Crohn's disease can be extremely debilitating and can lead to a lowered quality of life. As a result, many Crohn's sufferers are looking for a solution. Could that solution be cannabis?
We note that the subject contained in this article represents illegal activity in certain jurisdictions. Whilst we do not condone any acts which are contrary to any such laws, we understand that readers in those jurisdictions which have decriminalised cannabis may find this article of interest.
Cannabis is becoming more accepted within the medical community as a safe, alternative avenue to treat an amalgamation of ailments. Insomnia, nausea, weight loss, chronic and even cancer pain have all had an abundance of anecdotal, qualitative evidence supporting cannabis as an effective treatment option. This is a direct result of cannabinoids reacting to our endocannabinoid system (ECS), which is responsible for maintaining homeostasis in our body through our mood, appetite, and sleeping patterns.
As cannabis becomes increasingly legalized and accepted as a treatment rather than as a 'gateway drug,' the floodgates are also opening for the research community to explore the potential benefits cannabis might have on issues that have not yet been explored. In this case, Crohn's disease is no different.
What is Crohn's disease and how is it treated?
Crohn's disease, also known as Inflammatory Bowel Disease (IBD), is an auto-immune disease that disrupts one's digestive system: inflaming the colon, gastrointestinal tract, and rectum. IBD can present itself during childhood, adolescence or adulthood and is a life-long disorder with no current cure. During inflammation phases, individuals can suffer from mild to severe symptoms, sometimes resulting in hospitalization which can have a detrimental effect on one's overall mental and physical wellbeing.
Crohn's disease has a nasty effect on one's gastrointestinal tract, and, depending on the severity, can cause abscesses, fissures, and strictures throughout the intestinal wall. This can further lead to malnutrition and the need for surgery to remove any damaged portions of the tract. The result includes symptoms of abdominal pain as well as nausea, weight loss (as a result of a loss of appetite), fatigue, anemia, and digestive complications.
Unfortunately, because Crohn's disease is a life-long disorder, having surgery can only remove the damaged parts, while the disease can continue to affect other areas of the tract.
Currently, the treatment for IBD is centered around keeping individuals in remission and keeping their symptoms at bay. The existing medication that's prescribed to patients is aimed at reducing their inflammation while giving the intestines time to heal.
How can Cannabis help?
Firstly, it's important to note that cannabis is not a cure for Crohn's disease. It can, however, help in keeping the symptoms at bay and improving one's overall quality of life.
As previously mentioned, the cannabinoids in cannabis such as Tetrahydrocannabinol (THC), Cannabidiol (CBD) and tetrahydrocannabinolic acid (THCA) (which is the precursor for THC) directly interacts with our ECS. Cannabinoids encourage the dopamine release that helps with hunger, which in turn makes us sleep easier and stops feelings of nausea and pain by subsiding pain signals before they reach the brain.
While cannabis can't "cure" Crohn's disease, it's not hard to work out why researchers have turned to cannabis as a potential alternative to help ease its symptoms.
What does the research say?
Unfortunately, like most cannabis-related research, clinical evidence appears to be few and far between. Between an inconsistency of legalisation across the U.S. and a robust (albeit, slowly dwindling), stereotype surrounding the appropriateness of cannabis as a treatment option, the research is overflowing with positive, anecdotal evidence with very little clinical evidence to support it.
More complications have arisen with research concerning Crohn's disease with not only minimal research studies promoting its benefits, but, like other cannabis-related research, results which indicate that the use of cannabis doesn't always assist with symptomology.
According to a 2018 study review, the effects of cannabis on alleviating the symptoms of Crohn's are overall mixed and inconclusive, showing that cannabis reduced symptoms in some patients, while making little to no difference for others.
This leads us to question, why this is the case? While it's clear that more research is urgently needed, why does cannabis only seem to work on some?
Crohn's disease varies widely between patients, so it would make sense that its treatment should be administered as a reflection of that. According to Californian medical cannabis physician, Dr. Hergenrather, Crohn's disease needs individualized dosing of cannabinoids to properly treat symptoms on a case-by-case level. This is due to different levels of cannabinoids having different and vastly adverse effects. For example, strains or oils with low doses of CBD are not likely to help relieve pain while THC has psychoactive properties that might negatively affect the patient.
Dr. Hergenrather also suggests that the cannabinoid THCA should also be used in the treatment due to its anti-emetic properties and impact on reducing inflammation.
One thing that the medical community appears to agree on is that more research into how cannabis can alleviate the symptoms of Crohn's disease is urgently needed.
Currently, MGC Pharmaceuticals is developing a drug that targets inflammatory pain. According to a recent research report, InCann was developed through a collaboration with the Royal Melbourne Institute of Technology (RMIT) and the Hebrew University of Jerusalem (HUJ).
The trial has completed its Phase I trials and received positive results on inflammatory symptoms in its most recent observational study. Although the development of InCann is currently paused to allow for resources to focus on other cannabis-based drugs to be approved by the Therapeutic Goods Association (TGA), the more cannabis-based medications that become available the easier it will be for future developments.
What strains are best for Crohn's disease?
As previously mentioned, it's important to understand that cannabis is not a 'one-size-fits-all' treatment. Its effects are dependent on the levels of cannabinoids and its ratio of Sativa vs. Indica dominance.
For individuals suffering from inflammatory ailments like IBD, it's important to find a strain that will not only help ease inflammation but also increase mental well-being by reducing depression, stress, and anxiety.
The ACDC strain, for example, is a Sativa dominant strain with low levels of THC (around 1%) and high levels of CBD (upwards of 16% – 24%). This means that it's great for pain, inflammation, stress, and anxiety while helping one feel more relaxed and focused.
Where does cannabis stand now?
Crohn's disease is a life-long disorder with no current cure.
While we know that the evidence of the benefits of medicinal cannabis, there is still a shortage of clinical, quantitative evidence to support the anecdotal claims – restricting the availability and accessibility of medicinal cannabis to the community and those who could benefit from it.
Despite the existing red-tape that still surrounds the medicinal cannabis industry, companies such as MCG are looking into the development of cannabis-based medicines that may allow Crohn's patients to enjoy a better quality of life. As more research is conducted, the road to overall legalisation and cannabis as an approved treatment could be closer than you think.
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