Traumatic brain injuries not only upend a person’s entire life but are also notoriously difficult to treat. New research suggests that medical marijuana treatments may be able to prevent further damage and relieve ongoing symptoms.
Traumatic brain injury (TBI) is caused by an external impact to the head, which temporarily or permanently disrupts normal brain functioning. Concussions are the most common type of injury, but any severity of TBI can disrupt a patient’s life, possibly leading to long-term, debilitating symptoms.
A lack of truly effective pharmaceutical treatments for TBI means that many patients are curious about the potential of CBD and THC, the chemical compounds found in medical cannabis. While promising research has focused on treatments soon after initial injury, a growing number of patients are also considering medical marijuana as a way to manage ongoing issues.
The Basics of Traumatic Brain Injuries
We often hear about traumatic brain injuries in the context of professional sports — TBI affects many football players and at least 40% of former NHL players — or military service; 17% of soldiers have experienced some sort of TBI. But the general population is also at risk, from sports-related accidents, car accidents, and falls. TBI is responsible for about 30% of all deaths caused by injury, and some 2.8 million Americans are affected by this condition each year. The CDC estimates the economic toll of TBI could be up to $76.5 billion, including direct and indirect medical costs.
The injury is most commonly mild, in the form of a concussion that may temporarily disrupt the patient’s life. But even mild or moderate cases can lead to epileptic seizures, cognitive issues, and even lowered life expectancy. The results of severe TBI may include a coma or amnesia, and almost half of those hospitalized for the condition still have a related disability a year later. In fact, about 5.3 million Americans are on disability related to the condition.
The Struggle to Treat TBI with Pharmaceuticals
The initial trauma of a TBI causes instant and ongoing changes in the brain, including the release of glutamate and the production of free radicals and other inflammatory chemicals. These compounds can cause swelling, dysfunction, neurotoxicity, cell death, and more, leading to the associated neurological issues that can plague patients for months or years.
Immediate and long term consequences of TBI range widely. About 20% of patients with brain bleeding after a TBI experience seizures. Patients may feel that their personality has changed, or that their moods are out of their control. Anxiety and depression are common. TBI can also cause ongoing spasticity, leading to mobility issues or loss of speech.
Despite the ubiquity of TBIs, effective treatments are limited. The typical initial treatment for mild cases is simply physical and mental rest, while more severe cases call for controlling oxygen and blood pressure, removing blood clots, and even surgically relieving pressure in the skull.
Rehabilitation therapy is the main way patients recover function. Typical medication options may reduce associated anxiety, clotting, or seizures, but don’t necessarily aid recovery at the molecular level. While there is no “concussion pill” in existence, researchers continue to investigate pharmacological treatments.
Doctors may rely on a cocktail of pills to help patients control their ongoing, and sometimes lifelong symptoms, even though this option can itself lead to debilitating side effects. Patients have in many cases discovered that medical marijuana can relieve their long-term symptoms and help them regain control of their lives.
Research on Marijuana Use for TBI
Much of the research around medical marijuana — including CBD and THC compounds — has focused around its use in the short-term aftermath of the injury, when the brain is at its most vulnerable. While limited, the available research does show promise.
Most mammals – including humans – naturally generate endocannabinoids, which are suspected to help with blood flow and neuroplasticity, among other things. We know that cannabinoids have some neuroprotective effects and could prevent the release of inflammatory compounds after brain damage to potentially minimize oxidative stress.
One Israeli research team suggested that the endocannabinoid 2-AG, naturally released by the body, could help protect the brain. The anti-inflammatory compound is released in higher amounts after trauma, as a kind of self-protective mechanism. When researchers administered greater amounts of 2-AG to mice after a brain injury, motor and cognitive abilities improved in the following months. While promising, this study showed that both cannabinoid receptors, CB1 and CB2, are part of the response, which makes it harder to pinpoint the mechanism at play.
Additional research shows potential: a Pediatric Research study in 2011 showed that CBD reduced seizures, brain edema, and motor skills for injured newborn pigs. A survey at a hospital in 2014 showed that TBI patients who tested positive for THC had a 2.4% death rate, down from 11.5%, although the significance is not as clear as in a controlled study.
Overall, research suggests that the protective function would be most effective in the hours following the injury, in near-immediate response to the trauma. The “window of opportunity” to prevent secondary damaged to a brain is brief, and this research suggests that CBD can actually expand that window.
Next Steps for TBI Patients
Ohio legislators have approved the use of medical cannabis for brain injuries, potentially offering relief for thousands of suffering patients. While there is more research needed to pinpoint exactly how marijuana works in relation to a damaged brain, many patients have already used the substance for relief from debilitating symptoms.
If you’re curious about whether medical marijuana might be appropriate to relieve your TBI symptoms, please schedule an appointment with the Lakewood Medical Clinic. We can examine your medical history and help you understand if cannabis might be an appropriate and effective choice.