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The Therapeutic Evolution Of THC: From Recreational Use To Pharmaceutical Ingredient
As the field of THC-based medicine continues to evolve, the possibilities for improving patient outcomes and quality of life are endless.
In recent years, the perception of tetrahydrocannabinol (THC), the primary psychoactive compound in cannabis, has undergone an impactful shift. Once synonymous with recreational cannabis use and the "high" it produces, THC is now emerging as a promising pharmaceutical ingredient with potential therapeutic benefits across a range of medical conditions. This transformation is driven by groundbreaking research and development efforts aimed at harnessing the therapeutic potential of THC, paving the way for its integration into mainstream medicine as a pharmaceutical ingredient.
The pharmaceutical industry's interest in THC stems from a growing body of scientific evidence supporting its potential therapeutic effects. Research is building to show how THC interacts with the body's endocannabinoid system (ECS), a complex network of receptors and neurotransmitters that play a crucial role in regulating various physiological processes. By targeting the ECS, THC has shown promise in addressing a wide range of health conditions, including chronic pain, inflammation, nausea and muscle spasticity.
Targeted TreatmentsOne of the key drivers of the pharmaceutical industry's interest in THC is its potential as an alternative to traditional pain medications, particularly opioids. Chronic pain is a significant public health concern, affecting millions of people worldwide and contributing to the opioid crisis. THC-based medications offer a promising alternative, with studies suggesting that they may help reduce the use of opioids and improve pain management outcomes. One study led by Dr. Yasmin Hurd at Mount Sinai has explored the potential of cannabis as a substitute for opioid-based pain medication.
THC has also shown potential in the treatment of various neurological disorders, such as epilepsy and multiple sclerosis. In epilepsy, THC has been studied for its anticonvulsant properties, with some research suggesting that it may help reduce the frequency and severity of seizures. Similarly, in multiple sclerosis, THC has been investigated for its ability to reduce muscle spasticity and improve mobility.
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In addition to its therapeutic potential, THC also presents opportunities for drug discovery and development. The unique chemical properties of THC make it a candidate for the development of novel medications. For example, THC has been shown to have anti-inflammatory, antioxidant, and neuroprotective properties, making it a target to study for treating conditions such as Alzheimer's disease and Parkinson's disease.
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The development of THC-based pharmaceuticals is also driving innovation in drug delivery methods. Traditional cannabis consumption methods, such as smoking, are not suitable for pharmaceutical use due to concerns about dose control and delivery. As a result, pharmaceutical companies are exploring alternative delivery methods, such as oral capsules, inhalers and transdermal patches, to ensure precise dosing and consistent effects.
As the Vice President of Marketing at Brains Bio, a player in the cannabinoid-based pharmaceutical industry, I have had the privilege of witnessing firsthand the transformative potential of THC in medicine. Our company focuses on developing narrowly tailored pharmaceutical products that address evolving patient needs, and THC plays a pivotal role in our research and development efforts.
One of the challenges that we and others in the industry face in innovating with THC is navigating the complex regulatory landscape. The legal status of cannabis and its derivatives varies widely across jurisdictions, which can impact the ability to conduct research and bring products to market. Additionally, there is a need for more standardized testing and quality control measures to ensure the safety and efficacy of THC-based medications.
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Looking ahead, I believe the industry is poised for significant growth and innovation. In the next five years, I envision an expanded role for THC in mainstream medicine, with more targeted therapies and advanced drug delivery systems. As research continues to uncover the therapeutic potential of THC, we can expect to see a wider range of conditions being treated with cannabinoid-based medications.
The transformation of THC from a recreational substance to a pharmaceutical ingredient represents a significant paradigm shift in our approach to healthcare. With continued research and development, THC-based medications have the potential to greatly impact the treatment of various health conditions, offering patients safe, effective, and alternative treatment options. As the field of THC-based medicine continues to evolve, the possibilities for improving patient outcomes and quality of life are endless.
Anticholinergic Medications
Medically reviewed by Smita Patel, DO
Anticholinergic drugs are drugs that block the action of acetylcholine—a chemical messenger in your brain that plays a role in memory, learning, and muscle movement. These drugs affect your brain and muscles in a variety of ways. That said, they can help treat several health conditions ranging from Parkinson's disease or depression to allergies or nausea.
You can take these drugs via an oral pill. While these drugs require a prescription, some are available over the counter.
What Do Anticholinergics Do?Anticholinergics block acetylcholine signaling. Acetylcholine is particularly important for your parasympathetic nervous system. The parasympathetic nervous system is part of the nervous system that regulates your body when you are resting and relaxed. Blocking acetylcholine affects several muscles in your body that aren't normally under your conscious control, like ones in the gastrointestinal tract, lungs, urinary tract, or eyes.
In general, anticholinergics help your muscles be more alert and less relaxed. For example, these drugs may help your pupils dilate (to take in more light) or slow down muscle contraction in the gastrointestinal tract (to slow down digestion). These medications work quickly—generally between a few minutes and a couple of hours.
Types of Anticholinergic DrugsThere are several anticholinergic drugs available and the one that you receive will depend on the underlying condition(s) you have. You can take most anticholinergics via an oral pill, but certain subtypes have different medication routes. Consider the following:
Condition
Anticholinergic Subtype
Medication Examples
Administration Route
Depression
Antidepressants
Elavil (amitriptyline), Anafranil (clomipramine), and Pamelor (nortriptyline)
Oral pill
Schizophrenia or bipolar depression
Antipsychotics
Thorazine (chlorpromazine), Clozaril (clozapine), and Zyprexa (olanzapine)
Oral pill or injection
Nausea
Anti-nausea drugs
Compro (prochlorperazine), Phenergan (promethazine), and Maldemar (scopolamine)
Oral pill or injection
Allergies or nasal congestion
Antihistamines
Benadryl (diphenhydramine)
Oral pill or liquid
Insomnia or motion sickness
Antihistamines
Dramamine (meclizine), Dimetapp (brompheniramine), and Vistaril (hydroxyzine)
Oral pill or skin patch
Overactive bladder
Antispasmodics
Oxytrol (oxybutynin), Enablex (darifenacin), Toviaz (fesoterodine), and Urispas (flavoxate)
Oral pill
Parkinson's disease
Anti-Parkinson's agents
Cogentin (benztropine) and Artane (trihexyphenidyl)
Oral pill or injection
Irritable bowel syndrome
Antispasmodics
Bentyl (dicyclomine) and Hyosyne (hyoscyamine)
Oral pill
Muscle spasms
Muscle relaxers
Amrix (cyclobenzaprine) and Norflex (orphenadrine)
Oral pill
Seizures
Anti-seizure drugs
Tegretol (carbamazepine)
Oral pill
Gastroesophageal reflux disease
H2 blockers
Tagamet (cimetidine)
Oral pill
Slow heart rate
Antimuscarinic agents
AtroPen (atropine) or Tiazac (diltiazem)
Oral pill or injection
High blood pressure
Diuretics
Lasix (furosemide)
Oral pill
Many other medications may have mild to moderate anticholinergic effects. These effects can add up if you are taking multiple drugs. Ask your pharmacist or healthcare provider if you are unsure whether any of your prescription or over-the-counter (OTC) drugs are anticholinergics.
Potential Side EffectsBecause they affect the nervous system and muscles all over the body, anticholinergics can have several potential side effects. Side effects are more likely to occur if you take a high dose of anticholinergic drugs.
Mild potential side effects may include:
These side effects usually go away promptly after you stop taking the drug. However, you should never start or stop using a medication without the consent of your healthcare provider.
Drugs with high anticholinergic properties can sometimes have more severe side effects, like:
While these side effects usually improve after you stop taking the drug, it can take some time to recover from complications (e.G., an infection) in some cases. You are also more likely to have severe side effects if you have underlying health conditions.
Other ConsiderationsThe risks of serious side effects are generally greater in people 65 or older. Older adults using anticholinergics may also have a higher risk of poorer physical and mental functioning, an increased risk of falls, heart problems such as a heart attack, and increased rates of death. These risks are particularly high for older adults who live with underlying health conditions like heart disease, balance problems, or cognitive impairment.
For these reasons, experts recommend minimizing the use of anticholinergics in older adults. In some cases, the benefits of a specific drug are worth it. But other times, a different treatment approach is helpful.
Scientists have developed alternatives with less anticholinergic activation, which may be safer for older adults. Ask your healthcare provider about these options:
Prozac (fluoxetine) for depression
Seroquel (quetiapine) for schizophrenia
Zyrtec (cetirizine) for allergies
Sinemet (levodopa) for Parkinson's disease
Tylenol (acetaminophen) for muscle spasms or pain
Myrbetriq (mirabegron) for an overactive bladder
You may want to discuss your full medication list with your healthcare provider, including potential over-the-counter anticholinergic drugs, like Benadryl (diphenhydramine) or Tagamet (cimetidine). If your age or other health conditions put you at risk of serious side effects, it's important to discuss these concerns with your provider before using anticholinergics.
If you just started taking an anticholinergic and experience side effects, like difficulty urinating or changes to your emotional well-being, ask your provider if stopping the medication or changing the dosage is right for you.
A Quick ReviewAnticholinergics are medications that block acetylcholine—a chemical messenger that affects the brain, muscles, and overall nervous system. Several medications qualify as anticholinergics.
Many people use these drugs for a variety of conditions, such as depression, nausea, allergies, muscle spasms, and Parkinson's disease. However, these medications may pose significant side effects in older adults, so it's important to talk with your healthcare provider before starting treatment.
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MVH Uses Nitrous Oxide To Bring Patients Quick Pain Relief
As part of a federal spending bill recently signed by President Joe Biden, Massachusetts Sens. Elizabeth Warren and Ed Markey helped secure much-needed funds for Martha's Vineyard Hospital.
The federal money will assist the hospital in meeting the growing demand for healthcare on the Island for both its residents and visitors. The funds will be used to update equipment for the operating room, acute-care unit, and the radiology department, as well as expanding its use of nitrous oxide.
The hospital first introduced nitrous oxide as a treatment for severe pain, particularly for pediatric patients, in the Emergency Department last year.
Dena Kostka, a physician assistant in the Emergency Department, spearheaded the program at Martha's Vineyard Hospital after previously using the treatment in the pediatric ER at Newton- Wellesley Hospital.
The nitrous oxide delivery system is a pneumatically driven gas mixer designed to deliver a mixture of 50 percent oxygen and 50 percent nitrous oxide to patients to relieve moderate and temporary pain, and to decrease anxiety. It takes effect quickly (50 to 60 seconds), with variable pain relief, and has a rapid clearance, with a half-life of about five minutes. It acts as an anxiolytic, leaving the ventilatory and circulatory functions unaffected.
"Many times, other forms of pain control, such as lidocaine for anesthetizing a wound, are still needed prior to suturing, but the nitrous makes the injection less painful, and the remainder of the procedure less stressful, particularly for small children," said Kostka, who began moonlighting at Martha's Vineyard Hospital in 2017, and came aboard full-time in 2019. "I found nitrous to be an invaluable tool for helping patients with anxiety through otherwise painful procedures, without needing to be sedated."
The machine used to deliver nitrous oxide is kept in the Emergency Department, but it can be used in Maternity as well.
"Having nitrous available has multiple advantages: most importantly, improved patient experience in regard to decreasing anxiety and pain associated with certain procedures, or the ER experience in general," said Kostka.
Other advantages include:
Prior to nitrous, ED staff would utilize more antianxiety medications, conscious or full sedation, as well as the "baby burrito technique," where the child is wrapped in a sheet to minimize movement. While that technique is still sometimes needed, nitrous can provide pain relief for children over a year old.
The federal funding will also add 10 telemetry units in the hospital's acute-care wing to allow for continuous heart monitoring for at-risk patients. The hospital currently has three telemetry units, which have been dedicated to the Intensive Care Unit and Emergency Department.
The funds will also be used to purchase a fiber-optic surgical system that will help surgeons navigate lighting and imaging, as well as purchasing a fluoroscopy unit, which will increase the hospital's digital imaging capability, allowing faster results and better access for patients.
"These investments, made possible through federal funds, include equipment and infrastructure that will help us better confront significant challenges, including increased inpatient admissions for behavioral health, longer postsurgical stays, and patients with more acute illnesses," said Claire Seguin, chief nurse and vice president of operations.
Health Beat is sponsored by Martha's Vineyard Hospital. It informs and advises on health issues, shares health tips, and helps the community to become better acquainted with Martha's Vineyard Hospital, the physicians, and staff. For more information, visit mvhospital.Org.
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