One thing I’m asked about quite regularly is my view and the
naturopathic view on medicinal cannabis usage. Everyone seems to want to ask me
about this, whether it be friends, colleagues, or patients – it seems that everyone
wants to know whether I think it’s a good idea, what my experience with it has
been, and whether or not I prescribe it.
I’m not sure whether it’s because I use a variety of other
(legal) herbs in my practice, or because I’m an ‘alternative’ provider, but
this is a question that some people can’t wait to pose to me.
The irony of all of this is that, in four years of
naturopathic medical school, I don’t think that the use of medical cannabis was
discussed once. If I recall, we discussed cannabis usage in our Addictions and
Disorders class, we discussed it briefly in our Jurisprudence class, and I believe
that we discussed it in Normal Maternity class one time as having a potentially
damaging effect on the developing fetus. And that was pretty much it – we didn’t
discuss it in Botanical Medicine class, we didn’t discuss it’s use for cancer
patients in Oncology, we didn’t discuss it in the hours we spent discussing
chronic pain in Orthopedics, Naturopathic Manipulation, and Sports Medicine
classes. To be completely honest, if I were to go out and prescribe medical
cannabis, I would be practicing pretty much in the dark, drawing on basically
no instruction, very little research, and no clinical experience.
Few would argue that cannabis doesn’t have an effect on the
human body, but important questions regarding clinical use have yet to be
answered. These questions include: What is the proper dose of cannabis? What is
the proper dosing schedule? How does one evaluate response to therapy? I feel
confident in recommending 1000 mg of curcuminoids twice daily and re-evaluating
at 4-6 weeks, but when I’m not aware of similar regimens for cannabis
prescription. Prescribing cannabis in a manner that amounts to supervised
self-medication is haphazard and prone to inconsistent results.
Not, of course, that I would prescribe medical cannabis.
Though Washington, D.C., where I practice, does allow for the usage of medical
cannabis, cannabis remains a scheduled drug that is without a doubt outside the
prescriptive scope of naturopathic physicians. All of this continues to add to
the irony.
What this all boils down to is the fact that I’m really not
the guy to ask about medical cannabis. I haven’t been trained to use it, and
even if I were, I wouldn’t be able to prescribe it. That said, I do take some
interest in the topic, and so wanted to share an article that came across my
desk recently.
A study published in the Proceedings of the National Academy of Sciences has found that chronic use of cannabis does in fact result in loss
of IQ points. The study tracked approximately 1000 people from the area in and
around Dunedin, New Zealand. The study has achieved a remarkable 96% retention
rate since its inception in 1972, thus adding credibility to its results – not
only were a large number of people included in this study, but they have been
taking part in the study for approximately four decades. This is some of the
first solid evidence that cannabis use does in fact impact cognition – we’ve
suspected as much for several decades, but this study helps confirm it.
What was also extremely interesting is that the study found
that those who started using cannabis before their 18th birthday
were more susceptible to the damaging effects – those who started using
cannabis in their teens suffered an average loss of 8 IQ points compared to
their non-partaking counterparts. 8 IQ points may not seem like a lot for a
test where people regularly score above 100, but can actually make a
significant difference in percentile rankings – 8 points in either direction of
100 (the average score) can place you in either the 70th or 29th
percentile.
So what’s the message of this study? It’s pretty plain:
cannabis is not for kids. We live in a time when cannabis laws are becoming
more relaxed, and are likely to continue to become more relaxed. Without making
comments on that trend, I will say that this study indicates that, no matter the
direction of legislation, future laws should maintain the same type of age
restrictions that current laws for tobacco and alcohol do. The law restrictions
for alcohol and tobacco were done a bit arbitrarily, but given that we now have
some data to go on for in this case, I think we owe it to ourselves and our
children to act on it.
