How to Advocate for Medical Marijuana Legalization

By Ellen Lenox Smith, Columnist

I wish everyone in the U.S. had safe and affordable access to medical marijuana. Although legal in 23 states and the District of Columbia, many of you still live in states where cannabis is illegal and may want to know what you can do to help expedite the process of legalization.

I thought it might be helpful to share our experience with you to help you turn your state into a more compassionate state.  My husband and I are the co-directors of medical marijuana advocacy for the U.S. Pain Foundation. We are very proud of the foundation for supporting the use of this medication and for taking a positive stand.

So here are our suggestions:

1) Google your state’s medical marijuana laws and become familiar with where your state stands.

2) If a bill has been submitted, find the names of the legislators that submitted it. Contact them and request a meeting, leave a phone message, write a letter or offer to testify. The goal is to begin establishing a relationship with this person, to let them know of your willingness to help get their legislation passed.  

3) Remember that you are in an illegal state, so you want to share the success you had while living or visiting a legal state. You do not want to take any chance getting arrested!

4) You will find that telling your story is the key. Try to find others who will also be able to share how this medication helped them too.  Share your medical condition, how it affects your daily life, and how using medical marijuana made a difference.

5) If you are able to attend a hearing, be sure to dress like you are going to work. Keep the language clean and show them that you are an everyday person trying to live life with major medical difficulties. You do not want to be perceived as a recreational drug user, so dress and act with a serious demeanor.

6) Along with sharing your story, you also need to discuss the qualifying conditions for treatment in the bill. Some states where marijuana is legal do not allow cannabis to be prescribed for chronic pain. If you don’t get the correct wording in there now for chronic pain, it may never qualify. Therefore, it is very important to include the following language in your bill:

A chronic or debilitating disease or medical condition or its treatment that produces one or more of the following:

• Cachexia or wasting syndrome
• Severe, debilitating, chronic pain
• Severe nausea
• Seizures, including but not limited to those characteristic of epilepsy
• Severe and persistent muscle spasms, including but not limited to those characteristic of multiple sclerosis or Crohn's disease
• Agitation related to Alzheimer's Disease

If they want you to testify, prepare your speech before your arrive. Consider putting your main points on a card to talk from, instead of just reading from a paper out loud. Eye contact can really help.

Stay on point. Time is limited and you must respect this or they will shut you off to allow others time to speak. Share details about your medical condition, what effect it has on your daily living and how medical marijuana has made life more tolerable for you. Ask them to have a heart and help you and all the others in your state.

I always end with: “You never know what life might bring you next. I didn’t ask to have to cope with this condition. Please show your compassion.”

If there is no bill under consideration, then your work will be a bit different. You need find out if a bill had been submitted in the past and locate the sponsor. You should contact that person or persons and tell them you are ready to advocate and ask what they need from you to help get the bill reintroduced.

Whether you have a bill submitted or are working to get one started, you want to keep the topic alive in the media, so write letters to the editor, send a written story to news and radio stations, telling them you would like to share your story and why you want to see this legalized. You will be surprised how they can respond!

Another thing you can do is also contact us via the U.S. Pain Foundation to see if we have any ambassadors in your state that have expressed interest in advocating. We are happy to connect you if we have them listed. Email us at ellen@uspainfoundation.org or stu@uspainfoundation.org

Good luck and may medical marijuana soon be legal for all.

Ellen Lenox Smith suffers from Ehlers Danlos syndrome and sarcoidosis. Ellen and her husband Stuart live in Rhode Island. They are co-directors for medical marijuana advocacy for the U.S. Pain Foundation and serve as board members for the Rhode Island Patient Advocacy Coalition.

For more information about medical marijuana, visit their website.

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.

Survey Finds Medical Marijuana Safe and Effective

By Ellen Lenox Smith, Columnist

Recently HelloMD, an online “telehealth” service that provides consultations with doctors who can write prescriptions for medical marijuana, conducted an extensive survey of 1,400 of patients. Patients were asked to complete a questionnaire consisting of 31 questions dealing with their marijuana use.

The survey results (which you can see by clicking here)  really caught my attention and are very exciting.

The survey found that the most common conditions that medical marijuana was being used to treat were chronic pain, anxiety, stress and insomnia. Eight out of ten patients (84%) strongly agreed that cannabis provides them with relief from their symptoms.

Medical marijuana may be legal in 23 states, but many of those states have yet to certify chronic pain as a condition marijuana can be prescribed for. Yet we have 100 million in our country suffering from pain! Let’s hope surveys like this will help to educate those states.

“There were few to no reports of negative consequences of cannabis use, with over 96% of users either somewhat likely or highly likely to recommend cannabis use to friends, family or others seeking improved wellbeing,” according to the HelloMD report.

This statement does not surprise me at all, for we have not seen negative consequences of marijuana use since 2007, when my husband and I first started helping patients wanting to try cannabis. Those of us that have felt the benefits of cannabis talk and encourage others to consider trying it all the time when we meet someone who is suffering.

I also do not believe this was any select group surveyed by HellloMD, but are typical cannabis users that realized how gentle, safe and effective this medication is.

The survey found that middle aged and elderly patients were more likely to use marijuana for pain management, while younger age groups were using it to treat stress, anxiety, mental-health disorders, nausea and issues with appetite. I love this finding. That is exactly what we are observing in the different ages we deal with.  

HelloMD also found that social perception of cannabis use is moving into the mainstream of society, as more and more states pass legislation allowing medical marijuana.

“Amongst those that use medical marijuana, 82% are open with family members about their use with 44% strongly agreeing. 15% still hide their use from family members (perhaps their children, although this is unclear from our data). 59.5% of patients are open with their close friends and a further 35% with all friends (close and otherwise). Only 5.3% do not admit to friends that they use medical marijuana,” the report found.

How exciting that we are now able to feel comfortable sharing the truth of our lives and the benefits we are gaining by being allowed to use this medication. As the report points out, there has never been a death from overdose attributed to cannabis and the safety record of cannabis is superior to that of pharmaceutical pain medications. This reinforces what we have been observing and I am thrilled what we have been saying is mentioned here!

“Our data indicates that 78% of those using cannabis for health and wellness are above the age of 25. In stark contrast to the stoner stereotype, these people are highly educated working professionals. Many are parents. They could be your friends, your colleagues, or your neighbors. All of them have legitimate health issues. All of them are seeking alternatives to traditional prescribed medication considered toxic and laden with the potential of negative side effects,” the report concludes.

Thanks to surveys like this, we can continue to work to get the education out there for people to understand that those of us using cannabis for pain are not all getting high or stoned. The brain receptors react to marijuana and we simply get pain relief! However, anyone can take too much of any medication and have a negative reaction.

I hope we will see even more surveys about medical marijuana, along with research, so that more will get on board and understand the advantages of this plant.

Ellen Lenox Smith suffers from Ehlers Danlos syndrome and sarcoidosis. Ellen and her husband Stuart live in Rhode Island. They are co-directors for medical marijuana advocacy for the U.S. Pain Foundation and serve as board members for the Rhode Island Patient Advocacy Coalition.

For more information about medical marijuana, visit their website.

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.

Players Say Half of NFL Using Medical Marijuana

By Pat Anson, Editor

With the countdown underway for Super Bowl 50, there’s a renewed focus on the NFL’s high rate of injuries and concussions, and whether the league should be open to players using medical marijuana to treat their pain.

“The growing legality of the plant, especially for medical use, is putting the NFL into a bit of a moral quandary,” says former Denver Broncos wide receiver Nate Jackson.

“When you compare it to what the alternative is in their training rooms; pills, pills, pills, that are being put into these guys’ hands and turning them into addicts. I was never big on those pills. I medicated with marijuana and it helped me and I think it helped save my brain.”

Jackson suffered numerous injuries during his six years in the NFL, breaking several bones and suffering at least two concussions. After retiring, Jackson wrote a memoir about his football career, Slow Getting Up: A Story of NFL Survival from the Bottom of the Pile and became an advocate for medical marijuana.

Pain News Network recently spoke to Jackson at the Cannabis World Congress & Business Exposition in Los Angeles, where he told us he started smoking marijuana as a high school football player and has been using it ever since.

nate jackson

“It’s been pretty effective. It didn’t prevent me from getting to the NFL. It didn’t prevent me from excelling and being my best. It was an effective way to take the edge off, deal with pain, and deal with injuries without taking away my edge on the field,” said Jackson. “I would say probably half the guys (in the NFL) use marijuana. They’ve been using it since they were teenagers. They’re familiar with what it does with their bodies. Top level athletes, you tinker with the process as you go, with your body, with your performance, with what works for you and what doesn’t.

"So if these guys get into the NFL with a marijuana habit intact, it means that it’s under control, it’s actually something that works for them, works for their body, allows them to perform at the highest level they can, and it doesn’t affect them negatively. Because if it does affect them negatively, they get cut. The demands of the job are so strict and so intense, if you’re not playing well, you get cut. And so if they are in the league, they are playing really well. They’re punctual, they’re memorizing their playbook, and they’re taking care of their business. If they’re using marijuana to do that, I think it’s healthy.”

Although the NFL has a reputation as a league that closely monitors players for signs of illegal drugs or performance enhancing medication, Jackson says it’s relatively easy to avoid getting caught by a drug test.

“Because the street drug test is only once a year. It’s in May, June or July somewhere around there. Once you get it, then you’re good for the next year, as long as you don’t fail it. I never failed it,” he said.

“The problem is for those guys who get put into a substance abuse program. That could be because of a positive marijuana test or DUI or ephedrine or Adderall or domestic dispute program, whatever it may be. You get put in the substance abuse program and I would say there are maybe a couple hundred guys in the league who are in that program and you get tested. You’re urine tested three or four times a week, every week, all year long for several years.”

Several current players support Jackson’s claim that at least half of the NFL is using marijuana. They told the Bleacher Report that many players smoke marijuana three or four times a week during the season. None of the players wanted to be identified.

"It's at least 60 percent now," said Jamal Anderson, a former running back for the Atlanta Falcons. "That's bare minimum. That's because players today don't believe in the stigma that older people associate with smoking it. To the younger guys in the league now, smoking weed is a normal thing, like having a beer. Plus, they know that smoking it helps them with the concussions."

Former Chicago Bears quarterback Jim McMahon says medical marijuana helps him deal with severe headaches, depression, memory loss and early onset dementia – which he blames on the NFL’s negligence in handling concussions during his playing career. McMahon said he was taking 100 Percocet pills a month for pain before he started using marijuana.

"They were doing more harm than good," McMahon told the Chicago Tribune. "This medical marijuana has been a godsend. It relieves me of the pain — or thinking about it, anyway."

With about 300 players being put on injured reserve every season – many with career ending injuries – Nate Jackson says it’s time for the NFL to acknowledge what’s already happening and change its marijuana policy.

“I think they (injured players) should be given a choice at that point and be able to avoid the opioid painkillers, which are pretty much a scourge in the locker room,” Jackson says.

“When you get put on injured reserve, if you have a severe enough injury that your season is over, you’re going to be given drugs by the team doctors and the team trainers because you are legitimately hurt. Are you going to take those pills or are you going to take something else? I chose to take something else.”

Medical Marijuana May Reduce Migraine Headaches

By Pat Anson, Editor

New research is adding to the growing body of evidence that medical marijuana can be used to treat migraine headaches.

In a small study of 121 migraine patients by researchers at the Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of Colorado, 103 patients reported a significant decrease in the number of migraine headaches they had every month. The frequency of headaches dropped from an average of 10.4 to 4.6 per month. Most patients used more than one form of marijuana and used it daily. The study was published in the journal Pharmacotherapy.

"There was a substantial improvement for patients in their ability to function and feel better," said senior author Professor Laura Borgelt, PharmD. "Like any drug, marijuana has potential benefits and potential risks. It's important for people to be aware that using medical marijuana can also have adverse effects."

Fifteen of the patients reported marijuana use had no impact on their headaches, while three said they had more headaches.

The study looked at patients treated at Gedde Whole Health, a private medical practice in Colorado that utilizes medical marijuana for a variety of conditions. Inhaled marijuana appeared to be the favorite method for treating acute migraines, while edible cannabis, which takes longer to be absorbed into the body, helped prevent headaches.

Exactly how cannabis relieves migraines is not fully understood. Natural cannabinoid receptors in the brain, connective tissues, and the immune system appear to have anti-inflammatory and pain-relieving properties. These cannabinoids also seem to affect neurotransmitters like serotonin and dopamine.

"We believe serotonin plays a role in migraine headaches, but we are still working to discover the exact role of cannabinoids in this condition," Borgelt said.

“We have had numerous patients finding results with migraines and the use of cannabis,” said Ellen Lenox Smith, a Pain News Network columnist who is a caregiver to medical marijuana patients in Rhode Island.

“We just had a woman out at the house a few days ago that was suffering will full body Reflex Sympathetic Dystrophy (RSD) and when she took one hit on a vaporizer of day meds, you could actually see the forehead relax and had headache relief immediately. When it is right for you, the results are amazing.” 

A 2013 study on rodents published in The Journal of Neuroscience found that triptans – a drug widely prescribed to treat migraine – appear to activate cannabinoid receptors just as marijuana does.

A 2007 study published in the European Journal of Critical Pharmacology found that migraine patients possessed significantly lower levels of endogenous cannabinoids than healthy control subjects.

Finding the Right Strain of Medical Marijuana

By Ellen Lenox Smith, Columnist

As a medical marijuana patient and caregiver since 2007, I would like to share some thoughts and observations about a recent survey by Care by Design, a medical cannabis company based in California.

They surveyed 621 patients who had been using medical marijuana for over 30 days, asking them about:

1. The conditions for which they are taking cannabidiol (CBD) rich cannabis

2.  The ratio of CBD-to-THC (tetrahydrocannabinol) they are using

3. The impact of CBD-rich cannabis therapy on their pain, discomfort, energy, mood, and overall well being

I would like to address three areas about the survey findings, based on my personal use of medical cannabis and the patients we assist as caregivers.

“Patients with psychiatric or mood disorders and patients with diseases of or injuries to the CNS (central nervous system) system favor CBD-dominant cannabis therapies,” the survey found. “Patients with pain and inflammation favor CBD-rich cannabis therapies with more equal levels of CBD and THC.”

I have to agree with this personally and also through observation of the people we have helped find their correct medical marijuana strain. I now sleep better at night using a night oil made with a high CBD ratio. I found that when I used another strain that has a higher THC ratio, I experienced some strange head sensations that I did not enjoy. But when I use the higher CBD mix, I do not experience those odd sensations and can safely get out of bed without concerns.  

One patient, who has numerous medical issues including depression and post-traumatic stress disorder (PTSD), has found she does well mixing a day sativa plant with the highest CBD plant we have (24% CBD/1% THC) called ACDC. She uses this mixture both day and night and finds it addresses her levels of pain more effectively. Just using the high CBD strain does not address her pain.

Another patient, a scientist, was just thrilled switching to the new high CBD plants we grow. He has found that his mood is calmer and his PTSD is under control. He is a thriving, productive worker again with no negative side effects

I correspond with many people online and one person who uses legally pure CBD found that it did address her pain. Many will not be that successful with just pure CBD and most need some THC to address pain.

The Care by Design report also states that “THC matters. A higher ratio of CBD to THC does not result in better therapeutic outcomes. Patients using the 4:1 CBD-to-THC were the most likely to report a reduction in pain or discomfort, and improvements in mood and energy.

“Patients using the 2:1 CBD-to-THC ratio reported the greatest improvement in overall wellbeing. This finding is consistent with scientific research indicating that CBD and THC interact synergistically to enhance one another’s therapeutic effect.”

I have to totally agree with the above statement. Most will not be lucky and find success without some THC in their medicine.

People tend to have a negative attitude towards THC because it makes them high and think medical marijuana strains work better without THC or lower ratios of it. But we have not had one patient that just uses the highest CBD plant alone. They appreciate the fewer “head issues” that come from reduced THC, but quickly find that their medical problems are not being addressed successfully until they use a mixture with more THC.

Finally, they survey report states that, “CBD-rich cannabis’ does not appear to have a significant impact on energy levels (as compared to pain, discomfort or mood).”

I am living proof of that, as are all the patients we have worked with using medical marijuana. When I need a boost on a tough pain afternoon, I find vaporizing or using tincture from the high CBD plant does not provide an increase in energy. However, when I use the 2:1 ratio that includes more THC, I not only get pain relief but also increased energy and interest in being involved with life again.

As the study found and we have found, you still have to experiment with dosage and ratios to find the correct type of medication strain to successfully alleviate your issues.

Using medical marijuana will never be like it is going to the pharmacy. One pill does not fit all and one strain does not fit all. No single ratio is right for all people, even when dealing with the same conditions.

Ellen Lenox Smith and her husband Stuart live in Rhode Island. They are co-directors for medical marijuana advocacy for the U.S. Pain Foundation and serve as board members for the Rhode Island Patient Advocacy Coalition.

For more information about medical marijuana or to contact the Smith's, visit their website.

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.

Medical marijuana is legal in 23 U.S. states and the District of Columbia, but is still technically illegal under federal law. Even in states where it is legal, doctors may frown upon marijuana and drop patients from their practice for using it.

Decline in Teen Opioid Abuse Continues

By Pat Anson, Editor

An annual survey that tracks teenage drug abuse continues to show a decline in the misuse of prescription opioid pain relievers, as well as heroin, alcohol, cigarettes, amphetamines and other substances.

The University of Michigan's Monitoring the Future Study (MTF) has tracked drug abuse among 8th, 10th, and 12th graders since 1975. This year’s survey included nearly 45,000 students at 382 public and private schools in the United States.

The MTF survey tracked the steady rise in teenage abuse of prescription opioids in the 1990's, before the trend reversed itself in the last decade. For the fifth year in a row, the survey found there was a significant decline in the misuse of opioids by teens (reported in the survey as “Narcotics Other Than Heroin”).

About 5% of 12th graders reported using an opioid pain medication in the last year, including 4.4% who used Vicodin and 3.7% who used OxyContin.

The number of teens reporting that prescription opioids were “fairly easy” or “very easy” to get also continues to drop.

Most teens abusing prescription opioids reported getting them from friends or family members. About one-third reported getting them from their own prescriptions.

"The recent declines in the abuse of prescription pain medicines among teens are encouraging. The Partnership has been working for quite some time through both our Above the Influence program and the Medicine Abuse Project to help educate teens, parents and communities about the risks of medicine abuse and we are glad to see continued progress," said Marcia Lee Taylor, President and CEO of the Partnership for Drug-Free Kids.

“While today's news about substance use among teens is mostly positive, we cannot let that take our focus off of the prescription drug and heroin crisis among other age groups.”

Despite widespread media reports about the so-called heroin “epidemic” in adults – heroin use among teens is at its lowest level since the MTF survey began. Past year use of heroin fell to 0.5% of 12th graders, an all-time low.

Use of several other illicit drugs – including MDMA (known as Ecstasy or Molly), amphetamines and synthetic marijuana – also showed a noted decline in this year's data. Use of alcohol and cigarettes reached their lowest points since the study began.

Marijuana, the most widely used illicit drug, did not show any significant change. After rising for several years, teenage marijuana use has leveled out since 2010, but still remains stubbornly high. In 2015, 12% of 8th ­graders, 25% of 10th­ graders and 35% of 12th­ graders reported using marijuana at least once in the past year. For the first time ever, daily marijuana use exceeds daily tobacco use among 12th graders.

"We are heartened to see that most illicit drug use is not increasing, non-medical use of prescription opioids is decreasing, and there is improvement in alcohol and cigarette use rates," said Nora D. Volkow, M.D., director of the National Institute of Drug Abuse, which funded the MTF survey.

"However, continued areas of concern are the high rate of daily marijuana smoking seen among high school students, because of marijuana’s potential deleterious effects on the developing brains of teenagers, and the high rates of overall tobacco products and nicotine containing e-cigarettes usage."

One growing area of concern is the abuse of Adderall and other prescription amphetamines, which are typically used to treat Attention Deficit Disorder (ADHD) but are widely perceived as a study aid.  About 7.5% of 12th graders used those drugs in the past year.

Can Marijuana Help Treat Heroin Addicts?

By Pat Anson, Editor

There’s a new twist to the rising use of heroin in the United States – and what can be done to help addicts in recovery.

A recent study by researchers at Columbia University found that medical marijuana improves the treatment outcome of heroin addicts. Patients who were given dronabinol -- a prescription drug that contains THC, the active ingredient in marijuana -- had lower withdrawal symptoms compared than those given a placebo. In addition, patients who smoked marijuana regularly during the outpatient phase of treatment had fewer sleeping problems, less anxiety and were more likely to finish treatment.

"One of the interesting study findings was the observed beneficial effect of marijuana smoking on treatment retention," the researchers concluded.

"Participants who smoked marijuana had less difficulty with sleep and anxiety and were more likely to remain in treatment as compared to those who were not using marijuana, regardless of whether they were taking dronabinol or placebo."

The Columbia study appears in the journal Drug and Alcohol Dependence.

According to High Times, several other studies have reached similar conclusions. Studies at the New York Psychiatric Institute found that opiate addicts who consumed marijuana intermittently were less likely to start using opioids again, compared to those who never used marijuana or used it habitually.

Earlier this year, researchers at the RAND Corporation and the University of California, Irvine reported similar results in a study for the National Bureau of Economic Research – going so far as to suggest that marijuana is a good substitute for opioid pain medication.

“Many medical marijuana patients report using marijuana to alleviate chronic pain from musculoskeletal problems and other sources. If marijuana is used as a substitute for powerful and addictive pain relievers in medical marijuana states, a potential overlooked positive impact of medical marijuana laws may be a reduction in harms associated with opioid pain relievers,” they wrote. “We find that states permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not.”

And what happens in states where regulations make it harder to obtain prescription opioid medication?

There were unintended consequences in Washington, one of the first states in the country to impose strict new guidelines on opioid prescribing. From 2008 to 2014, the number of deaths from prescription opioids in Washington fell from 512 to 319. But over the same period, the number of heroin deaths almost doubled, to nearly 300.

But the surge in heroin use wasn’t confined to Washington. According to the National Survey on Drug Use and Health, the number of heroin users nationwide rose from 161,000 in 2007 to 289,000 in 2013, an increase of nearly 80%. During the same period, the U.S. Centers for Disease Control and Prevention (CDC) reported the number of poisoning deaths involving heroin rose from 3,041 to 8,257, an increase of 172%.

“There is no robust evidence that recently enacted policies regarding prescription opioids are responsible for large-scale shifts to heroin,” the CDC’s Courtney Lenard recently told Alcoholism & Drug Abuse Weekly. Only about 1 in 25 people who use prescription opioids recreationally start using heroin within five years, she said.

Pot for Pain Approved in Minnesota

By Pat Anson, Editor

After months of debate, Minnesota’s health commissioner has decided to include chronic pain in the list of conditions that allow residents to legally use medical marijuana. They just have to wait another nine months before they can buy it.

Commissioner Ed Ehlinger said it was “the right and compassionate choice” to allow pain patients into the program.  Only nine health conditions currently qualify for marijuana prescriptions in Minnesota – and chronic, intractable pain won’t be added until August 1, 2016. Health care providers can start certifying intractable pain patients on July 1 of next year.

Ehlinger, who is a physician, said “the existing tools are not working well” to manage pain, according to the Minneapolis Star Tribune.

“There are strong and conflicting opinions ... in both the professional community and in the general population. However, as a physician who is concerned about the treatment each individual patient receives and as the Minnesota Health Commissioner who is concerned about the overall health of everyone in this state, I believe that adding intractable pain to the list of qualifying conditions for our medical cannabis program is the correct decision,” said Ehlinger

Last month a state advisory panel recommended against the inclusion of chronic pain in Minnesota’s marijuana program, saying cannabis was not a “magic bullet” and there wasn’t enough evidence to support its use for pain.

“Panel members expressed concern that patients eligible to use medical cannabis for pain have expectations that it would provide total relief and that such a perception may leave patients to abandon other proven pain-management methods, such as physical therapy,” the recommendation said.

“Panel members cited the recent opioid crisis, where good medications were demonized because prescribers used it to treat pain without knowing its proper uses. Even after studying the information available on medical cannabis, panel members said providers do not feel prepared to certify patients for its use.”

Over a dozen public hearings on the issue were held across the state, and the vast majority of speakers favored including intractable pain in the list of health conditions marijuana can be used for.

Intractable pain is defined as “a pain state in which the cause of the pain cannot be removed or otherwise treated with the consent of the patient and which, in the generally accepted course of medical practice, no relief or cure of the cause of the pain is possible, or none has been found after reasonable efforts.”

The nine conditions that currently qualify for medical marijuana in Minnesota are cancer, glaucoma, HIV/AIDS, Tourette Syndrome, Amyotrophic Lateral Sclerosis (ALS), seizures, severe muscle spasms, Crohn’s Disease and terminal illness. In addition to strict limits on conditions it can be prescribed for, medical marijuana is not available in leaf form and cannot legally be smoked in Minnesota.  It is only legal in a pill, vapor or liquid form.

The limits are so restrictive, less than 800 patients have enrolled in the program so far. Enrollment is expected to increase dramatically once chronic pain is included.

"Congratulations to the State  of Minnesota for now becoming a true state of compassion," said Ellen Lenox Smith, a medical marijuana advocate and a columnist for Pain News Network.  "I do hope that in the near future, they will also consider to adjust their stand on cannabis being sold only in pill or liquid form — nothing smoke-able.  For those of us in Rhode Island, we can choose to vaporize, use topicals, smoke if that is your only way to make it work for you, along with tinctures, drinks and edibles. We all have to find the right way to make this medicine work for our conditions, so may they realize their limitations are very controlling and holding back pain relief for many."

Minnesota is one of 23 states and the District of Columbia where medical marijuana is legal.

8 Tips for Patients Newly Diagnosed with Ehlers-Danlos

By Ellen Lenox Smith, Columnist

Ehlers-Danlos Syndrome (EDS) is a condition that causes one to be born with deformed connective tissue, the “glue” that holds the body together. At this time, there is still no cure to correct this problem, so living life with this condition means a accepting a certain level of chronic pain.

There are simple things to learn to live your life with EDS more safely. For instance,  learning how to properly strengthen the muscles that are on overload doing their job, along with that of the useless ligament and tendons. Or understanding how certain twists and turns bring on other slippage of the body.

Living with Ehlers-Danlos Syndrome means, at times, a long, lonely and difficult journey burdened with a constant search for direction on how to try to create something resembling   a normal life. I am 65, but it wasn’t until eleven years ago that I was finally given the correct diagnoses of something I was actually born with!

There have been times that I felt guilty for almost wishing I had been given a diagnosis of cancer -- for then the doors of hope, direction, plans and medical interest would have been with me at all times. Instead, as many other EDS patients have learned, we cope with the unknown, judgment from friends and even family, isolation, confusion, and the lack of consistent knowledgeable  help.

All I ever wanted, when first diagnosed, was for someone to reach a hand out and guide me. That hand has never been there. So, instead, I have spent the past eleven years attempting  to help prevent others from having to replicate my experience. I simply wish to assist other EDS patients avoid some of the uncertainty and stress that I was forced to experience.

The task is often overwhelming and difficult, but you have no choice. This is the life you have been given.

With that in mind, I would like to make suggestions to the newly diagnosed, in hopes that your journey will begin safely by addressing these issues:

1) Confirm with a knowledgeable geneticist that you have EDS. If you get the feeling they do not understand or believe you have EDS, then go to another geneticist. I met with three before I was convinced and accepted the diagnosis.

2) Mourn your losses. It’s okay and necessary to allow yourself to mourn the loss of your past life -- it will never again be exactly as you have known it. As you go through that process, remember you need to reach the goal of moving on.

3) Address pain control. Accept that you cannot take this journey on your own. You need to address your pain to have a chance of living as normal a life as you can. You might be like many of us and have trouble metabolizing certain medications. In that case, DNA drug sensitivity testing would help you to identify a compatible pain medication.

Many respond beautifully to medical marijuana instead of opiates. It can be taken in a simple dose of oil at night, that not only allows you to sleep but also carries pain relief to the body even into the next day.

4) Be evaluated by a neurologist for common EDS conditions such as tethered cord, Chiari I Malformation, and instability of the neck . This is a very important. Every patient should have this evaluation and have a neurologist monitor you. Many of us need to have the tethered cord released to end issues with the bladder, kidneys, pressure in the chest, and issues with legs. If you test positive, get it done and then you will feel so much better and be able to progress onto physical therapy more successfully.

Instability of the neck will cause havoc with your body if strengthening does not succeed. Chiari I Malformation must also be addressed. Any or all of these may be an issue for you in time, but please know that correcting them when the time is right will make the difference in moving forward again.

5) Find a good manual sacral physical therapist. This is your chance to take better control of your life by learning, through the guidance of a manual therapist. “Living Life to the Fullest With Ehlers-Danlos Syndrome” is a new book written by my therapist, Kevin Muldowney. He learned by taking on many EDS patients at his clinic, that there are safe ways to strengthen our muscles. I have been through the protocols and have found they work for me.

You’ll need to stay loyal to the daily workouts. But believe me, I love being proactive and so appreciate the good that is now showing -- like having the sacrum hold!

6) Develop a network of doctors that understand EDS or are willing get educated.  Feel free to visit my website to see if a doctor is listed near you. Also feel free to contact us if you have a good doctor that we can add to the list.

Remember, we are complicated and never get all better. That is a lot for a doctor to want to take on. Be patient and look for compatible personalities and let them learn through you.

7) Be sure to have a cardiologist.  You should have an echocardiogram (echo test) done yearly. The test uses sound waves to produce images of the heart and allows the cardiologist to see if your heart is beating and pumping blood correctly.

8) Determine drug and food allergies. I wish years ago I had a clue that there was testing out there to see why I had bad reactions to some medications and foods since birth. A simple DNA drug sensitivity test can help you find a safe drug to be able to put into your body. The same goes for food sensitivity testing. You will learn what foods are causing issues or what drugs are not metabolizing.

Both these issues are VERY important to address. If you keep taking medication or eating foods that are not compatible to your body, then you are adding to the inflammation in your system. More inflammation means more pain due to the increase of subluxations.

It's also important to remember that you are not alone. Find a local EDS support group and learn as much as you can to live more safely with this condition.

Ellen Lenox Smith and her husband Stuart live in Rhode Island. They are co-directors for medical marijuana advocacy for the U.S. Pain Foundation and serve as board members for the Rhode Island Patient Advocacy Coalition.

For more information about medical marijuana, visit their website.

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.

Marijuana No ‘Magic Bullet’ for Pain in Minnesota

By Pat Anson, Editor

Minnesota may be one of 23 U.S. states where medical marijuana is legal, but getting a prescription for cannabis there is difficult – especially for chronic pain patients.

Since Minnesota enacted one of the nation’s strictest medical marijuana laws last year, less than 700 people have enrolled in the state’s cannabis registry. Only nine health conditions qualify for a marijuana prescription in Minnesota – and chronic pain isn’t one of them – a status that appears unlikely to change after an advisory panel voted 5-3 not to allow pain patients into the cannabis registry.

The reason? Medical marijuana is “not a magic bullet” and there’s not enough evidence that it can treat pain.

“Panel members expressed concern that patients eligible to use medical cannabis for pain have expectations that it would provide total relief and that such a perception may leave patients to abandon other proven pain-management methods, such as physical therapy,” the recommendation said.

“Panel members cited the recent opioid crisis, where good medications were demonized because prescribers used it to treat pain without knowing its proper uses. Even after studying the information available on medical cannabis, panel members said providers do not feel prepared to certify patients for its use.”

The panel recommended that marijuana not be prescribed to anyone with a history of substance abuse or patients with mental health problems. If marijuana is allowed for intractable chronic pain, the panel suggested that patients should be disqualified if they are under 21, have a history of psychosis, are pregnant or breast feeding.

The final decision is in the hands of Minnesota’s Health Commissioner, who has until the end of the year to decide if medical marijuana should be allowed for intractable pain.

The nine conditions that qualify for medical marijuana in Minnesota are cancer, glaucoma, HIV/AIDS, Tourette Syndrome, Amyotrophic Lateral Sclerosis (ALS), seizures, severe muscle spasms, Crohn’s Disease and terminal illness.

Terminally ill cancer patients – many of whom are in pain – are allowed to use medical marijuana. And many say they’ve been able to reduce their use of opioids since they started taking marijuana, according to the Minneapolis StarTribune.

“What are we going to do about patients? What do we tell patients who we know we can help, but we currently can’t help them? That’s the remarkably frustrating thing about this process that gets to me,” said Manny Munson-Regala, CEO of LeafLine Labs, one of the state’s two medical marijuana producers.

In addition to limits on the conditions it can be prescribed for, medical marijuana is not available in leaf form and cannot legally be smoked in Minnesota.  It is only legal in a pill, vapor or liquid form.

Heroin: The Coming Tsunami

By Percy Menzies, Guest Columnist

The unintended consequences of legalization of marijuana in several states, coupled with the political unrest in the Afghanistan, Pakistan and Burma, are combining to create a heroin epidemic of a magnitude that has never before been seen in the United States.

Non-medical use of marijuana is legal in Colorado and Washington, and medical use of the drug is legal in 23 states. States are developing plans to grow marijuana in their respective counties to meet the expected demand for medicinal marijuana.

With the availability of legal marijuana growing nationwide, demand for Mexican marijuana is drying up. So, Mexican farmers are switching to opium, the easy-to-grow crop that is used to produce heroin.

More Mexican heroin is being smuggled every year into the United States, hidden in vehicles or carried across the border in backpacks. The number of heroin seizures along the southwest border has quadrupled since 2008, according to the Drug Enforcement Agency.

As the supply increases, heroin is becoming cheaper and more available than ever before.

Exacerbating the problem is that Afghanistan and Burma, which together produce 90 percent of the world's heroin supply, have borders that are insecure, making smuggling into Iran, India, China, Thailand, Pakistan, the former Soviet Republics and Russia relatively easy.

With the availability of legal marijuana growing nationwide, demand for Mexican marijuana is drying up. So, Mexican farmers are switching to opium, the easy-to-grow crop that is used to produce heroin.

More Mexican heroin is being smuggled every year into the United States, hidden in vehicles or carried across the border in backpacks. The number of heroin seizures along the southwest border has quadrupled since 2008, according to the Drug Enforcement Agency.

As the supply increases, heroin is becoming cheaper and more available than ever before.

Exacerbating the problem is that Afghanistan and Burma, which together produce 90 percent of the world's heroin supply, have borders that are insecure, making smuggling into Iran, India, China, Thailand, Pakistan, the former Soviet Republics and Russia relatively easy.

As a result, there are 1.6 million heroin addicts in Afghanistan, which translates to 5.3 percent of the population – one of the highest heroin addiction rates in the world. There are 1.8 million heroin addicts in Pakistan. Heroin is so ubiquitous in parts of Afghanistan and Pakistan that it is easier to find than life-saving medications.

Burma's Shan State is its main area for heroin production, and it is regaining its notoriety as part of the Golden Triangle. The heroin is smuggled from Burma primarily into three countries, China, India and Thailand.

Drug traffickers are becoming bolder, and rather than relying on land routes, they are increasingly shipping heroin through sea routes to lightly patrolled coasts in African, where it is then distributed to Europe, and eventually North America.

During the past 18 months, the Combined Maritime Forces, a partnership of 30 seafaring nations including the U.S., Canada and Saudi Arabia, has seized 4,200 kilograms of heroin traveling on that route, according to the Wall Street Journal.

It is simple economics: as supply goes up, price goes down. As price goes down, use goes up.

Heroin use in the United States has already reached a new high since people addicted to prescription opiates switch to heroin because it's so much cheaper. Street prices range from $5 to $10 for one button of heroin, good for one use, compared to $50 or more for one tablet of a prescription opiate.

Heroin addiction has been growing steadily in the United States for more than a decade, and overdose deaths more than doubled from 2010 to 2012, according to the Centers for Disease Control and Prevention report released in October.

The U.S. is unprepared for the coming tsunami. We were caught unprepared for the “man-made” addiction to prescription pain medications. Heroin quickly became the “generic” version for the prescription opioids and may well become the primary drug of choice.

The treatment of opioid addiction is further complicated by the fact that the two most widely used medications to treat opioid addiction, methadone and buprenorphine, are abusable and their use is restricted. The widespread use of buprenorphine has inadvertently contributed to increased addiction.

We have a lot of work to do, especially in the area of prevention and offering evidence-based treatment programs. It's not going to be enough to just expand needle exchange programs and distribute Narcan (naloxone) kits that can reverse opioid overdoses. Few patients, policymakers, medical and law enforcement professionals are aware of treatment options, especially the class of non-addicting medications like naltrexone (a drug closely related to naloxone) that protect patients from relapsing.

We need to aggressively combat this problem by educating people on the danger of heroin addiction and by offering viable treatments options for those addicted to heroin.

Percy Menzies is the president of the Assisted Recovery Centers of America, a treatment center based in St Louis, Missouri.

He can be reached at: percymenzies@arcamidwest.com

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.

New Setback for Medical Marijuana Spray

By Pat Anson, Editor

A British drug maker has announced more disappointing results from clinical studies on the use of a medical marijuana spray to treat cancer pain.

GW Pharmaceuticals (NASDAQ: GWPH) said results from two new Phase III studies showed that its Sativex oral spray worked no better than a placebo in treating cancer pain. That was the same finding the company reported in January from an earlier study involving nearly 400 patients in the United States, Mexico and Europe.

However, patients in the U.S. did show “statistically significant improvement” in their pain levels when Sativex was taken along with an opioid pain medication. GW and its partner, Otuska Pharmaceutical, have requested a meeting with the U.S. Food and Drug Administration to explain that finding. Sativex is getting a “fast track” review from the agency as a treatment for cancer pain.

"In light of the missed primary endpoint in the first trial earlier this year, these additional results are not a surprise. Nevertheless, we are encouraged by data across the trials which consistently show positive outcomes for U.S. patients when analysed as a separate cohort," said Justin Gover, GW's Chief Executive Officer.

image courtesy of gw pharmaceuticals

"We believe that this finding may provide important guidance in determining the optimal target patient population for Sativex and look forward to a discussion with the FDA on a potential path forward."

Sativex is composed primarily of two cannabinoids, CBD and THC, which are administered in an oral spray. Sativex is already being sold in Europe, Canada and Mexico to treat muscle tightness and contractions caused by multiple sclerosis. Canada also allows Sativex to be used for the treatment of neuropathic pain and advanced cancer pain.

The spray is not currently approved for use in the U.S. for any condition. It is estimated that over 400,000 cancer patients in the U.S. suffer from pain that is not well controlled by opioid pain medications.

"While the results overall have been disappointing, and not necessarily wholly consistent with clinical experience, nonetheless they suggest that Sativex may have a useful role in the treatment of certain subgroups of patients with advanced cancer pain who have exhausted opioid treatments," stated Dr. Marie Fallon, Professor of Palliative Care, University of Edinburgh and a principal investigator in the Phase III program.

"In particular, the U.S. patients enrolled in this program showed a useful therapeutic benefit whereas results in European patients were generally not favorable. These U.S. patients were less frail, hence the Sativex intervention was subjected to less ‘noise,’ providing clearer results and valuable guidance in determining the optimal target patient population for Sativex. This is a patient population with a significant unmet need and I believe that this important observation for Sativex warrants further investigation."

Cancer patients in all three studies were given Sativex or a placebo spray 3-to-10 times a day over a 5-week period. Patients remained on opioid therapy during the studies. Sativex was well tolerated, with the only side effects in some patients being dizziness and somnolence.

GW is developing other cannabis-based medicines to treat epilepsy, glioma, ulcerative colitis, type-2 diabetes, and schizophrenia.

Patients Say Non-Opioid Therapies Often Don’t Work

By Pat Anson, Editor

Pain treatments recommended by the Centers for Disease Control and Prevention (CDC) as alternatives to opioids often do not work and are usually not covered by insurance, according to a large survey of pain patients.  Many also believe the CDC’s opioid prescribing guidelines discriminate against pain patients.

Over 2,000 acute and chronic pain patients in the U.S. participated in the online survey by Pain News Network and the Power of Pain Foundation. Most said they currently take an opioid pain medication.

When asked if they think pain patients are being discriminated against by the CDC guidelines and other government regulations, 95% said they “agree” or “strongly agree.”  Only 2% said they disagree or strongly disagree.

The draft guidelines released last month by the CDC recommend “non-pharmacological therapy” and “non-opioid” pain relievers as preferred treatments for chronic non-cancer pain. Smaller doses and quantities of opioids are recommended for patients in acute or chronic pain.  A complete list of the guidelines can be found here.

“Many non-pharmacologic therapies, including exercise therapy, weight loss, and psychological therapies such as CBT (cognitive behavioral therapy) can ameliorate chronic pain," the CDC states in internal briefing documents obtain by PNN.

DO THE CDC GUIDELINES AND OTHER GOVERNMENT REGULATIONS DISCRIMINATE AGAINST PAIN PATIENTS?

“Several nonopioid pharmacologic therapies (including acetaminophen, NSAIDs, and selected antidepressants and anticonvulsants) are effective for chronic pain. In particular, acetaminophen and NSAIDs can be useful for arthritis and low back pain, and antidepressants such as tricyclics and SNRIs as well as selected anticonvulsants are effective in neuropathic pain conditions and in fibromyalgia.”

Most patients who were surveyed said they had already tried many of these non-opioid treatments and had mixed results, at best.

“Does the CDC really believe that a pain patient on long term opiates hasn't already tried everything else possible?” asked one patient.

“The CDC says don't do something but comes up with NO viable, realistic alternatives. Tylenol, etc., are unrealistic. Exercise is unrealistic when you are in too much pain to move! “ said another patient.

“Anti-anxiety meds are just as addictive. Over the counter pain medicines are not strong enough to cover the pain in a patient with chronic pain. And there are hundreds of pain patients who can't take NSAIDs because of an allergic reaction. Same thing with steroids,” wrote another.

When asked if exercise, weight loss or cognitive behavioral therapy had helped relieve their pain, only about a third of the patients surveyed said they “helped a lot” or “helped a little.” Nearly two-thirds said they “did not help at all.”

Over half said non-opioid medications such as Lyrica, Cymbalta, Neurontin, anti-depressants and anti-anxiety medications “did not help at all.”

Over the counter pain relievers such as acetaminophen and NSAIDs were even less helpful. Three out of four patients said they “did not help at all.”

“We must be mindful of the treatment options that the CDC guidelines stress over opioids,” said Barby Ingle, president of the Power of Pain Foundation. “For instance in my case, taking NSAIDS for an extended period (a little over 1 year) caused internal bleeding and ulcers which lead to being hospitalized, a surgical procedure, and months of home nursing and physical therapy that could have been avoided.

HAVE EXERCISE, WEIGHT LOSS, OR COGNITIVE BEHAVIORAL THERAPY HELPED RELIEVE YOUR PAIN?

“It is important to include a multi-disciplinary approach to care. We have to use non-pharmacological treatments and non-opioid medications in conjunction with more traditional treatments. Using chiropractic care, nutrition, good dental health, better posture, meditation, aqua therapy, etc., can go a long way in the management of chronic pain conditions.”

But the survey found that many of those treatments are simply out of reach for pain patients because they’re not covered by insurance.

When asked if their health insurance covered non-pharmacological treatments such as acupuncture, massage and chiropractic therapy, only 7% said their insurance covered most or all of those therapies.

About a third said their insurance “covers only some and for a limited number of treatments” and over half said their insurance does not cover those treatments. About 4% do not have health insurance.   

“I tried acupuncture and massage, paying out of my pocket, but neither helped. In fact, they hurt. I tried Lyrica, Savella, and Cymbalta. No luck. I do warm water aerobics three days a week WHEN I CAN TAKE MY OPIATES FIRST,” wrote one patient.

Although the CDC didn’t even raise the subject of medical marijuana in its guidelines, many patients volunteered that they were using marijuana for pain relief and that it worked for them.

DOES YOU INSURANCE COVER ALTERNATIVE TREATMENTS SUCH AS ACUPUNCTURE, MASSAGE AND CHIROPRACTIC THERAPY?

“Alternative medicine is needed. I am a huge advocate of medicinal marijuana, in addition to opioids to treat my disease,” wrote a patient who suffers from CRPS (Chronic Regional Pain Syndrome).

“If cannabis was legal and accessible, it would greatly lessen the need for prescription pain medication,” said another patient.

“I should be able to get the proper medical marijuana legally. I have tried it from a friend and it helps tremendously. However, I will not purchase it because it is illegal. I pray every day I can get it someday,” said a patient who suffers from lupus, arthritis and other chronic conditions.

The survey found patients were evenly divided on whether they should be required to submit to urine drugs tests for both prescribed medications and illegal drugs.

"In order to receive my monthly pain medication, I must submit to a urine screen and a pill count each and every month. I must (whether they work or not) agree to have steroid injections every few months. While I don't have any problem to submitting to urine screenings or pill counts, I do not like having injections that provide no help. I am trapped playing this game,” said a patient.

“99.9% of pain patients are responsible adults but are treated like toddlers who need constant supervision. Pain patients are sicker, fatter, and poorer because they are pumped full of chemicals and steroids. Forced to be experimental guinea pigs or forced to suffer if they say NO,” said another patient.

DO YOU THINK PATIENTS PRESCRIBED OPIOIDS SHOULD BE REQUIRED TO HAVE URINE DRUG TESTS?

"As both a chronic pain patient and a provider I get to view this issue from multiple perspectives. Of course opioids aren't the first line treatment for chronic pain, and when they are used they shouldn't be the only treatment. They are one part of a larger toolkit for managing chronic pain," wrote a registered nurse practitioner.

"There are many fortunate people who are able to manage their pain without medication, or even recover from pain completely using some of the wonderful new interventions we now have available. But there are large numbers of patients out there who have tried all the other medications and dietary changes and injections and PT (physical therapy) modalities and mindfulness. And they are still left with pain that only responds to opiates."

For a complete look at all of the survey result, visit the "CDC Survey Results" tab at the top of this page or click here.

CDC Should Consider Marijuana as Alternative to Opioids

By Ellen Lenox Smith, Columnist

Presently in our country, those that are successfully using opioids for pain relief are feeling dirty and lost -- largely due to fears about addiction and  overdoses. Pain patients often have to cope with physicians who are reluctant to prescribe opioids and pharmacies that are sometimes unwilling to fill their prescriptions.

The Centers for Disease Prevention and Control (CDC) is considering new guidelines that would encourage doctors to shift even further away from prescribing opioids, leaving the patient with little effective medication to turn to.

Why is the CDC not even considering the use of medical marijuana to help these people in need?

The Boston Herald recently reported that hundreds of opioid addicts are being treated successfully in Massachusetts with medical marijuana.

“We have a statewide epidemic of opioid deaths,” said Dr. Gary Witman of Canna Care Docs, which issues medical marijuana cards in seven states. “As soon as we can get people off opioids to a non-addicting substance — and medicinal marijuana is non addicting — I think it would dramatically impact the amount of opioid deaths.”

Witman is treating about 80 patients at a Canna Care clinic who are addicted to opioids, muscle relaxants or anti-anxiety medications. After enrolling them in a one-month tapering program and treating them with cannabis, Witman says more than 75 percent of the patients have stopped taking the harder drugs. Medical marijuana gave them relief from pain and anxiety — and far more safely than opioids.

Patients across the country are also learning they can use cannabis for pain relief, decreasing or even eliminating their use of opioids.  Marijuana works far better than other substitutes since it is not synthetic and does not cause organ damage or deaths like opioids can in some circumstances.

Medical marijuana works naturally on what is known as the “endocannabinoid system,” binding to neurological receptors in the brain that control appetite, pain sensation, mood and memory.

Here in Rhode Island, my husband and I have witnessed the amazing transition of pain patients on opioids that chose to transition to medical marijuana.  Most that turn to cannabis do so to eliminate the side effects of opioids and concerns about their long term use. They still achieve pain relief but know they are gaining that relief in a safer manner -- no organ damage, no teeth getting destroyed, no concerns of addiction and no deaths.

Marijuana may still be illegal at the federal level, but it is legal in 23 states and the District of Columbia, and millions of people are discovering its therapeutic benefits. The CDC should consider adding medical marijuana to the list of “non-opioid” therapies in its guidelines.

Ellen Lenox Smith and her husband Stuart live in Rhode Island. They are co-directors for medical marijuana advocacy for the U.S. Pain Foundation and serve as board members for the Rhode Island Patient Advocacy Coalition. 

For more information about medical marijuana, visit their website.

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.

Medical marijuana is legal in 23 U.S. states and the District of Columbia, but is still technically illegal under federal law. Even in states where it is legal, doctors may frown upon marijuana and drop patients from their practice for using it.

Daily Marijuana Safe and Effective for Chronic Pain

By Pat Anson, Editor

Chronic pain patients who use medical marijuana daily for a year suffered no serious side effects and significantly improved their levels of pain, mood and quality of life, according to a new study in Canada.

The clinical study by researchers at McGill University in Montreal is one of the first to test the long term safety and efficacy of medical marijuana. It’s been published online in the Journal of Pain, the official journal of the American Pain Society.

“Quality-controlled herbal cannabis, when used by cannabis-experienced patients as part of a monitored treatment program over one year, appears to have a reasonable safety profile,” wrote lead author Mark Ware, an associate professor in Family Medicine and Anesthesia at McGill University and one of the world’s leading experts on medical marijuana.

Pain News Network had a lengthy interview with Ware about his research earlier this year.

In his most recent study, Ware and his colleagues assessed the long-term health of 216 medical marijuana users with chronic non-cancer pain who consumed a standardized dose (12.5% THC) of up to 5 grams of marijuana daily through inhaling or vaporization. They were compared to a control group of 215 chronic pain sufferers who did not use marijuana. Both groups were monitored over the course of the one year study.

Researchers said the cannabis users had no serious side effects compared to the control group, and had a significant improvement in their pain, anxiety, depression, anger and fatigue.

“We noted significant improvements in pain intensity and the physical dimension of quality of life over one year among the cannabis users compared to controls; there was also significant improvement among cannabis users in measures of the sensory component of pain, symptom distress, and total mood disturbance compared to controls. These findings, while not the primary outcomes of the study, are nevertheless important in considering the overall risk-benefit ratio of medical use of cannabis,” Ware wrote.

IMAGE COURTESY DRUG POLICY ALLIANCE

“The results suggest that cannabis at average doses of 2.5g/d in current cannabis users may be safe as part of carefully monitored pain management program when conventional treatments have been considered medically inappropriate or inadequate.”

The marijuana group did report more non-serious side effects, such as headache, nausea,  dizziness, and respiratory problems associated with smoking.