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Migraine & Headache Disorders and Cannabis
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Chronic Pain & Cannabis

by 420insight on July 25, 2015
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Prominent health organizations acknowledge the benefits and lack of side effects of using medical cannabis for controlling chronic pain

Chronic pain is widely accepted by the medical community to signify disease itself, which can be made much worse by environmental and psychological factors. Chronic pain persists over a long period of time and is resistant to most medical treatments. Chronic pain causes severe problems for patients, especially when you have two or more co-existing chronic pain conditions like:

  • Endometriosis
  • Fibromyalgia
  • Inflammatory Bowel Dises
  • Interstitial Cystitis
  • Temporomandibular Joint Dysfunction
  • Chronic Fatigue Syndrome
  • Vulvudynia
  • And many more…

There is scientific evidence that cannabinoids possess pain ­relieving properties, and some clinical evidence to support their medical use for patients suffering from painful conditions.

Cannabis helps cancer and HIV patients and others who suffer from the most severe cases of chronic pain. While some people can't walk without experiencing severe pain, others are unable to eat regularly due to a decreased appetite from other prescribed medications.

Cannabis helps you deal with non-stop chronic pain and function better throughout the day, increasing your quality of life

If you are suffering from chronic pain, you may experience greater relief if your doctors add cannabinoids – the main ingredient in cannabis or medical marijuana – to an opiates-only treatment.

A combined therapy of opiates and cannabis could result in reduced opiate dosages.

The number of Americans who suffer from chronic pain is approaching 80 million–more people than diabetes, heart disease and cancer combined, according to the National Centers for Health Statistics.

More and more influential medical associations support cannabis and its derivatives for pain management and other medical conditions because research has shown it to be effective. When examining the risks and benefits of marijuana use for pain, the benefits far outweigh the risks.

Cannabis has therapeutic properties not replicated by other available medications - and side effects of cannabis are typically less severe than ones associated with common prescription medications.


Research Shows

Three puffs a day of cannabis, better known as marijuana, helps people with chronic nerve pain due to injury or surgery feel less pain and sleep better, a Canadian team has found.

''It's been known anecdotally," says researcher Mark Ware, MD, assistant professor of anesthesia and family medicine at McGill University in Montreal. "About 10% to 15% of patients attending a chronic pain clinic use cannabis as part of their pain [control] strategy," he tells WebMD.

But Ware's study is more scientific -- a clinical trial in which his team compared placebo with three different doses of cannabis. The research is published in CMAJ, the Canadian Medical Association Journal.

The new study ''adds to the trickle of evidence that cannabis may help some of the patients who are struggling [with pain] at present," Henry McQuay, DM, an emeritus fellow at Balliol College, Oxford University, England, writes in a commentary accompanying the study.

Study Details

Three puffs a day of cannabis, better known as marijuana, helps people with chronic nerve pain due to injury or surgery feel less pain and sleep better, a Canadian team has found.

''It's been known anecdotally," says researcher Mark Ware, MD, assistant professor of anesthesia and family medicine at McGill University in Montreal. "About 10% to 15% of patients attending a chronic pain clinic use cannabis as part of their pain [control] strategy," he tells WebMD.

But Ware's study is more scientific -- a clinical trial in which his team compared placebo with three different doses of cannabis. The research is published in CMAJ, the Canadian Medical Association Journal.

The new study ''adds to the trickle of evidence that cannabis may help some of the patients who are struggling [with pain] at present," Henry McQuay, DM, an emeritus fellow at Balliol College, Oxford University, England, writes in a commentary accompanying the study.

Ware evaluated 21 men and women, average age 45, who had chronic nerve pain (also called neuropathic pain). A typical example, Ware tells WebMD, is a patient who had knee surgery and during the course of the operation the surgeon may have had no choice but to cut a nerve, leading to chronic pain after the surgery.

Ware's team tried three different potencies of marijuana, with the highest a concentration at 9.4% tetrahydrocannabinol (THC) herbal cannabis. He also tested 2.5% and 6% THC.

''Each person was in the study for two months, and used all four strengths [including placebo]," Ware says. He rotated them through the four strengths in different orders, and they didn't know which they were using.

The cannabis was put into gelatin capsules, then put into the bowl of a pipe. Each person was told to inhale for five seconds while the cannabis was lit, hold the smoke in their lungs for 10 seconds, and then exhale.

They did this single puff three times a day for five days for each of the doses and the placebo. The participants were allowed to continue on their routine pain medications.

After each of the five-day trials, participants rated their pain on a scale of zero to 10, with 10 being the worst.

The highest dose, 9.4%, provided relief, Ware says. "They reduced their pain down to 5.4," Ware says. "Those on placebo were at 6.1."

Although that difference may seem modest, ''any reduction in pain is important," Ware says.

The concentration of 9.4%, Ware says, is lower than that found in marijuana on the street. "On the street, it's 10% to 15% THC, more or less," he says.

"We've shown again that cannabis is analgesic," Ware says. "Clearly, it has medical value."

Side effects were reported, including headache, dry eyes, numbness, cough, and a burning sensation in the area with pain.

The cannabis relieves pain, Ware says, by ''changing the way the nerves function."

Second Opinion

Marijuana's pain-relieving potential is worth investigating, McQuay says in his commentary.

He points out the average daily pain relief was lower, ''but not hugely so," for people taking the highest concentration of marijuana.

The cannabis, he tells WebMD in an email interview, "may help some patients who have limited relief from other remedies, but current cannabis formulations are unlikely to replace existing treatments."

Among McQuay's disclosures are serving as an advisory board member for Pfizer's Data Safety and Monitoring Board, as a consultant for Sanofi and other companies, and receiving royalties for a textbook on pain.

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2 Comments
Leave a response
  • Marilyn (Lott)
    April 28, 2016 at 7:16 pm

    How come pain scale is one – ten? How about on a scale of 10 and up? Medical idiots don’t get that 10 is for amateurs.

    • 420insight
      October 17, 2016 at 1:24 pm

      THE PAIN SCALE

      0 – Pain free.

      Mild Pain – Nagging, annoying, but doesn’t really interfere with daily living activities.

      1 – Pain is very mild, barely noticeable. Most of the time you don’t think about it.

      2 – Minor pain. Annoying and may have occasional stronger twinges.

      3 – Pain is noticeable and distracting, however, you can get used to it and adapt.

      Moderate Pain – Interferes significantly with daily living activities.

      4 – Moderate pain. If you are deeply involved in an activity, it can be ignored for a period of time, but is still distracting.

      5 – Moderately strong pain. It can’t be ignored for more than a few minutes, but with effort you still can manage to work or participate in some social activities.

      6 – Moderately strong pain that interferes with normal daily activities. Difficulty concentrating.

      Severe Pain – Disabling; unable to perform daily living activities.

      7 – Severe pain that dominates your senses and significantly limits your ability to perform normal daily activities or maintain social relationships. Interferes with sleep.

      8 – Intense pain. Physical activity is severely limited. Conversing requires great effort.

      9 – Excruciating pain. Unable to converse. Crying out and/or moaning uncontrollably.

      10 – Unspeakable pain. Bedridden and possibly delirious. Very few people will ever experience this level of pain.

      Avoiding the Pitfalls

      When rating their pain, the most common mistake people make is overstating their pain level. That generally happens one of two ways:

      Saying your pain is a 12 on a scale of 0 to 10.
      While you may simply be trying to convey the severity of your pain, what your doctor hears is that you are given to exaggeration and he will not take you seriously.

      Smiling and conversing with your doctor, then saying that your pain level is a 10.
      If you are able to carry on a normal conversation, your pain is not a 10—nor is it even a 9. Consider the fact that natural childbirth (no epidural or medication) is generally thought to be an 8 on the pain scale. Just as with the first example, your doctor will think you are exaggerating your pain and it is probably not nearly as bad as you say.

      If you want your pain to be taken seriously,
      it’s important that you take the pain scale seriously.

      Because pain is subjective, it is difficult to explain what you’re feeling to another person—even your own doctor. The pain scale may not be ideal, but it’s the best tool we have right now. Researchers are working on developing tests that one day may be able to objectively measure the degree of pain we’re experiencing. But until those tests are perfected and become widely available and affordable, we’ll have to make the best use of what we have.

      Download a free, printable version of the pain scale right here

      Sources:
      “Comparative Pain Scale.” Lane Medical Library, Stanford Medicine. December 2008.
      “Medical Pain Scale.” The Spine Center. Retrieved 4/7/15.
      _______________

      Karen Lee Richards is ProHealth’s Fibromyalgia Editor. She is also co-founder of the National Fibromyalgia Association (NFA) and was Executive Editor of Fibromyalgia AWARE magazine for four years.

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