A healthy, natural alternative to traditional medications is becoming more and more accessible for persons suffering the effects of Parkinson’s disease. Studies show that cannabidiol, also referred to as CBD or CBD-rich cannabis, may relieve tremors and other debilitating symptoms of Parkinson’s. CBD is a natural compound found in cannabis sativa plants (cannabinoids), with none of the adverse side effects of prescription medications and without the “high” effect from THC in marijuana. And while traditional medications may become less effective over time, or stop working completely, CBD users are hailing long-lasting benefits, with many giving up their pharmaceuticals for good.
CBD is also gaining momentum as a treatment for Alzheimer’s disease, epilepsy, anxiety, and chronic pain. Studies are ongoing, but returns indicate CBD is an exciting alternative to traditional medications.
Parkinson’s disease (PD) is a disorder that affects the nervous system, with the average age of onset at 60. Simply stated, brain cells that produce the neurotransmitter dopamine, responsible for sending messages to the body in relation to movement, become damaged and die. This results in a variety of movement issues including tremors, lack of facial expression, difficulty balancing, and stiff muscles. In addition, PD may develop into Parkinson’s disease dementia (PDD), which impacts one’s cognitive functioning, such as the ability to remember things, make good decisions, and pay attention.
A difference between PDD and Alzheimer’s disease (beyond the physical impact) is that while Alzheimer’s more directly targets a person’s memory and ability to communicate, PDD is often associated with deteriorating problem-solving skills and thinking speed. A rarer form of dementia called Lewy-body dementia, however, has symptoms closer to PDD. (For more on PDD, click here.) https://www.dementiacarecentral.com/aboutdementia/parkinsons/
Initial symptoms of PD may be nearly unnoticeable and include:
– Difficulty standing
– Lack of facial emotion
– Tremors (shakiness of one’s hands)
– Bradykinesia (slow movement)
– Balance issues
Problems walking are so commonly seen that this symptom has its own name: Parkinson’s (or Parkinsonian) gait. This is often characterized by a stooped posture, short steps that are more like shuffling of the feet (as if the individual is dragging them), and reduced arm movement or arms that do not swing when one is walking. Persons with PD may experience other issues over time, including:
– Loss of smell
– Trouble swallowing
– Slurred speech
– Visual hallucinations
– Lack of judgement
– Difficulty concentrating
– Memory loss
Persons with PD may also suffer from depression, anxiety, apathy, irritability, pain, and difficulty sleeping. As mentioned previously, many people with Parkinson’s disease go on to develop Parkinson’s disease dementia.
Persons with PD and PDD often seek treatment in the form of prescription medications to alleviate the symptoms, frequently with adverse side effects including dizziness, drowsiness, blurred vision, nausea, diarrhea, vomiting, dry mouth, loss of appetite, heartburn, and more.
Exciting news about the therapeutic effects of CBD for persons with PD abounds. CBD has anti-inflammatory and antioxidant properties that make it a neuroprotective agent, meaning it can help with specifically neurological disorders like Parkinson’s disease. When nerve cells in the brain and body are protected, symptoms including movement and thinking problems are less pronounced and get worse at a much slower rate.
Further, CBD can help alleviate anxiety symptoms tied to tremors. A published study from Brazilian researchers showed that CBD reduced anxiety and tremors that occurred during a public speaking test for people over 60 with PD. Subjects who took 300 milligrams of CBD before giving a speech (public speaking is a classic anxiety-inducer) had less symptoms than a control group who were given a placebo.
This builds on exciting previous findings. Because PD affects the brain’s ability to produce dopamine, researchers from the University of Louisville, Kentucky, made an important discovery a few years ago when they found that CBD potentially increases dopamine levels, which would counteract the steady decrease of dopaminergic nerve cells experienced by those afflicted with PD.
Cannabinoid receptors run throughout our body as part of the endocannabinoid system regulating hunger, pain sensitivity, temperament, memory, and more. These natural receptors are affected in patients with PD. As analyses continue, CDB is demonstrating relief for tremors, psychosis, and problems sleeping. CBD may also reduce depression and anxiety, and relieve pain. A study at the Colorado School of Medicine has demonstrated relief of issues including tremors and difficulty sleeping. CBD studies are also showing it as effective in treating the psychosis that comes with PDD (Parkinson’s disease dementia). So far, patients are tolerant of low doses of CBD oil and report positive effects.
Numerous other studies echo CBD’s benefits:
– Researchers in Brazil had previously noted “Our findings point to a possible effect of CBD in improving quality of life measure in PD patients.” (Study)
– Researchers with the Department of Neuroscience and Behavior there concluded “preliminary data suggest that CBD may be effective, safe, and well tolerated for the treatment of the psychosis in PD” (Study)
– And a different Colorado study concluded: “Cannabis was rarely used in our population but users reported high efficacy, mainly for nonmotor symptoms.”
These more recent revelations come on the back of federally funded preclinical studies published in 1998 documenting strong antioxidant and neuroprotective properties in CBD and THC, particularly in treating “neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease, and HIV dementia.” These promising findings led to a U.S. government patent on cannabinoids as antioxidants and neuroprotectants. Further, THC and CBD products are becoming mainstream as an increasing number of states legalize cannabis for medicinal and even recreational purposes. (For more on legalized CBD, see below.)
In June of 2018, the first FDA-approved CBD medication, Epidiolex, was approved to treat two rare types of epilepsy. Epidiolex might have a future treating other diseases including Parkinson’s, after a study released in 2020 showed that for most participants with Parkinson’s saw improvements in motor function after taking the drug. Nighttime sleep and issues with emotions and behavior improved significantly as well.
CBD and Better Brain Cells
While there are currently no CBD medications approved by the FDA specifically for Parkinson’s disease, ongoing research is encouraging. In 2017, the Salk University in California found that THC and other compounds found in cannabis, such as CBD, reduce the amount of amyloid beta, a plaque protein that is toxic in the brains of persons with Alzheimer’s disease. This is great news for persons with dementia because the removal of amyloid beta preserves brain cells. Amyloid beta not only kills neurons, it also causes inflammation and contributes to memory loss and other cognitive issues. This type of plaque is found in the brains of some persons with Parkinson’s disease dementia.
Finally, we should note that there is evidence CBD is more effective in preventing the onset of movement disorders, including Parkinson’s disease, than reversing or eliminating symptoms of those diseases. This doesn’t mean that taking CBD will prevent someone from developing PD, but tests showed better benefits for mice when the drug was administered before the animal’s brain was manipulated to give it PD-like symptoms. CBD is more preventative, therefore, than therapeutic.
CBD Makes You Feel “High”
The effects of CBD and THC (Tetrahydrocannabinol), both cannabinoids that are extracted from cannabis sativa plants, are often confused. That said, both CBD and THC are known to have healing properties, and some researchers believe a combination of the two are very effective as a means of treatment. However, only THC produces a feeling of being “high” or “stoned.” Said another way, CBD-rich cannabis usage does not have any mind-altering effects. This makes CBD a desirable option for those that do not want to feel “high” from THC or certain prescription drugs.
CBD is a Regulated Product
Due to a lack of regulation when it comes to CBD products, there is no guarantee that a product labeled as containing a certain amount of CBD mg (for instance 30mg) actually has that amount. Therefore, there may be a lack of consistency from one product to the next. A researcher at Penn Medicine in Philadelphia discoveredthat almost 70% of CBD products sold on the internet are under-labeled or over-labeled when it comes to the concentration of CBD within the product. Just 30% of the products bought contained a concentration of CBD within 10% of what the label indicated. For the best and most consistently produced CBD products, locally sourced medical CBD is recommended. These products are held to a higher level of lab testing for strength, as well as impurities.
CBD has Sedative Properties
While some people may believe that CBD is a sedative, the truth is that it actually produces alertness without negatively impacting one’s sleep. Even if one takes a dose of 600mg of pure CBD, which is a very high dose, it still does not produce a sedating effect. However, one may take a CBD with a terpene (fragrant and flavorful essential oils found in plants) called myrcene, which is produced by several cannabis strains, that has sedating properties.
CBD is Legal in All States
As you will learn more below under “Legal Status of CBD in the U.S.,” CBD is in a legal gray area in some states. In Idaho, for instance, only CBD with absolutely zero THC is legal. South Dakota was the last state to say CBD of all forms is illegal, and voters have since changed that with a legalization law that goes into effect in July 2021. Regardless of specific local laws, CBD can be purchased legally online and delivered to all states. One can do so here.
Studies on CBD have shown that this form of treatment is usually tolerated well by users and is regarded as safe. There has also been no evidence for potential of abuse and/or addiction. That said, a few undesirable side effects have been noted, which include diarrhea, appetite changes, and tiredness. In addition, there may be dangerous drug interactions when CBD is combined with certain pharmaceutical medications. And the FDA warns that CBD can cause liver injury (as shown in some animal experiments with super high doses). The agency also says that long-term side effects remain unknown. Therefore, it is crucial that one speak with his/her physician prior to adding CBD to any medication regimen. In addition, one should monitor side effects upon use.
There are a variety of options when it comes to administering CBD.
– Ingestible CBD, which is a very common means of consumption, and includes oils (CBD is mixed with what is called a carrier oil, such as hemp seed, coconut, and olive oil) and tinctures (CBD is in an alcohol solution).
– Sublingual consumption, whereby a few drops of oil or tincture is placed under the tongue for a few minutes, is often suggested because the oil is absorbed quickly into the bloodstream and is generally effective within a few minutes. One can also digest the oil or tincture directly or add to food, such as a smoothie.
– Oil capsules can be taken like pills.
– CBD edibles, like gummies, can take an hour before they start working. The effects can then be felt for 4 hours or even longer.
– Oils and tinctures can also be applied topically, meaning they can be applied to the skin. Like with digesting CBD, it can take an hour or so for the effects to be felt and will last for a few hours. This method of use is good for persons suffering from localized pain.
– One can also opt for CBD vape products (vaporizer pens), CBD inhalers, or smoke high-CBD hemp strains. This method of inhalation allows users to feel the effects of CBD almost immediately and generally lasts a couple of hours.
There is no preferred method of CBD administration for persons with Parkinson’s Disease. Patients should choose a method with which they are most comfortable and one which is not hampered by tremors. If success with CBD is found, users should choose an administration method which can accommodate frequent and ongoing usage.
For the purposes of legality of CBD, it is important to be aware of the difference between hemp-derived CBD and marijuana-derived CBD. As previously mentioned, CBD is derived from both marijuana plants and hemp plants. Marijuana plants can contain as much as 30% THC, while hemp plants do not contain more than 0.3% THC. The percentage of THC in hemp plants is so low that it is impossible for one to get “high”, and therefore, the federal government has said it is legal and states have made hemp-derived CBD legally available in their state. As far as CBD manufactured from marijuana, each state has its own specific laws.
● CBD from marijuana plants, as well as medical/recreational cannabis, is legally available to users over the age of 21 in Alaska, Arizona, California, Colorado, the District of Columbia, Illinois, Maine, Massachusetts, Michigan, Nevada, New Jersey, Oregon, Vermont, and Washington. In order to purchase these products, one must have a legal state ID.
● Marijuana-derived CBD and medical cannabis is legally available by prescription in an additional 28 states (as of May 2021). These include Arkansas, Connecticut, Delaware, Florida, Georgia, Hawaii, Iowa, Louisiana, Maryland, Minnesota, Missouri, Montana, New Hampshire, New Mexico, New York, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.
● CBD is also available with limited or no THC content (generally under .3% to under 5% THC) in the following states: Idaho, Indiana, Kansas, Kentucky, Mississippi, Nebraska, North Carolina, South Carolina, Tennessee, and Texas.
● CBD in both forms is illegal in South Dakota until July 2021.
The best place to buy CBD rich medical cannabis is from state licensed medical (and in some states, recreational) dispensaries. Alternatively, CBD can be purchased legally online here.
For convenience, many dispensaries also provide delivery services. Unfortunately, dispensaries are not legal in every state. Oftentimes one can find hemp-derived CBD in local health stores. If taken once daily, a continuous regimen of CBD would cost approximately $2-$3 per day. As detailed in the following section, insurance will not cover the cost, therefore the daily cost would be out-of-pocket.
Unfortunately, private health insurance companies will not cover the cost of CBD products with the exception of Epidiolex, which is FDA-approved for epilepsy. That said, some Parkinson’s patients and their caretakers may find that high-CBD strains of medical marijuana aren’t overly expensive and are safer (have less harmful side effects) compared to medications prescribed for Parkinson’s disease.
People frequently want to know if Medicare covers the cost of CBD products. As stated above, CBD (as well as THC) does not have adequate FDA approval. Therefore, Medicare does not cover the cost of such products, nor does Medicare allow it to be used towards a Part B (health insurance coverage) or prescription drug plan deductible. This is true for all conditions, not just for Parkinson’s disease.
As with Medicare, Medicaid will not cover the cost of CBD products.
The VA will not directly cover the cost of products containing CBD. However, there are VA pensions, such as the basic pension and Aid & Attendance (A&A) Pension from which veterans or surviving spouses receive a monthly monetary benefit. Recipients of these pensions are able to use the money as they see fit, which means theoretically that one could use it towards purchasing CBD products. Learn more about these pensions here.
Many CBD retailers provide discounts to veterans who might need help covering the costs of their products. It is possible for active duty and military veterans to receive savings of more than 50% from companies that deliver CBD nationwide.