Articles by Dr. Malka

Your Right To Choose Alternative Medicine

Posted by on May 13, 2013 in Articles by Dr. Malka | Comments Off on Your Right To Choose Alternative Medicine

What Is Alternative Medicine?   Alternative medicine refers to any healing practice “that does not fall within the realm of conventional medicine.”  Exactly what is considered alternative changes constantly as more treatments are proven effective and move into the mainstream. When an alternative therapy is used in addition to conventional therapy, it’s called complementary, or known as CAM (complementary and alternative medicine). The combination of conventional medicine and alternative medicine is often referred to as integrative medicine. Alternative therapies may include naturopathy, chiropractic, herbalism, traditional chinese medicine, ayurveda, meditation, yoga, biofeedback, hypnosis, homeopathy, acupuncture, and nutritional therapies.   An alternative practitioner often works in partnership with the patient, empowering them to take more responsibility for their health choices. Alternative medicine treatments are often more cost-effective than conventional drugs or surgery. For example, meditation, or yoga are free! Another benefit of alternative therapies is that they are less likely to harm patients than using pharmaceutical medications that may have negative side effects.  Studies have shown that patients use CAM most frequently for musculoskeletal problems such as back, neck, or joint pain, but all health issues can benefit from alternative therapies.   CAM is Recognized in Health Care Reform Bill   The health care reform bill signed into law March 23, 2010, the Patient Protection and Affordable Care Act, includes several provisions that address complementary and alternative medicine. These include Section 2706, which prohibits discrimination against any health care provider licensed in a state, more specifically: “A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law.” In addition, Section 3502 creates “community health teams,” defined to include, among others, “licensed complementary and alternative medicine practitioners.” From AHPA(American Herbal Products Association)   National Health Interview Survey – 2007 Statistics   According to the data from the 2007 National Health Interview Survey (NHIS), 38 percent of adults (about 4 in 10) and 12 percent of children (about 1 in 9) are using some form of CAM for health services. Americans spent $33.9 billion out-of-pocket on CAM in 2007. 65 percent was for “self-care” in the form of natural products and supplements, and various exercise and fitness classes (approximately one-third of out-of-pocket spending on prescription drugs). The other 35 percent was spent for services by CAM practitioners (approximately one-quarter of total out-of-pocket spending on physician visits).   Herbal Medicine as Your Choice in Alternative Medicine   Recently, the World Health Organization estimated that 80% of people worldwide rely on herbal medicines for some part of their primary health care. In the last 20 years in the United States, public dissatisfaction with the cost of prescription medications, along with an interest in returning to more natural remedies, has led to an increase in herbal medicine use. Medicines, both herbal and pharmaceutical, are big business. It has been estimated that Americans spend $200 billion per year on prescription drugs and $20 billion on herbs and other dietary supplements. This figure (provided by the AHPA – American Herbal Products Association) does not include what is spent on herbal Cannabis! While the amount spent by medical Cannabis patients for...

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Topical Use of Cannabis

Posted by on May 13, 2013 in Articles by Dr. Malka | Comments Off on Topical Use of Cannabis

Why use topical?   Cannabis has been used historically to treat a variety of ailments by topical application.  Topical medicines are absorbed through the skin to affect a targeted area, as a minimally invasive way to administer, and as a way to reduce side effects.  Patients report that many of these conditions respond favorably to topically applied cannabis. Some patients prepare cannabis in alcohol extracts and apply it as a rub to the affected body part. Others use cannabis oils or balms that they procure at dispensaries or privately prepare.   The skin is one of our largest organs and is capable of absorbing medicine, as well as expelling waste. It makes sense to apply a medicine directly to the site of need.  The medicine gets absorbed in the area that is most desirable and will have less of chance to reach areas that are undesirable. Applying a cannabis preparation to the skin does not usually affect brain receptors, and thus has little effect on cognition or memory. It does not produce the “high” effect that has caused so much debate about marijuana as an intoxicant. Skin disorders, in particular, do well with topical cannabis.  Eczema, psoriasis, contact dermatitis, pruritis (itching) and even skin infections have been reported to improve with topical cannabis.  Marijuana may also be used topically for stopping migraines, headaches or pain.   Cannabis oil has a multitude of uses. It is an excellent pain reliever because it stimulates localized THC and CBD receptors throughout our bodies. It also acts as an anti-inflammatory by stimulating circulation. The massage oil is not only good for a body rub, but has taken pain and swelling away from arthritic joints.  Topical alcohol rubs are ideal for arthritic joint pain or sore muscles. Salves may be used anywhere you would use a first-aid ointment. You can use it for cuts and scrapes, infections and dermatitis, eczema, psoriasis and bruises.   Plant Material – Strain and Part of Plant             Cannabis Indica, as opposed to Cannabis Sativa, is best for providing relief for physical symptoms. Some benefits of Indica are – to reduce pain, relax muscles, relieve spasms, reduce inflammation, reduce nausea, relieve headaches and migraines, and as an anti-convulsant.   Recipes   Topical Cannabis Alcohol Fill a pint sized mason jar 25% full with dry crushed cannabis. (Most recipes use one part cannabis to 3-4 parts alcohol).Fill to top with alcohol (rubbing alcohol works fine.) Let stand for 2 to 4 weeks in a cool, dark place, shaking occasionally. Strain. Stronger preparations are made by repeating the process. Store in a dark bottle.   Topical Cannabis Oil Use dry crushed cannabis. Add oil (such as hemp oil, or olive oil) so that the plant material is covered with the oil. Keep in a dark cool place for 3 weeks. Shake daily. Filter using a sieve.   Topical Cannabis Ointment/Lotion Dry crushed cannabis is heated in a crock pot or over a double boiler for 45 to 60 minutes with a thick oil or fat, such as olive oil or cocoa butter. Store in a bottle or jar in a cool, dark place for 2-3 months. Filter using a cheese cloth. Reheat with beeswax to thicken for an ointment. Add aloe vera gel to make a lotion.   Topical Cannabis Salve Add beeswax to...

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The Medical Use of Cannabis in California

Posted by on May 13, 2013 in Articles by Dr. Malka | Comments Off on The Medical Use of Cannabis in California

States Approve Medical Marijuana   The use of marijuana, medicinal or otherwise has been illegal under federal law since 1937. Only Dronabinol, a synthetic pharmaceutical preparation of THC (tetrahydrocannabinol), a major active ingredient in marijuana, is currently approved for use as a Schedule I drug in the United States. As the federal laws have not allowed the use of cannabis as a legal medicinal prescription, several of the states in the US have sought an alternative route to ensure that patients with a need for its properties have access to it without penalty. As of 2013, 20 states – Alaska, Arizona, California, Colorado, Connecticut, District of Columbia, Delaware, Hawaii, Illinois, Maine, Massachusetts, Michigan, Montana, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Vermont and Washington – have approved of and regulate the medical use of marijuana. Each state has its own guidelines for use, including a specified list of medical conditions for which its use is approved, and the amount that can be grown, and possessed. In November 1996, the voters of California passed Proposition 215, the “Compassionate Use Act of 1996.” The purposes of the act were “to ensure that seriously ill Californians have the right to obtain and use marijuana for medical purposes where the medical use is deemed appropriate and has been recommended by a physician who has determined that the person’s health would benefit from the use of marijuana….and to ensure that patients and their primary caregivers who obtain and use marijuana for medical purposes upon the recommendation of a physician are not subject to criminal prosecution or sanction.” According to a survey on the recommendation of cannabis in California, cannabis is indicated for over 250 conditions. The 20th annual report of the California Research Advisory Panel (1990) recommended that personal use and cultivation of marijuana be legalized: “An objective consideration of marijuana shows that it is responsible for less damage to society and the individual than are alcohol and cigarettes.” A new state law took effect on Jan. 1, 2004, SB420, which protects Prop 215 patients from arrest provided they cultivate no more than 6 mature or 12 immature plants and possess no more than 8 ounces of dried marijuana. Many counties and cities have established higher guidelines than this state minimum.   Physician Guidelines in Recommending Marijuana   There was no good precedent to aid the physician in review of a patient’s need for medical marijuana and to make this recommendation legally known. Since cannabis was still illegal to prescribe by federal law, the advent of the physician “Recommendation” became a solution. In this case the physician recognizes the patient’s need for marijuana, advises in favor of its use, but is not able to “order” it for the patient as one would for a drug from a pharmacy. Nevertheless, guidelines for the recommending of marijuana have followed many of the same guidelines as those for pharmaceuticals. Before a physician prescribes a pharmaceutical the physician must advise the patient of the drug’s risks and benefits, so that the patient can make an informed decision as to whether or not to take the substance. Therefore, as with any medicine, the physician makes up to one year “recommendations”, and has follow-up visits with the patient to review the efficacy of the substance and monitor its effect...

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Raw Cannabis – Medicine Without the High

Posted by on May 13, 2013 in Articles by Dr. Malka | Comments Off on Raw Cannabis – Medicine Without the High

Cannabis in its raw state provides a “super-green” food, high in chlorophyll, giving our cells oxygen, antioxidants, and medicinal cannabinoids. In addition, the vitamin/mineral content of the plant is most highly preserved in its raw state. It is a difficult plant to eat raw, due to the stalactites (tiny hairs on the stem) that may irritate the mouth, throat, and stomach. The flowering tips, more concentrated in the cannabinoids, are usually full of a sticky resin which sticks to your mouth if you try to chew it and may taste bitter. One can avoid these problems by taking only tender young leaves, or juicing the leaves and buds.   Raw cannabis as a medicine has rarely been studied, mostly because it has a low content of THC, the chemical in cannabis that causes the psychoactive effect.  So, if not to “get high”, why would anyone want to deal with the discomfort of eating prickly sticky plant matter, needing a significant fresh plant supply, and possible ingestion of mold or other contaminants in order to use it raw? It turns out that in California, due to the liberal growing allowances in some parts of the state, enough patients have been able to experiment with raw cannabis to rediscover its remarkable medicinal properties. I met such a patient in 2009, who presented at the International Cannabinoid Research Society Conference.  She has had multiple serious chronic diseases, all improved to the most remarkable extent that I have ever seen in my experience with over 10,000 medical marijuana patients. When I asked her to what she attributes her success, she replied, “Using raw cannabis.” (See below Kristen’s Story). Kristen was treated by Dr. William Courtney in Mendocino, CA, who is at the forefront of the use of raw cannabis as medicine.  An increasing number of medical marijuana patients in Humboldt and Mendocino are exploring juicing the raw leaf.  A dispensary in Arcata has given out juicers to some patients, provided free raw leaf, and is gathering data on its effects.   Fresh green raw leaf should be used, taken right off the plant, not dried or heated in any way. If you dry the leaf/bud, it’s not really raw, and its chemical composition changes. Dr. Courtney advises the use of large shade leaves, or fan leaves picked from a plant that is 3 months of age. The leaves should be soaked in water for 5 minutes before juicing. 8-10 leaves a day is one dose for one person. Most mix it with other juices to improve the flavor or add some raw honey. Split the juice into 5 parts for 5 doses per day. A recent Washington Post interview with Dr. Courtney comments,  “Maybe nowhere else in the country could a pot doc advise growing 40 plants — enough for one juicing each day on the 45-day cycle required of the auto-flowering strain. Not only is it possible here, but a striking number of patients truly do not want to get high.”   It is currently thought that raw cannabis has medicinal activity due to the presence of cannabinoid-acids. All natural cannabinoids (such as THC and CBD) come from precursor carboxylic acids. This carboxyl group is unstable; heat, light, or alkaline pH make it evaporate as CO2, resulting in the more well researched...

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Medical Marijuana and Seniors

Posted by on May 13, 2013 in Articles by Dr. Malka | Comments Off on Medical Marijuana and Seniors

Since the passage of Proposition 215, the Compassionate Use Act of 1996, medical marijuana has been used in California by hundreds of thousands of patients. Many of these patients have chronic debilitating diseases, such as cancer or chronic pain, but the conditions that marijuana has been recommended for are drawn from a much larger list. These include such common complaints as Insomnia, Hypertension, Headaches, Arthritis, Depression or Anxiety. In addition, many autoimmuine diseases, such as Multiple Sclerosis and Rheumatoid Arthritis also benefit from marijuana. Of interest especially to seniors is the value of marijuana in treating neurological degenerative diseases such as Diabetic or Peripheral Neuropathy, Parkinson’s disease, Alzheimer’s disease and mood disorders.   A national Gallup poll released in November 2005 found that 78% of Americans support “making marijuana legally available for doctors to prescribe in order to reduce pain and suffering.” The excerpts given below address the issue of Senior’s current attitudes toward medical marijuana, and resources for more information on this emerging health alternative.   1) Marijuana and the Elderly By Jeralyn, Section Crime Policy Posted on Wed Apr 27, 2005 “No one knows exactly how many old folks use cannabis to address their ills, but activists and physicians say they probably number in the thousands. And unlike medical marijuana’s younger and more militant true believers, the elderly are difficult for doubters to castigate as stoners. Their pains are unassailable. Their needs for relief are real. Most never touched pot before.” 2) Medical Marijuana for Seniors Americans for Safe Access (ASA) is the largest national member-based organization of patients, medical professionals, scientists and concerned citizens promoting safe and legal access to cannabis for therapeutic use and research. The ASA’s Senior Union works with Americans for Safe Access to distribute important research information to medical professionals, work with other senior organizations to support patients’ right to cannabis in lieu of failed alternatives, and advocate for safe and legal access to cannabis for all seniors who need it. The Senior Union is open to seniors who use medical cannabis, caregivers, family members, researchers, physicians, and other health providers who support the use of medical cannabis.   3) Newsbrief: Senior Citizens Support Medical Marijuana, AARP Poll Finds 12/24/04 Nearly three out of four older Americans support legalizing the medicinal use of marijuana, a poll conducted for the American Association of Retired Persons (AARP) has found. The poll, conducted in mid-November for the nation’s largest group representing senior citizens, surveyed 1,706 people aged 45 or older. Overall, 72% of respondents agreed that “adults should be allowed to legally use marijuana for medical purposes if a physician recommends it.” Support was highest in the West (82%) and Northeast (79%) and lowest in the Midwest (67%) and Southwest (65%). In the South, 70% agreed with the statement. The poll asked if respondents thought marijuana had medical uses, and oddly enough, many seniors who said they didn’t think it had medical uses supported it anyway. Less than half of those over 70 agreed marijuana had medical benefits, but 69% of that group wanted it legalized for medical purposes. Younger respondents were more likely to think marijuana has medical benefits, with some 70% of 45-49-year-olds agreeing that it does. Personal use histories and attitudes toward marijuana’s addictiveness were also age-related, the poll...

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History of the Medical Use of Cannabis

Posted by on May 13, 2013 in Articles by Dr. Malka | Comments Off on History of the Medical Use of Cannabis

The use of marijuana as a medicine is undergoing a resurgence at a grassroots level. The hemp plant has a very long and varied history. Its considerable psychoactive properties have been both a source of interest and public debate for centuries. Some believe the term “marijuana” is derived from the Mexican words for “Mary Jane” or from the Portuguese word marigu-ano which means “intoxicant”. And therein lies the problem in utilizing marijuana as a modern medicine, is it to be regarded as a therapeutic drug or an intoxicant? The plant has been grown for fiber and as a source of medicine for several thousand years, but until 500 A.D. its use as a mind-altering drug was almost solely confined to India. Although the Chinese and Indian cultures knew about the properties of this drug from very early times, this information did not become general in the Near and Middle East until after the fifth century A.D., when travelers, traders and adventurers began to carry knowledge of the drug westward to Persia and Arabia. Several years after the return of Napoleon’s army from Egypt, cannabis became widely accepted by Western medical practitioners. With the rise of the literary movement of the 1840-1860 period in France cannabis became somewhat popular as an intoxicant of the intellectual classes. It also moved across North Africa, appeared in Latin America and the Caribbean, and finally entered the United States in the early decades of this century. Cannabis as a medicine was common throughout most of the world in the 1800s. It was used as the primary pain reliever until the invention of aspirin.  In the United States, medical interest in cannabis use was evidenced in 1860 by the convening of a Committee on Cannabis indica of the Ohio State Medical Society. Between the period 1840-1890, it was reported that more than 100 articles were published recommending cannabis for one disorder or another. The medical use of cannabis declined in the early 20th century with the rise of other, more easily measured pharmaceuticals and it began to lose support of the medical profession. It was during the years between 1856-1937 that cannabis lost its image as a medicine and was left with a disreputable image as an intoxicant. Nevertheless, prior to 1937 at least 27 medicines containing marijuana were available in the US. Strong public reaction coupled with a campaign in the public press led to a federal anti-marijuana law in 1937. (The drug was illegal in many states before 1937). By the time the US banned cannabis (the third country to do so) with the Marijuana Tax Act the plant was no longer extremely popular. Thus, the medical profession was denied access to a versatile pharmaceutical tool with a history of therapeutic utility going back thousands of years. In 1972 Tod H. Mikuriya M.D. reignited the debate concerning marijuana as medicine when he published “Marijuana Medical Papers 1839-1972”. Medical uses in the 20th Century After 1937, with the passage of the Marijuana Tax Act and subsequent federal and state legislation, it became virtually impossible for physicians to obtain or prescribe marijuana preparations for their patients. Preparations became rarely available (cannabis preparation and synthetic THC are obtainable only for research purposes), and prescriptions are regulated by special tax laws. In the United States, the “Federal...

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Cannabis Tea

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Cannabis tea is an infusion of cannabis—usually the leaves of the plant, are steeped in hot water. Typically, herbal infusions are used for delicate herbs, leaves and fresh tender plants. The leaves of mature cannabis plants have a stronger effect  so are often also used. With cannabis, tea making is not as simple as just adding water to the leaves and letting them steep. The primary medicinal components in cannabis, THC and other cannabinoids, are not water-soluble. While the oils are definitely not water-soluble, they can be extracted crudely by boiling the leaves; the heat makes the oil malleable and the boiling action strips it from the leaves. Adding either some alcohol or some oil to the mix is required to help them dissolve.   Historically cannabis tea has been prepared by many cultures, some as medicine, some as a ceremonial drink, and others for intoxication. The oldest culture that has traditionally used cannabis in tea form, and in fact has a special name reserved for the tea is India. In India cannabis tea is referred to as Bhang, which is tea mixed with cannabis. It’s mainly a ceremonial drink. It was common in India to serve a glass of your finest Bhang to guests. It’s also used as an offering to gods and is considered to enforce the spirit to help fight off illnesses. There are many recipes for preparing Bhang; it’s generally spiced with cinnamon, cloves, and nutmeg, then sweetened with a bit of sugar or honey. Some recipes call for adding milk or alcohol to it as well.   Another culture in which cannabis tea is important is In Jamaica. Here it is called ganja tea. In Jamaica drinking cannabis is looked upon completely differently than smoking it. Ganja tea is often used as medicine, particularly in the countryside, and is a widespread custom in many families. However, ganja tea is not made from the same, ripened and dried plants that are used for smoking. Ganja tea is drawn from the young, green plant, and is often made just as one would regular tea, so is not very potent. The tea is said to make the body strong and less susceptible to illness. It is also often drunk, if someone suffers from a fever or a cold. Furthermore, ganja is said to be a good remedy for stress.   Cannabis tea is of interest to the Dutch as well. Researchers in the Netherlands recently completed a study on the chemistry of the tea components. “Cannabis is one of the oldest known medicinal plants, and a large variety of biological activities have been described. The main constituents, the cannabinoids, are thought to be most important for these activities. Although smoking of cannabis is by far the most common way of consumption, a significant part of medicinal users consume it in the form of a tea. However, not much is known about the composition of cannabis tea, or the effect of different parameters during preparation, handling or storage. In this study we used the high-grade cannabis available in Dutch pharmacies to study the cannabinoid composition of tea under standardized and quantitative conditions.”   There are many recipes for Cannabis Tea, yet they are all similar. Some are given below for your tea pleasure. Drink one or more cups...

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Cannabis Edibles As Medicine

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History of ingested cannabis Cannabis has been used medicinally since 2500 BC in China when the plant was discovered to produce a mild euphoria in those who ingested it, and to be an effective general pain reliever. Its use as a medicine continued through 200 BC, when it was noted to be used by the Essenes in the holy land. Its therapeutic value by physicians can be traced back to Dioscorides and Galen around 1000 AD. By 1300 AD, the Inquisition outlawed cannabis ingestion in Spain, yet it continued to be used as a medicine throughout Europe.  Reports by W. B. O’Shaughnessy in 1839 recommended its medical use for a variety of ailments. Marijuana continued to be used as a medicine in the US, especially in tincture form, until 1937 when its use was stopped by the Marijuana Tax Act. Now the only form of federally legalized edible marijuana is THC in prescription form as Marinol.   Effects of ingestion Eating marijuana-infused preparations usually leads to a longer, stronger, and much more physical effect than smoking. For some conditions, such as muscle spasms and intestinal disorders, eating cannabis can be more effective than smoking. Also because ingestion provides a longer, slower release of cannabinoids, it may be a better choice for insomnia, lasting through the night. For patients concerned with the effects of smoked marijuana, or for those who require a maximum dose of medicinal compounds, oral ingestion of marijuana is a good treatment method. Although eating is a good way of absorbing marijuana into the bloodstream, higher amounts must be used in a preparation in order to make the product effective. It takes considerably longer to experience the effects. The effects of ingested cannabis may be felt within 30 minutes to 2 hours.  If the stomach is full the effects may take longer.  These effects may last for 6 – 8 hours. It is generally considered that up to three times as much cannabis is required when taken orally compared to smoking. THC is only one of the active cannabinoids in cannabis. For example, it is known that Cannabidiol (CBD) has sedative effects that offset the simulative effects of pure THC. Commonly, patients use marijuana leaf for cooking and flower tops (buds) for smoking. Because marijuana leaves usually contain a higher percentage of CBD than THC, eating cannabis leaf can make one drowsy. Occasionally a patient may feel uneasy, groggy, or disoriented with ingested cannabis. It is wise to allow time to rest in order to assess how you will respond. Always start with a small amount, wait an hour or two and, if needed, gradually increase the dose. Especially for those with tender digestion, all marijuana must be ground to a fine consistency before cooking. One of the drawbacks of eating marijuana leaf is the common complaint of stomach irritation. The top side of cannabis leaves are coated with thousands of microscopic thorns, and these sometimes cause minor intestinal irritation, even after grinding. As a general rule, the smaller leaves growing closest to the flower tops are closest to the plant’s resin glands, and therefore have the greatest amount of medicinal compounds, and are higher in THC content.   Cannabis edibles Cannabinoids are barely soluble in water. Fortunately they are fat-soluble, meaning that they bind to fat cells...

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Cannabis and Stress Management

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Stress has a great impact on our health. It has been estimated that,  “Stress is the most common cause of ill health in our society, probably underlying as many as 70% of all visits to family doctors.” What is stress and what can we do about it? Stress has historically been defined as “the nonspecific response of the body to any demand made upon it.” To meet this demand, we gear up with a fight-or-flight response. This involves a surge in the functioning of the sympathetic nervous system and a decrease in the parasympathetic response. Our bodies increase their production of adrenaline, a stimulating neurotransmitter, which leads to an increase in cortisol, a stimulating hormone. The changes include an increase in heart rate and blood pressure (to get more blood to the muscles, brain and heart), faster breathing (to take in more oxygen), tensing of muscles (preparation for action), increased mental alertness and sensitivity of sense organs (to assess the situation and act quickly), increased blood flow to the brain, heart and muscles (the organs that are most important in dealing with danger) and less blood to the skin, digestive tract, kidneys and liver (where it is least needed in times of crisis). In addition, there is an increase in blood sugar, fats and cholesterol (for extra energy) and a rise in platelets and blood clotting factors (to prevent hemorrhage in case of injury). Once the stress ends, our system tries to restore balance and return to normal functioning. However, if stress is chronic, restoration cannot occur, and instead of feeling energized, one can feel fatigued.   Some of the disorders associated with stress are: Anxiety, High blood pressure, Headaches, Depression, Weakened Immune System, Sleeplessness, Impotence, Headaches , Diarrhea, Change in Appetite, and Fatigue. Cannabis is well suited to treat many of the symptoms of stress. If we look at the list of disorders above, we can see that cannabis can be an effective tool for the treatment of almost all of them. The active components of marijuana, cannabinoids, affect many biological processes including appetite regulation, pain (including headaches), anxiety, mood, sleep and blood pressure.   The causes of stress are identified as “stressors” or “triggers.” In these difficult economic times we are faced with many stressors, such as loss of income, loss of jobs, perhaps having to move or stop one’s education. It is essential now, even more so than in easier times, to learn how to handle stress – this may also be termed, stress management. The ABC’s of stress management have to do with key concepts. Alter, avoid  or accept the stressor Behavioral modification Change-change your behavior, change your thinking, change your lifestyle choices and/or change the situations you are in.   If you can’t avoid stress then you need to manage it. The means to manage stress is long and multi-faceted.  These are –   1) Drugs that help deal with Stress Stress is often accompanied by anxiety and insomnia, so drugs used to treat these disorders are often prescribed. (See previous MediCann Newsletters for a review of these conditions). Anti-anxiety drugs decrease arousal and relax the body by reducing tension in the muscles. The most commonly prescribed anti-anxiety drugs belong to the family benzodiazepines. Long-term stress is often accompanied by high blood pressure. Beta-blockers...

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