Medical Cannabis for Parkinson's Disease in Canada

Living with Parkinson’s Disease presents unique challenges that affect nearly every aspect of daily life. As a degenerative neurological disorder that primarily affects the motor system, Parkinson’s symptoms appear slowly but become progressively more pronounced over time, making simple tasks increasingly difficult and impacting overall quality of life.

Over 100,000 Canadians are currently living with Parkinson’s Disease, which equates to one in every 500 people in Canada. Concurrently, over 6,600 new cases of Parkinson’s Disease are being diagnosed each year. With cases of the disease on the rise, more research is needed to determine the best treatments for managing symptoms and improving quality of life.

While traditional medications can help, many come with significant side effects that some patients find difficult to tolerate. Subjective reports from patients suggest that medical cannabis may be an effective way to manage the disease, especially in later stages, offering symptom relief with potentially fewer adverse effects.

Parkinson’s Disease is an illness that affects the brain in an area called the substantia nigra. The substantia nigra is responsible for dopamine production in the brain, which eventually carries signals to other parts of the body.

When cells in the substantia nigra begin to die, dopamine levels decrease, disrupting the normal function of the brain circuits that control movement. This disruption leads to the characteristic motor symptoms of Parkinson’s Disease.

How Parkinson’s Disease Progresses

People who suffer from Parkinson’s Disease may not recognize symptoms in the beginning, but as brain cells in the substantia nigra start to die, symptoms become more pronounced. The disease typically progresses through several stages:

Early Stage

• Mild tremors, usually on one side of the body
• Changes in posture, walking, and facial expression
• Symptoms may be inconvenient but don’t typically interfere with daily activities

Moderate Stage

• Symptoms affect both sides of the body
• Walking problems and poor posture become more noticeable
• Daily tasks become more difficult but independence is still possible

Advanced Stage

• Significant difficulty with movement
• Potential freezing when walking
• Increased risk of falls
• Greater dependency on caregivers

Common Symptoms of Parkinson’s Disease

Parkinson’s Disease manifests through a variety of motor and non-motor symptoms:

Motor Symptoms

• Tremors, often beginning in the hands
• Bradykinesia (slowed movements)
• Rigid muscles
• Impaired posture and balance
• Loss of automatic movements (such as blinking or swinging arms while walking)
• Speech changes (soft, slurred, or hesitant speech)
• Writing changes (smaller handwriting)

Non-Motor Symptoms

• Cognitive changes (memory issues, problem-solving difficulties)
• Depression and anxiety
• Sleep disturbances
• Fatigue
• Constipation
• Bladder problems
• Pain
• Loss of sense of smell

These symptoms can significantly impact daily functioning, independence, and overall quality of life, making effective treatment options crucial for those living with the condition.

There is no one specific test to determine if an individual has Parkinson’s Disease. A patient with symptoms of Parkinson’s Disease should consult with a Neurologist to determine if they meet the criteria for the disease. Neurologists will perform a series of physical and neurological examinations, as well as take a thorough medical history on each individual. If the exams, symptoms and background meet certain criteria, the patient will be diagnosed with Parkinson’s Disease.

It is important for doctors to rule out other conditions that may produce similar symptoms, so it is important to see a medical professional early if any of these symptoms arise.

Risk Factors for Parkinson’s Disease

Several factors may increase the likelihood of developing Parkinson’s Disease:

• Age: Parkinson’s Disease usually appears in middle or late life and risk increases with age
• Heredity: Having close relatives with Parkinson’s increases risk slightly
• Sex: Men are more likely to develop Parkinson’s than women
• Exposure to toxins: Ongoing exposure to certain herbicides and pesticides may increase risk
• Head injuries: Traumatic brain injury may increase risk

The endocannabinoid system plays a key role in regulating the lifespan of a cell, which is something vitally important in the central nervous system (CNS). Research suggests cannabis compounds may interact with this system in ways that could benefit Parkinson’s patients.

Potential Mechanisms

1. Neuroprotective effects: A study in the Journal of Neurochemistry demonstrated the neuroprotective effects of cannabidiol (CBD) in patients with Alzheimer’s. Alzheimer’s and Parkinson’s are similar disease processes in that they are both neurodegenerative. Therefore, cannabis may have a neuroprotectant effect and may slow down cell death in the brain.
2. Anti-inflammatory properties: Cannabinoids may reduce neuroinflammation, which plays a role in Parkinson’s progression.
3. Dopamine regulation: Some research suggests cannabinoids might influence dopamine production or activity.
4. Antioxidant effects: CBD and THC have been shown to have antioxidant properties that may help protect brain cells.
5. Symptom relief: Cannabis compounds may directly address specific symptoms like tremor, rigidity, and pain.

CBD and THC have both been shown to provide therapeutic promise for Parkinson’s Disease during pre-clinical trials, and further investigation is warranted. Additional research may shed light on the correct dosing of THC and CBD individually or combined to most effectively manage Parkinson’s Disease at different stages.

Daily cannabis use may also reduce the number of cell deaths in the substantia nigra and prevent severe symptoms from occurring in later stages of Parkinson’s Disease.

There are numerous subjective reports of how regular medical cannabis use has improved patient’s symptoms. It has been shown to reduce tremors, decrease muscle spasticity, and improve balance.

One U.K. woman, Diane Lee, reported that taking daily cannabis oil cured her tremors and allowed her to come off of other medications which were creating horrible side effects. Ms. Lee had been taking sertraline for several years and found that she could not hold things or sleep adequately due to the medication’s effects. Ms. Lee reported that she takes 2 drops of cannabis oil in the morning, and two at night, and has found that the dose is effective at controlling her tremors. Within 10 minutes of taking the cannabis oil, Ms. Lee is visibly calmer and does not shake.

Cannabis consumption also demonstrates analgesic effects in the body according to the European Journal of Internal Medicine. After six months of daily cannabis consumption, 18% of patients reported that they had reduced or eliminated opioid medications. After six months, 94% of patients reported an improvement in their condition. Cannabis may very well assist patients in managing their condition without the use of addictive opioids and other habit-forming medications.

For Canadians struggling with Parkinson’s Disease, medical cannabis may offer several potential benefits:

Primary Symptom Management

Many patients report improvements in core Parkinson’s symptoms, including:

• Reduced tremors
• Decreased muscle rigidity and stiffness
• Improved balance and coordination
• Better sleep quality
• Reduced pain
• Less anxiety and depression
• Enhanced overall comfort and quality of life

Complementary Therapy

Others find cannabis helpful as a complementary treatment to address the limitations or side effects of conventional Parkinson’s treatments:

• Alternative for those who cannot tolerate traditional medications
• Reduced reliance on medications with severe side effects
• Management of side effects from other Parkinson’s treatments
• Support during periods of symptom flare-up