Coronavirus Attacks the Body: https://www.nytimes.com/video/health/100000007056651/covid-ards-acute-respiratory-distress-syndrome.html
- COVID-19 AND CANNABIS: A GOOD OR BAD COMBINATION?: http://www.medleafrx.com/articles/covid-19-and-cannabis-a-good-or-bad-combination
- Cannabinoids and the Coronavirus: https://www.liebertpub.com/doi/10.1089/can.2020.0035?utm_source=Adestra&utm_medium=email&utm_term=&utm_content=%2B%C2%A0MORE&utm_campaign=CAN+Briefings+May21+2020&