ATrain Education

 

Continuing Education for Health Professionals

Cannabis (Marijuana) for Medical Use

Module 7

Case Examples of Cannabis Use

Case 1

Jamie, a 40-year-old female with MS, had progressively lost her ability to walk due to leg spasms that required a cane or wheelchair. She had lost vision to the degree that she had to give up her drivers’ license. She had lost control of her bladder, especially at night. Another MS patient suggested that she try cannabis. Jamie found that smoking the cannabis almost immediately relaxed her spasms. Since she had never used cannabis before, she started slowly by smoking part of a cannabis cigarette. When she felt a spasm starting, she would smoke some more. Over time she came to smoke about 10 low-grade (2%–3% THC) cannabis cigarettes throughout the day. She still doesn’t drive, but her vision has improved. On good days she walks without her cane and she no longer requires diapers for incontinence. She no longer needs the prescription Valium and her anti-depressant.

Case 2

Eileen is a 72-year-old female who was born with congenital cataracts. After multiple surgeries on both eyes, she developed glaucoma that could not be controlled with standard medications. Complications with the last surgery on her right eye caused her to lose all her vision. In her late thirties she began smoking and eating cannabis. She initially used the cannabis to help her quit smoking. Eileen found that she could keep her eye pressures within safe limits by eating homemade cookies throughout the day and that the oral route lasted longer. A few years later, she learned to make cannabis butter and ate a teaspoon of it on a cracker throughout the day and at bedtime. Eileen had a history of insomnia and initially could sleep only around 4 hours. As a bonus, she found that with the cannabis she could get 6 to 7 hours of sleep a night.

Case 3

Casey was a 19-year-old male when he was diagnosed with Crohn’s disease. He suffered from extreme abdominal pain and was losing >10 pounds/week, which resulted in his dropping out of college. His team of doctors tried everything, fearing Casey was going to die if he couldn’t maintain his weight. Casey tried cannabis at the urging of friends, and he began gaining weight. He told his medical team about his use and they quietly supported him. He no longer needed a strong opioid for pain management, but his consulting physician for pain did give him a prescription for Marinol; in case he was tested for drugs, this would justify a positive THC finding. Casey lives in a state that has no medical cannabis law and his main concern is getting quality medicine at an affordable price. His parents had always thought marijuana was a drug of abuse, but now support him, since they too believe it saved his life. He cannot afford a vaporizer, but has been advised to smoke a pipe rather than cannabis cigarettes, to inhale and limit his breath-holding to <3 seconds, and to clean the pipe daily to avoid tar build-up.

Case 4

Brian is a 45-year-old male who was diagnosed with AIDS more than ten years ago. Following the advice of his support group, he started using cannabis when his medical treatment for AIDS began. To avoid any risk related to inhaling contaminated cannabis, he bought a cannabis tincture. Brian found that he only needed a quarter to a half of a dropper of the tincture at a time. He would start with a quarter of a dropper and take an additional quarter if needed after waiting for 10 minutes.

Case 5

As a baby, Jeffrey was not eating or sleeping well and was always restless. As a toddler he was soon known as the out-of-control problem child who had temper tantrums and aggressive behavior. By age 7 he had been diagnosed with ADHD, impulse disorder, OCD, Tourette syndrome, intermittent explosive disorder, conduct disorder, oppositional defiance disorder, PTSD, and bipolar disorder. Over the years he had been prescribed 15 medications—Ritalin, Mellaril, Dexidrine, Imiprimine, Adderall, Clonidine, Depakote, Tenex, risperdal, Tegretol, Seroquel, Neurontin, Klonopin, Zoloft and Zyprexa—many of which are not approved for children.

Jeffrey’s desperate mother heard about cannabis and, through the Internet, located a compassion center in their state of California that could supply an edible form of cannabis and a physician who would write the recommendation. She was instructed on how to dose Jeffrey (now age 7½). About a half-hour after eating part of a medicated muffin, while being driven to his special school, Jeffrey relaxed his grip on his mother’s hand and began smiling. He said “Mommy, I’m not mad. I’m happy, and my head doesn’t feel noisy.” His teachers noticed his calmer demeanor and over time his outbursts decreased. Within 6 months of using cannabis Jeffrey was learning how to have fun and was able to benefit from counseling. (For the full story see: Debbie and LaRayne Jeffries, Jeffrey’s Journey: Healing a Child’s Violent Rages, 2005, Oakland, CA: Quick American.)

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