Does This Patient Have A Diagnosis Of Relapsing Forms Of Multiple Sclerosis: Fill & Download for Free

I started getting symptoms in my childhood, when i was about 8–9, i got tired easily, i could never walk as long as the others and running was hard. When i was about 11 i got foot drop, i couldn't run at all, walking was getting really hard at that point. I had my first relapse about age 12, ended up almost bedbound. Steroid treatments seemed to help with my walking.I think i got diagnosed same year or a year after that, after countless MRI-s, lumbar punctures, blood tests and many more things i don't even remember. The diagnosis was really bad on my mental health. I got depression and anxiety which lasted for years and i still have them.About 2 years ago my health got so bad i had to use a wheelchair, i was 15 then, i had so many relapses and lesions my doctor could not understand what was happening. After christmas this year my legs finally got better, i started walking om my own again after starting Tecfidera. Unfortunately i relapsed in february and that left me bedbound again. Many more MRI-s were done and i started Ocrevus infusions in june. Since the infusions i have been able to walk 5+ kilometres a day and I'm learning to run again, i feel like I'm finally healthy again.So my symptoms were foot drop, pain, fatigue, dizzyness, headaches, depression and anxiety weren't actual symptoms but they got really bad after my diagnosis.

The only concerns will come from those who choose to continue smoking it instead of moving to healthier methods of consumption, like tinctures, edibles, vaporizers, suppositories, etc.What I discuss below:Overall negative health effects of cannabis consumptionNegative health effects when smoking cannabisClaims that it makes people lazyClaims that it impacts one’s emotions permanentlyClaims that it damages one’s brainClaims that it impairs one’s immune systemClaims that it stunts growthClaims that it causes psychosisClaims that it’s an addictive substanceClaims that it’s a gateway drugWhat are the negative health effects of cannabis?For the average consumer, there are no long-term negative health effects from consuming marijuana in a non-smoking fashion.What about when you smoke it?Smoke from the combustion of any plant material, be it tobacco, cannabis or a leaf from the tree outside, produces a lot of toxins and carcinogens. Smoking any plant material or even sitting next to a wood-fueled campfire will all lead to exposure to these substances, resulting in compromised cardiovascular function and other negative health effects. The pattern of abnormalities associated with cannabis smoking, as has been discovered thus far, seems to differ from tobacco smoking, but the two are still a means to the same end if smoked consistently and in large quantities. Smoking anything at all is unhealthy, and if alternative methods of consumption are available, they’re highly recommended above smoking.An important distinction to make here is that the negative side effects of cannabis smoking comes specifically from the combustion of plant matter, not the inhalation of phytocannabinoids, such as THC and CBD, themselves. Cardiovascular issues are observed even in studies where all phytocannabinoids have been removed from the smoke inhalation. Alternative methods of smoking cannabis, such as vaporization, should be considered if one wishes to avoid the negative side effects.Cannabis smoke differs from that of tobacco in a few notable ways. It contains roughly 20 times more ammonia, 5 times more hydrogen cyanide and nitrogen oxides, but lower levels of carcinogenic polycyclic aromatic hydrocarbons (PAHs). Some studies have refuted the drastically higher ammonia and hydrogen cyanide levels, but all studies conclude that there’s less PAHs. Recent research has indicated that secondhand cannabis smoke impairs the cardiovascular system even more than secondhand tobacco smoke. It impairs the blood vessels’ ability to dilate, and seems to last longer for cannabis smoke than it does for tobacco smoke. Furthermore, a 2016 study examining chronic marijuana smokers of more than 20 years found the only negative health effect to be an increased risk of periodontal disease, a gum infection that can destroy the jawbone. This condition is treatable and typically clears up in a few months.Specifically, the carcinogens benzene, naphthalene and toluene have been found in cannabis smoke. Benzene is formed during the natural processes of combustion and can be damaging to the reproductive system when inhaled in large quantities. Naphthalene is a potential carcinogen, and research on it is lacking. In high concentrations, it’s been shown to destroy red blood cells, and in one severe case was shown to cause organ damage. Toluene is a benzene derivative, though thankfully far less toxic. Overexposure to this compound has been shown to have negative effects on the central nervous system (CNS), as well as symptoms of headaches, nausea, fatigue, sleepiness and irritation of the eyes and upper respiratory tract. An important reminder is that traditional smoking of marijuana will not guarantee any of the above issues; those studies were done under specific circumstances involving unrealistically large amounts of the carcinogens, much more than would be produced in traditional smoking, even when taken to the extreme.Comprehensive and extensive research has been conducted on tobacco smoke, linking it to an array of lung and other issues, most drastically lung cancer. In contrast, studies conducted thus far have found no link between cannabis smoking and lung cancer, emphysema and respiratory infection. A number of well-designed epidemiologic studies suggest that the risk for lung or otherwise-related cancers from cannabis smoke is far lower than that of tobacco, and a meta-analysis of 19 studies conducted in 2006 found no correlation between heavy marijuana use and lung cancer when factoring out tobacco use. In 2012, Dr. Donald Tashkin, the professor of medicine at UCLA, conducted a study examining 5,115 young adults over the course of 20 years, beginning in 1985, and found that marijuana smoke as a whole did not affect the rate of lung cancer among frequent users.Further research suggests that the phytocannabinoids found in the smoke alongside the carcinogens may play a role in the lack of cancer from heavy marijuana smokers. Numerous phytocannabinoids and terpenes found in cannabis have been shown to have anticancer and antioxidant properties, and may counteract many of the carcinogens that are also inhaled while smoking.Another key way that cannabis smoke differs from that of tobacco is its effects on the immune system. In general, cannabis has anti-inflammatory and immunosuppressive effects, which are beneficial to patients suffering from inflammatory diseases such as inflammatory bowel disease or multiple sclerosis. On the other hand, since regular cannabis smoking causes airway issues, the immunosuppressive effects may leave regular smokers more susceptible to respiratory infections. This is another area that requires much more research than the US Government is willing to allow. The anti-inflammatory and immunomodulatory capacity of phytocannabinoids are well established, and these agents have a broad therapeutic potential in various inflammatory diseases, including cardiovascular diseases.To recap the discoveries of dozens of scientific studies and papers done on this subject, overall, the negative effects of smoking cannabis may be lower than that of tobacco in regards to lung health. Cannabis is associated with lung function abnormalities, but the pattern of these abnormalities is different than that of tobacco. Regular cannabis smoking can cause physical airway damage, is associated with the symptoms of bronchitis and increases the risk of periodontal disease. Secondhand cannabis smoke exposure leads to impairments in cardiovascular function. There is no compelling evidence that cannabis smoke leads to obstructive airway disease or emphysema, and evidence suggests it helps to reduce arterial plaque and reduce the inflammation that causes it. A number of high-quality studies have failed to find a link between cannabis smoking and lung or upper airway cancers for occasional, moderate or chronic consumers. To date, despite decades of research, a link between cannabis smoking and lung cancer has never been found. Alternative methods of cannabis consumption, such as vaporizers, edibles, tinctures and more, do not carry any of the risks associated with cannabis smoke inhalation.Doesn’t it make you lazy?Many claims over the years have asserted that consuming marijuana frequently will cause a deleterious effect on society by making consumers passive, unproductive, apathetic and either unable or unwilling to fulfill their responsibilities. This stereotype is so ingrained in cannabis’ image that it’s nearly impossible to see a stoner stereotype in any media not have the lazy trait.Fact of the matter is, science does not support it. Coined as “amotivational syndrome,” the phrase was created in the late 1960s just as marijuana saw rapid use among the American youth. No studies corroborated this information at the time; it was pure hearsay and fear mongering. Studies in the following decades and recent years have concluded that consumers are actually, on average, more productive in work environments while high, and that there is no substantial link to marijuana and amotivational syndrome at all.Doesn’t it impact one’s emotions permanently?More recently than many of the other negative claims on cannabis use is the idea that frequent, chronic or long-term cannabis consumption negatively impacts one’s emotions, one’s ability to empathize or increase the likelihood of suicidal thoughts. This is a grossly stretched conclusion that implies much worse than what was ever observed. Studies conducted in 2007 and 2012 claiming to observe negative emotional impact both admitted in their studies that adjusting for confounding factors may eliminate this association. A further 2013 study claimed to observe an increase in likelihood of depression among high school students who had consumed cannabis, examining 76 subjects. In their conclusion, they note that cannabis use appeared to have no effect on which subjects got depression later in life, and credited most of these observations to “other illicit drug use.”Another study to assert these claims came in 2016, led by Lucy Troup at Colorado State University who examined 70 individuals using an electroencephalogram (EEG) for 2 years. All volunteers were grouped into either chronic, moderate or non-consumers of cannabis. While hooked up to the EEG, the volunteers studied images of 4 different expressions: neutral, happy, fearful and angry. The cannabis consumers scored slightly lower than the control group in their ability to discern emotion just from looking at a face’s eyes. That’s all that was observed. Since this study, Dr. Troup has continued studies with essentially the same basis, though other psychologists have called into question the kind of conclusions she and other researchers have made based on these minor observances.Doesn’t prolonged or adolescent use cause brain damage?There are many reports of marijuana causing brain cell damage, which in turn leads to memory loss, cognitive impairment and difficulties in learning. There is no significant drop or increase in IQ points (which is an absolutely ridiculous, scientifically unsupported and inaccurate means of measuring intelligence to begin with) between twins when one consumes marijuana and another does not, there is no difference in GPAs among marijuana consumers and non-consumers, and some longitudinal studies of college students, after controlling for other factors, actually found marijuana users to score higher on tests than their non-consumer peers. One study that found lower average grades for marijuana consumers failed to identify a causal relationship and concluded that both phenomena (consuming marijuana and having low grades) were part of complex, inter-related social and emotional problems. One wasn’t the cause or effect of another.The original study to make this claim reported in postmortem examinations of rhesus monkeys exposed to high quantities of THC to have abnormalities in the hippocampus, a cortical brain region known to play an important role in learning and memory, and thus concluded there must be negative side effects. They further “confirmed” this study by finding similar brain changes in rodents, who were given up to 200 times the psychoactive dose in humans. For reference, this amount in rats to produce minor abnormalities is comparative to a human smoking 30,000 joints and being reported as having some lingering brain dysfunction. Further studies found no significant brain abnormalities in rodents with 100 times the psychoactive dose in humans. In 2006, the Nathan S. Kline Institute for Psychiatric Research and the New York University School of Medicine scanned the brains of 10 individuals who consumed cannabis daily for one or more years in their adolescence, and 10 control subjects who had not, using MRI methods. There was no evidence of cerebral atrophy or loss of white matter integrity, and the researchers concluded that frequent cannabis use is unlikely to be neurotoxic to the normal developing brain. Plenty of other studies have been conducted using similar methods and found no long-term negative health effects when looking at their brains.Clinical research has continually reaffirmed the opposite of these brain damage claims as well; the phytocannabinoids found inside cannabis actually have potent neurogenerative and neuroprotective properties. Compounds like THC and CBD play a role in helping the brain to build new neurons and then protect them from neurodegenerative diseases or injuries caused by stroke, concussions or head trauma.More recent studies have been finding measurable differences in brain matter, particularly in the amygdala and hippocampus, among chronic cannabis users and non-users. The issues with a lot of these claims is their inconsistency; no discernible pattern has been found in what kind of brain changes occur, whether or not these changes are inherently negative, positive or neutral, and how researchers define “chronic” cannabis use seems to differ drastically from study to study, with some considering “multiple times a day” to be chronic, and others considering “daily” as chronic. Despite these inconsistencies, studies have continuously claimed to observe cannabis users having difficulty with attention, concentration, decision-making, risk-taking, impulsivity, inhibition, working memory and verbal fluency. Much of the medical world, and certainly much of the cannabis industry, sees these examples as outliers or victims of the very subjective experiences one can have from cannabis use. The majority of these studies use sample sizes of around 5 people, did not specify dosage amounts or lengths of abstinence and did not control for outlying factors. Some people can operate fine on cannabis, and some people just can’t.There is no consistent evidence that marijuana users, even those of decades or more and of any age, suffer permanent brain impairment in any regard. Numerous studies comparing chronic marijuana users with non-user controls have found no significant differences in learning, memory recall or other cognitive functions when controlling for other factors.Doesn’t it impair one’s immune system?Claims in the 1970s and into the 1980s asserted that frequent marijuana use impairs the user’s immune system and makes them more susceptible to other diseases. The principal study fueling this claim of immune impairment involved preparations of white blood cells that had been removed from marijuana consumers and controls. After exposing the cells to immune activators, they reported a lower rate of transformation in cells taken from the marijuana consumers. The study was conducted by Gabriel Nahas, a scientist staunchly against the use of marijuana in all forms. He was eventually fired from the Water Reed Medical Center, and publicly admitted to tampering with the results of every study he conducted. Numerous groups of scientists since have failed to confirm the original claims of his study in any way, and another study conducted in 1988 demonstrated an increase in responsiveness when white blood cells from marijuana consumers were exposed to immunological activators. Clinical studies conducted since have never shown an increase in bacterial, viral or parasitic infection among marijuana consumers, and have actually shown the opposite. Conclusive studies have shown it does not increase the risk of HIV infection, or increase the intensity of AIDS symptoms.Doesn’t it stunt teenagers’ growth?Claims have been made that marijuana consumption at early ages may stunt growth, interfere with the production of hormones associated with reproduction, cause infertility among adult users and delay sexual development in adolescents. Despite these claims, no significant difficulties in fertility or hormone levels have ever been reported. One peer-reviewed, longitudinal study found that when smoking high dosage THC 20 times a day for 30 days straight, there was a slight decrease in sperm count in males, but it was minuscule enough that it would not affect actual fertility. This decrease may be attributed to benzene, a carcinogen formed during the natural processes of combustion that has been shown to be damaging to the reproductive system when inhaled in large quantities. Using another consumption method of cannabis, such as vaporization, edibles or tinctures, produces no benzene or carcinogens of any kind.Doesn’t it cause psychosis and schizophrenia?There is no medical or psychiatric consensus on the relationship cannabis has with psychosis, and evidence seems to point in numerous directions. The most agreed upon answer, and one I’ve come to agree with after reading every study and review I’ve been able to find on this subject, is that cannabis has a very low chance of worsening psychosis symptoms in people who already have psychosis, but there is no proven link between cannabis directly causing psychosis to develop on its own.To be as clear as possible; if you already have psychosis, there is a chance cannabis can make your symptoms worse. If you do not have psychosis, there is no evidence that cannabis can cause psychosis to suddenly develop.Cannabis-Induced Psychosis, or CIP, is a form of psychosis purportedly directly caused by cannabis; its confirmation as an existing disorder in of itself is heavily debated as well, and the psychology world seems split on whether to recognize it as a legitimate disorder or not. The term first appeared in 1987 after a Swedish research team determined that early cannabis consumers were more likely to develop psychosis later in their lives, going off of self-reported data. Research into cannabis’ relationship to psychosis skyrocketed, and in a few years, it became the most funded part of cannabis research as a whole. Unfortunately, many of these studies relied on poor data collection methods, such as cold-call surveys and singular cases, as well as poor control factors, as very, very few took environmental, social or prior psychological factors into account. This trend continued into the 2010s, when studies conducted by Benford 2011, Every-Palmer 2010, Muller 2010, Van Der Veer 2011 and Hurst 2011 all counted temporary anxiety, disorganization, paranoia, agitation, confusion, tachycardia or an increased heart rate, and hypokalemia or low potassium levels, as psychosis symptoms. Many psychologists, doctors and therapists disagreed with this notion, as these symptoms are neither severe nor do they last more than a few hours after consumption, at most. They are very common and do not cause psychosis, yet these studies seem to affirm that they can.Evidence against a connection between cannabis and psychosis is rather prominent in the psychiatry and cannabis worlds as well. In 2015, Matthew Hill of the Hotchkiss Brain Institute at the University of Calgary said there is little evidence of a causal relationship between cannabis and psychosis, and went further to say there is evidence that cannabis use does not cause psychosis. His conclusion was similar to many others; cannabis can induce psychosis in individuals sooner by worsening their pre-existing psychosis. Dr. Romina Mizrahi, the director of the Focus on Youth Psychosis Prevention Clinic at The Centre for Addiction and Mental Health in Toronto agreed that cannabis does not cause psychosis in individuals who do not already have psychosis, but could trigger an underlying condition. Other experts speculate that reverse causality may play a role in so many studies’ false positives, believing cannabis use to be a byproduct of mental illness, not the cause; those with psychotic episodes use cannabis to self-medicate before their diagnosis. Furthermore, and even more drastically contradictory to CIP, THCV, CBD and the terpene myrcene have both been clinically shown to be active treaters of schizophrenia, a form of psychosis, and CBD was demonstrated to be as effective as amisulpride, a standard antipsychotic.Rather unfortunately, CIP’s ambiguous status was determined legally defensible in Canada under matters of assault in 2017. Mark Phillips, a personal injury lawyer from Ontario, attacked a family of immigrants in a parking lot mall because they were speaking Spanish, accusing them of being terrorists and members of ISIS. He crushed one of their ribs with a baseball bat. He plead guilty to assault, but claimed he was suffering from a cannabis-induced psychotic episode. He was granted a conditional discharge. After serving three years’ probation and community service, he will have no criminal record. This ruling was widely denounced, resparking the debate about cannabis’ relationship to psychosis. Paul Armentano, Deputy Director of the National Organization for the Reform of Marijuana Laws, or NORML, made a great point that I agree with, “My presumption is that if someone knowingly engages in substance that alters mood or behaviour, how can it be excusable? That is like saying that, if I hadn’t consumed so much alcohol, I wouldn’t have done this — so my actions were excusable.” The issue with this case is that it legitimizes CIP as a mental disorder that anyone, at any time, can just develop from casual cannabis consumption; something that is not medically accurate. It now allows consumers to smoke weed, break the law, and later claim they were suffering from psychosis to get off on the charges.Isn’t it addictive?Yes, it is possible for someone to become addicted to marijuana, though this depends on how you define addiction. This dependency has a name; Marijuana Use Disorder. People can become mentally dependent on any substance or action. It’s why you’ll read about people addicted to consuming drywall, or eating nothing but cheesy potatoes. Nothing about drywall or cheesy potatoes is inherently addicting, it’s just the consumer’s brain that’s created a dependency. The same is true for cannabis. Cannabis itself is no more addicting than sugar, caffeine, gambling, skateboarding or drinking orange juice, but people can still form addictions on all of those.Depending on what country you're in and who you ask, some claim that Marijuana Use Disorder is a mental dependency, not an addiction. A mental dependence is often defined as a dependence on a substance whose cessation involves emotional-motivational withdrawal symptoms, such as a state of unease or dissatisfaction, a reduced capacity to experience pleasure, or anxiety upon quitting. A physical addiction is defined as a compulsive desire to continue using a substance, despite harmful consequences, including dangerous withdrawal symptoms and a failure to meet work, social or family obligations. By traditional definition, Marijuana Use Disorder doesn't classify as an addiction, as there are no significant or life-threatening negative physical side effects after cessation. By other, more recent definitions, mental dependency and addiction are the same thing. There's not a general consensus on these two terms, so you can call it whatever you like, but the facts remain the same; marijuana can be habit-forming, as with anything, and it could be detrimental to people’s lives if they let it get out of control.While physical symptoms may arise for those quitting marijuana who have a dependency, they’re not life-threatening or even very serious. Common symptoms include decreased appetite, minor physical discomfort, irritability, headaches and sleep difficulties for up to two weeks after quitting, before subsiding entirely. For more chronic users, those typically over 2 or more years, these symptoms might last up to a month, but are still not comparable to the withdrawal symptoms of many, many other substances.The National Institute on Drug Abuse, for all the good that they do, gets this subject wrong quite frequently. They state that the reason they do not have proper estimates of the number of people addicted to marijuana is because of contradicting studies, but fail to acknowledge that their estimate of marijuana addiction being roughly 9% includes those who completed court-ordered addiction treatment for cannabis possession crimes in order to avoid stiff penalties. The best estimates the rest of the medical world has is that around 4% of people who use marijuana frequently will develop a mental dependency; compare this to 7% of caffeine consumers eventually developing a dependency, 29% of alcohol drinkers developing an addiction, and up to 34% of tobacco smokers. The national, presumed average of people with “addictive personalities,” is roughly 10%, for any substance or action.Cognitive-Behavioral Therapy, Contingency Management and Motivational Enhancement Therapy have all shown promise in helping those with Marijuana Use Disorder. The FDA has not approved any medications for the treatment of this disorder, but certain drugs like the sleep-aid Ambien, the anti-stress medication BuSpar and anti-epileptic drugs like Horzant and Neurontin have shown promise. Other substances such as N-acetylcysteine and FAAH inhibiting chemicals may also help with treatment. In 2015, over 138,000 people in the US voluntarily sought treatment for their marijuana use. The vast majority were cleared from their programs or support groups after 3 weeks. Possible relapse data was not collected.Isn’t it a gateway drug?The majority of people who try marijuana for the first time don’t even continue smoking marijuana. There are a few studies that correlate links with marijuana consumption and the use of other addictive substances, such as alcohol and nicotine. However, more recent studies taking into account other factors besides biological mechanisms, such as a person’s social environment, have concluded that people who are more vulnerable to drug-taking are simply more likely to start with readily available substances such as marijuana, tobacco, or alcohol, and their subsequent social interactions with others who use drugs increases their chances of trying other drugs.A common claim against the legalization of marijuana is that consumption makes you more likely to commit crimes. The only reason this claim is technically true, is because of a technicality. Smoking marijuana is itself a crime in many places, so choosing to smoke will obviously make you more likely to commit a crime; you’re committing a crime to smoke it in the first place. Aside from this, statistically speaking, the average marijuana consumer is no more or less likely to commit other, unrelated crimes.Furthermore, the popular school program D.A.R.E. has been, by all accounts, an utter failure. Despite its continued renewal in hundreds of school districts around the country, studies looking into its effectiveness have found it either making no significant impact on the use of drugs by underaged teens, but in some cases actually increasing the rate in which drugs are used at earlier ages.