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Cannabis and Chronic Pain

Medical Marijuana Tips for Chronic Pain Patients
Over one third of patients who carry a medical marijuana card in Ohio use their cannabis as medicine to treat chronic pain. Since the Ohio Medical Marijuana Control Program (OMMCP) commenced in January 2019, Ohio’s certified to recommend (CTR) physicians have issued more than 130,000 recommendations for medical marijuana to patients with chronic or intractable pain. 

If you’re one of these new patients beginning the journey to legally treat your pain with medical cannabis, consider these observations from doctors, scientists, and dispensary budtenders.

 

Traditional Chronic Pain Treatments

Chronic pain is defined as pain that continues for 3 months or more and may be caused by injuries, surgeries, or a wide range of other health conditions. Chronic pain usually involves treatment with medicines such as OTC or prescription pain relievers, antidepressants, and anticonvulsants. Treatment can be tricky, because it can be difficult to determine what specific condition may be causing the pain. Furthermore, different types of medicines need to be prescribed for patients who have different types of chronic pain. 

Doctors sometimes prescribe narcotics or opioids to treat chronic pain. In these cases, doctors weigh the risk of addiction versus the benefit of comfort to the patient. In some instances, medical marijuana can be used in tandem with opioid medicines to achieve a greater sense of comfort to the patient, especially in palliative care. In other instances, patients with chronic pain have been able to reduce or eliminate their use of opioids by switching to medical marijuana. 

If you are currently taking other pain medicines, it’s important to speak with your pain management provider before you get your medical marijuana card. Many pain management clinics will discontinue your opioid pain medicines if you join the medical marijuana program, often due to insurance reasons. 

 

What the Latest Science Says

While a myriad of anecdotal evidence of cannabis’ effectiveness in chronic pain treatments exists, research is beginning to catch up. Two important studies have been published this year: 

  • A small study by researchers at Harvard Medical School and McLean Hospital in Boston determined that long-term use of medical cannabis may be an effective treatment for chronic pain.The researchers observed thirty-seven patients suffering from arthritis, joint pain, neuropathy and other chronic pain conditions over a six-month period while ingesting cannabis products through smoking, vaporizing, edibles, oils, and other methods. All of the patients were relatively new to cannabis; they had either never used cannabis before or hadn’t used it at least a year prior to the study.

After six months of daily treatment with cannabis, patients in the Harvard study reported significant improvements in their pain, sleep, mood, anxiety and quality of life. Their use of opioid pain medication declined by an average of 13% and 23% after 3 and 6 months of treatment, respectively.

  • A July 2021 study from the Journal of Cannabis Research aimed to learn more precisely how to dose and administer medical cannabis in patients with chronic pain. Using a multistage modified Delphi process, twenty global experts across nine countries developed consensus-based recommendations. In the study, researchers developed a routine protocol for the participants of a CBD-predominant variety at a dose of 5 mg CBD twice daily and titrated the CBD-predominant dose by 10 mg every 2 to 3 days until the patient reaches their goals, or up to 40 mg/day. The study offered this advice: Physicians should be encouraged to titrate medical cannabis to the effects desired by each patient, as opposed to a specific CBD or THC dose. During the titration phase, the total daily dose of CBD and/or THC can be divided between two to four administrations. More information about the study can be found here. 

In Ohio, like most other legal states, a doctor may recommend a particular dose and form of administration, but a patient may purchase whatever products they want from the dispensary and dose themselves however they see fit. This can be a benefit to some patients, but other patients have expressed they’d rather have more guidance. 

 

Tips At the Dispensary

When visiting a dispensary for the first time, patients may have a lot of questions as a about how to medicate. Menus can be pages long and include flower, concentrates, tinctures, edibles, and other forms of administration. Many patients discover that despite a budtender’s knowledge about certain things, most of them are unable to answer every question. Be patient with staff and ask for another budtender or store manager to help you if you’re not getting the answers you need. 

The most important advice that budtenders and doctors alike echo is “Start low, go slow.” Even for patients who take powerfully high doses of opioid medications, a high-THC variety of cannabis will not produce an equivalent pain-relieving effect. Using cannabis that contains THC can be a vastly different experience than an opioid. Too much THC can cause paranoia, which can be a terrifying experience for a new cannabis patient. 

Once a patient has become accustomed to the effects of THC, it’s important that they then begin selecting strains and forms of administration to determine what will work best for their chronic pain condition. Keeping a cannabis journal can help you decide which strains aremost effective for your chronic pain. Way of Leaf suggests these 5 strains for chronic pain: White Widow, Blue Dream, Bubba Kush, Ak-47, and Jack Herer. If your chronic pain is specific to your lower back, you might find Northern Lights, AC/DC, or BlackJack could be an effective strain for you. Many chronic pain patients also find Rick Simpson Oil RSO to be helpful. 

 

If you believe you may qualify for a medical marijuana card due to chronic or intractable pain, make an appointment to be evaluated by a Duber Medical doctor today. 

 

Author: Gabrielle Dion Visca

Gabrielle has been writing and editing professionally for the medical and wellness industries for more than 20 years. She’s held positions with The Journal of Pediatrics, Livestrong, The Cincinnati Enquirer, and Patient Pop. She currently writes articles about medical marijuana for Duber Medical, and is the founder of the Ohio cannabis journalism non-profit, MedicateOH.

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