By Leyna Roget
Imagine you haven’t eaten a real meal all day. I’m talking no solid food, and barely enough to feed a small child. Repeat; for at least two more days. The mere sight of food elicits a panic and cyclical thought process bordering on neurotic. ‘How much pain will this food generate?’ ‘What’s enough nourishment to keep me teetering above lethargic delirium?’ Thoughts that have likely bounced around your head during a severe bout of the flu, but not days on end, every few months, year after year. Relief to me is a sweet, sweet word.
These questions embody an ebbing struggle of mine, to quiet recurring digestive pains with little compromise to my physical and mental wellbeing. Crohn’s is a chronic Inflammatory Bowel Disease (IBD) characterized as an autoimmune disorder. Essentially portions of my gastrointestinal tract (GI) are set ablaze with misguided inflammation. The Crohn’s and Colitis Foundation of America (CCFA) estimates that upwards of 500,000 people experience the ruthless abdominal cramping, diarrhea, weight loss, vomiting, mal-absorption and anemia that accompany this condition; 100,000 are under the age of 18. Chronic inflammation along with potent pharmaceuticals wreak havoc on normal digestive function, so a savory stir-fry may come with a side of incapacitating pain.
My experience as an undersized pre-teen and teenager meant prescription painkillers were non-existent, unless I was hospitalized or of legal age. When pain pills became more readily available, the side effects often left me feeling added nausea, digestive unrest and overly sedated. Aspirin, Motrin, Aleve and Celebrex are just some of the NSAIDs (nonsteroidal anti-inflammatory drugs) available for pain management, but they cause GI irritation and even discourage remission in IBD patients. Acetaminophen (Tylenol) is in the clear but ineffective for code red discomfort, and overdosing causes liver damage. Today, my diamond in the rough has been medicinal marijuana, which significantly reduces and relieves symptoms of inflammation and side effects from medications. Even as I became of legal age, I was never offered a joint and told to sit back and relax- let the pain melt away, simply enjoy that mouth-watering bowl of potato mush.
California Prop 215 or The Compassionate Use Act of 1996 lists chronic pain (in addition to spasticity, arthritis and glaucoma) as suitable conditions for medicinal cannabis treatment, as deemed appropriate by a physician. However, cannabinoid-based medications such as dronabinol (Marinol®) and nabilone (Cesamet®) have only been FDA approved in the U.S. to AIDS and cancer patients for the treatment of nausea. According to the National Institute on Drug Abuse, “scientists have confirmed that the cannabis plant contains active ingredients with therapeutic potential for relieving pain, controlling nausea, stimulating appetite, and decreasing ocular pressure”. My recent Crohn’s flare-up and subsequent stay in the hospital illuminated the ‘symptom snowball’ or band-aid approach rampant in our healthcare system. But there are only so many years you can take a pill, wade thru the side effects then take another pill, before losing your mind to frigid frustration, heaping medical bills and new side effects. It was the soothing relief of cannabis, not the IV painkillers or anti-nausea medications that calmed the storm of physical and emotional distress when I was in the hospital- one spoonful of soup at a time.
I’ve been smoking medicinal cannabis to varying degrees over the last four years. This past year, and the weeks of heavy use prior to and following recent hospitalizations, weaved endless knots through my mind about the adverse effects of smoking cannabis. The most active, naturally occurring chemical (or cannabinoid) that binds to the human body is delta-9-tetrahydrocannabinol (THC), it attaches to parts of the brain with the highest density of cannabinoid receptors; those that influence pleasure, memory, thinking, concentrating, sensory and time perception, and coordinated movement.
Brain imaging studies show some consistent alterations from long-term and chronic cannabis use on the structure of the brain. However, their connection to impaired cognitive function is unclear due to other factors, such as the indistinguishable effects of synthetic compounds from pharmaceutical drugs on the brain. What troubles me is the knowledge that marijuana smoke can contain 50-70 percent more carcinogenic hydrocarbons in one joint than tobacco smoke from a single cigarette. This can prove detrimental for AIDS patients with weakened immune systems or the immunosuppressed (like myself), as regularly smoking may damage the cells in the bronchial passages to the lungs, which protect the body against inhaled microorganisms that could develop into an infection or pneumonia; fatal when your immune system doesn’t pack the necessary punch to ward off intruders.
Medicinal marijuana is something I utilize on and off again as symptoms present. However, extended periods of active disease have made me well aware of the uninspiring hints of brain and body dysfunction that accompany chronic smoking. Branching out for alternative options at the dispensary is a welcome change! Less popular and potentially more effective ways of obtaining the chemical constituents of medicinal cannabis can be found through the inhalation of vapors, digestion of edibles, and absorption through tinctures. The use of a vaporizer heats the cannabis just enough to inhale virtually clear vapors that immediately address symptoms, and deliver almost contaminant free THC. The drawback for me is the rush of cannabinoids to my brain and less so to my body. In my experience, eating any number of baked goods produces some of the most inconsistent results and even aggravates my intestines (also per the additional baking ingredients; I’m gluten and dairy intolerant). Eating cannabis causes the liver to convert delta-9-THC into another exponentially stronger form, more slowly released into the body. Individual rates of digestion and absorption are hard to gauge so I have instead turned to tinctures as a physician recommended alternative.
A tincture is a liquid of ethanol, or other solvent, that has dissolved and thereby extracted a certain number of active cannabinoids directly from the flowering bud. It is absorbed sublingually (under the tongue) and transported by the bloodstream to the body and brain with less psychoactive effects. The process of using a measurable dose and single source means you can replicate the outcome. The mild calm sustained by the tincture was an overall positive expression on my pain.
As I go forward in my evolving dis-ease, I am more knowledgeable about the options I have for managing my chronic symptoms with less artificial and inhibiting forms of medication. I recognize the arguments against medicinal marijuana as a latently psychedelic pain therapy with mocking potential to erode my health. However, at present I prefer to responsibly medicate so that I may flourish rather than wither through physical distress. As the occasion arises, I find solace in the greens of our earth until the gifts of our mind provide permanent relief from this pain.