Medical Marijuana Provides Hope to Dementia Researchers and Patients
Many times I watched helplessly as my mother who was diagnosed with dementia was administered psychotropic drugs to control her agitation. I advocated for her constantly but you can’t as a layperson argue with a physician about the best treatments. You don’t understand the disease. You don’t recognize the person exhibiting the behavior and you have to resign yourself to respecting the need to control aggression. Then you notice tardive dyskinesia. I often wondered why something less harmful could not be implemented. Thankfully, now, new research is asking does marijuana hold promise for Alzheimer’s and Dementia patients, and how?
Worldwide, people are living with the difficult reality of a dementia or Alzheimer’s diagnosis. It is painful to watch a family member become confused and agitated. You see the fear in their eyes when it begins to dawn on them that something has gone terribly wrong. 200,000 Americans under the age of 65 are living with younger-onset Alzheimer’s and more than 6 million live with Alzheimer’s. By the year 2050, that statistic is expected to rise to 13 million afflicted. 1 out of every 3 seniors dies of Alzheimer’s or dementia, killing more people than breast or prostate cancer combined.
The aggressive behaviors so often associated with dementia can be challenging. Families are forced to face the difficult decision of whether psychotropic drugs are a good fit for someone they love. While these drugs can play a role in managing aggressive behaviors, they can also decrease a patient’s quality of life. Is it preferable for a loved one to be calm and unaware of their environment, or should they be fully aware but anxious, stressed, and agitated because of their condition? And, do these drugs actually work?
Unfortunately, most LTC homes in North America opt to medicate residents rather than address the reasons for their frustration and agitation. It’s all about the convenience of the institution taking precedence over what might be in the best interests of the resident.
Is Marijuana the Effective and Humane Solution to Dealing with Dementia?
Research on the prevention of neurological decline is readily available, but how do you help people after Alzheimer’s disease and dementia have been diagnosed? Currently, medical researchers are working to determine whether or not medical marijuana might be a good fit for people living with dementia or Alzheimer’s. What they are discovering provides hope that marijuana could be the alternative to the administration of psychotropic medications.
The Science of Degenerative Brain Disease:
In order to comprehend how Alzheimer’s and dementia treatment works, it’s important to first understand what researchers know about degenerative neurological conditions.
In a healthy brain, neurons fire messages to one another. These messages govern the actions and processes of both the brain and the body. When a person develops Alzheimer’s disease, neural communication is disrupted. It’s normal for the brain to shrink somewhat with age, but in a person with Alzheimer’s disease, brain deterioration far beyond normal aging occurs. In the initial stages of Alzheimer’s, patients experience memory issues. As the disease progresses, patients experience changes in reasoning and behavior. Unfortunately, Alzheimer’s disease is progressive and eventually fatal.
Dementia isn’t a disease—it’s a condition that can include many symptoms, such as changes in reasoning, memory, attention, focus and other cognitive tasks. About half of the population in their 80’s have some symptoms of dementia. The degree to which a person experiences dementia can vary. Many people with the condition experience some heavy-symptom days as well as some light-symptom days. Alzheimer’s disease is a form of dementia.
Traditional Dementia and Alzheimer’s Treatments
Behaviors common to Alzheimer’s and dementia can include anger and aggression, anxiety, suspicion, delusions, and agitation. Sometimes, triggers for these behaviors are difficult to identify. Other times it’s easier to pinpoint a trigger such as loud noises, a change in environment or some forms of overstimulation. For behavior modification purposes the first go-to for many healthcare providers is the use of psychotropic drugs.
Family members and caretakers can modify a person’s environment by lowering the likelihood that something might trigger unwanted behavior. Other times, these issues are impossible to avoid. Alzheimer’s and dementia patients living in managed care facilities have little if any control over their environment.
Traditional treatments used for behavior management can mitigate unwanted behaviors, but can also make it difficult for the patient to express themself. Many families feel a sense of frustration when it comes to deciding how to treat their loved ones living with degenerative neurological conditions. While they may want to provide their family member with an environment free from agitation and stress, they also want them to be as present as possible in the time they have remaining.
Thankfully, research indicates that medical marijuana may be an alternative to the use of psychotropic drugs.
Marijuana and the Brain
In people with and without dementia, marijuana can be an effective tool in managing anxiety, stress, and agitation. Our brain contains a chemical called anandamide that works similarly to THC, the active ingredient in marijuana, that causes a “high” in the body and/or the brain. When a person ingests marijuana, the brain recognizes THC as anandamide. THC binds to cannabinoid receptors and causes a change in the way the brain functions.
For many, the ingestion of THC results in a calm feeling, but not always. There are other factors determining how a person might respond to marijuana ingestion such as body fat levels, environment, genetics, and age. A person’s general mood can also play a role in how their brain and body respond to marijuana.
How Medical Marijuana Could Help People Living With Dementia and Alzheimer’s
Research on medical marijuana for easing agitation and behavioral modification is in the early stages, but researchers are hopeful that medical marijuana could eventually replace psychotropic drugs for some patients.
Psychologist and neurologist Dr. Danielle Goldfarb of the Banner Alzheimer’s Institute claims that research on medical marijuana for dementia patients is promising. Goldfarb states, “There is not much research yet, but what we do have suggests that marijuana can have a calming effect on some of the behavioral symptoms of dementia. The synthetic form, Nabilone, also showed positive results in one recent study.”
A 2019 study showed that many patients experienced a decrease in agitation and other behavioral changes associated with degenerative neurological conditions. There is also some promise for the use of medical marijuana to actually fight the cognitive decline associated with Alzheimer’s and other forms of dementia. According to the Psychiatric Times, “Some research suggests that marijuana’s active alkaloids, the cannabinoids, can mitigate Alzheimer disease progression through neuroprotective blockade of microglial activation.”
On a cautionary note, there is a danger that use of marijuana can interfere with some medications and might actually worsen certain conditions such as a reported bleeding risk in combining marijuana and warfarin. Another case reported a myocardial infarction attributed to the combination of marijuana with sildenafil.
Some researchers and dementia advocacy organizations caution against the blanket use of marijuana in all dementia cases, as the use of marijuana may exacerbate memory issues. If a dementia patient is prescribed medical marijuana to help calm their symptoms or slow their cognitive decline, it’s important that they work closely with their memory care physician. You want to ensure that the treatment is slowing down—not speeding up—the progression of the condition.
As the controversy continues, Sunnybrook Hospital in Toronto studied the use of Nabilone, a synthetic form of tetrahydrocannabinol or THC, the psychoactive ingredient in cannabis. Used to assess the treatment of agitation in Alzheimer’s patients, it was found to significantly decrease levels of agitation much to the relief of caregivers. Patients received Nabilone over a period of 6 weeks followed by a one-week break and then were given 6 weeks of a placebo. The outcome: “Nabilone treatment was associated with a clinically and statistically significant reduction in agitation over six weeks, compared to the six weeks on placebo,” says Dr. Lanctot, who led the study. “Also, caregiver distress was significantly lower.”
Finally from Israel comes word of the cannabis research Dr David (Dedi) Meiri is conducting in his lab at the Technion-Israel Institute of Technology. Dr. Meiri is hopeful as to the promise cannabis holds for reducing agitation associated with Alzheimer’s and dementia: “I think that one of the things that is still not being treated with cannabis … and I really, really believe in it, and in my lab I have phenomenal results, is dementia and Alzheimer’s.”
Can the Use of Cannabis Chemovars Reduce Amyloid Plaques In The Brain?
Most encouraging in Dr. Meiri’s research was the finding that not only will certain chemovars treat agitation and aggression in Alzheimer’s and dementia, but this:
“We screened a lot of cannabis chemovars and defined a few that are reducing the amyloid plaques in the brain. We also identified the mechanisms that are activated in the brain, how this occurs, and why they are reducing the plaques. We have very strong results showing improvement in the pathology of the disease in mice with quite advanced Alzheimer’s after treatment with specific molecules of cannabis. This includes improvements in the damage from the amyloid plaques in the brain and the neurons that were treated with the specific cannabis molecules, as well as improvement in their behavior as evidenced through various tests.”
Although Dr. Meiri acknowledges that these experiments involved mice, it is a start and the anecdotal evidence is encouraging and compelling. Marijuana’s stigmatization appears to be giving way to scientific research into and optimism about the plant’s healing potential.
Does medical marijuana hold Promise for Alzheimer’s and dementia patients? The jury is still out, but how I wish I could have spared my mother the numerous pharmaceuticals she was administered to “control” her agitation over a decade of living with dementia. How I wish there had been something to reverse or arrest her dementia. And how I wish the known side effects of antipsychotics had resulted in a more cautionary approach to their widespread use. Let us hope that marijuana might provide safe therapeutic value without the awful side effects of current medications.
