Natural Awakenings reached out to a variety of local professionals for insight on the medical marijuana system in Florida. This is the second article in our three-part series. 

Cannabis is a plant-based product believed to have first been used medicinally around 400 AD. Evidence suggests it was used 5,000 years ago in what is now Romania. It was used in the US during the 19th and 20th centuries as a patent (over the counter) medicine. Since that time, cannabis has undergone federal restriction, became a controlled substance and then began legalization starting with the state of California. Since 1996, 36 states have enacted legislation governing medical cannabis for sale and distribution, including Florida. 

“The discovery and synthesis of the THC (tetrahydrocannabinol) molecule isolated from Cannabis is credited to Israeli scientist Dr. Raphael Mechoulam in 1964,” says Jessica McCain, MD, of Southern Comfort Marijuana Clinic in Port St. Lucie. “By 1992, it became understood that the plant THC acts on the same human version endocannabinoid receptors as AEA (anadamide), which is one way how Cannabis is used as a medicinal plant.”

Endocannabinoids and their receptors are found throughout the human body in the nervous system, internal organs, connective tissues, glands, and immune cells. “This is a system that is very important. It maintains homeostasis in our body, which has to do with sleep, appetite, memory, mood; basically, this system balances the body,” says Alita Sikora, MD, of Sikora Integrative Medicine in Vero Beach. 

Studies indicate that endocannabinoid system (ECS) deficiencies are related to multiple sclerosis, Huntington’s disease, Parkinson’s disease, anorexia, chronic motion sickness, and failure to thrive in infants

Studies indicate that endocannabinoid system (ECS) deficiencies are related to multiple sclerosis, Huntington’s disease, Parkinson’s disease, anorexia, chronic motion sickness, and failure to thrive in infants. It is also suspected that migraine, fibromyalgia, irritable bowel syndrome and related conditions are also associated with deficiencies.

Medical marijuana is being used to help supplement when someone is low on their natural production of endocannabinoids in the body. “Clinical Endocannabinoid Deficiency Syndrome refers to when you are actually depleted in your natural production of endocannabinoids. This can lead to downstream disease, because this body system actually regulates many chemicals that influence the function of appetite, pain-perception, mood, sleep, and memory,” says Dr. McCain.

One of the chemicals the ECS regulates is dopamine. Studies related to Parkinson’s’ disease have shown that under dopamine depleted conditions, proper motor function is dependent on adequate levels of both acetylcholine and dopamine. Findings suggest that progressive dopamine deficiency reduces the activity of striatal cholinergic interneurons (the main source of acetylcholine), resulting in progressive motor difficulties.

“Marijuana helps with the nervous system balance serotonin and noradrenaline levels, shorten sleep onset, reduce inflammation, improve appreciation of food, provide tolerance for emotional triggers.  So basically, think about it like a vitamin or a supplement that you're using to treat a naturally occurring or disease occurring deficiency,” says Dr. McCain.

Researchers have identified two different receptors in the ECS that can accept cannabinoids. “There are at least 400 different chemicals called cannabinoids. Each one has a different effect on the body. While there are many receptors in the body that cannabinoids will bind to, it is thought the main medicinal effects of marijuana are happening when the cannabinoids from the plant bind to the CB1 and CB2 receptors,” says Dr. Sikora.

A sense of wellbeing or calm occurs when the ECS’s natural cannabinoids bind to the CB1 receptors in the brain that have to do with relaxation. “You have mainly CB1 receptors in your brain. That's thought to be why people get benefits with mood, anxiety, sleep and pain,” says Dr. Sikora. 

“Worldwide, the three most common reasons to use cannabis would be number one: pain, number two: anxiety and depression, and number three insomnia. A lot of our patients actually have that trifecta because the mind-body experience is very interconnected,” says Dr. McCain.

Medical marijuana is an increasingly popular alternative to traditional pain-relieving medications, including opioids, as well as for insomnia and anxiety medications.

Medical marijuana is an increasingly popular alternative to traditional pain-relieving medications, including opioids, as well as for insomnia and anxiety medications. “In my experience, I have had people be able to reduce the amount of their sleeping medications (benzodiazepines),” says Dr. Sikora. “I’ve also been able to help people get off anxiety medications such as Xanax and Ambien, which have a risk of addiction.”

Fighting inflammation is another use for medical marijuana, leading to a reduction in symptoms for a variety of conditions. Disorders stemming from inflammation include autoimmune diseases such as rheumatoid arthritis, inflammatory bowel disease, Crohn’s disease and fibromyalgia.

“You have CB2 receptors in the lungs, the gut, the liver, and the colon. CB2 is thought to be more beneficial for the immune system and for inflammation,” says Dr. Sikora. Both CB1 and CB2 receptors are found in the digestive tract, an indication of why medical marijuana has been effective for inflammatory bowel disease.

A 2016 research paper from The Journal of Pain, U.S. Association for the Study of Pain, found that marijuana use for cancer pain led to a 64-percent reduction in opioid use, improved quality of life, and caused fewer medication side effects. It also led to participants using fewer medications.

Dr. McCain says that medical marijuana is extraordinarily successful for cancer patients. “I would encourage most patients who are undergoing cancer treatment to use cannabis. One, for the palliative benefits because it can allow them to succeed and do the max tolerable doses of chemotherapies.” Cannabis has also been shown to help control the spread of cancer.

“I have tons of success stories…this is an excellent therapy modality. I love seeing our educational center full of such a variety of different people,” says McCain. “It's a pretty amazing time right now to be in the Cannabis world.”

“I see many people with chronic pain conditions such as, rheumatoid arthritis, osteo arthritis, stroke related pain, fibromyalgia. I also see a lot of people with insomnia, PTSD, anxiety and depression,” says Dr. Sikora. “They're all getting some benefits from medical marijuana.”

Hear more from these doctors in our Natural Inspiration Podcast interviews:

How Medical Marijuana Can Help the Body [Video Podcast] - Episode 44

Take a peek into the world of medical marijuana. If you think you might benefit from cannabis, this podcast is a great introduction. Discover what conditions are well-suited for cannabis ... Read More » 

Medical Marijuana and Mind-Body Health Connection [Video Podcast] - Episode 45

Dr. Alita Sikora shares why medical marijuana can be a helpful option for addressing pain, insomnia, anxiety and much more. Read More »