Medical Cannabis for the Treatment of Inflammatory Bowel Diseases

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Inflammatory bowel diseases (IBD), such as Crohns and Colitis, are chronic diseases which negatively impact the lives of many, interfering with their overall quality of life and well being. Currently there is no cure, and standard pharmacological interventions are not always effective and tend to expose users to undesirable side effects. As such, many individuals suffering from IBD have taken agency in the management of their health and turned to complementary and alternative medicines for symptom relief and disease management. Cannabis has a long-standing history of medicinal use, specifically for the treatment of gastrointestinal pain and diarrhea. This is fitting as we know cannabis has anti-inflammatory properties, and that the endocannabinoid system (ECS) plays a key role in maintaining gut homeostasis1,2. In studies using mice, THC (main psychoactive component of cannabis), has been shown to protect against experimentally induced colitis, and CBD (a non-psychoactive component of cannabis) has been shown to reduce injury to the colon in mice with colitis3,4,5,6. These findings are very promising; however, we need more evidence from human studies to draw clear conclusions.
In examining past survey research, it is evident that individuals suffering from IBD have long since been using cannabis to better manage their symptoms, and improve their quality of life. Cannabis use is more common amongst those with IBD as compared to the general population, and individuals with IBD often specifically site symptom relief as their reason for using cannabis1,7. Patients report successful management of symptoms such as abdominal pain, nausea, loss of appetite and diarrhea through medicating with cannabis7,8,9,10. In an interview based retrospective study involving 30 patients living with Crohns disease and medicating with cannabis, all patients reported it had a positive impact on their disease activity11. Patients also reported a reduction in both their number of bowel movements per day, and their need for other drugs. Specifically, the number of patients requiring steroid treatments before beginning treatment was reduced from 26 to 4. While survey and interview data cannot be taken as conclusive proof of the efficacy of cannabis as a treatment for IBD, the data does largely point towards a positive impact on disease activity.
Some of the most promising research in this area has been conducted by a group of researchers in Israel. They ran the first experimentally controlled study looking at the impact of medicating with cannabis on disease activity in 21 patients with Crohns that had been unresponsive to treatment with steroids12. Of the 21 patients 11 were treated with cannabis cigarettes, and 10 with placebo cigarettes devoid of any substantial amount of cannabinoids. Of those that received cannabis, 45% reached full clinical remission after 8 weeks of treatment, as compared to 10% who reached remission in the placebo group. This finding was not statistically significant, however that may be due to the small sample size. What was found to be significant were patients scores on the Crohns Disease Activity Index, when treated with cannabis the patients, on average, saw over a 100-point improvement in their scores, indicating a positive impact of cannabis on disease activity.
Due to a lack of available research on the topic it is too soon to draw any full conclusions about the efficacy of medicinal cannabis to treat IBD. However, taken together, research from animal and human studies as well as personal testimony from those with IBD, points to a positive effect of cannabis on symptomology and disease activity. For patients with IBD finding a treatment plan that is effective without exposing them to unwanted side-effects can be frustrating. Medicinal cannabis is a viable complementary and alternative form of medicine which can allow individuals to take greater agency in the management of their disease activity, and improve their quality of life. It may be especially helpful for those who have failed to find relief through standard pharmacological intervention. This is a research area which is ripe with promise, and we look forward to future research to further substantiate what many people treating their IBD with cannabis have been saying for years, it works.

1. Di Carlo, G., Izzo, A. A. (2003). Cannabinoids for gastrointestinal diseases: potential therapeutic applications. Expert Opinion on Investigational Drugs, 12(1), 39-49. doi: 10.1517/13543784.12.1.39
2. Klein, T. W. (2005). Cannabinoid-based drugs as anti-inflammatory therapeutics. Nature, 5, 400-411. doi: 10.1038/nri1602
3. Kimball, E. S., Schneider, C. R., Wallace, N. H., Hornby, P. J. (2006). Agonists of cannabinoid receptor 1 and 2 inhibit experimental colitis induced by oil of mustard and by dextran sulfate sodium. American Journal of Physiology – Gastrointestinal and Liver Physiology, 291(2). doi: 10.1152/ajpgi.00407.2005
4. Massa, F., Marsicano, G., Hermann, H., Cannich, A., Monory, K., Cravatt, B. F., Ferri, G., Sibaev, A., Storr, M., Lutz, B. (2004). The endogenous cannabinoid system protects against colonic inflammation. The Journal of Clinical Investigation, 113(8), 1202-1209. doi: 10.1172/JCI200419465
5. Jamontt, J. M., Molleman, A., Pertwee, R. G., Parsons, M. E. (2010). The effects of D9-tetrahydrocannabinol and cannabidiol alone and in combination on damage, inflammation and in vitro motility disturbances in rat colitis. British Journal of Pharmacology, 160(3), 712-723. doi: 10.1111/j.1476-5381.2010.00791.x
6. Borrelli, F., Aviello, G., Romano, B. (2009). Cannabidiol, a safe and non-psychotropic ingredient of the marijuana plant Cannabis sativa, is protective in a murine model of colitis. Journal of Molecular Medicine, 87(11), 1111-1121. doi: 10.1007/s00109-009-0512-x
7. Weiss, A., Friedenberg, F. (2015). Patterns of cannabis use in patients with Inflammatory Bowel Disease: A population based analysis. Drug and Alcohol Dependence, 156, 84-89. doi: 10.1016/j.drugalcdep.2015.08.035
8. Ahmed, W., Katz, S. (2016). Therapeutic Use of Cannabis in Inflammatory Bowel Disease. Gastroenterology & Hepatology, 12(11), 668-679.
9. Lal, S., Neeraj, P., Manijeh, R. (2011). Cannabis use amongst patients with inflammatory bowel disease. European Journal of Gastroenterology & Hepatology, 23(10), 891-896. doi: 10.1097/MEG.0b013e328349bb4c
10. Yanai, H., Salomon, N., Lahat, A. (2016). Complementary therapies in inflammatory bowel diseases. Current Gastroenterology Reports, 18(12), 1-8.
11. Naftali, T., Bar Lev, L., Yablekovitz, D., Half, E., Konikoff, F. M. (2011). Treatment of Crohn’s disease with cannabis: An observational study. Israel Medical Association Journal, 13, 455-458.
12. Naftali, T., Schleider L. B., Dotan, I., Lansky, E. P., Benjaminov, F. S., Konikoff, F. M. (2013). Cannabis induces a clinical response in patients With Crohn’s disease: A prospective placebo-controlled study. Clinical Gastroenterology and Hepatology 11, 1276-1280.I am text block. Click edit button to change this text.

Health Care Spending Account 101

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Will Your Benefits Cover Medical Cannabis?
Medical Cannabis is a controversial and complicated subject in the Canadian healthcare industry. Ongoing legislation is constantly changing the medical landscape of prescribed Medical Cannabis. If you or someone in your family has been prescribed Medical Cannabis in Canada you’re probably unsure whether or not the prescription can be covered by your health plan. As of this moment a Medical Cannabis prescription is not covered in a basic benefits health plan, however, due to the August 24, 2015  CRA rulings it qualifies as a medical expense. Meaning patients can use their Healthcare Spending Accounts (HCSA) to cover the cost because it now qualifies as a legitimate medical expense under CRA guidelines.

What Is a Healthcare Spending Account?
A Healthcare Spending Account is a pre-determined amount of money provided to employees at the beginning of each benefit year by their employers for the coverage of their medical and dental expenses. Healthcare Spending Accounts (commonly referred to as HCSA) are an increasingly popular alternative to conventional group health and dental plans. Claims made on a HCSA are submitted by employees and reimbursed similarly to a conventional benefits plan.  

If You Do Not Have an HCSA
You can still submit your Medical Cannabis expenses on your Canadian income tax return under the allowable medical expenses section, which could result in an income tax credit. You must have a prescription for medical marijuana from a physician, and purchase cannabis from a licensed producer. Just be sure to have all your receipts included.

Sample of Information Required for HCSA Claim
Enclosed please find my Healthcare Expenses Statement With Healthcare Spending Account. Per my discussion with one of your HCSA representatives over the phone, I am also enclosing:

• The form from your website;

• A copy of my prescription from Dr. ____

• A copy of my patient registration card from my Licensed Producer, ______,
which contains my patient identification number;

• A summary of my orders for reimbursement, including volume and payment amounts

• Original receipts for my orders that are emailed to me upon consummation of any orders.

We’re Coming to Downtown Toronto!

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Since 2015, CannaConnect has been delivering best-in-class service to Canadians in need of access to medical cannabis resources. Our compassionate and knowledgeable team has expanded rapidly to maintain the excellent level of service for the ever-increasing number of patients from coast to coast. To keep up with the patient demand, we have opened our doors with Education Centres in several Canadian cities, including Winnipeg and Kingston to add more of a personal touch to the patient intake process. Keeping the trend going, we are opening another Education Centre & Medical Cannabis Clinic in the heart of downtown Toronto!

Torontonians can visit CannaConnect Toronto at 120 Adelaide Street West, Suite 2500 – right above Toronto’s legendary Hy’s Steakhouse! Here, potential patients can find comfort and privacy while seeking information for medical cannabis treatment. This includes information on the most effective ways to use medical cannabis, details on some of the best Licensed Producers, tips for utilizing your Health Care Spending Account (HCSA) for subsidizing your medication, assistance with creating a patient file, and much more.

As downtown Toronto’s only Medical Cannabis Clinic, we are more than excited to be opening our doors on March 6, 2017. We hope you are excited, too! Make sure to look for our posters on the GO Train, TTC subway platforms, and in the PATH.

See you in March!

The Difference between Cannabis Strains

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Super Silver Haze; Hawaiian Snow, Lemon Skunk; Master Kush, Cupid. No, that isn’t some bizarre, psychedelic haiku; rather, those are all names of cannabis varieties. You don’t have to be a frequent user to know that marijuana is usually labeled in a variety of different types, known as “strains”, but have you ever wondered what actually makes each strain different? Read More