LBD and Marijuana, Part 1

Now that marijuana (MJ) is legal in many states, we are beginning to get questions and comments about its use.

Bottom line, medical MJ is probably safer for the person with LBD than most pain, anxiety, or behavior management drugs and is therefore worth considering. It is not a cure and probably won't work to improve cognition, even short term.

MJ is NOT an anticholinergic. This is perhaps its biggest attraction for LBD families. It doesn't block acetylcholine,  the main brain chemical that LBD attacks. Thus, MJ starts out being more compatible with LBD than many drugs, including most of those for pain, anxiety and psychosis.

But what about MJ's high? Couldn't that cause more problems instead of fewer? Well, it turns out that there are two types of MJ: Recreational and medicinal. MJ is a naturally grown plant, that produces several "cannabinoids" or chemical compounds, the two main ones being THC* and CBD*. In nature, these two compounds balance each other.

• THC is psychoactive, and can trigger a high, with hallucinations, paranoia and other psychotic behaviors. If a person is already displaying psychotic behaviors, such as hallucinations or anxiety, it may increase them. Although it is only mildly addictive chemically, it can be psychologically addictive. That is, it doesn't change body chemistry to where it requires more and more of the drug to get the same result the way alcohol does. However a person can become psychologically attached to the process of its use and the enjoyment of the high.
• CBD is an antipsychotic that acts to counteract the high caused by THC. In some cases, it may decrease already present BPSD* such as hallucinations, delusions, depression and anxiety. However, we believe that CBD's value in this area is more about what it isn't than what it is: it isn't psychoactive and it isn't addictive.

Plants can be bred selectively to produce varying amounts of each compound.

• Recreational marijuana is produced by cannabis plants bred to have such a high ratio of THC to CBD that the latter cannot stop the psychoactive qualities of the drug.
• Medicinal marijuana is produced by cannabis plants bread to have such a high ratio of CBD to THC that it prevents any psychoactive effects.
• Marinol, a synthetic marijuana, is mostly THC with no CBD at all.
• CBD oil is oil made from low-THC, high-CBD plants. So far as we know, there is no straight CBD product. That is not a bad thing. While both THC and CBD act to treat a variety of issues, THC, with its psychoactive qualities buffered, is often the most effective of the two.

Marijuana has long been used as an effective treatment for:

• Pain, including chronic nerve pain which is common with Lewy body disorders.
• Poor appetite
• Intestinal upsets, such as nausea.

Research is showing that it may also be useful:

• As an anti-inflammatory agent. It appears to block the release of cytokines, substances that signal the production of inflammation. Thus, it may help with autoimmune diseases such as arthritis.
• To decrease motor symptoms, such as tremor, rigidity and bradykinesia. The research for this is still very limited, but side effects appear minimal and so it might be worth a try. It only treats symptoms--its effect stops when the drug is no long used.
• For maintaining circadian (sleep) rhythms. CBD works to improve alertness, especially in lighted areas. Medical MJ may help with excessive daytime sleeping, but it should not be taken before bedtime. THC tends to promote nighttime sleep, but medicinal MJ probably won't be effective and the recreational MJ's psychoactive qualities make it a poor choice for someone with LBD.

Next week, more about marijuana, how to find it and how to use it.

Reference:
Medical cannabis. Wikipedia. https://en.wikipedia.org/wiki/Medical_cannabis

* Acronyms:
MJ: Marijuana, or cannabis. A plant grown for its psychoactive and medicinal qualities.
RMJ: Recreational marijuana
MMJ: Medical marijuana
THC: tetrahydrocannabinol, the cannabinoid or chemical compound in marijuana that provides a high.
CBD: cannabidiol, the cannabinoid in marijuana that does not provide a high.
BPSD: behavioral and psychological symptoms of dementia

LBD: Lewy body dementia
PlwD: person living with dementia
PlwLBD: person living with LBD
DLB: dementia with Lewy bodies
PDD: Parkinson's disease with dementia
MCI: mild cognitive impairment
MCI-LB: the form of MCI that precedes LBD

For information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

Treat? Oh Yes! Cure? Not Yet.

We love comments. Agree with us or disagree. That's great. But recently, we've been receiving comments from people advertising cures by this miracle herbal therapy or that patent drug. We cannot support such claims of a cure and no such comments will be published.

We support alternative and complementary therapies. We believe that such non-drug and drug-accompanied treatments can decrease symptoms and the need for drugs and increase quality of life. However, neither they nor any drug can, at this time, CURE diseases like Parkinson's, Lewy body dementia or Alzheimer's. These disorders are hidden for many years, with little or no symptoms, while the damage-causing proteins, such as Lewy bodies, grow and spread. By the time there are enough symptoms present for a diagnosis, the proteins are so numerous and widespread that a cure is as likely as one for Stage IV cancer.

A cure is coming, and some of the clinical trials now in the works sound very hopeful. For starters, researchers are working on ways to identify the presence of disease-causing proteins early on. This will mean that people who feel perfectly healthy will need to be tested...remember there are no symptoms for years!

Researchers are also working on ways to eradicate the damaging proteins, once they are found in the body. Started soon enough, there is hope that these treatments may actually provide a cure. Started after diagnosis, these same treatments could not promise a cure-- but they might decrease symptoms and improve quality of life. However all of this research has many years to go before it is available to the general public.

In the meantime, we will not publish comments advertising "cures." To do so is to encourage our readers to spend hope, money and effort uselessly. Instead, we urge you to investigate all the well-researched ways that non-drug therapies can improve the effectiveness of traditional drugs to decrease symptoms and increase quality of life for both the person with the disorder and their care partner.

* Acronyms:
LBD: Lewy body dementia
PlwD: person living with dementia
PlwLBD: person living with LBD
DLB: dementia with Lewy bodies
PDD: Parkinson's disease with dementia
MCI: mild cognitive impairment
MCI-LB: the form of MCI that precedes LBD
BPSD: behavioral and psychological symptoms of dementia

For information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

LBD and Football: How Do You Vote?

Last week's blog was about how repeated concussions from playing football can cause LBD symptoms to show up sooner and be more aggressive. But even if LBD isn't involved, CTE* is very likely to occur, causing its own type of dementia and an early death. I believe this is a cultural issue. By making football a national sport, by making the players heroes and stars, we show that we care more for our entertainment now than we do for their future health. As a culture, we are encouraging our sons to unwittingly trade their old age and their very lives for our entertainment. We've become a nation of people joyfully sending our own sons out into the arena to fight the lion of football.

And that's why I boycott football. I believe it is the individual person, you and I, who will eventually make the difference. Not the players, whose short term vision is on the adulation and money the get now, not on the, to them, unlikely chance that they will eventually have CTE. Not the NFL, that makes the big bucks on game. Not the coaches, who need to keep winning to keep their jobs. No, it is up to each of us. When we stop supporting the game, it will either change drastically or it will stop being worth playing.

One of the questions I get is, "Well, what about other sports. Boxing, for instance." Well, boxers use their fists as weapons. Football players use their heads. Even when the player leads with his shoulder, the head will absorb some of the impact. A recent article in our local newspaper reported that the average impact speed of a football player tackling a stationary player is 25 mph, compared to a professional boxer's punch of only 20 mph. If you deduct several mph for the average boxer's punch, the difference will be even greater.

One way that many of our local schools are trying to reduce concussions is by providing better helmets. This is no small thing; these helmets cost from $400 to $600 each! But the consensus is that even with the better helmets, concussions are likely to be an ever-present issue. It will continue to be an issue as long as players use their head as a weapon. The article suggests better education of coaches and players about the risks and coaching proper techniques, but it goes on to say that support for this is poor because "People are used to playing the way it is played."

Spectators are used to the violence and expect (demand?) it. I've never been a spectator sports fanatic. And so I'm at a disadvantage now, in my effort to boycott football. I can't say I used to love it but stopped when I learned how it damaged our children. But Jim, now, he really enjoys a good football game. He still watches. Yes, you can see how well my boycott is working. Even my husband, who has been active with Lewy body dementia since 2003, still watches football! But that means I can use him as a guinea pig. "Why do you watch?" I ask.

"It's exciting," he says.

"But, knowing what you know, how can you continue to watch?" I ask.

He shrugs. It's there. It will be there whether he turns the TV off or not. And so he turns it on.

I remember back to the 1980's when smokers were in the majority and it was considered bad form for non-smokers to complain. That changed when researcher found that smoking was bad, not just for the smoker, but for anyone around them. Non-smokers became more verbal. Restaurants started banning cigarettes. We voted higher taxes on cigarettes. People began to quit, one by one. Eventually, smokers became a minority.

I think we have to do the same with watching football. We have to accept our responsibility just as smokers had to accept theirs. Each person who watches football on TV or in a stadium helps to turn our young men into eventual dementia patients.

That's pretty extreme, you say? You say that this is the life they chose? That they get paid good money for it? Besides, I'm not responsible for these men. This is America. They have the right to choose to play or not. Who am I to stand in their way?

True. But, what young man really thinks about their old age at 18 or 20? Or believes that in a few years they will have dementia? Or turns down big bucks now because in 10, 20, 30 years they may have major health problems? We make it much too attractive!

Ah, you say. We aren't doing anything. It's the NFL that makes it attractive. That pays the big bucks.

Yes, but would they pay those big bucks if the TVs stayed off and the stadiums were empty? What are YOU going to do? How are you going to vote? Will you vote for more dementia, or less? You vote one way or the other every time you watch or don't watch a football game. You can't opt out. You DO vote. How are you voting?

Reference: Decker R: Better helmets still not solution to concussions. Cronkite News. Arizona Republic. The Weekend. 12.31.16.

* Acronyms:
LBD: Lewy body dementia
CTE: chronic traumatic encephalopathy

For information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.