I wouldn’t blame you for thinking something along the lines of “just like everyone else,” but I’m here to tell you otherwise.
Being a veterinarian is a lot like being a human doctor. Besides the fact that both professions practice medicine, albeit on different subjects, they both require top grades and many years of school. They usually necessitate one to go into debt, to work long hours, to have extreme empathy and to be on call for days at a time.
Given their similarities, we’d expect them to have similar mortality rates and causes of death, but that isn’t the case. Veterinarians are at an extremely elevated risk for suicide.
If you’ve never gotten fast food after leaving a bar late at night (or, more correctly, early in the morning) I’d highly recommend it. I’ve never been sure if it’s the intoxication, the tiredness, or the unusual hour that makes post-pub falafel taste like heaven, but somehow after I go out drinking with my lab mates the food always just is better. I had resigned myself to the mysterious joy of 2 a.m. poutine remaining just that, a mystery. But last Christmas my grandfather took me by the shoulders and with odd earnest asked me to write an article finding out if alcohol is an appetite stimulant. Well, Grandpa, it may have taken seven months, but here it is! Let’s take a look at the evidence for alcohol as an appetite stimulant.
Kratom is rapidly becoming a choice recreational drug, but there’s a good chance you’ve never heard of this substance, which can cause sedative effects like morphine at high doses as well as stimulating effects, like caffeine or methamphetamine at low doses. This drug is not new, though regulations concerning it are (at least in North America), and not everyone is pleased about them.
Mitragyna speciosa, commonly known as kratom or ketum, is a tropical evergreen found in Southeast Asia. Its leaves are chewed fresh, or dried, powdered and put into capsules, extracts, slurries or drinks. A user feels the affects about 30 minutes after taking the drug, and they last roughly 6 hours, though the dosage and timings are highly strain dependent. The leaves contain several active compounds, most notably mitragynine and 7-hydroxymitragynine which act as alkaloid opioids. An alkaloid is any molecule that contains nitrogen, and has a biological effect. In these chemicals’ cases, that biological effect is achieved through acting as μ-opioid receptor agonists. These molecules bind to, and activate the opioid specific receptors, much like other opioids such as morphine, codeine or fentanyl. 7-Hydroxymitragynine has a potency equal to 17 times that of morphine, and as well as the molecules mentioned, kratom contains about 25 other alkaloids, each which will affect the body in some way.
Unlike these other opioids however, kratom remains largely unregulated in most of the world. Here in Canada it’s possible to purchase kratom in bulk online, though illegal to advertise it for consumption. While America has had a slightly more complicated relationship to the drug, as of October 2016 the DEA has rescinded its August 2016 move to place mitragynine and 7-hydroxymitragynine on the schedule 1 drug list. Around the world policies vary country to country- unregulated in most African countries, but regulated in Sweden, the UK, Australia and Denmark. Kratom remains entirely illegal in Thailand, where it’s been a controlled substance since 1943. Prior to this regulation, kratom leaves were often chewed fresh to achieve a small stimulation similar to that of coffee.
It’s worth exploring why public outcries to banning kratom have been so fierce, especially when the regulation of other opioids has been met with favourable responses. There is a distinct lack of studies performed on kratom and its effects, and it seems that most studies that were performed conclude by pointing out how it`s too difficult to draw conclusions based on so few studies. The DEA and other law enforcement agencies point to the questionable purity levels of kratom products, the potential for abuse and how leaving drugs unregulated leaves them in reach of young adults. Of concern is the fact that kratom is not detected on standard drug tests, its low cost, its wide availability online, and like any drug, its potential to be cut with dangerous chemicals. Considering the fentanyl crisis currently sweeping BC, a fear of opioids makes sense, but whether the concern is warranted remains to be seen.
While kratom is itself addictive, with even the user guide sites for it instructing users to not take more than 1 or 2 doses a week, there is growing evidence that it could serve as a stepping stone for opioid addicts on the path to getting clean. Studies have shown that kratom may be effective to wean addicts off their opioids of choice. When kratom is fermented, an additional bio-active chemical is produced- mitragynine pseudoindoxyl. This substance has been the subject of much scientific excitement, as it has been shown to be an antagonist for the delta opioid receptor, a process which has been correlated with reduced withdrawal symptoms, and reduced morphine tolerance. The withdrawal symptoms of kratom, which include anxiety, restlessness, tremor, sweating and cravings for the substance, are generally considered to be milder than the withdrawal symptoms of other opioids, though longer lasting.
Studies have shown that tolerance to kratom is not built over time as it is with other opioids. This, combined with its potential to lessen withdrawal symptoms, while still providing the painkiller effects that most patients take opioids for, makes me really look forward to the kratom research that will take place in the near future. It undeniably has potential that warrants study, but at present it is far too soon to start referring addicts to Madam Kratom’s online emporium. The toxicity of kratom has not been properly studied, nor has its interactions with other drugs (legal or otherwise), its long term effects, or even really, its short term effects. While the promise is present the science is not, and it would be truly foolish to rush to the kratom bandwagon without knowing how it will affect most major organs, amongst other things.
Take-home message: – THC is very dangerous to most companion animals – Medical cannabis has only a few uses in humans, and even fewer in animals – Cannabis, hemp or CBD treats, food or supplements are not approved or regulated by Health Canada. They are illegal and could be quite dangerous for your pets.
While medical marijuana has been available to varying degrees for decades, with recreational marijuana legalized this week in Canada, discussions about what (if anything) cannabis can treat seem to be at an all-time high (see what I did there?)
Discussions of treating medical problems with cannabis are not limited to humans. If cannabis may benefit humans, it may similarity benefit companion animals like dogs or cats. Considering that some of the major ailments cannabis is touted to treat are prime concerns for pet owners (anxiety, arthritis, pain) it makes sense for pet owners to be curious about cannabis.
Cannabis can be very dangerous for pets
When discussing cannabis and companion animals, it’s important to define a few terms.
Tetrahydrocannabinol or THC is the main psychoactive component of cannabis. As most pet owners aren’t interested in getting their furry friends high, the vast majority of pet-marketed cannabis products are free, or almost free, from THC. Which is good, because THC is quite dangerous for animals.
Since it’s difficult to study cannabis (due to it’s soon-to-expire illegal nature) we lack recent numbers on the dose based effects of THC in dogs. Early studies report intoxication effects in dogs with doses between0.25 and 0.5 mg/kg of body weight. If your average German Shepard is about 30 kg, they would show THC’s effects after ingesting 7.5 – 15 mg, or about a 10th of your average “special” brownie.
Though cannabis intoxication and adverse effects have been reported in other animals like cats, horses and ferrets, it’s much more common in dogs. Why? Because dogs like to eat. As Dr Sarah Silcox, the President of the Canadian Association of Veterinary Cannabinoid Medicine explained to me, “edibles, in particular, are very attractive to dogs, and if left within reach of pets, will often be gobbled up quickly.”
While it’s not likely that pets will die from cannabis exposure (through smoke or edibles) there can still be serious effects, especially if left untreated. Fluffy and Rover probably won’t get a kick out of the intoxicating effects of cannabis, given that they can’t understand what’s happening. Pets may experience significant anxiety, agitation or lethargy. Smoke of any kind can cause respiratory distress and potentially lung cancer to pets who inhale it regularly, due to the polyaromatic hydrocarbons created during incomplete combustion. Cats in particular are at risk of developing malignant lymphomas when exposed to secondhand cigarette smoke, a risk that may transfer to other types of smoke. .
So what’s with all the cannabis products for pets then?
Pet treats, foods and supplements in general feature no THC. They instead contain a different cannabinoid found in cannabis: cannabidiol or CBD. CBD is not toxic to animals like THC, and it does not cause the same psychoactive effects.
This study of 16 dogs with osteoarthritis showed a significant decrease in pain after treatment with CBD oil, but similar studies, or studies looking at cannabis to treat other conditions are seriously lacking.
Dr Silcox mentioned many anecdotes of positive effects of CBD products on pets, and this survey have found that that well over half of all owners polled who have used cannabis products on their pets felt it helped. But anecdotes are never evidence enough. We need good, large, controlled studies to properly evaluate the potential benefits and risks of cannabis products on cats, dogs and other pets.
For pain treatment however, the evidence for cannabis hasn’t looked wonderful. This 2015 review found evidence for use of low dose cannabis for neuropathic pain, but not for other pain. This 2018 Cochrane review states that the use of cannabis for “chronic neuropathic pain might be outweighed by their potential harms.”
Second, as Dr Silcox wrote, there is a “concern that that pet owners will attempt to medicate their pets with cannabis products and without appropriate guidance, put their pets at risk of adverse effects.” When we give our pets, children or ourselves any medication we first check dosage information, but the problem is that it isn’t available in any well researched, accurate or well-defined way for most species.
Third, pet owners may use cannabis in lieu of other evidence-based treatments, putting their pets at risk or hurting their quality of life. We don’t really know what cannabis can or should be used for in animals, but that hasn’t stopped many owners from using it for things like pain, anxiety management and diabetes management. My fear, simply put, is that owners will choose cannabis over NSAIDS, over other pain killers, over insulin, and even over euthanasia. I hope that no animals are suffering as a result of receiving cannabis as an alternative treatment to conventional veterinary medicine, but my fear is that it’s already happening and will begin to happen more with legalization.
Whether they work or not, they’re illegal and unregulated.
Until October 17th, 2018 all products containing plant-derived cannabinoids (which includes THC and CBD) fall under the Controlled Drugs and Substances Act. But even after the 17th, it isn’t open season for cannabis products. The new Cannabis Act will regulate the approval and sales of cannabis products, meaning that anything sold legally will need to be approved by Health Canada.
Health Canada currently has no products approved for veterinary or animal use. So CBD and cannabis products currently have, as Dr Silcox explains, “no regulatory oversight to ensure their quality, safety, or effectiveness. While they are marketed to treat a range of ailments, these health claims are unsubstantiated by Health Canada, the products are not approved, and as such, are not compliant with Canadian law.”
Now, that could soon change. With legalization around the corner, studies on cannabis and its effects are about to become a lot more feasible. With more evidence we will be able to hash out which CBD claims have merit, and which are baseless.
With entire conferences being held on veterinary use of cannabis we can hopefully expect some answers soon. In the meantime, a few things remain really important.