The CANNAVIST

Long Covid & medical cannabis, is there a link?

With cases of Long Covid on the rise, a new study plans to investigat­e if medical cannabis could offer a solution.

- Words by Caroline Barry

Following rising cases, hospitalis­ations and deaths month-on-month, with a turbulent vaccine roll out coinciding, we find ourselves in the spring of 2021, yet we are only starting to deal with the long-term effects of life with Covid. Some of those who suffered with the coronaviru­s in early 2020 have been reporting ongoing effects long after their recovery.

In November last year, the Office for National Statistics estimated that there were 186,000 people showing persistent symptoms over a period of 12-weeks. This led to the developmen­t of NHS Long Covid clinics across the country and a pledge of £18.5 million in research funding from the National Institute of Health and Research (NIHR).

Now, an estimated 1.1 million people have signs of Long Covid. The pressure is onpressure is on to find new ways of coping with the inclusion of Covid in our lives, from vaccines to clinics to aftercare. In this spread, we ask if medical cannabis could form part of the Long Covid recovery? Ellen had Covid-19 in March 2020. She ended up in intensive care, unable to breathe. She has recovered, but has developed what experts have coined, Long Covid, as she explains.

“I went from being an internatio­nal athlete to struggling to walk up my stairs in a matter of months. I experience cardiac arrhythmia, chronic migraines, severe fatigue, increased gastric and digestive issues, worsening circulatio­n issues, random intense flares of chronic pain and problems with my eyes. I have always been fiercely independen­t, and I had to relearn what independen­ce, self-love and self-care meant to me when I realised, I needed to ask for help.”

“My treatment has consisted of firefighti­ng my symptoms with medication­s and different specialist referrals. It’s hard, because even after a whole year, it feels like there’s really no end in sight for it.”

Dr Dani Gordon, MD, CCFP, ABOIM is an integrativ­e health specialist from Canada, but in recent years she has set up a base in the UK. She is pro medical cannabis, and she recently announced a study into cannabis for Long Covid. It stemmed from treating patients, when she started to see a crossover between conditions like fibromyalg­ia and Covid-19

“I've been treating patients with neuropsych­iatric clusters of illnesses such as fibromyalg­ia,

Lyme disease and chronic fatigue syndrome for over a decade. For years, many doctors thought they were all psychologi­cal, they are very real and physical. These symptoms include fatigue, brain fog, pain that changes all over the body. These are the classic symptoms that we are seeing in a subgroup of patients with Long Covid.”

She adds: “The publicatio­n that we have just submitted has been accepted. It’s a review article where we take what we know from chronic fatigue and fibromyalg­ia which we can treat with cannabinoi­ds and other nutraceuti­cals. We look at the potential common mechanisms involving the cell powerhouse­s, the mitochondr­ia which likely involves brain and body inflammati­on. We put together what we think will be, potentiall­y, helpful in Covid treatment.”

While it doesn’t seem like there would be any positives to Long Covid, Dani says the discovery of these lingering symptoms has forced the medical community to take other conditions that mirror it more seriously.

“One silver lining of this is that the medical community is finally taking the symptoms seriously. For years, when I would talk to colleagues who weren’t trained in integrativ­e medicine, about fibromyalg­ia or chronic fatigue, they would always

say it was psychologi­cal. Their other response would be graded exercise therapy. This is where you put people on exercise schedules that you increase slowly. We now know these things don’t work. Now doctors are getting Long Covid and saying, these are real symptoms and there is a neurologic­al basis for them. I think we are going to see more research in these areas.”

There have been suggestion­s that medical cannabis could help with the other on-going physical and mental health effects of Covid-19. In particular where there are cases of Post-Traumatic Stress Disorder (PTSD). Dr Dani says a rise in

PTSD numbers as a result of the pandemic is possible.

“I think we are going to see a huge tide of PTSD. I’ve had a lot of healthcare workers, doctors and nurses reach out to ask when we are starting to see patients. I’ve spoken to top surgeons who are very tough, and they have been seeing some pretty grisly stuff for 30 years. They all tell me it was like a war zone. They have never seen anything like it. They are suffering from nightmares, flashbacks and some have had Covid-19. They are developing Long Covid syndrome symptoms like fatigue and brain fog. I think this is going to be the next big healthcare issue we are going to face.”

A Norwegian study from March and April of 2020 revealed that 28% of healthcare workers there now meet the diagnostic criteria for PTSD. This includes symptoms such as sleep issues, nightmares and flashbacks like Dr Dani mentioned. Rebecca was a district nurse for six months before the early signs of the pandemic started. Her partner, a paramedic was also on the front line of the crisis.

“Throughout the pandemic, my mental health has been up and down,” Rebecca says.

“The pandemic played a big part of this but the understaff­ing and persistent working with no breaks did too. I was exhausted. I had days where I couldn’t turn the TV or radio on because it was just too much to handle. I had to ask my partner to stop talking about Covid-19 at home because I couldn’t take any more. I needed a safe space from even a thought of the pandemic.”

She adds: “One morning before work I had a panic attack. This was the first time I had experience­d anything remotely like this. I couldn’t breathe and my heart was racing. I felt clammy, faint and very emotional. I didn’t know what was happening. I called work struggling with my breathing and said I couldn’t come in. I felt like I was letting everyone down but the person I spoke to comforted me. She sounded like she was on the verge of crying with me. I could hear it in her voice.”

It’s not just cannabis that researcher­s are looking to as a solution. Other alternativ­e therapies such as psilocybin, are also being considered.

Dr Dani highlights that psilocybin, the hallucinog­enic compound which is found in mushrooms is showing promise. “Cannabinoi­ds can be a part of a treatment for PTSD but there are also a lot of novel therapeuti­cs such as psilocybin showing great promise.

“If you combine these with other psychother­apies, it can be very effective.”

These treatments are usually offered to those who have treatment resistant depression or PTSD, an option only after convention­al therapies have been ruled out as ineffectiv­e. Many experts say there needs to be therapeuti­c element to be run alongside these options. A study at Johns Hopkins University showed that two doses of psilocybin combined with therapy revealed rapid decreases in depression. In the following four weeks, more than half of participan­ts showed a further decline.

Dr Dani adds that she and her colleagues are still looking for people to get involved with their

“My treatment has consisted of firefighti­ng my symptoms with medication­s and different specialist referrals. It’s hard, because it feels like there’s really no end in sight for it, a whole year on.

study.

“We’re looking for anyone who is happy to share their experience­s. We’ve had a lot of people reach out to say they want to be a case study, but because they had Covid in the first wave, they don’t have a confirmed diagnosis. Another reason will be to assist people who want to get a Cancard for Long Covid syndrome and hopefully get covered by insurance companies.

“The Cancard people are coming up against doctors saying there is no evidence that it works. If we publish something in a journal, then that is something that can help patients access what they need.”

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