Children who grow up with an inhaler always at the ready must quickly learn an entirely new way of life. Asthma pulls kids out of their favorite sports, plops them in a doctor’s office and prepares them for a lifetime of avoiding triggers and emergencies that could potentially end their life. Though the condition is manageable for many, around 250,000 people die prematurely from asthma attacks every year.
A chronic, atopic respiratory condition affecting a low estimate of 334 million people worldwide, asthma can be initially caused by early or repeated exposure to allergens or environmental triggers. The characteristic symptoms of constricted airways and spasms - known as an “asthma attack” in acute cases - can be easily triggered by a vast range of factors.
Typically, patients with chronic asthma will undergo Pulmonary Function Tests in order to identify which triggers are setting off the symptoms. During these tests, the patient sits in a sealed chamber and practices breathing through several tubes. A Respiratory Therapist administers controlled amounts of certain chemicals directly into the patient’s airways, measuring absorption, breathing rhythms and lung capacity to determine how severe the condition is, and how to treat the appropriate triggers. Physicians also use peak flow tests to regularly assess the severity of a patient's’ asthma symptoms at any given time.
Asthma symptoms are triggered by over excitement, exercise, heartburn, or environmental factors such as allergies or the ambient temperature. Asthma patients also tend to deal with an overproduction of mucus in the upper respiratory system, leading to more complications with breathing.
The population of asthma patients in the U.S. continues to grow, By 2008, more than half of children and one-third of adults with asthma had missed a day of school or work due to an attack. While many patients’ symptoms are manageable on the day-to-day, the asthma community is in need of novel alternative treatments that work.
Common treatments for asthma have not changed much since the FDA’s approval of prednisone in the 1950s. To this day, most popular asthma medications are steroid-based.
For almost all asthmatics experiencing symptoms, doctors will prescribe an albuterol “rescue” inhaler for situations where quick relief is needed. The aerosol spray inhaler is a beta agonist bronchodilator, not a steroid, used by thousands of patients prior to exercising, nerve-inducing situations or anytime they need a boost in their breathing. However, it’s not a suitable long-term treatment for controlling daily asthma symptoms.
For youths and adults struggling with chronic asthma, the typical medication prescribed is a daily corticosteroid, either in a swallowed pill or in one of countless inhaled formats. This method of treatment helps to reduce inflammation and enlarge the respiratory pathways, making constriction and spasms much less likely to occur. Specialized prescription allergy medications are also common, since indoor and outdoor allergies are one of the top triggers for asthma.
While these treatments have been commonly used for over half a century, there are certainly some limitations to their effectiveness in chronic patients. Drugs for asthma are expensive and need to be taken at least once every day, ticking up the monthly cost for families. Certain adverse side effects can occur as a result of taking these corticosteroid medications, such as impaired growth in children, thinning of the bones and skin, and cataracts in the eyes.
For patients who have poorly controlled asthma and will need to take these medications every day for the long term, these pricey prescriptions with potentially serious side effects simply won’t do. Asthmatics need alternative bronchodilator treatments that can help their body regulate spasms by itself. THC and CBD, the active ingredients in cannabis, happen to be just that.
Can Cannabis Help?
Though it may at first seem outrageous to suggest that marijuana might be able to treat the lungs, a clinical study confirmed that even if smoked, cannabis has the potential to correct bronchospasms, the rapid constriction of the lower airways, stopping asthma symptoms in their tracks. Both cannabinoids and select terpenes have been found to enhance lung function, with THC being the key anti-inflammatory factor. Only one study has found a treatment correlation using CBD for asthma. Though it was a study using lab rats, it proved that cannabinoids have potential in treating the upper respiratory system.
Oddly enough, inhaling cannabis may actually help to cleanse the lining of the sinuses and lungs. Among the hundreds of compounds contained within the cannabis plant, several chemicals could be at play here, though one tends to stand out. In the Brazilian lab rat study, CBD was found to reduce the prevalence of proteins called cytokines, resulting in a reversing effect on mucus secretion. Perhaps this is the reason why asthmatics are only minimally irritated by cannabis smoke - the cannabidiol tends to cancel out some of the toxic damage,
As it turns out, a particular type of cannabis strain is popularly used for asthma relief, as crowdsourced by patient reviewers on Leafly. According to the site, strains that are high in the terpene Limonene, like those with lemon, orange, or pineapple flavors and aromas, have typically reviewed quite well with asthma patients. That’s likely because limonene has been proven to have a positive anti-inflammatory effect on the bronchioles of asthma patients. So, patients would be wise to pick up fresh and fruity strains like Super Lemon Haze, Tangie or Pineapple Express to help control their symptoms.
Medical cannabis is far from a cure-all for asthma patients, but even based on the limited existing research, it’s clear that the herb can serve as a more affordable and less chemical form of daily symptom relief.
Safety: Risks vs. Rewards
Medical cannabis is a low-risk treatment for asthma, but since there are still some unknowns when it comes to its reactions, patients must always remember to be cautious and sensitive when trying out new cannabis products.
When it comes to medical cannabis to help clear the airways, the ideal form of administration for asthma patients is vaporization. While smoking is technically the most effective cannabinoid delivery method, it creates far too much irritating particulate matter that may cause spasms or labored breathing. Vaporizing allows the patient to take in all the beneficial cannabinoids and terpenes at a low heat, and with absolutely no tar or ash.
As for cannabis-infused edibles, it seems they are not proven to be of much help in combating asthma symptoms. Oral administration was found to have little effect in a double-blind study, with one out of six asthmatic patients actually developed severe bronchoconstriction shortly after taking cannabis orally.
Lab testing is another factor that is crucial to ensuring patient safety, especially in concentrates. In non-regulated medical cannabis markets, products may be on trace amounts of chemical solvents may be left over from the production process. These leftover solvents can be irritating or even poisonous to the asthmatic lungs, making them a no-go for scrutinizing medicinal patients.
Asthma is a chronic condition that affects so many people for, often, a large percentage of their lives. Any potential new treatment deserves a chance to be proven in a clinical setting. If cannabinoids and other compounds within the cannabis plant stand a chance against the lung inflammation experienced by asthma patients, current and future generations would benefit.
Alangari, Abdullaha. "Corticosteroids in the Treatment of Acute Asthma." Ann Thorac Med Annals of Thoracic Medicine 9.4 (2014): n. pag. Web. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4166064/
Dahl, Ronald. "Systemic Side Effects of Inhaled Corticosteroids in Patients with Asthma." Respiratory Medicine 100.8 (2006): 1307-317. Web. https://www.ncbi.nlm.nih.gov/pubmed/16412623
Vuolo, Francieli, Fabricia Petronilho, et al.. "Evaluation of Serum Cytokines Levels and the Role of Cannabidiol Treatment in Animal Model of Asthma." Mediators of Inflammation 2015 (2015): 1-5. Web. https://www.ncbi.nlm.nih.gov/pubmed/1099949