David Johnston, who was diagnosed with autism at the age of 49, says a new discreet cannabis vaping device has helped his anxiety and chronic pain.
Fifty four-year-old David Johnston has a condition called Ehlers danlos syndrome (EDS), a disorder which affects the connective tissues that provide support in skin, tendons, ligaments, blood vessels, internal organs and bones.The condition causes hypermobility, meaning the collagen in the body doesn’t work as well as it should, leaving the joints bendy and prone to injury.
The condition can be serious, affecting various aspects of the body, including the heart and the digestive system, but for David he struggles most with the pain.
“For some people EDS can be a far more serious condition, but with me it is mostly the hypermobility. As a result of that, I do have a lot of pain and frequent joint injuries,” he says.
“I’ve been on all sorts of painkillers over the years, a lot of opiates and various other medications to help me manage my conditions and pain. Some have helped and some haven’t.”
As is not uncommon in those with chronic health conditions, David lives with mental health issues, alongside his physical symptoms, including anxiety and obsessive compulsive disorder (OCD). But in his 40s, he was also diagnosed with autism.
“I’ve definitely struggled with thinking differently all of my life, and with sensory sensitivity – I knew I was different and always felt that it was my fault, that I was wrong or foolish,” says the former research fellow at Strathclyde University in prosthetics and orthotics.
“I’d asked a couple of times if the diagnosis was possible, as most of my nephews and nieces were in the spectrum, my father had his quirks too and as a family we wondered if he would have been diagnosed if there was greater awareness in his time. However, I was told that because I could make eye contact and hold a conversation with the psychiatrist then I obviously didn’t have autism.”
David eventually saw an NHS psychiatrist who referred him to the adult autism team, and after a 40-week wait for an assessment he received confirmation that he was autistic.
“I’ve always had social anxiety, that’s habitual and is still there, but the diagnosis put a whole lot into perspective at age 49,” he says.
“In the last five years since diagnosis I have had a bit more bravery to go out and explore the world a little more.”
David has used cannabis recreationally in the past, but due to his mental health, struggled with the fact it meant breaking the law.
“Cannabis has always helped but the illegality of it didn’t,” he admits.
“As a result of OCD, I have that kind of nature where I don’t like to break the rules. When I was smoking recreationally and illegally in the past, there was always anxiety around it.”
Six months ago he signed up to Project Twenty21 and was able to obtain a legal prescription through The Medical Cannabis Clinics.
Under the guidance of his prescribing doctor, David tried oils and flower products, but they weren’t necessarily as effective for him as he had hoped.
It’s the first product of its kind, encompassing a medical-grade handheld vaporiser with controlled metered dosage, allowing patients to administer an accurate, measured dose of cannabis extract.
Kanabo hopes that providing an alternative solution to the inhalation of medicinal cannabis flowers, will improve patient access and boost trust amongst medical professionals.
David has found the VapePod to be hugely effective in relieving his symptoms, compared to other products he has tried.
“The VapePod has been so effective for me in easing pain quickly due to inhalation and the fast onset, I get almost instant relief,” he says.
“I’m halfway down on my pregabalin medicine as prescribed for nerve pain. I’m down to four tablets in the morning and four tablets at night, compared to nearly 30 at one time.”
But importantly for David, the device is discreet enough for him to medicate in situations where he may find himself experiencing anxiety.
“Now I take cannabis out with me and medicate as needed,” he says.
“I still get really panicked trying to be myself and make small talk in a shop or similar. I am working on it, but it’s hard to undo a lifetime of fear.”
He continues: “Cannabis definitely helps me cope with the sensory stuff as well as the anxiety.
“If I’m out and about and a little bit stressed, I’ve got the device with me and I can take one or two metered doses. Whereas if I had a big heavy desktop flower vaporiser, you can’t use that until you get home or somewhere where you can discreetly medicate.
“Unfortunately there is still this stigma associated with medicinal cannabis despite it being legal. It’s all about growing the awareness.”
David is doing his own bit to help bring about this awareness, working closely with patient advocacy group PLEA (Patient-led Engagement for Access) to help challenge the inequalities in access to cannabis-based medicinal products in the UK.
“For many people cannabis can be life changing, so access for patients is so important. Attitudes are changing and it’s becoming increasingly clear how effective it can be for so many people suffering with many different conditions,” he adds.
“Through my involvement with PLEA I have spoken publicly, whereas before my prescription I’d hardly spoken to anyone outside of immediate family and a few friends.
“It has certainly been life changing for me.”
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.”
Cantourage Clinic now offers discounts to Armed Forces community
Cantourage Clinic, is hoping to improve access to cannabinoid therapies for members of the Armed Forces community, after committing to the Armed Forces Covenant.
The CQC-registered clinic, which launched in the UK this year, is now offering a permanent 10 per cent discount on consultations for veterans and their direct family members.
This is in addition to making donations to the veteran’s mental health charity, Combat Stress, following its recent commitment to the Armed Forces Covenant.
The Armed Forces Covenant is a government-run obligation pledging support to those who have served in the UK Armed Forces.
In honour of Armed Forces Day on the 25 June, Cantourage Clinic has also now reduced the cost of initial consultations for all patients from £99 to £49 for the month of June. Members of the Armed Forces community will receive a further 10 per cent discount off this price.
A donation of £1 from each consultation will be made to COMBAT STRESS – a UK charity dedicated to helping servicemen and women in dealing with post-traumatic stress disorder, and other mental health conditions.
Shortage of mental health staff within the NHS and military is an ongoing issue.
Reports from a study conducted by the Royal College of Psychiatry and published in the BMJ last year, highlighted that England has just one consultant psychiatrist for every 12,600 people.
With at least 1.5 million people waiting for mental health treatment, sufferers are being forced to contact emergency services or crisis services whilst they await treatment, with one in 10 ending up at an emergency department.
According to data presented by the British Journal of Psychiatry (2018), the prevalence of post-traumatic stress disorder (PTSD) among veterans (7.4 per cent) is almost double that of the UK public (4 per cent) – and even higher among veterans who served in Afghanistan or Iraq.
Effective mental health services and treatment options is, therefore, an important consideration in the support of veterans and those close to them.
PTSD often has a long-lasting and debilitating effect on the affected individual and a wider impact on those close to them.
It often co-occurs with other mental health concerns, including anxiety, depression and insomnia. A growing body of evidence supports the potential of medical cannabis in the treatment of PTSD and co-occurring conditions.
Recent data shows that cannabis use is on the rise among veterans diagnosed or experiencing symptoms of PTSD.
A recent study found that participants with a diagnosis of PTSD who used cannabis were 2.57 times less likely to no longer meet the criteria for PTSD at the end of the one-year study period.
In another study, participants with PTSD reported improvements in sleep quality among other therapeutic effects of cannabis use.
Cantourage hopes its 10 per cent discount on initial and follow-up consultations to all veterans and their direct families will help to improve the accessibility of treatment to those affected by PTSD and related conditions.
Lead psychiatrist Dr Anup Mathew said: “I’m extremely proud be part of an organisation such as Cantourage Clinic which acknowledges and understands that those who serve or who have served in the Armed Forces, along with their families, should be treated with fairness and respect in the society they serve with their lives.
“Especially in view of recent and on-going conflicts, we should never forget the sacrifices the Armed Forces community have made and continue to make for all of us.”
Gabriel Newman, CEO at Cantourage Clinic, said: “We are delighted to show our support to the brave community of veterans. All over North America, there are programmes in place to equip military servicemen and women with improved access to cannabis.
“The benefits of substituting Opioids or Benzodiazepines for medical cannabis have been widely reported, studies have shown that patients experienced ‘fewer adverse side effects’ and ‘better symptom management’ in comparison to opiate-based drugs.
“Cantourage Clinic is the UK’s first medical cannabis clinic to directly support the Armed Forces Covenant. We are proud to be leading the way in providing education and support to help improve the quality-of-life for military veterans in the UK.”
US study to explore best CBD/THC ratio for anxiety
To date not much is known about the specific ratio of cannabinoids that works best to alleviate symptoms.
A new study aims to shed light on the best ratio of CBD and THC to treat anxiety symptoms.
A new study – led by Florida Gulf Coast University (FGCU), the Releaf App, which allows patients to track their symptoms and usage and CannaMD, a network of medical cannabis prescribers – aims to explore the subject.
Researchers plan to recruit up to 1,000 medical cannabis patients to track patient-reported experiences while consuming medical cannabis purchased at dispensary locations across the state of Florida.
Eligible study participants will use MoreBetter technologies to answer standardised anxiety-related questions via a smartphone for a 45-day period to track details of their cannabis use and associated outcomes related to symptom relief and side effects.
MoreBetter technologies are widely used by researchers, healthcare professionals, and cannabis product manufacturers to collect data on the performance of cannabis and CBD products, as reported by cannabis patients and consumers.
“Given the increased anxiety and stress that has been reported over the past few years, this is a timely study,” says Tyler Dautrich, COO of MoreBetter Ltd, the company behind Releaf App.
“Working with groups like FGCU and CannaMD enables us to collect localised real-world data outcomes, which will ultimately help improve the experience for registered cannabis patients in Florida.”
Representing one of Florida’s largest networks of medical cannabis physicians, CannaMD’s chief medical researcher, Jessica Walters, agrees: “Identifying specific CBD/THC ratios that work best for anxiety is a critical area of study with immediate real-world applications for a large percentage of the patients we see every day.”
As Dr Martha Rosenthal explains: “Approximately one-third of Americans will suffer from a significant anxiety disorder at some point in their lives, and many turn to medical cannabis to alleviate their symptoms.
“This study will expand our knowledge on the effects of medical cannabis on symptoms of anxiety, patient patterns of use, and the correlation of medical cannabis with other anxiolytic drugs and practices.”
This study marks the first in an ongoing collaboration between FGCU, MoreBetter, and CannaMD to advance medical cannabis research in the state of Florida and contribute to evidence-based literature regarding the use and efficacy of cannabis products statewide.
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