Legislation recently passed in Maine allowing nurse practitioners to certify patients for cannabis use goes into effect this fall.
Jay Reighley, APRN, believes cannabis used appropriately under medical guidance is a first-line treatment for chronic pain, anxiety, insomnia and other neurological symptoms.
"Patients should not have to go down the slippery slope of long-term opioid or benzodiazepine use before discovering an herb that works better and is much safer," she said.
Reighley, a nurse practitioner at medical marijuana practice Integr8 Health in Falmouth, Maine, strongly encourages patients with Lyme disease who reside in a medical cannabis state to explore the symptom-management and potential disease-modifying effects the herb may offer. She discusses cannabis and its effect on Lime disease in the following interview.
ADVANCE: How can patients with Lyme disease benefit from cannabis?
Reighley: Based on pre-clinical and clinic research, and my own experience working with cannabis as a therapeutic agent for the last three years, I can say with confidence that cannabis is an excellent tool for ameliorating all of the aforementioned symptoms, especially if used with the appropriate dosage, delivery system and strain.
Cannabis is also much safer than many conventional approaches to management of Lyme symptoms, including opioids, benzodiazepines, neuroleptics and even NSAIDs. There is no lethal dose of cannabis, and under informed medical supervision, most side effects are mild and easily mitigated by adjusting the specifics of cannabis treatment.
In addition to symptom relief, it is possible that cannabis can modify the disease course of Borellia and other co-infections. Cannabinoids also have a similar ability to modulate inflammation in connective tissues, another important approach for Lyme patients with joint and connective tissue involvement.
ADVANCE: In what way is cannabis used to treat symptoms?
Reighley: Most patients get excellent results with surprisingly low dosages of cannabis. Inhalation can be useful due to its fast onset and easily titratable dosage. When inhalation is recommended, our patients use a cannabis vaporizer, which heats the oils to a temperature that allows them to be inhaled, but does not cause any combustion of plant material. Using a vaporizer removes the harms associated with smoking cannabis.
Other patients do well with liquid extracts of cannabis, called tinctures, or other forms, such as cannabis concentrate prepared in a capsule that can be swallowed.
There are various strains of cannabis that can be helpful, and there is a lot of collaboration between clinicians, growers and patients to continue to fine tune our treatment approaches. Some strains are better for pain, others better for insomnia, others better for anxiety.
ADVANCE: How does cannabis work to manage the symptoms of Lyme disease?
Reighley: For many patients and clinicians, it can be hard to believe that one herb can be effective at ameliorating such a wide variety of symptoms, including notoriously difficult-to-treat symptoms like neuropathic pain. I was also skeptical until I learned about the ubiquitous presence of the endocannabinoid system throughout the body, and its primary role in cellular homeostasis. It turns out all of us have been using cannabinoids in all our tissue and organs throughout our entire lives to keep ourselves healthy. We are hard-wired to respond to cannabinoids, and this is why taking exogenous plant-based cannabinoids have such a profound and versatile therapeutic effect.
ADVANCE: Who is able to administer this drug to patients?
Reighley: Each state has its own rules governing who can recommend cannabis, certify them for legal use and supply cannabis. In Maine, for example, a physician must provide certification, and the patient can access cannabis by growing their own, purchasing at one of the eight dispensaries, or purchasing from a caregiver, a grower (and often also a patient themselves) who can supply up to five patients with cannabis.
- Beth Puliti