Tuesday, 8 December 2015

Two Videos About Neuropathy, Medical Cannabis And HIV (Vid)

Today's two YouTube videos presented by Dr. Donald Abrams, are pretty much a follow-up to yesterday's post and are directed at people living with both HIV and neuropathy. They set about justifying the use of medical marijuana to relieve nerve pain. The first video concentrates on Dr Abram's experiences of medical cannabis and HIV/Aids wasting syndrome and serves more as a background to the Part Two video. The second video, talks about how he discovered the benefits of cannabis for people living with both HIV and neuropathy.
The transcripts are shown below each video.

Dr. Donald Abrams Tells Us How Medical Marijuana Helps AIDS Patients - Pt 1




Transcription
There are patients able to overcome their nausea and vomiting from their chemotherapy and perhaps even be cured of these malignancies by using cannabis. But what really started me in my research was in my work with HIV AIDS patients. Again seeing them being eaten alive if you will by the AIDS wasting syndrome, which was a common sort of end of life phenomenon that we had before we discovered effective anti retroviral drugs and about the time Delta-9 THC was approved, thats the drug durnabinol or marinol, for treatment for this wasting syndrome in HIV patients. We began to hear from these patients that they actually preferred smoking the cannabis because of their ability to titrate the effect better than swallowing a pill. We know now that cannabis taken by mouth either as baked product or the medication Delta-9 THC has much different absorbs ion and kinetics. It takes a much longer time to reach a much lower peak and then it stays in the system for quite a while. Whereas when it is inhaled, either smoked or vaporized, the peak plasma concentration is actually reached in about 2 minutes and then falls over the next 30 minutes. So the effect happens more rapidly and perhaps dissipates more rapidly. When taken by mouth, the Delta-9 THC, then main psychoactive component is metabolized in the liver to a 11 hydroxy form that is also psychoactive. So when eaten as either a baked product or as the pill the Delta-9 THC creates this psychoactive metabolite that makes people have even more of a psychoactive effect that when it is smoked. And for many patients this is unpleasant. So in 1992 I was challenged, if I may, to study smoked marijuana in patients with the Aids wasting syndrome and to compare it to marinol or durabinol which had been just approved for that indication. And that began a bit of a sort of struggle with our government to be able to conduct a clinical trial. But ultimately after a number of years we did get a million dollars and 1400 government cannabis cigarettes to do a clinical trial. It wasnt any more in patients with the AIDS wasting syndrome, because by this time we had effective anti-retroviral drugs and that syndrome had disappeared. And with the national institute on drug abuse they have actually a congressional mandate that they can only study substances of abuse as substances of abuse. So they were never going to allow me or to give me marijuana to study as a possible therapeutic agent. The study I ultimately got funded for was to study whether or not it was safe. For patients with HIV on the new potent anti-retroviral regimes to use cannabis. Because there had been a report in the literature of a patient using ecstasy or MDMA and dying from an overdose of ecstasy when taken with these antiviral drugs. So the question I posed and the government allowed me investigate, was is it safe for patients on the anti-retroviral drugs to smoke cannabis or to take the cannabis pill while they were taking the protease inhibitors.

Dr. Donald Abrams Tells Us How Medical Marijuana Helps AIDS Patients - Pt 2



Uploaded on 5 May 2010


Transcription

So we did that study, and we showed that there was no damage to the level of the aids drug in the blood stream to the patients immune system or to the level of the virus in their blood stream over 21 days of smoking a government cigarette 3 times a day. And that led us then to move on and do other research looking to see if whether or not cannabis had any medicinal benefit for patients with HIV. Particularly we were fortunate in California when we had a budget surplus that one of our state senators established a center for medicinal cannabis research at the university of California. And that center worked out a deal with NIDA so that NIDA the only legal source of marijuana for research in the country would supply investigators who had been favorably peer reviewed by the University of California Center for Medicinal Cannabis Research to do clinical trials looking at the effectiveness of smoked marijuana. So I submitted a study to look at marijuana in patients with the painful HIV related peripheral neuropathy, which is the damage to the nerves in the hands and feet. For which we really didnt have any treatment. Opioid analgesics dont work well. We tried acupuncture. Most people use anti seizure medications. And these also could interact with the levels of the aids drugs. So we proposed a study to see if smoked cannabis could alleviate the pain of this peripheral neuropathy and ultimately we wound up doing a placebo-controlled trial where 25 patients smoked real cannabis from the government and 25 smoked cannabis that had the active ingredient had been extracted. And we showed the group that smoking the real cannabis had a decrease not only in their peripheral neuropathy pain in an experimental pain that we created in the patients by heating their skin to 104 degrees and then applying caparison cream on top of their skin. So that study funded by the Center for Medicinal Cannabis Research actually was the one of the first modern studies to be done that showed in a randomized placebo control fashion that cannabis does have a medicinal use and that is for treatment of HIV related peripheral neuropathy. And when we looked at our results the effectiveness of cannabis in that situation is comparable to the effectiveness of the drug that is most commonly used the anti seizure medications. Now do I think the government will change cannabiss schedule 1 classification which means it has no accepted medical use, on the basis of a study of 25 patients smoking cannabis and 25 smoking placebo. No, I think I have been around long enough to know thats not gonna do it.

https://www.youtube.com/watch?v=oAOGESbo22k and
https://www.youtube.com/watch?v=Qfs6RMFYBec

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