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CANNABIS and GLAUCOMA

"Marijuana and its derivatives or analogues might be useful in the treatment of glaucoma, of nausea and vomiting brought on by cancer chemotherapy, and of asthma." ~Institute Of Medicine  "Marijuana and Health," 1982

My brother has had glaucoma since a childhood accident. We were playing tag and I accidently shoved him into a bramble bush. The many stickers that lodged in his eye eventually blinded him and he began to test positive for glaucoma shortly afterwards. His eyesight was so poor it prevented him from joining the service. John became a cop instead.  Without the benefit of cannabis, he underwent a number of surgeries over the years that never did him any good. 

A friend lived in prison for a year and a half for trying to prevent the loss of his sight by using cannabis.  While in prison, not only was he deprived of cannabis, but no proper medical treatment was offered for the glaucoma.  He now has a glass eye to fill the empty socket where his real eye used to be.  He lives in constant fear that he will lose the other eye, but the medicine that helps him is illegal. 

Elvy Musikka doesn't face the same fears.  Elvy was able to get approved for the Compassionate IND program back in the 80s.  For all these years she has received 300 pre-rolled joints per month from the Federal government's 'marijuana' farm in Mississippi and has retained the limited vision she had when she began using cannabis. 

Questions flood my mind:  Why has a non-toxic, useful plant like cannabis become the target of drug warriors?  Why do a handful of people get government grown cannabis while the rest of us go to prison for trying to treat ourselves. How can the agents of the government encourage synthetic forms of the plant to be researched and manufactured while keeping the actual plant in a category that has 'no medicinal value'?  Isn't that a bit like saying we can get vitamin C from pills but not from oranges? Why do we allow this farce to continue? Kay Lee

Glaucoma
Glaucoma is a disorder that results from an imbalance of pressure within the eye. The condition is characterized by an increase in intraocular pressure (IOP) that progressively impairs vision and may lead to permanent blindness. Glaucoma remains second leading cause of blindness in the United States.

The aim of glaucoma treatment is to reduce interocular pressure. Several human studies demonstrate that inhaled cannabis lowers IOP in subjects with normal IOP and glaucoma. Some animal studies indicate that cannabis can also be effective when administered topically (e.g. as an eye drop.) Two of the eight legal U.S. medical marijuana patients have used government cannabis to effectively maintain their eyesight for more than a decade.

Health Aspects of Cannabis Dr. Leo Hollister

Glaucoma  http://www.druglibrary.org/Schaffer/hemp/medical/hollisterhealth.htm

Discovery of the ability of cannabis to lower intraocular pressure was more or less fortuitous. Intraocular pressure was measured as part of a multifaceted study of the effects of chronic smoking of large amounts of cannabis. Intraocular pressure was found to decrease as much as 45% in 9 of 11 subjects, 30 min after smoking (75). Lowered intraocular pressure lasted 4 to 5 h after smoking a single cigarette. Its magnitude was unrelated to the total number of cigarettes smoked. the maximal effect on intraocular pressure was produced by the amount of THC absorbed in a single cigarette containing 19 mg of THC. When patients with ocular hypertension or glaucoma were tested 7 of 11 showed a fall of intraocular pressure of 30%. Confirmatory evidence was obtained from a trial in which i.v. injection of THC in doses of 22 µg/kg and 44 µg/kg produced an average fall in intraocular pressure of 37%, with come decreases as much as 51% (40). Many experiments done in rabbits using various routes of administration, including instillation of cannabinoids into the eye, have confirmed the ability of cannabis to reduce intraocular pressure.

Topical administration would be especially desirable for treating glaucoma as with other drugs used for this purpose. Smoking cannabis or taking THC i.v. would be totally unsuitable for patients with glaucoma. Rabbits have been used traditionally for studying eye medications. The lipid solubility of THC has been overcome by using mineral oil as the vehicle for its instillation into the eye. The degree of lowering of intraocular pressure is at least as great as that with conventional eye drops, such as pilocarpine, and the duration of effect is often longer. Some minimal systemic absorption of the drug occurs when it is applied to the conjunctivae, but it is of no consequence in producing mental effects. Other cannabinoids besides THC, such as cannabinol or 8­alpha­ and 8­beta­11­dihydroxy­delta­9­THC, have also produced this effect in rabbits (62). These agents have no mental effects, which makes them of considerable interest for therapeutic use.

An extract of nonpsychoactive components of cannabis whose composition is still uncertain has been tested both alone and in combination with timolol eye drops in patients with increased intraocular pressure. The effects of the two agents are additive and are said to be effective when other measures have failed (177). BW 146Y, a synthetic THC homolog, has been given p.o. to glaucomatous patients. Unfortunately, mild orthostatic hypotension and subjective effects were noted in addition to reduced intraocular pressure (167).

No psychoactive component of cannabis can be considered as a feasible therapeutic agent in this situation. Intraocular pressures, although they are reduced acutely, have not been shown to be reduced following long­term treatment, nor has there been any demonstration that visual function is preserved by the use of cannabinoids in glaucoma. Some of the problems associated with the development of cannabinoids as treatment for glaucoma have already been cited (61). The exploitation of cannabinoids for treatment of glaucoma will require much further developmental work to ascertain which cannabinoid will be lastingly effective and well tolerated. The potential benefits could be great, as present­day glaucoma treatment still does not prevent blindness as often as it might. If the effects of cannabinoids are additive to those of other drugs, the overall benefit to patients may be greater than is currently possible with single drugs.

Eye Problems http://www.druglibrary.org/Schaffer/hemp/medical/hollisterhealth.htm

Eye complaints of cannabis users are vague and mild. All 350 cannabis users had some eye complaints. Several consistent findings were (a) photophobia and belpharospasms; (b) injection of the globe; (c) increased visibility of the corneal nerves; and (d) accommodative or refractive changes. Visual acuity was preserved, but pupillary reactions were sluggish. Both alcohol and cannabis produced a moderately debilitating effects on lateral phoria and abduction. During smoking, lacrimation may be observed along with the characteristic marked conjunctival injection. Despite the fact that numerous and complex changes occur in the eyes of cannabis users, these effects are confined to the anterior segment and in most respects mimic an irritative process of that region. They are transient and not cumulative. They are probably of little clinical significance (60).

Reduction intraocular pressure is a characteristic effect from cannabis. this action provides distinct therapeutic possibilities.

PHARMACOLOGICAL REVIEWS
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