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Using Cannabis for Fibromyalgia

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#1 SkunkyAroma

SkunkyAroma

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Posted 30 August 2016 - 12:58 AM

Using Medical Marijuana/Cannabis for Fibromyalgia

 

By Ginevra Liptan, MD

 

 

My last blog post examined the current legal and medical status of using marijuana as medicine. But how about specifically for treating fibromyalgia symptoms?

Many of my fibromyalgia patients report that medical marijuana/cannabis reduces their pain and improves sleep. A study of 28 fibromyalgia patients reported that two hours after use of cannabis they had a significant reduction of pain and stiffness.

 
The use of cannabis to relieve symptoms of fibromyalgia is not new. Around 2000 BC, the Chinese Emperor Shen-Nun described marijuana’s ability to diminish pain and inflammation and noted that it “undoes rheumatism” (an antiquated term for fibromyalgia). Fast forward to the U.S. in the early 1900s and we find medicinal cannabis extracts marketed by Merck, Bristol-Meyers, and Eli Lilly, among other pharmaceutical companies, along with medical textbooks listing numerous indications for cannabis including joint and muscle pain.

But then cannabis use was outlawed in 1936. All access for medical purposes was lost until 1996, when California became the first state in U.S. to legalize medical marijuana use. So now we find ourselves about 60 years behind in medical understanding of the cannabis plant.

We do know that the two primary active ingredients of cannabis are THC and CBD (cannabidiol). THC is a strong analgesic (pain reliever) and is also strong anti-inflammatory—in fact, it is 20 times stronger than aspirin! THC is responsible for the psychoactive effects or “high” of cannabis. CBD also has some pain-relieving and anti-inflammatory properties, along with strong anti-anxiety and muscle relaxation effects. CBD has the effect of lowering the psychoactive effects of THC, so cannabis with equal amounts of CBD to THC tend to be the most medicinally effective by providing desired pain relief with less of the undesirable “high.”

But we currently don’t have any standardized medication options beyond the two THC- only prescription medications, dronabinol and nabilone, which are expensive and tend to cause lots of side effects. Pharmaceutical companies are now racing to better find ways to produce standardized ingredients and dosing of cannabis.

In Canada and Europe, a cannabis-based medical extract is approved for use as an oral spray (Sativex). It is entirely derived from a specially grown plant with extensive quality control and balanced amounts of THC and CBD, and it has been shown to significantly lessen pain and improve sleep for rheumatoid arthritis, with few side effects. This product is currently undergoing clinical trials in the U.S. and will hopefully be available within the next few years.

But for now, patients who want to try medical cannabis for fibromyalgia—or any health condition—are at the mercy of the knowledge of the dispensary or growers that are providing them the cannabis. Here is a scenario I see quite frequently: a patient gets a medical marijuana card and goes to a dispensary. There, the employees are the only guide to strain and dose. It’s the equivalent of someone walking into a drugstore with a blank prescription and asking the cashier what medicine they should purchase. Some dispensary employees are quite knowledgeable, but often they are more recreational marijuana enthusiasts who have no idea what to recommend for a fibromyalgia patient.

One of my patients, who is 65 and had never used marijuana in her life, went to a dispensary and was directed to buy a cookie that contained a high amount of THC. An hour later she was so terrified that she called 911!

 

In general, you want to look for strains with roughly equal THC to CBD ratio. Start with very low dosages; one study found that while low-to-moderate doses lowered pain, high doses actually increased pain! Avoid smoking cannabis, as this is damaging and irritating to lung tissue. Instead, consider edibles, tinctures (liquid cannabis extracts), or topical balms or salves. My fibromyalgia patients report that cannabis balms and salves applied topically to sore muscles can be a very effective pain reliever with little to no brain “high.”

If you are serious about trying cannabis as medicine, you need to first educate yourself, because your doctor or your grower/dispensary staff may not be able to give you much guidance. I highly recommend the book Cannabis Pharmacy: The Practical Guide to Medical Marijuana by Michael Backes. Another helpful resource is the website www.leafly.com, which is like the Yelp of marijuana, with user reviews on different strains.

Remember, we are just beginning to uncover exactly how to use the cannabis plant safely and most effectively.



#2 SkunkyAroma

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Posted 30 August 2016 - 12:59 AM

Fibromyalgia: Big Pharma vs Medical Cannabis
 
 

fibro-image-500x223.jpg

 

The estimated five million Americans coping with fibromyalgia are not use to hearing good news. They live with chronic all-over pain, fatigue, depression, headaches, and sleeplessness, and doctors don’t know why this disease develops or how to cure it. Most fibromyalgia patients are women, and they often feel that healthcare professionals don’t take them seriously. The available medications frequently cause more problems than they solve. But there is finally a ray of sunshine for fibromyalgia sufferers: medical cannabis.

A recent survey of 1,339 fibromyalgia patients conducted by the showed that medical cannabis is far more effective than the three drugs approved to fight this disease (Cymbalta, Lyrica, and Savella). Of the patients who had tried medicinal cannabis, 62 percent rated it very effective at treating their fibromyalgia symptoms, 33 percent said it helped a little, and only 5 percent said it did not help at all. Compare that with the offerings from Big Pharma: 60 percent said Cymbalta did not help at all, 61 percent said Lyrica didn’t help at all, and 68 percent said the same about Savella.

Not only are these drugs expensive and ineffective, they often come with a nightmarish list of side effects. Here are just a few of the adverse reactions listed on a bottle of Lyrica:

  • Serious, even life threatening, allergic reactions
  • Suicidal thoughts or actions in about 1 in 500 people
  • Swelling of your hands, legs and feet, which can be serious for people with heart problems
  • Dizziness, blurry vision, weight gain, sleepiness, trouble concentrating, swelling of your hands and feet, dry mouth, and feeling “high”

Of those, the only side effect also caused by medical cannabis is feeling “high,” and strains of cannabis with lower ratios of THC to CBD (a non-psychoactive chemical) have been shown to be very effective at treating pain without affecting cognition.

 

 

Noting the surprising survey results, Dan Bennett, MD, an inter-ventional spine and pain surgical physician and chairman of the National Pain Foundation, commented, “Fibromyalgia is devastating for those who must live in its grip. There is much we do not understand. We need innovative ‘out of the box’ solutions that change the face of this disease.”

Unfortunately, one of the other things the survey showed was that only 29 percent of respondents had tried medical cannabis. Why are so few people getting access to the best medication for fibromyalgia? Because cannabis is still not legally available in most US states.

To add insult to injury, the federal government pretends cannabis is a dangerous drug with “no currently accepted medical use,” but for over a decade it has held a patent (#6630507) for cannabinoids, the chemicals that make cannabis an incredibly safe, useful medicine.

Despite what the Feds claim, and as they surely know, cannabis has many medical uses.In addition to being the only medication that truly helps with fibromyalgia, cannabis has been shown by study after study to help with glaucoma, tumors, nausea, epilepsy, multiple sclerosis, back pain, muscle spasms, arthritis, herpes, cystic fibrosis, rheumatism, insomnia, emphysema, stress, migraines, and nerve pain. Its topical extractions can have antibiotic properties and help with skin conditions, and it can increase appetite and reduce nausea in cancer and HIV patients suffering the side effects of treatment. This goes without saying, but none of the other drugs approved for treating fibromyalgia can claim all of that.

We need full legal access to medical cannabis so the five million Americans who struggle with fibromyalgia day in and day out will finally get some relief—and so the millions of our fellow citizens suffering the many other diseases that cannabis treats can get the medication they need, too.

Ending marijuana prohibition has been put on the back-burner by cowardly politicians who don’t want to look “soft on drugs.” Your representatives need to know that they have your support! Call or write your representative and demand immediate decriminalization of cannabis for all Americans.






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