Yuliyan Kardjov is a doctor of brain biology and a non-governmental drug expert. He wrote two of the most comprehensive and popular publications on the subject of narcotic substances published in Bulgaria: "Drugs - almost everything about them" (an encyclopedic reference book on the composition and properties of different groups and types of narcotic substances) and "Cannabis - science and politics"” (detailing the origins, composition, uses, effects and legislative restrictions of cannabis in different countries during different historical eras). We talk to Dr. Karadjov about the medicinal use of cannabis
Dr. Karadjov, in the treatment of what diseases is cannabis used?
- An American doctor already ten years ago made a huge list of cases and diseases in which cannabis is used. There is also such information in the medical literature. But generally, cannabis is used for autoimmune inflammatory diseases, from rheumatoid arthritis to multiple sclerosis and Crohn's disease. In them, the inflammatory process is suppressed, pain decreases, there are even reports that the development of the disease is slowed down. The second major area of application of cannabis is cancer. There, the use of cannabis products is diverse. Some patients use them as an anti-nausea and vomiting agent during chemotherapy in order to better tolerate it. 2015 and 2016 animal studies show that
the combination of cannabis product and chemotherapy
is much better than either of them individually. Other cancer patients use it for pain relief. In advanced phases of cancer, the pain is of a very different nature and not all of them can be controlled with conventional painkillers. It may sound strange, but there are pains for which morphine is helpless, but for which cannabis is very effective - especially in neuropathic pain, when there is an inflamed nerve.
Let's clarify though - does cannabis cure cancer?
- I know a man who claims to have been cured. But it cannot be said that cannabis cures every case. No one can say at what locations of cancer it is effective. No scientific research has been completed yet. A clinical trial has started in England by the pharmaceutical company "Glaxo Wellcome" together with a Spanish team, but I don't know how far it has gone. No published results. There is hope in time to find out if it helps in cancer at all and in what cases.
Is there an application for Parkinson's disease?
- A clinical study of "Glaxo Welcome" with cannabis extracts was conducted on Parkinson's patients, and in Bulgaria. But if you ask about the results at the Ministry of He alth, they will tell you that they are a company secret. The company has paid, we have done the research on a standardized extract with the two main components of cannabis in the form of a sublingual spray (injected under the tongue). The medicine is called "sativex".
Has it been authorized for use in Bulgaria?
- In Bulgaria - no, but it is allowed for use in a number of European countries and in Canada. When we talk about the application of cannabis in medicine,
there are different varieties of cannabis with different active components
Some varieties work well for some diseases, second varieties - for other diseases, whether it is the vulgar plant product or standardized extracts. Some components are more effective for pain, others - for inflammation, others are sleep-inducing, etc. A clinical study was done with one of the components of cannabis, which was used to treat schizophrenia. This dispels the myth that cannabis causes schizophrenia. It all depends on the specific cannabis preparation. Some of them do the same job as antipsychotic medications, but with fewer side effects. This is proven scientific fact based on published medical research, not "one woman said that…". Cannabis even has potential applications in psychiatry.
US Medical Laboratory
Where are these drugs administered officially?
- There are 27 states in the USA, and in each of them there is a slight difference in the list of allowed cannabis extract medications that are prescribed by doctors. These medications are legally used in many countries and states, and their lists generally overlap. This means that for a number of diseases doctors are unanimous about their healing effect.
In what form is cannabis used for treatment?
- There are patients who smoke it, but they are not many. They do it because their illness is associated with sudden pains for which they need a fast-acting remedy. If he takes any extrat, it will take 1-2 hours for it to work. With smoking, it happens immediately.
t a dozen years ago, special inhalers - vaporizers were created for these people,
in which the plant material is placed, heated to a standard temperature, does not burn, does not produce smoke, and the product is an aerosol with the active substances of cannabis. It represents air with a very light aroma that does not irritate the bronchi. There are small to large inhalers. In a hospital in Israel, I saw such a cannabis vaporizer. Special balloons are inflated with the resulting aerosol and distributed to patients who are prescribed this pain control agent.
How is the medical use of cannabis regulated in Israel?
- The legal use of cannabis for medicinal purposes begins in the gray area at first. The authorities and the Ministry of He alth decide, after a whole council of doctors swears that cannabis products help in the treatment of certain diseases, to allow their use and convince themselves of the results. About 22,000 patients are currently being treated with cannabis. Meanwhile, laws are being changed in Israel to make this treatment completely legal. The number of medical speci alties in which doctors are allowed to prescribe such treatment has also expanded. I attended a seminar in the Israeli parliament with the participation of two politicians, representatives of patient organizations and doctors from six speci alties, each of whom explained the results of his patients. Such a thing should be done in our country. The people who are directly interested in the treatment with cannabis products must be brought together - the doctors and the patients. It is they who should talk to the politicians.
Cannabis Vaporizer
Since when has this treatment been used around the world?
- Illegal this treatment started in the 1960s and 1970s in the USA when a lot of weed was smoked, more so than now. Young cancer patients notice that if they smoke weed before they go to chemotherapy, they don't feel sick or vomit afterwards. On the other hand, chemotherapy drugs work more effectively because the body is not exhausted. Cannabis restores the appetite of the sick, they eat well, sleep peacefully. The modern use of cannabis for treatment has been discovered by patients. They share with the doctors, who in turn begin to observe the effects.
But the medicinal effect of cannabis was known even before that. I have a Bulgarian pharmacology textbook from 1949, which also describes cannabis extract. The problem then was in the standardization of this extract. It was difficult in 1949, but nowadays it's no problem to do it.
Is there a lobby of doctors and patients who could contact the politicians and arrange the legalization of the medicinal use of cannabis in Bulgaria?
- If it's a lobby, it must have a lot of money. There is no such lobby in Bulgaria. Otherwise, talks with politicians have been held, but things are moving terribly slowly. Politicians do not want to deal with this problem because they do not understand and do not want to take any responsibility. They need an expert to write to them what it is about and then express an opinion. The ideal is what I saw in Jerusalem. Politicians dealing with medicine and drugs gathered and discussed the issue together with doctors and patients.
How is the regulation made to make sure that cannabis is prescribed to sick people?
- In the same way as the use of morphine and tranquilizers for medical purposes is regulated. And now there are medications that are written with green and pink prescriptions. In other countries, things have been settled and the mistakes that have been made are now clear and clean. It's just that those interested should study the ready experience of other countries.
Macedonia legalizes marijuana for medical purposes
Macedonia legalized marijuana for medical purposes back in May 2016. Then procedures for issuing production licenses began and in June the first medical marijuana products were available in pharmacies in Macedonia.
This became possible with amendments to the Narcotics and Psychotropic Substances Control Act. "The changes made the use of cannabis products for medical purposes possible for people who suffer from serious diseases - malignant, multiple sclerosis, HIV and childhood epilepsy," explains He alth Minister Nikola Todorov. The Ministry of He alth in cooperation with the Agency for Medicinal Products and Medical Devices have invited foreign experts to train local medical professionals and pharmacists on the safe and effective use of cannabis products.
Bulgarian patients judge
To our question about what happens to Bulgarian patients who are illegally treated with cannabis, Dr. Karadjov answered: When Bulgarian patients are caught, they are sued. I know of five convicts. One of them had phantom pains after very severe trauma from an accident. They also convicted a young man with leukemia, a boy with severe acne who smeared cannabis extract on his face and did not smoke it. Marin Kalchev from Lovech, who has multiple sclerosis, was sentenced to a fine of BGN 1,000. Cannabis is used for multiple sclerosis around the world and it seems to work. It is smoked by people who are still moving and going to work. They use it not because they enjoy smoking it, but because it is the most compact way to carry it with them and because cannabis vaporizers are expensive devices.
In my opinion, it is a perversion to judge a sick person for being treated .
