1]. What is cannabis?
Cannabis is a drug that comes from Indian hemp plants such as
Cannabis sativa and Cannabis indica. The main active chemical in cannabis is THC (delta-9 tetrahydrocannabinol).
Cannabis is a depressant drug. Depressant drugs do not necessarily make you feel depressed. Rather, they slow down the activity of the central nervous system and the messages going between the brain and the body. When large doses of cannabis are taken it may also produce hallucinogenic effects.
For information on synthetic cannabinoids, see our “Legal high” facts page.
Other names
Cannabis is also known as grass, pot, hash, weed, reefer, dope, herb, mull, buddha, ganja, joint, stick, buckets, cones, skunk, hydro, yarndi, smoke and hooch.
What does cannabis look like?
Leaves from the cannabis plant are bright green and have a distinctive shape with five or seven leaflets. The flowering tops and upper leaves are covered in a sticky resin.
Cannabis is used for the psychoactive (mind and mood-altering) effects of THC and other active ingredients. THC is the chemical in cannabis that makes you feel “high”.
There are three main forms of psychoactive cannabis:
marijuana, hashish and
hash oil.
Marijuana is the most common and least potent form of cannabis. Marijuana is the dried leaves and flowers of the plant.
Hashish (“hash”) is dried cannabis resin, usually in the form of a small block. The concentration of THC in hashish is higher than in marijuana, producing stronger effects.
Hash oil is a thick, oily liquid, golden brown to black in colour, which is extracted from cannabis. Hash oil is the strongest form of cannabis.
How and why is it used?
The different forms of cannabis are used in different ways:
Marijuana is smoked in hand-rolled cigarettes (joints), or in a pipe (a bong).
Hashish is usually added to tobacco and smoked, or baked and eaten in foods such as hash cookies.
Hash oil is usually spread on the tip or paper of a cigarette and then smoked.
Cannabis and hash can also be smoked in a vaporiser. Vaporisers heat cannabis to temperatures that release its active ingredients while minimising the toxins associated with burning.
The THC in cannabis is absorbed into the bloodstream through the walls of the lungs (if smoked), or through the walls of the stomach and intestines (if eaten). The bloodstream carries the THC to the brain, producing the “high” effects. Drugs inhaled get into the bloodstream quicker than those eaten. This means that the effects of cannabis when smoked occur more rapidly than when eaten.
Some species of cannabis have few psychoactive effects. These plants are used to produce hemp fibre for use in paper, textiles and clothing.
Cannabis has been used for medical purposes for many centuries. It has been reported that cannabis may be useful to help conditions such as:
nausea and vomiting, particularly when associated with chemotherapy
wasting and severe weight loss, in people with HIV/AIDS, cancer, or anorexia nervosa, as it may be used as an appetite stimulant
pain relief, for example in people with cancer and arthritis
relief from symptoms of some neurological disorders that involve muscle spasms, including multiple sclerosis and spinal cord injury
glaucoma
epilepsy
asthma.
For more information, please click on the Australian Drug Foundation's DrugInfo Clearinghouse web site link below.
youtube link. https://youtu.be/3nEkja9QV9c
Recreational marijuana is now legal in Canada,
Medicinal cannabis (medical marijuana) is cannabis that has been prescribed by a doctor to relieve symptoms or to treat a medical condition. There are several types of medicinal cannabis (both natural and man-made) that can be accessed in Australia, but access is tightly regulated. Research into the effectiveness and safety of medicinal cannabis for treating various conditions is ongoing.
Cannabis is probably most well known as a recreational drug. Also called marijuana, hash, pot, grass or weed, various parts of the Cannabis sativa plant can be used and taken in different forms. For example, marijuana (the dried leaves and buds of the plant) can be smoked and hashish (the dried plant resin) can be baked into foods (such as cookies) and eaten.
What are the effects of cannabis on the body?
In addition to its mind-altering effects, cannabis has medicinal effects such as pain-relieving, anti-nausea and anti-inflammatory properties. What’s more, when cannabis or cannabis products are used in a controlled way, these medicinal effects can be achieved without the feeling of getting ‘high’ or ‘stoned’.
The Cannabis sativa plant contains up to about 100 different substances called cannabinoids that are involved in the workings of the endocannabinoid system – a communications system in the brain and body. By acting on specific receptors in this system, cannabinoids can influence your immune system, mood, memory, learning, sleep and appetite.
The 2 main types of cannabinoids that have been studied for medicinal use are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).
Tetrahydrocannabinol (THC) is the type that can make you feel ‘high’. THC can also relieve pain, reduce muscle spasms and prevent or reduce nausea and vomiting. It also has anti-inflammatory properties and can help stimulate appetite and improve sleep.
Cannabidiol (CBD) doesn’t have mind-altering properties, so doesn’t cause you to get high. It reduces the psychoactive effects of THC, and may reduce side effects of THC, such as anxiety. CBD may be helpful in controlling seizures and pain. It is also being investigated for the treatment of several other conditions.
Research into several of the other cannabinoids and their possible uses as medicines is ongoing.
What can medicinal cannabis be used for?
Medicinal cannabis (medical marijuana) has been investigated for treating a variety of medical conditions, including:
(ongoing pain);
(nerve pain);
;
nausea and vomiting associated with cancer chemotherapy;
improving appetite in people with cancer and ;
certain types of .Medicinal cannabis has also been prescribed for people with terminal illnesses as part of their palliative care.
Types of medicinal cannabis
Medicinal cannabis may be a synthetic (man made) cannabis product or a natural Cannabis sativa plant extract. Pharmaceutical cannabis preparations include oils, tinctures and other extracts. Both synthetic and natural extract products can relieve symptoms without harmful psychological or THC-related effects.
Types of medicinal cannabis include the following.
Nabiximols is a standardised cannabis extract containing approximately equal amounts of THC and CBD. The brand is the only currently available medicinal cannabis registered on the Australian Register of Therapeutic Goods. It is given as an oromucosal (mouth) spray.
Dronabinol is a synthetic form of THC taken by mouth as a capsule.
Nabilone is a synthetic cannabinoid with similar actions to THC. It is available as a capsule that is swallowed.
Controlled and standardised herbal cannabis (plant products) can also be used as medicinal cannabis.
How do you take medicinal cannabis?
You can take medicinal cannabis by mouth as a tablet, capsule, oil, liquid or mouth spray. It can also be taken as a nasal spray. Products that are applied to the skin (patches, gels and creams) have been developed, and raw cannabis can be vaporised for medical use, but not smoked.
How is medicinal cannabis different from marijuana?
Medicinal cannabis comes from cannabis that is grown specifically for medicinal and research purposes. While it is now legal in Australia for cannabis to be grown by approved organisations for these reasons, it’s still illegal to grow your own cannabis or to get it from unapproved sources.
2]. Medicinal cannabis is a medical product made by a pharmaceutical company, which means that the quality and amounts of ingredients are known and regulated. When you smoke marijuana, you are exposed to unpredictable levels of cannabinoids and possibly also impurities. Smoking cannabis from unapproved sources (‘street cannabis’) is more likely to cause side effects, and any type of smoking is bad for your health. It is also illegal to use cannabis for non-medical purposes and to take marijuana for recreational use.
Safety and side effects of medicinal cannabis
Medicinal cannabis is carefully formulated, but there is no standard dose that is suitable for all patients or all conditions. So, the dose is usually started low and gradually increased to maximise its effectiveness while minimising the side effects.
The side effects depend on the type of medicinal cannabis used, and can vary from person to person. They may include:
tiredness or drowsiness;
nausea and vomiting;
changes in appetite;
dry mouth;
diarrhoea;
dizziness;
loss of balance;
anxiety;
convulsions; and
problems with thinking, memory and concentration.
More severe psychological side effects, including hallucinations, euphoria, confusion, paranoia and psychosis are possible but rare at low doses.
Medicinal cannabis is not recommended for people with current or past problems with mental illness (including anxiety and depression), people with unstable heart disease and pregnant or breastfeeding women.
Depending on the type of medicinal cannabis you take, you may need to avoid driving or operating heavy machinery. Check with your doctor. It is a criminal offence to drive under the influence of drugs.
Before prescribing medicinal cannabis, your doctor will want to check whether you are taking any medicines, as they may interact with the cannabis.
Does medicinal cannabis really work?
While research into its effectiveness is still ongoing, some results have been promising. However, more evidence is needed to show that medicinal cannabis is effective, and which forms and doses are best. At the moment, medicinal cannabis is usually only recommended when other treatments have not been effective.
There is limited evidence that medicinal cannabis has possible benefits for the following conditions.
Relief of some types of chronic (ongoing) pain. For use in chronic pain, most studies have looked at the use of tetrahydrocannabinol (THC) or THC-rich extracts together with other treatments. There is some evidence that medicinal cannabis can help relieve neuropathic pain to some degree, as well as improve sleep. However, there is currently no clear evidence that it improves overall quality of life or functioning.
Relief of some symptoms related to cancer and its treatment. According to the Cancer Council Australia, medicinal cannabis may be of benefit to some people with cancer as an add-on pain medicine in people with moderate to severe pain; to relieve nausea and vomiting in people undergoing chemotherapy; and to improve appetite in people who have had significant weight loss and muscle wasting.
Reducing seizure frequency and severity in people with epilepsy. The strongest evidence is for the use of a particular type of medicinal cannabis (CBD) in children with certain types of epilepsy.
Relieving muscle spasticity in people with multiple sclerosis (MS). The only currently TGA-registered medicinal cannabis product – – is indicated for use in people with MS who have muscle spasticity (continuous contraction of muscles that causes stiffness and tightness and can interfere with functioning) that has not responded to other treatments.
How to access medicinal cannabis
The use of medicinal cannabis is highly regulated in Australia. Only doctors (not patients) can apply to the Therapeutic Goods Administration (TGA) to access it. Both specialists and general practitioners (GP) can help people access medicinal cannabis.
Ask your doctor whether medical marijuana may be suitable for you. They may be able to help you access it (if you are a suitable candidate) as an unapproved drug through the Special Access Scheme or Authorised Prescriber Scheme. These are programmes that the Australian Government Department of Health is using to help the appropriate people access these medicines. However, access may still be limited in some states and territories.
The other way to access medicinal cannabis is through a clinical trial. Talk to your doctor about whether there are any clinical trials starting that you may be able to enrol in.
3].
Potential Benefits of CBD
Exciting studies demonstrating the therapeutic effects of CBD for persons with PD abound. Because PD affects the brain’s ability to produce dopamine, researchers Alyssa S. Laun and Zhao-Hui Song from the University of Louisville, Kentucky, made an important discovery when they found that CBD acts as an “inverse agonist” on CPR6 receptors found predominantly in the basal ganglia region of the brain, which connects to the cerebral cortex and brainstem, driving functions in our bodies including movement, learning, and emotion. This means CBD potentially responds within the receptors to provide therapeutic effects against the symptoms of PD. Any increase in dopamine levels would counteract the steady decrease of dopaminergic neurons experienced by those afflicted with PD.
Cannabinoid receptors run throughout our body as part of the endocannabinoid system regulating physiological operations including hunger, pain sensitivity, temperament, and memory. These natural receptors are affected in patients with PD. As analyses continue, CDB is demonstrating relief for tremors, psychosis, and problems sleeping.
CBD may also reduce depression and anxiety, and relieve pain. A study at the Colorado School of Medicine has demonstrated relief of issues including tremors and difficulty sleeping. CBD studies are also showing it as effective in treating the psychosis that comes with PDD (Parkinson’s disease dementia). So far, patients are tolerant of low doses of CBD oil and report positive effects.
Numerous studies echo CBD’s benefits. Researchers in Brazil have noted “Our findings point to a possible effect of CBD in improving quality of life measure in PD patients with no psychiatric comorbidities.” (Study) Researchers with the Department of Neuroscience and Behavior there concluded “preliminary data suggest that CBD may be effective, safe, and well tolerated for the treatment of the psychosis in PD.” (Study) And a different Colorado study concluded: “Cannabis was rarely used in our population but users reported high efficacy, mainly for nonmotor symptoms.”
These more recent revelations come on the back of federally funded preclinical studies published in 1998 documenting strong antioxidant and neuroprotective properties in CDB and THC, particularly in treating “neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease, and HIV dementia.” These promising findings led to a U.S. government patent on cannabinoids as antioxidants and neuroprotectants.
4]. According to the Parkinson’s Foundation, roughly 60,000 Americans are diagnosed with Parkinson’s annually, and more than 10 million people worldwide live with PD.
In June of 2018, the first FDA-approved CBD medication, Epidiolex, was approved to treat two rare types of epilepsy. While there are currently no CBD medications approved by the FDA specifically for Parkinson’s disease, one should not be discouraged, as research is ongoing. In 2017, the Salk University in California found that THC and other compounds found in cannabis, such as CBD, reduce the amount of amyloid beta, a plaque protein that is toxic in the brains of persons with Alzheimer’s disease. This is great news for persons with dementia because the removal of amyloid beta allows brain cells to survive. Amyloid beta not only causes neuron death, but also causes inflammation and contributes to memory loss and other cognitive issues. This type of plaque is also found in the brains of some persons with Parkinson’s disease dementia. In addition, some animal studies suggest that CBD might protect one against developing neurological disorders, such as Parkinson’s disease, in the first place.
Misperceptions & Myths
CBD Makes You Feel “High”
The effects of CBD and THC (Tetrahydrocannabinol), both cannabinoids that are extracted from cannabis sativa plants, are often confused. That said, both CBD and THC are known to have healing properties, and some researchers believe a combination of the two cannabinoids are very effective as a means of treatment. However, only THC produces a feeling of being “high”. Said another way, CBD-rich cannabis usage does not have any mind-altering effects. Given this fact, CBD is a desirable option for those that do not want to feel “high” from THC or certain prescription drugs.
CBD is a Regulated Product
Due to a lack of regulation when it comes to CBD products, there is no guarantee that a product containing a certain number of CBD mg (for instance 30mg) is the same as another stating it has the same mg dosage of CBD. Therefore, there may be a lack of consistency from one product to the next. A researcher at Penn Medicine in Philadelphia discovered that almost 70% of CBD products sold on the internet are under labeled or over labeled when it comes to the concentration of CBD within the product. Just 30% of the products bought contained a concentration of CBD within 10% of what the label indicated. For the best and most consistently produced CBD products, locally sourced medical CBD is recommended. This is because these products are held to a higher level of lab testing for strength, as well as impurities.
CBD has Sedative Properties
While some people may believe that CBD is a sedative, the truth is that it actually produces alertness without negatively impacting one’s sleep. Even if one takes a dose of 600mg of pure CBD, which is a very high dose, it still does not produce a sedating effect. However, one may take a CBD with a terpene (fragrant and flavorful essential oils found in plants) called myrcene, which is produced by several cannabis strains, that has sedating properties.
CBD is Legal in All States
As you will learn more below under “Legal Status of CBD in the U.S., CBD is not legal in all 50 states. However, only in 3 states is it illegal: Idaho, Nebraska, and South Dakota. That said, CBD can be purchased legally online and delivered to all states. One can do so here.
Potential Risks of Use
Studies on CBD have shown that this form of treatment is usually tolerated well by users and is regarded as safe. There has also been no evidence for potential of abuse and/or dependence of CBD. That said, a few undesirable side effects have been noted, which include diarrhea, appetite changes, and tiredness. In addition, there may be dangerous drug interactions when CBD is combined with certain pharmaceutical medications. Therefore, it is crucial that one speak with his/her physician prior to adding CBD to any medication regimen. In addition, one should monitor side effects upon use.
Forms of CBD Administration
There are a variety of options when it comes to administering CBD. There is ingestible CBD, which is a very common means of consumption, and includes oils (CBD is mixed with what is called a carrier oil, such as hemp seed, coconut, and olive oil) and tinctures (CBD is in an alcohol solution). Sublingual consumption, whereby a few drops of oil or tincture is placed under the tongue for a few minutes, is often suggested. This is because the oil is absorbed by the sublingual tissue and quickly gets into the bloodstream. Therefore, the CBD is generally effective within a few minutes. One can also digest the oil or tincture directly or add to food, such as a smoothie. There are also oil capsules that can be taken like pills, as well as CBD edibles, like gummies. This method of ingestion can take an hour before the effects of CBD kick in, and once it kicks in, the effects can be felt for 4 hours or even longer.
Oils and tinctures can also be applied topically, meaning they can be applied to the skin. Like with digesting CBD, it can take an hour or so for the effects to be felt and will last for a few hours. This method of use is good for persons suffering from localized pain. One can also opt for CBD vape products (vaporizer pens), CBD inhalers, or smoke high CBD hemp strains. This method of inhalation allows users to feel the effects of CBD almost immediately and generally lasts a couple of hours.
There is not a preferred method of CBD administration for persons with Parkinson’s Disease. Rather, patients should choose a method with which they are most comfortable and one which is not hampered by tremors. If success with CBD is found, users should choose an administration method which can accommodate frequent and ongoing usage.
Legal Status of CBD in the U.S.
For the purposes of legality of CBD, it is important to be aware of the difference between hemp-derived CBD and marijuana-derived CBD. As previously mentioned, CBD is derived from both marijuana plants and hemp plants. Marijuana plants can contain as much as 30% THC, while hemp plants do not contain more than .03% THC. The percentage of THC in hemp plants is so low that it is impossible for one to get “high”, and therefore, many states have made hemp-derived CBD legally available in their state. As far as CBD manufactured from marijuana, each state has its own specific laws that govern the legality of it. Please note: While CBD is readily available across the states and many states have legalized the use of it, in the eyes of the U.S. Federal government, CBD rich medical cannabis is still illegal. This holds true even when CBD has very little to no THC.
What is CBD?
CBD (aka Cannabidiol) is a compound derived from the Cannabis plant that has positive medicinal effects but does not make people feel “high,” or anxious. CBD, in various forms, is legal in 47 US States.
CBD should not be confused with Marijuana or the THC (Tetrahydrocannabinol) compound which is known for generating a “high” with users. CBD is derived from Cannabis plants, similar to how caffeine is derived from the coffee bean, or aspirin from the bark of a Willow tree. CBD oil is the most common form of administration of the compound with the oil contained in a gel cap or dropper bottle.
CBD Health Benefits for Dementia
The dementia-related conditions that can be helped by CBD include: Alzheimer’s disease, Vascular Dementia, Dementia with Lewy bodies (DLB), Parkinson’s disease, Frontotemporal dementia and Huntington’s disease.
According to researchers at California’s Salk Institute, their 2017 study has found evidence that cannabinoids such as CBD could help remove dementia from brain cells. While the US Food and Drug Administration has yet to approve a CBD drug for the purposes of treating dementia, it has approved a CBD-based drug for treating epilepsy.
There are three ways CBD can work to improve health outcomes for persons with dementia: by reducing inflammation, by reducing oxygen buildup, and by working as a brain stimulant and neuroprotectant. From a user’s perspective, CBD may reduce stress and anxiety in the individual with dementia as well as reduce the decline of memory and other brain functions.
It should be noted that much controversy surrounds CBD and the claims companies have made as to its positive effects.
Alzheimer’s Disease
The topic of CBD health benefits continues to grow with new CBD and Alzheimer’s research. In recent studies, CBD has been shown to reduce or remove the impact of inflammation, oxygen buildup and brain cell decline.
Inflammation has been shown to increase the negative impact of Alzheimer’s disease. The inflammatory response happens when the brain’s immune cells fail to clear disorienting blockages. The inflammation that is a core cause of Alzheimer’s symptoms can often be reduced by using CBD oil.
Oxygen is released as a reactive, stress-induced component of Alzheimer’s disease. When inflammation happens in the brain, oxygen is released as a result. The greater the inflammation, the greater the negative impact. Important brain functions such as memory are decreased as more oxygen is released in the brain’s cells. Memory loss and other brain deterioration indirectly leads to increased oxygen in the brain. CBD is an antioxidant, which helps reduce the problems associated with oxygen stress. Brain functions negatively impacted by oxygen stress can be improved by using CBD.
Alzheimer’s patients’ brain cells often show a path of rapid decline and destruction. The potential of stimulating brain tissue was recently discovered as a potential benefit of CBD. In clinical trials, CBD has shown the ability to reverse and even prevent the development of Alzheimer’s negative impact. A 2011 study by Australian researchers Tim Karl and Carl Group found that CBD promotes the growth and development of brain cells, which were shown to reduce the decline of memory and other brain functions.
Vascular Dementia
Vascular dementia is a general term describing problems with reasoning, planning, judgment, memory and other thought processes caused by brain damage from impaired blood flow to one’s brain. To effectively treat vascular dementia, a 2016 study by the US National Institute of Health (NIH) found that activating CB2 (cannabinoid) receptors in the brain helped recover better blood flow to the brain. Activating the CB2 receptors with CBD has increased brain cell activity and helped reduce brain cell damage commonly associated with vascular dementia.
Dementia with Lewy Bodies
Lewy body dementia (LBD) is a disease associated with abnormal deposits of a protein called alpha-synuclein in the brain. These deposits, called Lewy bodies, affect chemicals in the brain whose changes, in turn, can lead to problems with thinking, sleeping, movement, behavior, and mood. Unlike most pain, anxiety or behavior management drugs, CBD does not block acetylcholine, the main chemical that LBD attacks. Research has shown that CBD can be an effective anti-inflammatory agent, reduce motor symptoms (tremor, rigidity, bradykinesia) and maintain circadian (sleep) rhythms.
Parkinson’s Disease
Parkinson’s is a chronic progressive disease of the nervous system chiefly affecting middle-aged and elderly people. Parkinson’s is linked to decreased dopamine production and marked by tremor, muscular rigidity, and slow, imprecise movement. Digestive imbalance may also play a role in the progression of Parkinson’s and the severity of symptoms. Cannabinoids such as CBD have shown to contain effective brain protectors, antioxidants and anti-inflammatory properties which can be beneficial for managing Parkinson’s disease. Read more about Parkinson’s and CBD.
Frontotemporal Dementia / Pick’s Disease
Frontotemporal dementia (FTD) or frontotemporal degenerations refers to a group of disorders caused by progressive nerve cell loss in the brain’s frontal lobes (the areas behind one’s forehead) or its temporal lobes (the regions behind one’s ears) that leads to symptoms of depression and psychosis. Unlike most anti-psychotic drugs, CBD does not lead to an increased risk of death. Research has shown that CBD can be an effective anti-inflammatory agent, reduce anxiety, reduce motor symptoms (tremor, rigidity, bradykinesia) and maintain circadian (sleep) rhythms.
Huntington’s Disease
Huntington’s disease (HD), also known as Huntington’s chorea, is an inherited disorder that results in death of brain cells. The earliest symptoms are often subtle problems with mood or mental abilities. A general lack of coordination and an unsteady gait often follow. According to 2016 research from the University of Madrid, due to CBD’s effectiveness as antioxidants and its anti-inflammatory properties that is safe and tolerable at high doses, CBD can be beneficial for managing Huntington’s disease.
Risks & Side Effects
The World Health Organization (WHO) stated that “no public health problems… have been associated with the use of pure CBD,” and there has been no known association with potential for dependence or abuse, unlike most pharma alternatives. The most commonly reported potential side effects of CBD usage were diarrhea and bloating, with some also reporting nausea. About 3% of patients in studies reported liver problems and had to discontinue CBD use. Specifically, in dementia, some patients reported increased tremor with high doses of CBD. As with any new treatment, patients and caregivers should monitor effects and outcomes closely.
Misperceptions & Myths
1) CBD is non-psychoactive and medicinal while THC is recreational, not medicinal
CBD (cannabidiol) has been shown to have antipsychotic and anti-anxiety effects in humans. This does not mean it is non-psychoactive, but rather that the psychoactive effects are often beneficial and non-intoxicating vs. the “high” feelings of the THC (aka Tetrahydrocannabinol) compound. THC has also shown medicinal benefits for patients, particularly those suffering from pain or inflammation, especially when combined with CBD for consumption by patients.
2) CBD is a sedative and reduces awareness or alertness
Even in high doses (600mg), CBD has not produced sedating effects in healthy humans. CBD usually makes humans feel more awake and alert without negative impact on sleeping patterns. What is more likely happening is that cannabis strains being used by a patient that have high levels of CBD also contain a potentially sedating terpene such as myrcene.
3) All CBD sources are the same
There are multiple sources of CBD such as hemp, medical cannabis and isolate. Hemp-based CBD is plagued by mislabeling and recent studies have found that only 31% of 84 tested hemp-based CBD products were accurately labeled. Medical, locally sourced cannabis has consistently produced the best CBD source as it is held to stricter laboratory testing for potency and contaminants.
4) CBD is legal in all 50 States
Despite CBD being sold in health food stores, tobacco shops, on Amazon, etc., and legalization by many US States, the Federal government has not legalized CBD-rich medical cannabis, even when there is little or no THC included. Hemp-based CBD would not technically have this restriction, but the sourcing and labeling risks are many. Medical-based CBD has been legalized in more than 30 states and is recreationally legal in a growing number of US locations. The US Federal Drug Administration recently has approved one CBD medication, Epidiolex, to treat rare forms of epilepsy in patients 2 years and older.
Forms of CBD Administration
CBD comes in many forms. It can be inhaled or taken in pill format as an oil, to name just a few options. Most CBD patients prefer non-inhalable options, such as CBD-rich cannabis oil products that can be consumed orally (such as gel caps), squeezed under the tongue (with liquid dropper) or delivered via patches on the skin (like Band-Aids). The effects of orally administered CBD can last for up to 4 hours, and the onset of effects has shown to take between 30-90 minutes.
In cases of acute symptoms that require immediate attention, inhalation of concentrated CBD-rich cannabis effects can be felt within 2-3 minutes and last up to 1 or 2 hours. Inhalation can be achieved either through smoking of CBD-rich cannabis flower, or through increasingly popular vaporizer ‘pens’. Both forms are widely available at medical marijuana dispensaries.
Legal Status of CBD in the U.S. (as of Feb. 2019)
Despite CBD being sold in health food stores, tobacco shops, on Amazon, etc., and legalization in many US states, the US federal government has not legalized CBD-rich medical cannabis, even when there is little or no THC included.
CBD and medical cannabis is legally available to all adult users (21+) in Alaska, California, Colorado, District of Columbia, Maine, Massachusetts, Nevada, Oregon, Vermont, and Washington. Legally recognized state ID is required for purchase.
CBD and medical cannabis is legally available by prescription only in Arizona, Arkansas, Connecticut, Delaware, Florida, Hawaii, Illinois, Maryland, Michigan, Minnesota, Montana, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, and West Virginia.
CBD is also available with limited THC content in states such as Alabama, Indiana, Kansas, Kentucky, Louisiana, Mississippi, South Carolina, North Carolina, South Carolina, Tennessee, Texas, Utah, Virginia, and Wyoming.
CBD in all forms is prohibited in Idaho Nebraska and South Dakota.
In spite of the diverse legal status in different states, CBD can be purchased online and delivered legally to all 50 states.
CBD can also be used in legally in most states by residents of assisted living and memory care communities. Read more.
Obtaining CBD
The most common means to obtain CBD rich medical marijuana is from a state licensed dispensary. These dispensaries can be found by searching on any number of dispensary directories (Leafly, Yelp, etc.) or Google Maps.
For those that have trouble with transportation, another increasingly available option would include delivery-based options. However, while convenient for senior patients, these options are not available in every city or town.
Finally, CBD can be purchased over the Internet and delivered to all 50 states. One reputable seller is CBDPure. One can visit their website here.
Dosage Information
Given the lack of regulation in the CBD marketplace and given the challenges of self-reporting of the benefits with persons with dementia, getting the CBD dosage correct is especially challenging. Even though no prescription is required to purchase CBD, many doctors are still knowledgeable about the product and can provide dosage recommendations. Furthermore, given many persons with dementia take multiple medications, it is worth researching drug-drug interactions when considering CBD. CBD dosage consultations can be arranged online with a doctor for about $60. This is a preferable approach to proceeding without professional medical input. However, it is unlikely one’s insurance would pay for these online dosage consultations.
Should one proceed in testing CBD’s impact on a loved one’s dementia, it is suggested that one proceed with the gel cap form of administration as the levels of CBD are consistent (when compared to a dropper) and the act of swallowing a pill is familiar. A further benefit is the once-daily scheduling. While many of CBD’s hypothetical benefits cannot be easily observed, loved ones should pay careful attention for behavior changes. Persons with dementia who appear calmer or experience less severe sundowning symptoms may be benefitting from CBD. Another area in which CBD’s impact may be observed is in reducing sleeplessness.
Insurance Coverage of CBD
At this early stage of development, there are few options covered by insurance. However, when compared to the prices of alternative pharmaceuticals, patients and caregivers may still find that CBD-based medical marijuana is a more cost effective and safer option.
Medicare’s Policy
Does Medicare cover CBD? Because of the federal prohibitions on prescribing Schedule 1 substances, there is no Medicare coverage for the purchase of medical marijuana or CBD derivatives. Any out-of-pocket costs one would incur purchasing marijuana for medical use will not count toward any deductibles under Part B or a Medicare Prescription Drug Plan.
Medicaid Policy
Medicinal cannabis is not covered by Medicaid, private plans, group plans, the Veterans Administration (VA) or Obamacare plans.
