Is getting high important for feeling better? A new study titled “Understanding Feeling High and its Role in Medical Cannabis Patient Outcomes” was recently published in the journal “Frontiers in Pharmacology” by researchers at the University of New Mexico. The study found that patients who reported feeling high also experienced 7.7% better symptom relief than those who did not report feeling high. Does getting high contribute to medical treatment? The researchers at UNM are the first to ask the question.
1,882 people recorded the results of 16,480 Cannabis using sessions. That calculates to an average of just more than eight recorded sessions over almost five years. Generally, I see this as a red flag. Most regular Cannabis users use daily to weekly. This study population is clearly different. The respondents reported feeling high 49% of the time. That’s an encouraging result. I would estimate, conservatively, that 75-80% of my patients are getting high. As Cannabis becomes popular and its medical benefits are realized, users may not wish to “get high” thus reflecting this study population. In this study, patient who got high reported 4.4% greater positive effects like “Relaxed” and “Chill”, as well 14.4% increase in negative effects like “Dry Mouth” and “Red Eyes.”
“Feeling high is poorly defined in the scientific literature,” explains senior author and associate professor of psychology, Jacob Vigil, “but it is generally associated with both impairment and feelings of euphoria. Typically, feeling high is assumed to be the goal of recreational use, but a limitation to Cannabis therapeutic potential. In this paper we test the validity of this assumption and find that feeling high may be an unavoidable component of using Cannabis medicinally. “
Definitively, this study found a positive association between feeling high and symptom relief. The analysis controlled for THC and CBD levels, dose, mode of administration, and symptom severity. There were other interesting associations. Smoking a pipe appears to be a better predictor of symptom relief than either smoking a joint or vaporizing the flower. However, the major discovery of this study is that higher THC levels are not significant predictors of symptom relief and only become significant once feeling high is included in the analysis. As well, THC is a significant and independent predictor of negative effects. These results suggest that feeling high may be a fundamental component to effectively using Cannabis as medicine.
It's all in your head, some might say. They may partially be right. The benefit of Cannabis includes a neuro-emotional component. Thus, a better perspective may be not to separate emotions from physiology. The nexus of the two worlds appears to be where Cannabis has its influences.
Our Cannabis research group, the CESC, describes the challenges of understanding Cannabis therapeutics as the “many-to-many problem.” The study’s lead author and associate professor of economics, Sara Stith, also highlights the challenges of using Cannabis as medicine. “Cannabis products are extremely variable in their phytochemical composition and patients vary extensively. These complexities suggest that the future of Cannabis-as-medicine lies in highly customized treatments rather than the conventional pharmaceutical model of standardized dosing.”
This study concludes with some important recommendations.
But Are the Costs Sustainable?
What happens early, happens often. In California, we’ve realized for quite some time that Cannabis is effective medicine. Our laws have progressed to make Cannabis more accessible, yet some things haven’t changed. Cannabis patients continue to exchange personally grown Cannabis at a high rate. Personal gardens are an immediate solution to high cost, low quality dispensary products. Can’t start a garden or don’t have a green thumb? Find a neighbor who is willing to share or better yet, sign up for a MediCann Membership and join their Patient Exchange Program.
Researchers in New Zealand are just discovering what we already know in California. They interviewed 213 people enrolled in New Zealand’s Medical Cannabis program. Participants were asked about the quality of Cannabis they used and its effectiveness. Findings were published in the journal Drugs, Habits, and Social Policy.
As high as 96% reported that cannabis helped them with their medical conditions. Almost half (49%) said they were able to reduce or stop taking prescription drugs. Sounds to me like competition for the pharmaceutical industry. The most common therapeutic use of medical cannabis was pain relief where 96% of participants said it helped reduce their pain. Cannabis also helped those who had difficulty sleeping (97%) and those with mental health issues (98%). Of the participants who took Cannabis for other reasons, such as autism, attention deficit disorder, post-traumatic stress disorder, and difficulty eating, 98% found it helpful.
According to co-author Geoff Noller,"This both reinforces that they experienced some actual effect from using Cannabis in that they ceased or decreased other medications with recognized efficacy, and in the case of many of these other medications, they reduced their use of potentially more problematic medications.” Do we need more study? Sure. But the empirical evidence is clear. As medicine, Cannabis works.
Many New Zealanders find medical cannabis difficult to obtain, relying on the personal or illegal market. According to another study, only 6% of Kiwis who use Cannabis acquire it through their medical cannabis program. Many New Zealand doctors won’t prescribe medical cannabis. There are a limited number of products on the market, keeping prices high. CBD oil in New Zealand can cost a patient $150-350 per month, with other Cannabis products costing even more.
"At present, current regulations create problems for many New Zealanders who otherwise report positive benefits from their use of medicinal cannabis,” says Noller.
In my opinion, Cannabis users are spun by mainstream industry that has yet to decide how to capitalize. Legal products are scarce, in poor quality, and their costs are high, in New Zealand, in California, everywhere. The current cost of one gram of flower per day can be on average $300 per month or more. According to CESC Dosing ProjectTM results, pain or disordered sleep best improve with a smoked or vaporized dosage of 1 gm. These costs are not sustainable for those with low means and who require treatment every day.
Jean Talleyrand, M.D.,