Canadian CANNAINVESTOR Magazine January 2019 | Page 32

ECS have been shown to improve neuropsychiatric symptoms associated with neuroinflammatory conditions. The coupling of cognitive impairment with anxiety and agitation is a common early signal of problems associated with the “difficult road.” Some individuals express overwhelming and crushing feelings of isolation and fear. The dying individual is called upon to modulate an overwhelming array of physiological, sensory, somatic, perceptual, relational, cognitive, environmental, and spiritual input. The neuropsychiatric aspects of the “difficult road” can involve confusion, restlessness, fear, overwhelm, panic, and shock. There is often frustration with losses of control and changes to mobility-status. Some people express an urgent need to move physically and/or exit their current setting, reflecting a fight or flight experience.

The role of neuroinflammation in neuropsychiatric illness has been well established, and the literature suggests that cannabinoids may improve symptoms in this context. Najjar et al. (2013:1) state that “multiple lines of evidence support the pathogenic role of neuroinflammation in psychiatric illness.” Pre-clinical studies show improvement of neuropsychiatric symptoms with cannabinoids in the context of neuroinflammatory conditions such as Alzheimer’s disease (Aso & Ferrer 2016; Scotter, Abood & Glass 2010), Parkinson’s disease (More & Choi 2015), and AIDS-associated neurodegenerative disease (Benito et al. 2008).

In addition to the potential improvement of neuropsychiatric symptoms via the anti-inflammatory effects of the ECS, the literature describes an additional benefit that is well-matched to the challenges faced during the dying process. The ECS supports adaptation to, and integration of, fear, anxiety and stress. Lutz et al. (2015:705) explain:

The endocannabinoid (eCB) system has emerged as a central integrator linking the perception of external and internal stimuli to distinct neurophysiological and behavioral outcomes (such as fear reaction, anxiety and stress-coping), thus allowing an organism to adapt to its changing environment. eCB signalling seems to determine the value of fear-evoking stimuli and to tune appropriate behavioural responses, which are essential for the organism's long-term viability, homeostasis and stress resilience; and dysregulation of eCB signalling can lead to psychiatric disorders.

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