Q & A

Frequently Asked Questions

What is a Geriatric Assessment and why is it important?

Geriatric assessment is a multifaceted approach to the care of older adults, with the goal of promoting wellness and independent function.

Assessment of function includes physical, cognitive, psychologic, and social domains.

Time-efficient, valid tools are available for use in a variety of settings to evaluate the status of older adults in all these domains. Domains include: function, social environment, mobility, cognition, depression, sleep, pain and more. Conditions such as frailty, polypharmacy and dementia are assessed. Furthermore, their medical history and a physical examination are included. An informant, ideally a caregiver or family member who lives with the older adult, is often required to provide or to verify pertinent historical information about the older adult's day-to-day functioning.

Is NiaMedic a Cannabis Clinic?

In our view, there is no such thing as Cannabis Clinic. Medical Cannabis is one of the many other treatments available to treat symptoms and illnesses. Niamedic is a multidisciplinary geriatric clinic that practices above standard medical treatment specialized in introducing Medical Cannabis treatment in appropriate cases. We perform a comprehensive geriatric assessment and present our recommendations of goals and treatment. When Medical Cannabis is appropriate, we have the knowledge and experience to select the right patients, initiate treatment, and continue follow up titration until reaching the treatment goals and effects.

Is Medical Cannabis addictive? Can I develop dependence?

Yes. Medical Cannabis can cause dependence but it is much lower than other substances, as seen in the Table below. Patients who have a history of addiction are more prone to develop dependence and should disclose that to our medical staff.

Does Medical Cannabis replace other medications?

Medical Cannabis does not replace, at first, current treatment medications a patient takes. When a positive medical effect is achieved with cannabis and after the end of titration, we sometimes recommend discontinuation of specific medications. This discontinuation is done cautiously by the primary care physician and only if he feels comfortable with our suggestions.

Does Medical Cannabis cures diseases?

So far, we do not have medical evidence that cannabis cure diseases. We do, however, have good evidence that it can relieve symptoms and help improve quality of life for many people suffering from chronic illnesses and debilitating diseases.

For what medical conditions Medical Cannabis may benefit?

Medical conditions that may benefit from Medical Cannabis are:

Chronic pain, Parkinson's disease, sleep disturbances, spasticity in Multiple Sclerosis, chemotherapy induced nausea and vomiting, Fibromyalgia, Tourette Syndrome, appetite and weight loss associated with HIV/AIDS. Futhermore it can help with anxiety disorders, PTSD, depression as a comorbidity of other chronic disease, dementia symptoms (behavioral and psychosocial), and traumatic brain or spinal cord injury.

Will Medical Cannabis influence my sleep?

Evidence suggest that the endocannabinoid system (where cannabis works in our brain) is involved with sleep mechanism. Medicinal use of cannabis appears to reduce sleep disturbances and improve sleep quality. This positive effect of cannabis on sleep is especially proven in Fibromyalgia, chronic pain and Multiple Sclerosis.

Cannabis and Dementia - will Medical Cannabis benefits in Dementia conditions?

Probably yes- although the data so far is not conclusive. The cannabinoid system is important in the regulation of synaptic transmission with Cannabinoid Receptors found throughout the central nervous system. This normal synaptic transmission is disordered in patients with dementia.

Some evidence suggests that cannabinoids have the potential for neuroprotectivity and thus help prevent fast deterioration in dementia. Small studies show that institutionalized dementia patients refusing nutrition increased body-mass index (BMI) after consuming Medical Cannabis. Other studies presented decreased agitation and irritability in dementia patients who received Medical Cannabis with no major side effects. Marked benefits also reported on neuroleptic drug sparing, reduced aggression, improved sleep quality, reduced nursing care demands, self-mutilation, and pain control.

Are there any side effects using Medical Cannabis?

Yes. There are side effects of Medical Cannabis. The most common are fatigue, dizziness, dry mouth, cough and nausea. The slow and cautious titration as we recommend in Niamedic, which is based on our experience, usually prevents most of the possible side effects.

What is the treatment process in the clinic and why it is important to supervise patients?

Following a comprehensive assessment in the clinic, we can recommend Medical Cannabis for appropriate cases and exclude those in which we think it is inappropriate for aversive reasons. We follow patients who started Medical Cannabis treatment after recommending the specific strain and through the titration process. Since many of our patients have other comorbidities and medications, we feel responsible to continue follow up until we see a stable positive effect without having side effects from suggested Medical Cannabis treatment.

Interaction between drugs? Can cannabis be used with other medications?

Yes, cannabis can interact with other medications used by patients. The enzymes and mechanisms that degrades medical cannabis are the same as those for medications. Additionally, some medications that influence the brain can have a synergistic effect with medical cannabis. This is exactly the reason why we perform a thorough assessment and continue follow up on our patients.

Consumption forms and products in the market?

There are three basic delivery methods: inhalation, oral, and topical. Under these umbrella methods are various techniques that serve unique functions, each appropriate for different occasions.

Inhalation: When cannabis is inhaled, the gases enter the lungs before absorbing into the bloodstream. There are currently two prevalent types of inhalation methods: smoking and vaporization.

Oral method includes Oil or Tinctures that are a liquid cannabis extract used by consumers looking for dosage control and fast-acting effects without the health risks associated with smoking. Edibles are a different oral method which includes any food that contains cannabis. These products have longer onsets and tend to cause powerful full-body, psychoactive effects.

Topical cannabis administration utilizes full cannabis extract — a thick oil that has been decarboxylated to activate cannabinoids. Once cannabinoids are activated, they can be absorbed through your skin.

There are many different products in the market and we at Niamedic will recommend the best method and product we feel is best for a specific patient. It depends on the medical problem, goals of treatment, and possible side effects for maximum efficacy.

What are the active components in the Medical Cannabis plant?

The cannabis plant contains more than 500 different chemical compounds with three Families of Herbal Metabolites: Terpenoids, Flavonoids, and Cannabinoids. All function in plant development, mad protection, pollination extraction, as well as therapeutic effects on human health. The plant cannabinoids –Phyto Cannabinoids are considered to be compounds with pharmacological activity and the most common of them are the THC and CBD. Terpenoids and flavonoids contribute greatly to the smell and taste although we see more and more importance of their therapeutic value as evidence accumulates.

Will I be stoned/ a zombie?

Definitely not. The therapeutic effect of Medical Cannabis does not require the psychoactive effect. By the precise and slow titration that we recommend to our patients, we aim to get a therapeutic effect without influencing normal activity or level of alertness. This is not the aim of the current recreational cannabis products proliferating the market.

This is what separates NiaMedic from the everyone else in the field.

Can I continue driving?

Consumption of cannabis affects cognitive and psychomotor performance in ways that can impair driving. The cannabis use impairs skills related to driving, as well as performance in driving simulators and in on-road driving studies. There is uncertainty about how these changes translate into crashes and vehicular incidents. We recommend waiting at least 3 hours after consumption before handling heavy machinery..

Can I consume cannabis and alcohol at the same time?

It is not recommended to use Medical Cannabis and alcohol at the same time. It can have harmful effects on cognitive and psychomotor performance, impair driving performance, and significantly increase the risks of collision. In terms of social and behavioral consequences, simultaneous use of alcohol and cannabis has been found to have substance-related consequences such as legal, health, academic, and personal relationship problems.

When should cannabis not be used? Contraindications.

Ages below 18, pregnancy, severe liver or kidney disease, unstable or severe heart disease, history of addiction, serious mental illness or psychosis- are all relative contraindications to usingMedical Cannabis.

Can a heart condition prevent Cannabis use?

It is not recommended for unstable heart patients or those who have a newly diagnosed heart problem to use medical cannabis. However, those who have a long-standing heart problem and are stable on chronic medications can consume medical cannabis for other indications under close supervision.