Ohio Recommends Cachexia as a Qualifying Condition for Medical Marijuana

Leafwell brings you the most up to date legislative changes across the US for medical marijuana programs. Today we have an update in Ohio, where cachexia has become a qualifying condition. This blog looks at what cachexia is and how medical cannabis can be a treatment.

Table of contents
  1. What is Cachexia?
  2. What Are the Symptoms of Cachexia?
  3.  What Complications Can Cachexia Cause?
  4. How is Cachexia Treated?
  5. How Can Medical Cannabis Be Used to Treat Cachexia?
  6. How Much THC is Required to Treat Cachexia?

The Ohio Medical Board has recently recommended cachexia as a qualifying condition for medical marijuana. Anxiety and autism were also considered, but have failed to be added to the list of qualifying conditions (for now, at least). The addition of cachexia as a qualifying condition was actually considered and recommended by the Ohio Medical Board since 2018, but has only recently been approved. An Ohio State Medical Board committee approved to recommend cachexia, or wasting syndrome, as a qualifying condition on 10 June, 2020. The State Medical Board of Ohio has yet to vote on whether or not cachexia will be a qualifying condition – this will hopefully be voted on and decided this year.

So, whilst Ohio hasn’t accepted cachexia as a qualifying condition as of yet, it is in other states like Alaska, Hawaii, and Illinois. Here’s more on why cachexia is often considered a qualifying condition for medical marijuana in many other states.

What is Cachexia?

Cachexia is a wasting disorder, where the patient suffers extreme weight, fat and muscle loss. Cachexia is usually associated with cancer, chemotherapy, malaria, AIDS/HIV, kidney disease, rheumatoid arthritis, Chronic Obstructive Pulmonary Disease (COPD), Crohn’s disease, cystic fibrosis and congestive heart failure (CHF). Unlike with other forms of weight loss, those with cachexia are not purposefully attempting to lose weight, i.e. their weight loss is involuntary.

Changes in metabolism due to prescription drugs and treatment methods (e.g. chemotherapy) can also lead to appetite loss, as nausea and damage to the digestive tract prevents proper nutrition absorption. Inflammation caused by tumors can also decrease the appetite and cause the body to burn calories more quickly than usual. Many researchers believe that cachexia is a natural response by the body in response to some diseases and conditions, as the body starts to break down fat and muscle stores for energy when nutritional stores are low.

Types of malarial cachexia from A practical study of malaria (1909). Pictures of males suffering from malarial cachexia.
From: ‘A practical study of malaria’, 1909. Authors: Deadrick, William Heiskell. Source. No known copyright restrictions.

What Are the Symptoms of Cachexia?

You must:

  • Have lost at least 5% of body weight in the past 12 months.
  • Have been diagnosed with a known illness or disease.

You must also display at least 3 of the following symptoms:

  • Appetite loss
  • Anorexia
  • High levels of inflammation identified by blood tests
  • Anemia – low red blood cell count
  • Low levels of the protein, albumin
  • Fatigue
  • Reduced muscle strength
  • Low fat-free mass index (calculated based on weight, fat and height)

What Complications Can Cachexia Cause?

Suffering from cachexia can lead to infections, as the body’s immune system is compromised. Cachexia can also lead to insomnia, delirium, anxiety and extreme fatigue, all of which can further compromise the immune system. Between 50%-80% of people with late-stage cancer have cachexia, and around one-fifth (20%) of late-stage cancer patients die from cachexia.

How is Cachexia Treated?

Unfortunately, simply eating more and getting in more calories is not enough. It is just as important to eat the right type of food (i.e. healthily), decrease inflammation, add nutritional supplements, and develop an adapted exercise regime in order to prevent muscle loss. Appetite stimulants such as megestrol acetate (Megace) are also prescribed.

Interestingly, for late-stage cancer patients and AIDS/HIV patients who are suffering from cachexia, the synthetic form of THC, dronabinol (Marinol) is sometimes prescribed in order to improve appetite, nausea, sleep and mood. Unfortunately, as dronabinol is a synthetic form of THC, it does not contain all the other cannabinoids and terpenes that can help make the effects of THC more tolerable. Dronabinol can therefore have much stronger psychoactive effects in comparison to natural cannabis.

The other cannabinoids and terpenes also help make natural cannabis a more effective cancer-beater compared to THC alone. The combination of cannabinoids can also make natural cannabis more effective for the treatment of pain, spasticity, arthritis and anxiety.

Cancer, cachexia and the complications associated with both.
Author: Muscleatrophyyy. Source. CC BY-SA 4.0.

How Can Medical Cannabis Be Used to Treat Cachexia?

  • Those with cachexia have reduced levels of the hunger-causing hormones leptin and ghrelin. Cannabinoids like THC may help increase the levels of these two hormones and help overcome conditions like anorexia and cancer-induced cachexia.
  • Cannabis can help improve sleep, thereby reducing the chances of infection.
  • Cannabis can help reduce stress, anxiety and depression, which also reduces the chances of infection.
  • Utilizing CBD, CBC and terpenes like limonene and pinene can help improve the therapeutic effects of cannabis and prevent some of the more negative effects of using THC alone (e.g. paranoia, anxiety).
  • High doses of tetraydrocannabivarin (THCV) ought to be avoided, as THCV can curb hunger. However, a small amount of THCV combined with CBD may help regulate insulin levels, which can also be helpful when a lot of food needs to be eaten. This can help prevent muscle atrophy.

How Much THC is Required to Treat Cachexia?

Many of those using dronabinol for cachexia use 2.5 mg of THC twice a day. Similar amounts of naturally-derived THC can be used. Some people may require more, especially as tolerance to THC increases. An equal amount of CBD (so a 1:1 ratio) can help balance out THC and prevent the effects from being overwhelming, whilst also boosting cannabinoids’ pain-beating, antipsychotic and mood-improving properties.

In Which States is Cachexia a Qualifying Condition for Medical Marijuana?

Cachexia is a qualifying condition/symptom in the following states:

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Featured Image Credits: Author: Steve K aka BarkSource. CC BY 2.0.

Written by
Dipak Hemraj
Dipak Hemraj

Dipak Hemraj is a published author, grower, product maker, and Leafwell’s resident cannabis expert. From botany & horticulture to culture & economics, he wishes to help educate the public on why cannabis is medicine (or a “pharmacy in a plant”) and how it can be used to treat a plethora of health problems. Dipak wants to unlock the power of the plant, and see if there are specific cannabinoid-terpene-flavonoid profiles suitable for different conditions.

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