To mark the beginning of Crohn’s and Colitis Awareness Week, Integro Clinics explores how medical cannabis can help manage the symptoms of these conditions.
It is estimated that Crohn’s and colitis affect one in every 650 people in the UK.
National Awareness Week for these conditions takes place in the UK 1 – 7 December 2021 and it is an excellent opportunity to highlight that there are new cannabis medicines available, which some patients find helpful in managing their symptoms.
Crohn’s disease is a type of inflammatory bowel disease (IBD). It causes inflammation of your digestive tract, which can lead to symptoms including, abdominal pain and cramps, severe diarrhoea, fatigue, weight loss and malnutrition.
It can affect people of all ages, with the symptoms generally starting in childhood or early adulthood. Ulcerative colitis is another long-term IBD condition, where the colon and rectum become inflamed. The colon is the large intestine (bowel), and the rectum is the end of the bowel where stools are stored. Small ulcers can develop on the colon’s lining and can bleed and produce pus.
Inflammation caused by Crohn’s disease can involve different areas of the digestive tract in different people. This inflammation often spreads into the deeper layers of the bowel. It is a condition that can be both painful and debilitating and sometimes may lead to life-threatening complications. It can also be very depressing and emotionally overwhelming for the sufferer.
The exact cause of Crohn’s disease is unknown. It’s thought several things could play a role, including:
- your genes – you’re more likely to get it if a close family member has it
- a problem with the immune system (the body’s defence against infection) that causes it to attack the digestive system
- a previous stomach bug
- an abnormal balance of gut bacteria
While there’s no known cure for Crohn’s disease and colitis, therapies can reduce their signs and symptoms and even bring about long-term remission and healing of inflammation. With treatment, many people are able to function well. Traditional medicines used to reduce inflammation in the digestive system are usually steroid tablets or in very severe cases sometimes surgery to remove a part of the intestine is undertaken.
At Integro Clinics we have seen considerable success in treating Crohn’s and colitis patients’ symptoms using CBM’s (Cannabis-Based Medicines).
CBM’s are medicines derived from cannabis that are used to treat medical conditions. CBM’s contain cannabinoids derived from the cannabis plant, including delta-9-tetrahydrocannabinol (THC), cannabidiol (CBD), or a combination of THC and CBD.
Taking CBM’s either via oil (generally a mix of CBD and THC) or by vaping flower allows the human endocannabinoid system to re-balance and the effect of the active ingredients is found to encourage appetite and help with the pain of abdominal spasms. It also can help with sleep and insomnia, which can become highly disrupted if you are in frequent pain.
Once the patient is sleeping better, eating more and pain is eased, their general well-being will be increased. At Integro Clinics we believe that we can help patients achieve this using CBM’s. Living with Crohn’s disease can be difficult at times, but if symptoms are well controlled, you can live a normal life with the condition.
“At Integro we have found that cannabis medicines have been very helpful for some of our patients with Crohn’s disease,” commented Sophie Hayes, clinical Nurse at Integro.
“They appear to be quite effective in the management of symptoms such as appetite stimulation, nausea, pain management and sleep, as well as low mood and anxiety often associated with the condition. We find they are often more suitable medications than opioid painkillers that can have some significant negative effects on gut motility in these patients.”
Alex, a patient living with Crohn’s added: “Consuming cannabis, particularly inhaled THC medicines, greatly reduces my pain. It also means fewer toilet trips and much better sleep. It practically eliminates my nausea and gives me the appetite to eat well and keep my weight up. When I started taking cannabis it was illegal and it was difficult to find what worked best for me and to have a consistent supply. It’s fantastic that we now have legal access to prescribed cannabis medicines with the guidance and expertise of doctors like those at Integro.”
Integro Medical Clinics Ltd always recommends remaining under the care and treatment of your GP and specialist for your condition while using cannabis-based medicines. The Integro clinical team would always prefer to work in collaboration with them.
If you would like further information or to speak to Dr Anthony Ordman please contact Integro Clinics:
Email: [email protected]
Support is available from your care team and organisations like Crohn’s and Colitis UK if you need it.
Mental health, addiction and medical cannabis – an expert’s insight
We sit down with the recently-appointed medical director of The Medical Cannabis Clinics, Dr Luisa Searle.
The recently-appointed medical director of The Medical Cannabis Clinics, Dr Luisa Searle, shares how her background in psychiatry and addiction is feeding into her new role.
Dr Luisa Searle has been treating patients with addiction disorders for the last six years, seeing patients struggling with substance misuse and establishing outreach services for young people and the homeless across London.
Now, she is helping people legally access cannabis, a substance that has historically been demonised as a ‘gateway drug’.
Feeling burnt out and craving a fresh new challenge, Dr Searle was looking for a change in her career when she crossed paths with The Medical Cannabis Clinics, joining the team as medical director in April this year.
“It frustrates me, this division that there seems to be in mental health, whereby if you’ve got a substance misuse issue, you’re not worthy of mental health treatment,” Dr Searle told Cannabis Health.
“But actually, your mental health is often being self-medicated by substances and whether you agree with that or not, that’s how some people cope.”
Prior to joining TMCC, Dr Searle was unaware that medical cannabis was beginning to be prescribed more widely.
She was coming into the industry with a fresh perspective, and despite her background in addiction medicine, she said she had very little prejudice against cannabis.
“It didn’t make sense to me to not explore it,” Dr Searle said.
Dr Luisa Searle, medical director at The Medical Cannabis Clinics
A balanced approach
“I’m not here to say it’s a wonder drug. I’m not here to say it doesn’t have its risks or side effects. It’s by no means suitable for everybody, but this idea that it’s a substance of abuse and not even [worth] researching as a potential medicine I think is, unfortunately, based in historical racism and hysteria, which has no place in science as far as I’m concerned.”
But while she was intrigued by this new and emerging field of medicine, due to her past experience, she was determined to take a “balanced approach” to prescribing.
For Dr Searle, it is imperative that cannabis is seen for what it is. While it has immense potential for managing hard-to-treat conditions and a possible alternative to physically addictive opioids, it is still a substance that can cause dependence.
“Any substance, legal or illegal, with some psychoactive effect has the potential for abuse, but that’s where I come in as the doctor,” Dr Searle said.
“If I felt that you needed diazepam, that prescription is entirely under my control. It is down to me to work with patients to try to prevent [dependency] from happening and to advise and educate them, so that they can make informed decisions about their care.”
Dr Searle is only three months into her role at TMCC but she is already seeing the positive impact that medical cannabis is having on patients.
People with difficult-to-treat conditions like insomnia and anxiety are seeing improvements in their lives after trying numerous conventional treatments that failed to help.
Meanwhile, patients who have previously relied on pharmaceuticals like antidepressants and SSRIs – which can come with severe side effects – were able to “feel themselves” again after reducing their dose of traditional medication in favour of medical cannabis.
“What’s really been nice is seeing success with people who have tried lots of different conventional treatments and haven’t really gotten anywhere,” Dr Searle said.
“I was talking to a gentleman who had a traumatic brain injury and was getting migraines on a regular basis. He had really struggled with his work and his life. With a small amount of medicinal cannabis flower, he feels much more himself.
“That’s the really nice thing [about] working in this clinic; just seeing that turnaround in people who’ve been quite stuck.”
Having worked for the NHS for 15 years, Dr Searle is a firm believer in everyone having access to the healthcare they need.
Right now, this does not apply to the medical cannabis space. Very few people have been able to access an NHS prescription while private prescriptions can cost hundreds per month.
“It is a little bit challenging for me that I have to be in a private clinic in order to provide medical cannabis treatment,” Dr Searle said.
“While TMCC has extremely reasonable prices in comparison to other types of private health care, it is still a cost and if you’re on a low income it might as well be a million pounds.”
Dr Searle wants to see medical cannabis being more widely prescribed, but it has to be “sensible” with regulations around who can prescribe and how.
She continued: “Why shouldn’t it be available on the NHS in the right circumstances? What I don’t want to see is what can potentially happen with opioids – with people becoming dependent on them.
“It’s not a medication for all. There are concerns, particularly among younger people. We’re still not 100 per cent clear as to the risks around potentially life-changing mental health issues and specifically psychosis.”
Importance of eduction
Dr Searle has not encountered huge numbers of cases where recreational users have later developed psychosis, but she has seen enough for it to be a concern.
“It’s not something that I could just dismiss,” she said.
“When we have young people coming to us, it’s all about education. It’s just like any medication, if you start on antidepressants, you don’t start with a high dose, you start on a low dose and build it up. You check the tolerance and you review the patient regularly to see if there have been any improvements or side effects.”
Dr Searle also points out that studies into psychosis and cannabis use have examined street cannabis rather than medical-grade products prescribed by clinics like TMCC.
“Street cannabis potentially has incredibly high levels of THC and very low levels of CBD,” she said
The benefits for some patients speak for themselves, but Dr Searle stresses the fact that a medical cannabis prescription is not right for everyone.
“Whilst I think [medical cannabis] is great and we get lots of positive feedback, we do have some adverse reactions to it where it’s not suitable,” she said.
“People shouldn’t be lulled into a false sense of security that just because your doctor prescribed it and it’s legal for medicinal use it’s not without its risks.”
Dr Searle sees a lot of potential in cannabis as an alternative drug for chronic mental health disorders and pain, even as a possible method for weaning patients off opioids. But she warns that people who are prone to addiction may end up transferring their dependency from one substance to another.
“If you break your leg, opioids are fantastic for that, but what they’re not so good for is chronic pain,” she said.
“The withdrawal process from them can be horrendous and there could be a place for cannabis to alleviate some of those withdrawal symptoms.”
But, she added: “I think I would be much more cautious about that, simply because until you’ve dealt with and understood your addiction and those behaviours and those are resolved and you’ve engaged with other ways to cope with your emotional stresses, you may just be switching one addiction for another.”
Medical cannabis and pregnancy – what you need to know
Canadian cannabis patients use less opioids and alcohol – study
Just under half of patients say they have reduced their use of other controlled substances.
Just under half of Canadian medical cannabis patients say the treatment has enabled them to reduce their use of other controlled substances.
According to new data, nearly one in two Canadian patients authorised to use medical cannabis say they have been able to reduce – or cease entirely – their consumption of other controlled substances, particularly opioids and alcohol.
A team of researchers from Canada and the United States surveyed almost 3,000 Canadian patients enrolled in the nation’s federal medical marijuana programme, which began over two decades ago.
Medical cannabis has been legal in Canada since 2001, the country legalised the possession and retail sale of adult-use cannabis in 2018.
In the research, which was published in the Journal of Cannabis Research, investigators reported that 47 per cent of respondents acknowledged substituting cannabis for other controlled substances.
Of those who said that they used cannabis in place of prescription medications, half acknowledged doing so for opioids – a finding that is consistent with other studies.
Many respondents also reported using cannabis to reduce their alcohol intake.
However, the study highlighted the need for more open communication between patients and their doctors.
Around one-third of respondents did not inform their primary care providers (PCP) that they were engaging in drug substitution.
Authors concluded: “This study examined patient-provider communication patterns concerning cannabis use and substitution in Canada.
“Results suggest that patients often substitute cannabis for other medications without PCP guidance. The lack of integration between mainstream healthcare and medical cannabis could likely be improved through increased physician education and clinical experience.
“Future studies should investigate strategies for effectively involving PCPs in patient care around medical cannabis with specific focus on substitution and harm reduction practices.”
Commenting on the findings, NORML’s deputy director Paul Armentano, said: “Cannabis has established efficacy in the treatment of multiple conditions, including chronic pain, and it possesses a safety profile that is either comparable or superior to other controlled substances.
“It is no wonder that those with legal access to it are substituting cannabis in lieu of other, potentially less effective and more harmful substances. As legal access continues to expand, one would expect the cannabis substitution effect to grow even more pronounced in the future.”
- 10 key patient takeaways from Cannabis Europa
- New fully digital cannabis dispensary launches in UK
- CiiTECH celebrates five years with five days of CBD offers
- Researchers are using firefly genes to understand cannabis biology
- Jazz Pharmaceuticals announes top-line results from Phase 3 trial on MS
- Fair Trials and Last Prisoner Project seek to launch global cannabis justice project
- News2 years ago
Community extends support to cannabis icon Rick Simpson
- News2 years ago
Cancer survivor claims cannabis oil helped her beat brain tumour
- Case Studies2 years ago
CBD oil and fibromyalgia – a case study
- News2 years ago
NHS lines up cannabis medicine manufacturing
- News2 years ago
Living with chronic fatigue – my CBD story
- News1 year ago
UK grants second licence to grow high-THC medical cannabis
- Insight2 years ago
I’ve gone from a wheelchair to walking thanks to cannabis
- Feature2 years ago
Medical cannabis could help long-term effects of COVID-19, says David Nutt