The Big Debate: Medical Marijuana for Arthritis and Chronic Pain - by Ashley Boynes-Shuck

The medical use of marijuana has been a hotly debated and highly politicized topic in recent years. In many circles, it is touted for naturally alleviating symptoms of a variety of medical conditions including, but not limited to, arthritis and chronic pain. In other circles, it is frowned upon as a gateway drug that is likely to be abused, and, to some, a moral abomination.

In many countries, the use of marijuana is legal and widely accepted, and, in the United States, it is just beginning to become legalized in certain states for medical use only. According to the Americans for Safe Access and Marijuana Policy Project organization, the use of cannabis (for medical reasons ONLY) has been endorsed by numerous professional organizations, some of which include the American Academy of Family Physicians, the American Public Health Association, The American Public Health Association, and the American Nurses Association. Its use is supported by such leading medical publications as The New England Journal of Medicine and other publications and, of course, by many marijuana advocacy organizations. 

But – that doesn’t mean that everyone agrees with it. Over the years, the FDA repeatedly doubted its medical benefit, but multiple studies have shown that it can, in fact, help with various conditions ranging from glaucoma and anxiety, to chemo-induced nausea and cancer pain, and more. 

Despite generally being written off by the FDA & DEA, in 1999, Institute of Medicine, a part of the National Academy of Sciences, conducted a study that found marijuana to be “moderately to well-suited for particular conditions,” including those listed above. 

This is just one of many studies showing the benefit of medical marijuana. According to the organization Americans for Safe Access, “Between 1840 and 1900, European and American medical journals published more than 100 articles on the therapeutic use of the drug known then as Cannabis Indica (or Indian hemp) and now simply as cannabis. Today, new studies are being published in peer-reviewed journals that demonstrate cannabis has medical value in treating patients with serious illnesses such as AIDS, glaucoma, cancer, multiple sclerosis, epilepsy, and chronic pain.”

One might ask why there’s such concern when so many studies have proven it to be useful? According to the FDA and other government organizations like the DEA, these studies aren’t enough to prove its medical efficacy. The DEA states that, “adequate and well-controlled studies on the medical efficacy of medical cannabis do not exist,” and many conservative groups are against its use for moral reasons. After all, marijuana and its components and/or derivatives have been largely labeled as “gateway drugs” that can potentially cause users to become addicted, eventually moving on to stronger, and harsher drugs that are well-documented to be far more dangerous. 

That doesn’t mean, however, that steps aren’t being taken to use marijuana for medical purposes. It is illegal on the federal level, but has already been legalized on the state level in Alaska, Hawaii, Oregon, Nevada, Vermont, Montana, Michigan, Colorado, California, Main, Arizona, Vermont, New Jersey, New Mexico, Washington, the District of Columbia, and Rhode Island, and many other states in the US have pieces of legislation on the table to potentially do the same. 

There are also pharmaceutical companies that are trying to capitalize by developing cannabis-based products, such as Sativex, by British pharma company, GW. Sativex is a cannabis mouth-spray that is currently seeking FDA approval for cancer pain and multiple sclerosis. Sativex was also evaluated for efficacy for arthritis.  According to ProCon.org, 

“Rheumatology reported in a Jan. 2006 article titled “Preliminary Assessment of The Efficacy, Tolerability and Safety of A Cannabis-based Medicine (Sativex) in The Treatment of Pain Caused By Rheumatoid Arthritis,” by D.R. Blake et al.: ‘In comparison with placebo, the CBM [cannabis-based medicine] produced statistically significant improvements in pain on movement, pain at rest, quality of sleep….

In the first ever controlled trial of a CBM in RA [rheumatoid arthritis], a significant analgesic effect was observed and disease activity was significantly suppressed following Sativex treatment.’”

Other marijuana-based pharmaceuticals have been developed such as Marinol (dronabinol) and Cesamet (nabilone), which are synthetic versions in pill form that are available by prescription for AIDS patients and cancer patients, but many wonder if the synthetic versions are as beneficial as it is in its natural form — after all, the “natural” and holistic part of marijuana is part of its appeal for many, who don’t want to put more drugs into their bodies.

But would it help with arthritis? Aside from the studied mentioned above, there is evidence to indicate medical marijuana/cannabis use for various forms of arthritis and rheumatic disease.

Pain Management of America states that, point blank, “medical marijuana is an effective treatment for arthritis pain and inflammation.”  Health.com did an article on a Rhode Island resident who had RA. His name is Steve, and he grows it himself. He said he, “grows one plant — marijuana — specifically to relieve RA pain and discomfort.



“If my pain is at a 10, it will take it down to a 6 or 6.5,” he says. “I’m an old-man weight lifter. After I smoke, I am able to work my shoulders and arms to keep my joints healthy. It gives me the desire and ability to get through a workout.”



Steve has had permission to grow marijuana for medicinal purposes since 2006. He smokes it and cooks it in butter (for baking) and makes THC-containing solutions called tinctures (which can be added to foods and drinks) for himself and five other patients with various medical conditions. His home state is 1 of 16, along with the District of Columbia, where marijuana is permitted for medicinal use.”

According to an article in Huffington Post, “Cannabis may be useful for people with RA and other chronic pain conditions because it can alleviate pain, reduce inflammation, and promote sleep. But unlike other pain-causing conditions, such as osteoarthritis, RA is associated with a higher risk of lung problems and heart attacks. (RA is an autoimmune condition that attacks the joints and causes multiple health problems.)



It’s not clear if smoking marijuana is a relatively safe pain reliever for people with RA, or if it could increase the risk of RA-associated conditions. And if cannabis is safe, it’s still debatable whether it’s safer to take it as a pill or mouth spray rather than smoking it. Smoking marijuana raises the heart rate and one study found that heart-attack risk rises fivefold in the hour after lighting up, according to the National Institute on Drug Abuse.



Medical marijuana remains controversial — and thus under-studied — in part because it is the most commonly abused illicit drug in the U.S.

How marijuana works


There are hundreds of chemicals in marijuana, but the best known is delta-9-tetrahydrocannabinol, or THC. THC is what produces the high that comes with smoking or eating products made from marijuana. 



But THC also binds with receptors in the brain that produce an analgesic affect. It may also reduce anxiety experienced by some people dealing with chronic pain.



Marijuana is typically smoked, which produces the most rapid delivery into the bloodstream, says Kathryn Cunningham, Ph.D., director of the Center for Addiction Research at the University of Texas Medical Branch, in Galveston.”

As you can see, like most medical drugs out there today, there are pros and cons to using marijuana. Every medication we take has a risk/benefit ratio, and, the potential for side effects. Medical marijuana is no different, but, appears to have potentially less risk for side effects or long-term damage than traditional meds. That being said, the lack of definitive evidence either way is why the FDA, DEA – and maybe even your doctor – are skeptical or, at the very least, hesitant.

But advocates for “mmj” as it is often referred to online, say that any risks or potential side effects are worth it. “Cannabis has also been shown to have powerful immune-modulation and anti-inflammatory properties,[23-26] suggesting that it could play a role not just in symptom management but treatment of arthritis,” says Americans for Safe Access. They have a whole section on medical marijuana and arthritis, here. You can also read more from a 2005 study, published in Rheumatology, and featured in Medical News Today, here, that states that “The first study to use a cannabis-based medicine (CBM) for treating rheumatoid arthritis has found that it has a significant effect on easing pain and on suppressing the disease.” 

With all of that being said, the fact remains that marijuana remains the most illicitly abused illegal drug in America, and we certainly aren’t the only country with this same marijuana debate. 

DrugAbuse.gov says that “Marijuana is the most common illicit drug used in the United States. After a period of decline in the last decade, its use has generally increased among young people since 2007, corresponding to a diminishing perception of the drug’s risks. More teenagers are now current (past-month) smokers of marijuana than of cigarettes, according to annual survey data,” and that, “Research clearly demonstrates that marijuana has the potential to cause problems in daily life or make a per-son’s existing problems worse. In fact, heavy marijuana users generally re-port lower life satisfaction, poorer mental and physical health, relation-ship problems, and less academic and career success compared to their peers who came from similar back-grounds. For example, marijuana use is associated with a higher likelihood of dropping out from school. Several studies also associate workers’ marijuana smoking with increased absences, tardiness, accidents, workers’ compensation claims, and job turnover.

Research has shown that, in chronic users, marijuana’s adverse impact on learning and memory persists after the acute effects of the drug wear off; when marijuana use begins in adolescence, the effects may persist for many years. Research from different areas is converging on the fact that regular marijuana use by young people can have long-lasting negative impact on the structure and function of their brains,” so you can see why there are strong proponents on both sides of the great marijuana debate.

If it is legal in your state, and you have been prescribed marijuana for your arthritis pain, we’d love for you to leave a comment and share your experience. Likewise, if you are against it, or live in an area where the use of marijuana is not legalized, we’d like to hear your thoughts, too.

 

Stay Well,

Ashley Boynes-Shuck

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