Top Medical Uses of Cannabis: A Multi-directional Approach
Cannabis and Sleep:
Various research studies on cannabis and sleep disorders have established that cannabidiol (CBD) may possess therapeutic potential for treating insomnia. Additionally, delta-9-tetrahydrocannabinol (THC) may be associated with decreased sleep latency but can cause impairment in sleep quality over long periods of time. In terms of obstructive sleep apnea (OSA), studies have suggested that synthetic or exogenous cannabinoids, such as nabilone and dronabinol, may exert temporary benefits by modulating serotonin levels in the brain that cease OSA by enhancing inspiration. CBD may hold a potential for the treatment of excessive daytime sleepiness and REM sleep behaviour disorders by reducing REM sleep duration, while nabilone may aid in reducing nightmares caused in PTSD and lead to an improved sleep in patients with chronic pain. Similarly, THC reduces the amount of time spent in REM sleep, which reduces vivid dreaming associated with PTSD. The theory behind these statements is that the lesser time spent dreaming, the more restorative, restful and deep sleep is possible. However, a word of caution is that REM sleep is very important for the proper cognitive and immune functioning, and cannabinoids that reduce this stage of sleep can impair memory and weaken immunity.
Cannabis and Stress and Anxiety:
The endocannabinoid system (ECS) is integrally expressed in the central nervous system (CNS) and is responsible for processing the feelings of anxiety, stress and fear. Recent research has highlighted possible mechanisms underlying these central roles of the ECS. The ECS acts as a regulatory buffer system that, after processing anxiety and fearful memories, decides an appropriate reaction to stressful events via generating emotional responses. The endocannabinoids, or the endogenous cannabinoids present in our bodies naturally, establish a complex network between stressful events and the associated rewards network by interconnecting the ECS, dopamine system and the hypothalamo-pituitary-adrenocortical axis of the brain, that together work to create a balance between well-being and distress. Similar to the positive effects of social networking and exercising, cannabis causes a state of relaxation and contentment, thanks to the increased concentration of cannabinoids in the system that activate oxytocin and dopamine, the “feel good” neurochemicals. In contract, withdrawal from cannabis produces the opposite effects by lowering the ECS time, enhancing the release of stress hormones and reducing dopamine levels.
Cannabis and Cancer:
Patients undergoing treatment for various cancers who took the aid of cannabis have reported several associated benefits such as suppressed nausea and vomiting, increased appetite, reduced pain and decreased levels of anxiety and stress. Clinical studies do indicate that cannabis alone does not reduce these adverse effects any better than the other pharmacological medications available, however, it has a clear advantage of treating these side effects simultaneously - a trait that traditional cancer medications lack. Additionally, medications derived from certain chemicals in cannabis can also be used as adjuvant therapy with the standard medications to enhance the beneficial effects or as treatment options for those refractory cases for whom traditional medications have failed. THC in the form of dronabinol has been applied for more than a decade for treating nausea, vomiting and stimulating appetite in cancer and has been used for several years for AIDS patients as well. Other cannabinoids, or any combinations of cannabinoids, may prove to be more beneficial than THC alone. In any case, such novel pharmaceutical discoveries hold a promise to benefit people living with AIDS and debilitating forms of cancer. Currently, commercially available cannabinoids, such as dronabinol and nabilone, are approved for the treatment of cancer-related adverse effects.
Cannabis and Autoimmune Disorders:
Some preclinical investigations have been performed to assess the role of few cannabinoids in autoimmune diseases. CBD, in particular, has been found to be immunomodulatory, rather than immune-suppressive. The possible mechanism proposed is that CBD actually slows down the production of T-cells (a kind of immune cell), which suppresses the memory of the immune system. By such method, CBD helps cut down the likelihood of future autoimmune attacks. Additionally, CBD has been shown to upregulate the expression of genes that are involved in reducing oxidative stress, which in turn help reduce cell damage incurred by autoimmune diseases. THC is another exogenous cannabinoid that is immunosuppressive but only at high doses. In lower doses, it functions as an analgesic and anti-inflammatory. THC may help downregulate the T- cell functions, thereby decreasing the harmful and robust effects of immune cells. According to growing preclinical evidence, cannabinoids may aid in keeping the immune system in a healthy balance, protecting against cell damage caused by autoimmune attacks, reduce production of T-cells, and prevent the triggering of the immune system with little to no side effects.
Cannabis and Seizures:
Both THC and CBD are exogenous cannabinoids that bind to receptors in the brain and are effective in reducing pain linked with conditions like multiple sclerosis, HIV and AIDS. By attaching to such receptors, these cannabinoids prevent the signal transmission of pain. Although the exact mechanism of how CBD controls epileptic seizures is not fully understood, it appears to work on other signalling systems in the brain that control pain as well as possess neuroprotective and anti-inflammatory properties. The use of cannabinoids for the treatment of seizures is has a lot of scope and it poses an opportunity for the researchers to confirm its safety, efficacy, strength and route/method of administration. Similar to conventional anti-seizure medications, cannabis affects cognitive function (especially in children), which might cause patients to miss their doses, resulting in the return of seizures.
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Common nursing interventions for decreased cardiac output include:
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Monitor fluid intake, including IVs if necessary.
Monitor the patient's heart rate.
Monitor blood pressure.
Record heart sounds.
Record pulse.
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