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Integro Medical Clinics: Living with and managing arthritis

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In the second of their new Medical Casebook Series, the team at Integro Medical Clinics explore living with and managing arthritis.

Arthritis is a common condition that causes pain and inflammation in joints.

In the UK, more than 10 million people have arthritis or other similar conditions. It is a disease that can affect people all ages including children, and at this time of year is exacerbated by the cold and damp of the winter months.

Although there is no cure for this condition, cannabis medicines can both help control inflammation and rebalance the body’s endocannabinoid system and regulate its immune response.

There are many different types of arthritis and related conditions, but the two most common are osteoarthritis and rheumatoid arthritis.

Rarer forms include psoriatic arthritis, lupus, and others. Osteoarthritis is the most common type of arthritis, affecting nearly nine million people. It generally develops post mid-40’s or later.

Initially, it affects the smooth cartilage lining of the joint and makes movement painful and feel stiff. Once the cartilage lining starts to roughen and thin out, the muscles, tendons and ligaments may have to work harder, causing further swelling, inflammation and pain around the joint.

Severe loss of cartilage leads to bone rubbing on bone, which alters the shape of the joint and can change the shape of the joint. You normally find this type of arthritis in hands, hips, knees and spine.

Rheumatoid arthritis affects over 400,000 people in the UK, and often starts at around 40 years of age, with women three times more likely to be affected than men.

In this type of arthritis, the body’s immune system targets the affected joint, which leads to inflammation, pain and swelling. This can lead the cartilage bone to weaken, and change the joint shape to alter, sometimes causing the direction of the fingers to drift sideways.

People suffering rheumatoid arthritis can also develop problems with other tissues and organs.

Cannabis medicines not only have an anti-inflammatory affect but in this form of arthritis they can actually rebalance the bodies endo-cannabidiol system and help manage the immune system response.

“Cannabis medicines can help manage the pain associated with arthritis by rebalancing of the body’s natural endo-cannabinoid pain-processing system. Cannabis medicines may also have some anti-inflammatory effect, helping to soothing the inflamed body tissues,” says Dr Anthony Ordman, Senior Clinical Adviser and Hon. Clinical Director Integro Clinics.

“Integro Clinics Ltd always recommend remaining under the care and treatment of your GP and specialist for your condition, while using cannabis based medicines, and the Integro clinical team would always prefer to work in collaboration with them.”

Sophie Hayes Specialist Cannabis Nurse at Integro Clinics adds: “The insomnia and low mood associated with the pain can also be really helped by the correctly-balanced prescription of cannabis medicines.”

 

The patient’s story

Martin is a 67-year-old retired Church of England Vicar, whose story of arthritis began with a sports injury when he 15 years.

“When I was playing rugby at school, I suffered a terrible knee injury, which I was treated properly for, but it went on to cause
huge problems,” he says.

“Once I appeared to be better, I continued to play but it became obvious that I had really weakened and damaged the knee. Over time this affected my gait.

“I started to suffer terrible pain from arthritis in my knee, that spread to all my main joints, leading to full knee replacement surgery. You can imagine the chronic pain I was in.”

If this wasn’t enough, Martin was then diagnosed with Parkinson’s disease five years ago. One might imagine that with these terrible adversities Martin could easily be forgiven for feeling depressed or sorry for himself.

However, this is far from the case, and Martin does not like to refer to himself an arthritis sufferer.

Instead, he used his own energy and initiative to effectively manage his arthritis and associated conditions pain through cannabis medicines.

Martin continues: “As soon as it was legalised, I got a prescription and found the purity and consistent quality way better than any of my previous experiences. Within five minutes of vaping cannabis, I can physically see the tension and rigidity of my arthritis relaxing – the muscles and joints begin to ease and open.

“Over time the anti-inflammatory effect of the cannabis eases the inflamed joints and as it accumulates in the fatty tissue, it naturally dials down my pain and little by little it subsides.”

He adds: “In addition, the cannabis really helped with my Parkinson’s symptoms – it stops my trembling, modulates my body temperature and helps make my speech clearer. I am now able to mostly rely upon Cannabis for my pain relief, it won’t completely take it away, but it makes it manageable.”

 

Read the first in the Medical Casebook Series here

 

If you would like further information, or to make an appointment for a medical consultation, please contact us at Integro Clinics:

Website: www.integroclinics.com
Email: Contact@integroclinics.com
Twitter: @clinicsintegro

 

For support groups and charities please visit the following links:

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Six big cannabis sector stories you might have missed this week

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It’s been another week of big news in the cannabis world.

At Cannabis Health, our in depth coverage of the ongoing growth of cannabis as a medical and wellness product continues

Meanwhile, over at Cannabis Wealth, we’ve been following all the big industry and policy news in a week which has seen some important developments..

Been busy and want to get caught up in a hurry?

Here are the six things you need to read to stay in the loop this week.

1. Reprieve for medical cannabis patients

The Department of Health has reached an agreement with Dutch officials to extend the supply of medical cannabis oils to existing patients in the UK until 2022.

Medical cannabis patients, living with severe, life-threatening epilepsy were left without access to medication when the UK left the EU at the end of last year.

Medical cannabis

Families, whose children are prescribed Bedrocan oils in the UK but must obtain their prescription through the Transvaal pharmacy in the Netherlands, were given two weeks notice that their medication could no longer be dispensed following the end of the Brexit transition period on 31, December 2020.

Read the full story.

2. UK largest’s medical cannabis trial reports back

The first findings from the UK’s largest medical cannabis patient study show quality of life improved by more than 50 percent.

Preliminary results from Drug Science’s Project Twenty21 study, have found medical cannabis significantly improves quality of life for people with life-limiting conditions such as chronic pain, multiple sclerosis (MS) Tourette’s syndrome and post-traumatic stress disorder (PTSD).

Published on Tuesday 11 May, the report is the first real-world data to be collected on medical cannabis in the UK.

Read more here.

3. Harrowing first-hand account of medical cannabis user
Diagnosed with a personality disorder and experiencing debilitating anxiety which left him housebound, Craig – whose name has been changed – had exhausted all treatment options and was losing all hope.
He speaks about how medical cannabis helped save his life here.

4. CBD market set to shrink

The UK’s CBD sector looks set to shrink significantly as the roll out of new regulations continues to batter the industry.

The FSA has confirmed to Cannabis Wealth it received applications for 803 different CBD products – but only 42 have been advanced to the next stage of the process so far.

More than half of all applications (445) were ‘incomplete’ and a further 41 have been withdrawn altogether.

Read the full story here.

5. CBD not linked to single doping case

CBD has not been linked to a single failed drugs test in UK sport despite fears about the undeclared levels of THC in some products.

The World Anti-Doping Agency removed the cannabinoid from its banned substances list in 2017 and since then several high profile athletes have publicly endorsed CBD products.

Even though CBD – which has no psychoactive properties – is not banned, the UK Anti-Doping (UKAD) still warns athletes to be cautious with treatments.

Read our exclusive report here.

6. School’s out for cannabis class

The first class on a pioneering university medical cannabis course have concluded their first year of studies.

The research programme at the Humboldt-Universitat zu Berlin examines the medical and nutritional uses of cannabis, production and the legal and economic frameworks of the business.

It’s the latest sign that medical cannabis is becoming a part of the mainstream education offering and a positive indication that new industry leaders will emerge in the coming years.

Full story here.

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Science finds a way for medical cannabis to relieve pain without side effects

Researchers have developed a molecule that allows THC to fight pain without the side effects.

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Medical cannabis
Many people living with chronic pain have found that cannabis can provide relief. 

Scientists may have developed a molecule which could allow medical cannabis to provide pain relief without any side effects.

Many people live with chronic pain, and in some cases, cannabis can provide relief. 

But the drug also can significantly impact memory and other cognitive functions. 

Now, researchers have developed a peptide that, in mice, allowed THC to fight pain without the side effects.

According to the US Centres for Disease Control and Prevention (CDC) around 20 percent of adults in the states experienced chronic pain in 2019. 

In some studies, medical cannabis has been helpful in relieving pain from migraines, neuropathy, cancer and other conditions, but the side effects can present hurdles for widespread therapeutic use.

Previously, researchers identified two peptides [molecules which are made up of amino acids] that disrupt an interaction between a receptor that is the target of THC and another that binds serotonin, a neurotransmitter that regulates learning, memory and other cognitive functions. 

When the researchers injected the peptides into the brains of mice, the mice had fewer memory problems caused by THC. 

Now, this team, led by Rafael Maldonado, David Andreu and colleagues, has gone one step further to improve these peptides to make them smaller, more stable, orally active and able to cross the blood-brain barrier.

Based on data from molecular dynamic simulations, the researchers designed two peptides that were less than half the length of the original ones but preserved their receptor binding and other functions. 

They also optimised the peptide sequences for improved cell entry, stability and ability to cross the blood-brain barrier. 

Then, the researchers gave the most promising peptide to mice orally, along with a THC injection, and tested the mice’s pain threshold and memory. 

Mice treated with both THC and the optimised peptide reaped the pain-relieving benefits of THC and also showed improved memory compared with mice treated with THC alone. 

Importantly, multiple treatments with the peptide did not evoke an immune response. 

Reporting in the American Chemical Society’s Journal of Medicinal Chemistry, researchers say that these findings suggest the optimised peptide is an ideal drug candidate for reducing cognitive side effects from cannabis-based pain management.

The abstract that accompanies this paper can be viewed here.

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Dutch Government to supply medical cannabis for UK patients until 2022

The Department of Health has reached an agreement to continue the supply of Bedrocan oils

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The Dutch Government will supply medical cannabis to UK patients until 2022

The Department of Health has reached an agreement with Dutch officials to extend the supply of medical cannabis oils to existing patients in the UK until 2022.

Medical cannabis patients, living with severe, life-threatening epilepsy were left without access to medication when the UK left the EU at the end of last year. 

Families, whose children are prescribed Bedrocan oils in the UK but must obtain their prescription through the Transvaal pharmacy in the Netherlands, were given two weeks notice that their medication could no longer be dispensed following the end of the Brexit transition period on 31, December 2020. 

After outrage from campaigners, the Dutch government agreed to continue supplying the life-saving products until 1 July, 2021 while a more permanent solution was reached.

This waiver period has now been extended until 1 January, 2022.

Health ministers promised to work with officials in the Netherlands to find a “long-term” solution, but according to those at the forefront of the campaign, there is still “some way to go”.

Hannah Deacon and son Alfie Dingley

Hannah Deacon’s son Alfie Dingley, who is prescribed Bedrocan products for a rare form of epilepsy, recently celebrated one year seizure-free.

In a letter to Deacon on Thursday 13 May, the DofH said it was working with the Dutch government, Bedrocan and the Transvaal pharmacy to proceed as “quickly as possible” with the UK production of these medicines.

It added that domestic production is “complex” and that manufacturing “unlicensed herbal medicines” comes with “significant challenges”. 

Deacon said that the UK production of Bedrocan products was the “only solution”.

While other cannabis-based medicines are available in the UK, experts have warned that there is ‘significant variation’ from one product to the next and switching an epilepsy patient’s treatment could be ‘life-threatening’.

“With the 1 July deadline for Bedrolite supply to cease from the Netherlands looming ever closer, we made it clear we wanted an extension to the agreement to stop the situation becoming dangerous for Alfie and the other patients receiving this vital medicine,” commented Deacon.

“The long term solution of Bedrocan products being made in the UK still has some way to go, but it can be the only solution and we thank everyone who is working very hard to achieve this. 

“This is still a long way off from being okay, but for now we have the pressure taken off on the supply issue.”

With limited access to medical cannabis on the NHS, families are still calling for the Government to help fund their children’s prescriptions, which can cost thousands of pounds each month.

Deacon added: “The ever-pressing issue of financial burden on the many families and patients wishing to use medical cannabis in the UK remains and this is a huge issue which needs dealing with.

“There are many ways in which the Government could step in and help access for very vulnerable people and we will continue working as hard as we can to make things better for all.”

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