While there is enough conversation around marijuana and cancer, what is the real dope on use of marijuana for glaucoma treatment? The question assumes significant importance because medical use of marijuana is legal in several states of the USA, as is its recreational use.
In fact, some states even allow you to possess and grow small amounts of marijuana for personal use.
In India, marijuana consumption is legal in Odisha and Uttarakhand. Interestingly, the Indian Government issued the first-ever license to grow cannabis for research purposes in 2017, while bhang (cannabis leaves) are freely consumed throughout the country. In fact, the retail price of cannabis in India is the lowest of any country in the world (US$0.10 per gram)
Logic behind use of marijuana for glaucoma treatment
High eye pressure or intraocular pressure, IOP, is known to cause damage to the optic nerve in glaucoma. The damage to the optic nerve may also be because of decreased blood supply.
All current treatment strategies target the eye pressure, and aim to lower it. This is known to prevent glaucoma progression and consequently, blindness. Treatment to increase blood flow to the optic nerve is still to be backed by substantial evidence.
Marijuana use lowers intraocular pressure for a few hours. On the other hand, marijuana also lowers blood pressure.
This implies that marijuana can have two effects on the optic nerve.
1. Decrease in as eye pressure will protect the optic nerve.
2. Low blood pressure can reduce the optic nerve’s blood supply, and consequently cause damage.
Recommended dose of marijuana for glaucoma treatment
The 70s were a really exciting time indeed. Several researchers reported smoking a marijuana cigarette lowered eye pressure for three to four hours. The amount of tetrahydracannabinol, or THC, the active ingredient in a cigarette cannot be quantified since there is no standardized measure. Similarly, we do not know what dose of oral marijuana would have a similar effect on your eye pressures.
How often
Let’s assume that each cigarette of unknown strength of marijuana will lower your eye pressure for about 3 to 4 hours. Which means, for round the clock eye pressure control, you will need to smoke weed every 3 hours. In other words, at least eight cigarettes a day are need for IOP control.
How much
We also don’t know how much of IOP lowering will be done by each cigarette. We don’t even know if the eye pressure reduction is dose dependent.
So let’s again assume that each cigarette lowers IOP by 20%. If your target pressure is 40% reduction, this may or may not be 2 cigarettes every three hours. Plus, we don’t know how the low blood pressure due to marijuana will impact optic nerve health.
Either ways, marijuana, with current knowledge, is not the most intelligent choice for treatment.
Marijuana has no side effects … right?
Ha Ha Ha!
Smoking or eating marijuana for glaucoma treatment has absolutely the same effects as recreational marijuana. Some of these rather interesting side effects can actually be dangerous. Here’s a brief list of some:
- Feeling high, impaired functioning
- Dizziness
- Decrease in coordination
- Weaker immune system—Less ability to fight off infections
- Loss of memory and concentration
- Lung damage due to smoking
- Eye damage due to smoking: cataract, dry eye, ARMD
Remember, glaucoma affects the elderly. In this age group, can you imagine what a disaster loss of coordination and dizziness can be? And also an impaired memory?
Can you imagine feeling safe if your glaucoma doctor had smoked up weed before your eye consult? How can you then feel safe driving or going out to work, on round the clock marijuana for glaucoma?
Marijuana does help. Why don’t glaucoma doctors prescribe it?
Your eye doctor has read the same stuff online as you, with a little more perspective perhaps. Remember, the following reasons for choosing conventional glaucoma medication over glaucoma:
1. Eye drops are effective in managing your eye pressure and glaucoma progression. This has been proven by large population based clinical trials.
2. Eye drops are safe. Yes, they have side effects, but the benefits are far more than the risks.
3. In case medication is not enough, there is glaucoma surgery. You can even discuss glaucoma lasers if you do not want to use eye drops.
4. Yes, eye drops are expensive, and in some places you can grow your own weed in a pot. Do not, however, forget the collateral damage caused by marijuana for glaucoma treatment. Remember, you can ask your doctor is lasers or surgery will be more cost effective for your glaucoma. You can even shift to generic drugs, if cost is a problem.
So, while marijuana can temporarily lower your IOP, your doctor will not recommend it for treating glaucoma.
Whoopi Goldberg uses the vape pen for glaucoma
“With each sip comes relief — from pressure, pain, stress, discomfort.” Yes, Whoopie Goldberg writes about medical use of marijuana. She says she uses marijuana to help ease the pain of the headaches she suffers with glaucoma. She does not mention whether she uses glaucoma eye drops, or whether she has had surgery or laser for glaucoma. Or whether her eye doctor concurs with what she is doing.
Research on the use of marijuana for glaucoma treatment continues. And as patients continue to rely on complementary and alternate medication, doctors increasingly look for evidence that says it helps.
Believe me, when I say this, your doctor is waiting for the results of the research as eagerly as you.
