Asthma and Medical Marijuana

Asthma and medical marijuana- Asthma is a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath. Asthma is a chronic inflammatory disease which causes constriction of the bronchial tubes, resulting in chest pain and difficulty breathing.

Asthma is one of the most ubiquitous chronic inflammatory diseases in the U.S., affecting an estimated 35 million people, and claiming the lives of 4,000 each year.

For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack. Asthma can’t be cured, but its symptoms can be controlled.

Traditional Treatment

Traditional treatment of asthma involves the inhalation of steroids with anti-inflammatory effect, which dilate bronchial passages and allow for normal breathing to resume. More severe cases require a nebulizer, which changes the treatment from a liquid to a mist, ergo more easily absorbed by the lungs.

Most people with asthma need two kinds: quick-relief medicines and long-term control medicines. Patients may be reluctant to take medication because of cost or the potential side effects.

Quick-relief medicines are taken at the first sign of symptoms for immediate relief:

  • Short-acting inhaled beta2-agonists
  • Anticholinergics

Both types of drugs are bronchodilators, meaning that they expand the passageways into the lungs (the bronchi), allowing more air in and out and improving breathing. They also help to clear mucus from the lungs by enabling the mucus to move more freely and get coughed out more easily.

If you have exercise-induced bronchoconstriction (EIB), also known as exercise-induced asthma, your allergist may recommend that you use these medicines before exercise or other strenuous physical activity.

Quick-relief medicines can stop asthma symptoms, but they do not control the airway inflammation that causes the symptoms. If you find that you need your quick-relief medicine to treat asthma symptoms more than twice a week, or two or more nights a month, then your asthma is not well controlled.

An asthma inhaler

Long-term control medicines are taken every day to prevent symptoms and attacks:

  • Antileukotrienes or leukotriene modifiers
  • Cromolyn sodium and nedocromil
  • Inhaled corticosteroids
  • Long-acting inhaled beta2-agonists (always administered with another asthma-related drug)
  • Methylxanthines
  • Oral corticosteroids
  • Immunomodulators

These medicines are taken every day, even if you do not have symptoms.

Asthma and Medical Marijuana

The cannabinoids THC and CBN have been proven to be successful in the treatment of asthma.

Published in the British Journal of Pharmacology, a study shows marijuana may have a similar effect on the airways as some asthma medications.

Using samples of human lung tissue, French researchers found that THC could block muscle contractions caused by a signaling molecule called acetycholine.

What is THC in Medical Marijuana?

THC, or tetrahydrocannabinol, is the chemical responsible for most of marijuana’s psychological effects. It acts much like the cannabinoid chemicals made naturally by the body, according to the National Institute on Drug Abuse (NIDA).

Cannabinoid receptors are concentrated in certain areas of the brain associated with thinking, memory, pleasure, coordination and time perception. THC attaches to these receptors and activates them and affects a person’s memory, pleasure, movements, thinking, concentration, coordination, and sensory and time perception, according to NIDA.

THC is one of many compounds found in the resin secreted by glands of the marijuana plant. More of these glands are found around the reproductive organs of the plant than on any other area of the plant. Other compounds unique to marijuana, called cannabinoids, are present in this resin. One cannabinoid, CBD is nonpsychoactive, according to the National Center for Biotechnology Information, and actually blocks the high associated with THC.

Acetycholine is responsible for maintaining muscle tone of the airways and also contributes to contractions in asthma attacks. Interestingly, asthma medications block the same molecule, but from a slightly different angle.

They prevent the acetycholine from binding to its receptor. THC works proximal to that. It doesn’t have any competitive effect for binding to receptors. It just prevents the acetylcholine from being released.

How to Medicate

Cannabis infused edibles and tinctures are the most common cannabinoid treatment of asthma as well as vaporizing, based on research done by Dr. Donald Tashkin. Smoking of cannabis is rarely encouraged, due to the carcinogens that still remain in the smoked marijuana.

What are edibles and tinctures?

Edibles are food items made with marijuana or infused with marijuana oils. Edibles may be an alternative to smoking or vaporizing marijuana. Edibles come in many forms, e.g. brownies, cookies, candies, including animal or fruit-shaped gummies, suckers and chocolates, and as beverages.  Unlike smoking marijuana, where the effects can be felt almost immediately, effects from edibles can take from 30 minutes to 2 hours to take effect, and may last longer than expected, depending on the dose, when your last meal was consumed, and/or any medications or alcohol used at the same time.

Tinctures are essentially alcohol extractions of whole cannabis (usually the flowers and trim leaves). The best way to use tinctures is by placing a few drops under the tongue. Dose control is easily achieved by the number of drops a patient places under the tongue where the medicine is rapidly absorbed into the arterial system and is quickly transported to the brain and body. All a patient need do with tincture is use a few drops, wait for the desired medical effects, and either use more or stop as the situation indicates. Tinctures can be flavored for better taste. They are best stored in dark bottles in the refrigerator.

Dr. Donald Tashkin, a lung expert and professor of medicine at UCLA, was part of the team that first discovered marijuana’s effect as a bronchodilator. In 1973, his group published a study in the New England Journal of Medicine that found airways widen in both healthy and asthmatic individuals after smoking marijuana.

It also succeeded in reversing experimentally induced asthma, in a manner that was comparable to what could be achieved with a standard therapeutic bronchodilator that was widely used at the time.

In fact, Dr. Tashkin’s findings led to a number of subsequent studies on delivering THC through an inhaler. But the inhaler route didn’t work, he says, because THC was too large of a molecule and caused patients to cough.

When Dr. Tashkin was performing his research, it was before vaporizers were readily available and ‘vape pens’ common place. Vaping is a method of medicating for asthma sufferers.

What is Vaporizing?

Vaporizing marijuana is one techniques of inhaling marijuana. It is a method that allows the inhaler to experience the affects of marijuana without putting themselves at risk from the toxins that accompany smoking marijuana – namely carcinogenic tars and gases.

Since the substance being inhaled is vapor, not smoke, there is no coughing associated with inhaling vaporized marijuana. You can also dispel with all the extra equipment needed to smoke marijuana, like lighters, papers, filters etc. if you simply vaporize weed.

Vaporizers usually take anywhere from about 1 – 5 minutes to heat the air, although there are digital vaporizers, which heat the air or CO2 cannabis oil instantly if you don’t like waiting.

Vaporizers can be a larger piece of equipment to be used in your home or what is commonly known as a Vape Pen, which is a pen like tool used to vaporize medical marijuana oil.

The Patient

There has been no human research on cannabinoid treatment of asthma since the 1970s, but these studies did show THC to be a temporary bronchodilator, lasting one to two hours after inhalation. THC was shown to be a more effective bronchodilator than isoproterenol, which was the most common prescribed treatment at the time of the 1977 study. Contrastingly, tobacco smoke is well known as a broncho-constrictor.

Recent studies involving cannabinoids and asthma in animal models have revealed that administration of THC and CBN were successful in reducing the presence inflammatory molecules and mucous overproduction. Synthetic cannabinoids have also been effective in reducing coughing and shortness of breath in such studies.

When it comes to overall lung function, cannabis appears to be an asset before an hindrance. In a 20 year study that concluded in 2005, researchers proved that mild to moderate cannabis use actually increased lung volume and air flow in participants. There continues to be a call for further study into the dynamic interaction of inhaled cannabis and the lungs, and the properties of therein.