We already know that medical cannabis can be used for a huge number of different health problems. So what about conditions that predominantly affect black and brown people? Here’s what science says so far, focusing on three conditions that affect the black community and other minorities in particular: sickle cell diseases (SCD’s), diabetes and stroke.
Medical Marijuana for Sickle Cell Diseases (SCD)
Cannabis use amongst SCD sufferers is not uncommon. The following states explicitly list sickle cell disease as a qualifying condition:
Many other states have qualifying conditions such as chronic pain, a side effect of sickle cell diseases which would allow someone to get a medical marijuana card.
Pain relief is the most common given reason, but are there any other potential uses for medical marijuana when it comes to sickle cell disease? Here are some more potential advantages:
- Cannabis may inhibit the chance of infection from other sources
- Induces relaxation and aids sleep
- Relieves anxiety and depression
- Lowers heightened sensitivity to pain (hyperalgesia)
- THC and pinene have bronchodilatory effects, meaning they can open up the airways and allow for easier breathing
SCDs are a group of blood disorders that results in abnormalities in the blood cells, of which the most common disease is sickle cell anemia. Sickle cell anemia results in sickle-shaped, rigid blood cells. This is caused by an abnormality in the oxygen-carrying protein in the hemoglobin found in red blood cells. There are various subtypes of sickle cell anemia, and they are usually inherited from one’s parents.
Sickle cell anemia and other such diseases can cause problems such as pain (“sickle pain”), anemia, shortness of breath, bacterial infections, swelling in the hands and feet, and an increased chance of stroke. The disease mainly affects people of Sub-Saharan origin, where about 80% of cases of sickle cell anemia are found. People from Arabia and India are also affected due to the high incidence of malaria in such places, where sickle cells offer some degree of protection against the parasite from attaching itself to blood cells. Unfortunately, SCDs have severe side-effects, often rendering the protections moot in an era of advanced medical interventions.
As of 2015, 4.4 million people worldwide suffer from sickle cell anemia. An estimated 43 million have a sickle cell trait. Around 100,000 people in the US suffer from a sickle cell disease of some sort, and black- or African- Americans are more likely to be affected. People from Arabia, India and the Southern Mediterranean are also affected to a lesser extent.
The therapeutic effects of cannabis for sickle cell carriers have only been looked at more recently. Traditionally, the opioids were used to manage “sickle pain”, but it has problematic side-effects like extreme sedation, nausea, appetite loss, constipation, respiratory depression and, of course, addiction. Cannabis could certainly be a useful alternative to opioid-based painkillers.
In this recent study, 23 sickle cell disease sufferers “reported that pain interfered less and less with activities, including walking and sleeping, and there was a statistically significant drop in how much pain affected their mood.”
Medical Marijuana for Diabetes
Diabetes is not always a qualifying condition for a medical card in and of itself but many sufferers of diabetes have compounded health complaints, of which some are qualifying conditions (e.g. chronic pain associated with neuropathy).
The following states list neuropathy or similar as a qualifying condition:
- New York
- North Dakota
There are several reasons why cannabis can help treat diabetes, including:
- Cannabidiol (CBD) and tetrahydrocannabivarin (THCV) could help regulate glucose levels and prevent insulin resistance.
- May improve carbohydrate metabolism, helping control and maintain weight.
- Keep blood vessels open and improve circulation.
- Topicals can be useful for preventing tingling sensations.
- THC may help sweet things taste more sweet, and possibly even help reduce sugar intake as the desire for it is satiated quicker!
- Cannabis can help treat the neuropathic (nerve) pain often associated with diabetes.
Diabetes occurs when there is a defect in the body’s ability to produce the hormone insulin, which leads to improper control of blood-glucose (sugar) levels. When the pancreas is unable to make enough insulin, or if cells do not respond to insulin, high sugar levels in the blood can lead to heart disease, kidney disease, stroke, blindness, amputation and death.
Racial and ethnic minorities have a higher burden of diabetes, worse diabetes control and are more likely to experience complications due to diabetes. Among Hispanics, the death rate from diabetes is 50% higher than for non-Hispanic whites. There are a number of reasons given, including lack of access to health care, socioeconomic status, activity levels, diet, and cultural attitudes and behaviors. Genetic factors may also play a part, but there is much debate in this area when it comes to diabetes incidence.
According to the National Health Interview Survey by the Centers for Disease Control and Prevention (CDC) and the U.S. Census Bureau, these are where the incidence of diabetes falls most often:
- 14.7% of American Indians/Alaska natives
- 12.5% of Hispanics
- 11.7% of non-Hispanic blacks
- 9.2% of Asian Americans
- 7.5% of non-Hispanic whites
Medical Marijuana for Stroke
Potential benefits of using medical cannabis to treat stroke include:
- Preventing cell death due to lack of oxygen supply to the affected area (“infarction”).
- CBD can prevent an overabundance of the neurotransmitter, glutamate (the main “go” or excitatory neurotransmitter), from forming. Too much glutamate can be toxic.
- Cannabis contains a multitude of antioxidant and anti-inflammatory compounds (e.g. cannabichromene (CBC)) that can help reduce neuronal overexcitement, improve blood flow and prevent inflammation in the brain.
Stroke is caused by a blockage of blood flow or rupture of an artery, leading to a lack of oxygen going through to brain cells and cell death. Common symptoms include sudden loss of speech, a loss or partial loss of one or more of the senses, and weakness or paralysis of one side of the body.
“Overall, African Americans, Hispanics, and Native Americans have higher stroke risks, stroke occurrence at an earlier age, and for some minorities possibly more severe strokes than non-Hispanic whites.” Many of these disparities can be attributed to lower socioeconomic status and healthcare system challenges. An increased likelihood of suffering from conditions like diabetes compounds this problem.
The CDC states that the risk of having a first stroke is nearly twice as high for African-Americans than white Americans, and that the highest increase in death rates due to stroke since 2013 is in the Hispanic community. Fortunately, stroke-related deaths have been decreasing in general for all ethnic groups.
So, why can cannabis help with the treatment of stroke? There is an increasing body of evidence suggesting that cannabinoids like THC and CBD have neuroprotective effects. This means that someone who is using cannabis could be less likely to suffer from stroke and that, if they do, CBD and THC can help mitigate some of the damage.
Medical Cannabis and Minority Health: Overall
Cannabis has long been associated with minority cultures in much of the Western world, and there are many cultures in Africa and Asia that have seen cannabis as medicine for a long time. In fact, this association between cannabis and minorities has long been used to demonize the plant in the first instance, and played a huge part in its eventual criminalization.
Minority populations in the US may not be getting equitable healthcare treatment, and in some ways this is reflected in the fact that cannabis was made illegal in the first instance. I.e. by engaging cannabis regulation politically rather than scientifically, we have already put healthcare on the back burner!