This webinar first aired on Thursday, May 21, 2020.
- The spectrum and prevalence of allergic reactions to cannabis
- Updated information on diagnosis and management
- The benefits and harms of cannabis
Dr. William Silvers
Questions and Answers from the Webinar
Tonya Winders, President and CEO of Allergy & Asthma Network, and William Silvers, MD, a board-certified allergist and clinical professor of medicine at University of Colorado School of Medicine, recently answered questions about the use of cannabis (marijuana) as a medical treatment for asthma.
Q: What are the benefits and risks of marijuana for people living with asthma?
A: Marijuana does have some bronchodilator properties. However, it can also be an irritant in the upper airway. It can cause increased cough and mucous production with long-term usage. So it is important to look at the individual patient and their responsiveness.
Inhalation is definitely not recommended for people living with asthma. If medical cannabis is indicated, consider oral edibles or tinctures. study of marijuana use is important for people with asthma.
Natural compounds found in cannabis:
THC – tetrahydrocannabinol
THC is the compound in cannabis that is psychoactive and gives the “high” sensation. It’s consumed by smoking and in oils, edibles, tinctures and capsules.
CBD – cannabidiol
CBD is the cannabinoid that is associated with anti-inflammatory and immune modulating properties, and is not psychoactive, so it does not typically provide a “high” sensation. It’s sold as gels, gummies, oils, supplements and extracts.
Q: There appear to be some conflicting views on the overall use of marijuana. What are the actual benefits?
A: The reaction to marijuana is highly individualized. It has been shown to have positive effects for inflammation, anxiety, pain relief and sleep, while it has adverse effects on cough, wheeze and sputum production. With more rigorous scientific research (as with other medications), the safety, effectiveness, benefits and harms will be better understood. For example, THC and CBD combinations are being explored.
Q: Is there any regulation on cannabis (marijuana) products?
A: It is far too unregulated currently. The public perception and acceptance of marijuana has gone beyond the scientific basis for safe and effective use.
Also, this is not the same marijuana as the marijuana used from the 1960s to the 1990s. This is far more potent. The marijuana used in research is 7-12% THC (tetrahydrocannabinol); the dispensary marijuana is 15-25% THC; the tincture and concentrates may contain 65-90% THC. It may be difficult to determine exactly what is being purchased.
Q: Are recreational and medicinal marijuana the same product?
A: Yes, they are exactly the same plant. The difference is just in the way it’s tracked from seed to sale since medical marijuana is taxed differently than recreational.
What is less known is the milligrams of marijuana in edible and inhaled products. Micro dosing of edible products is now practiced – starting with a low dose and only increasing after 1 to 1.5 hours if no effect.
However, this just highlights the need for further regulation to understand the exact amount of THC and CBD in any given product.
Q: Is it important to distinguish the difference between “street” marijuana and recreational marijuana (sold via a dispensary) due to the potential of the street products being laced with other things?
A: Medical marijuana is legal in 33 states, including the District of Columbia, and recreational marijuana is legal in 11 states. So now that it is legalized in many states (though street products still exist), there is a much better understanding of what exactly is being purchased and people are getting what they want. People really do not know what they are getting when they purchase street products.
Q: Is recreational and medicinal marijuana legal in Canada?
A: Recreational marijuana is legal throughout Canada. In the eastern part of the country, it is controlled by the government (similar to alcohol), while in the western part of the country it is a dispensary model.
In the United States, each state has different requirements and indications. Some states require training and prescription for medicinal products. There are certain conditions that have been shown to respond to marijuana, such as epilepsy, and the government has approved synthetic products that can be used in treatment.
There are other conditions that it is useful in as well and once it is declassified as a class 1 FDA schedule drug, there can be more research and understanding of the medical benefits.
CME is available for this webinar through ACAAI
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