Blind Faith? Considerations About Medical Marijuana & Glaucoma

Ophthalmology concept. Male patient under eye vision examination

Generally speaking we tout the potential of marijuana, advocating its medical advantages left, right, and center. We praise its benefits for pain reduction, epilepsy, nausea, autism, MS, anorexia, and countless other conditions — the list is positively exhaustive. And yet, we would not advocate for marijuana unequivocally. One case where we do not outright recommend marijuana’s medicinal properties is with glaucoma.

Glaucoma is a condition where increased pressure within the eyeball causes damage to the optic nerve, risking and often causing blindness, especially among the elderly. Several advocates of medicinal marijuana cite small-study or anecdotal evidence that cannabis can lower intraocular pressure (IOP) in people with glaucoma. However, these products are less effective than safer prescription drugs.

Side Effects

In order to produce a clinically-relevant pressure reduction on IOP, frequent inhalation is required because the effect only lasts a few hours. This means one would need to smoke a joint every 3 hours. The number of significant side effects generated by long-term oral use of marijuana or long-term inhalation of marijuana smoke can make it a poor choice in the treatment of glaucoma, a chronic disease requiring proven and effective treatment.

The only marijuana currently approved at the US-federal level for medical use is Marinol, a synthetic form of tetra hydrocannabinol (THC) — the most active component of marijuana and the one which produces the “high.” Marinol was developed as an antiemetic (an agent that reduces nausea used in chemotherapy treatments), which can be taken orally in capsule form.

But it turns out that the effects of Marinol in general, and on glaucoma in particular, are not impressive compared to the real thing. Yet in terms of glaucoma, no studies have shown that marijuana or any of its approximately 400 chemical components can safely and effectively lower intraocular pressure better than the variety of drugs currently on the market. In addition, according to the Glaucoma Research Foundation, while marijuana might lower intraocular pressure, it also lowers blood pressure, which in turn could provide less blood to the optic nerve.

IOC pressure notwithstanding, the issue of pain still remains. That is to say, while medical marijuana might not help with curing glaucoma, it can provide a great sense of pain-relief comfort to glaucoma sufferers. Part of the reason for legalizing marijuana is to allow adults to make the best choices. Glaucoma, it seems, is a prime example of such a dilemma, best discussed with your medical marijuana supportive care provider.


Originally published at www.medicalmarijuana.com on May 12, 2016.

Is Marijuana Safe During Pregnancy?

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Nausea. Anxiety. Pain. These symptoms are part of most women’s pregnancies, often defining them for the entire nine months. Since marijuana can help these symptoms, and is now legal in several states, pregnant women are starting to beg the question: Could marijuana be medically useful for the nausea, the anxiety, and the pain? But if so, would it be dangerous for my baby?

For discussion purposes, we will look at two reports.

1) A December 2015 abstract from the NIH’s PubMed.gov (under the auspices of the national biotech research center) says don’t even go there. Evidence is lacking to prove marijuana is safe during pregnancy, and all the more so, past studies indicate that marijuana could be dangerous for the fetus. Complications center around “problems with neurological development, resulting in hyperactivity, poor cognitive function, and changes in dopaminergic receptors,” the report says.

2) A report by labor support doula Pamela McColl in the homebirth midwifery Birth Institute reviewed several studies dating between 1975 and 2011, and concluded similarly to the PubMed.gov abstract, stating outright, “Marijuana use during pregnancy interrupts fetal brain development.”

While both of these reports conclude that pregnant women should not use marijuana, neither of them can say that it is 100% dangerous. The PubMed.gov report admits that studies have not been comprehensive, and the studies cited by McCall are older and do not all examine cannabis usage during pregnancy per se.

More Questions Remain

All things considered, perhaps pregnant women are missing out if marijuana could be deemed safe, in quantity and quality, for them and their babies. As a related matter on the feminine front, a recently-released cannabis product called Fiora Relief garnered viral attention for its cures for premenstrual and menstrual cramps. Stick the cannabis suppository up the vagina, and voila, those wrenchingly-heavy, stop-you-in-your-tracks uterine pangs and lower back aches are gone.

Wait a minute. Menstrual cramps are mini uterine contractions. So could this solution do the trick for the really heavy labor contractions? After all, it can also be inserted rectally. At this point it’s unlikely anyone in the conventional medical community will suggest this because the effects of a cannabis suppository, even rectally, might risk the baby getting high and affecting the heart rate. Another question is whether cannabis for pain relief would be any safer than other medical pain relief, such as epidurals, which can also affect heart rate. We do not mean to imply the safety of either option, rather to raise the question of statistical probability of risks when comparing marijuana usage to accepted modern medicine norms.

No for Now

All told, to date, the safety of marijuana usage in pregnancy is toggling the line of opening up a can of worms. Like many pregnancy safety questions, researchers and doctors understandably are leery of giving a definitive answer because there’s a developing baby involved. As such, the answer — like the blanket US medical stance on alcohol consumption during pregnancy — is “since we can’t know, the answer is no.” In other words, the better-safe-than-sorry approach is the official medical word. Pregnant women are advised against using marijuana routinely during pregnancy, legalities notwithstanding. What people try on their own has been, and remains, another story.

Originally published at www.medicalmarijuana.com on February 18, 2016