More Patients Swapping Out Opioids For Medical Marijuana To Manage Pain

January 12, 2023 / Thomas Cohn, MD

New research has found that nearly one-third of patients with chronic pain report using medical cannabis to manage their pain, with more than half of them decreasing their reliance on other pain medications, like opioids, in the process.

“That patients report substituting cannabis for pain medicines so much really underscores the need for research on the benefits and risks of using cannabis for chronic pain,” said lead author Mark C. Bicket, MD, PhD, assistant professor, Department of Anesthesiology, and director, Opioid Prescribing Engagement Network, University of Michigan, Ann Arbor, in an interview with Medscape Medical News.

Medical Cannabis Use

For the study, researchers surveyed 1,724 Americans over the age of 18 with chronic noncancer pain living in areas where medical cannabis was available. Participants were asked about their use of three different types of pain management:

Medical marijuana
Pharmacologic treatments like opioids, non-opioid analgesics and over-the-counter medications
Non-pharmacologic treatments like physical therapy, cognitive behavioral therapy or mindfulness

After looking at the survey results, researchers found that 25.9 percent of respondents reported using medical cannabis within the last year, and 23.2 percent reported using it within the past 30 days. More than half of patients who said they used medical cannabis said this also led to a decrease in prescription opioid use, prescription non-opioids and over-the-counter medications. “Almost no one” said that medical cannabis led to a higher use of these medications, said Dr. Bicket.

Medical cannabis use also impacted other treatments as well, for the good and the bad. 38.7 percent of people said that cannabis use led to decreased physical therapy sessions, 19.1 percent said it led to lower use of meditation, and 26 percent said it led to less CBT. Conversely, 5.9 percent of patients said cannabis use led to more physical therapy, 23.7 percent said it led to more meditation therapy, and 17.1 percent said it led to more CBT, so cannabis use clearly had a more widespread variance on other therapies than it did on pharmacological treatments, which saw a very obvious decreased correlation.

While Bicket was pleased with the findings, he noted that the current environment – where cannabis use is medically approved on some state levels but illegal on the federal level – makes it harder to accurately study the best ways to implement cannabis use for a patient population.

“We really don’t have a good sense of the relative risks and benefits that could come from cannabis as a treatment for chronic pain,” said Bicket. “As a physician, it’s difficult to have discussions with patients because I’m not able to understand the products they’re using based on this regulatory environment we have.”

Bicket seems to have the same gripes about the current medical marijuana climate that we have about chronic pain care in general. For one reason or another, we’re not able to easily study the best ways to treat chronic pain or harness the power of certain treatments like medical marijuana. Hopefully the landscape changes in the near future so that patients can have better access to the right treatments for their individual needs.

Five Ways To Get Your Doctor To Take Your Chronic Pain Seriously

January 5, 2023 / Thomas Cohn, MD

Chronic pain is nothing if not frustrating, and that’s especially true when you’re trying to get others to understand the extent of your chronic pain condition. People oftentimes fail to understand the depth of another person’s chronic pain simply because pain is so unique to the individual. And while you may not be much worse off if a friend or family member doesn’t take your pain seriously, you can feel helpless when it’s a medical professional who isn’t taking you seriously.

Not being taken seriously or not being believed is one of the biggest complaints we hear from patients who have had no success treating their pain condition with other providers. We strive to show that we take each patient seriously, but if you want to make it easier for your pain physician to believe your story, we have some tips for you. Below, we showcase some ways to get your doctor to take you chronic pain seriously.

How To Have Your Pain Taken Seriously

The best advice we can give is to search for a physician who takes your word at face value. We understand that’s not always easy, but if you want to make it easier for your physician to understand your pain and take it seriously, consider these five tips.

1. Be Detailed – Be very detailed about your chronic pain and discomfort. Many patients find it helpful to keep a pain journal so that both the patient and provider can get a better idea of how pain has impacted you recently. Don’t just note how intense your pain is, document what makes it better or worse, what foods you ate and what activities you pursued that day so that the total picture becomes clearer.

2. Follow Through – If you’re not willing to do what the doctor recommends, they may assume that you’re embellishing your pain a bit. If you’re skipping your physical therapy sessions, not seeking out exercise or failing to change your diet, then your doctor may assume that you don’t take your condition seriously, so why should they?

3. Have Two-Way Conversations – You may be in a lot of pain, but if you just show up to the doctor’s office and expect them to figure out what’s going on and the best way to treat it on their own, you may end up frustrated with your care. If you want to be taken seriously and have a better chance of finding the right treatment for your pain, the conversation can’t just be one sided. You need to open up to your doctor, ask them questions and then converse with them when they have questions for you. Being helpful and engaged during your appointments shows that you are committed to helping find the right treatment.

4. Ask About Active Solutions – As we’ve said on the blog numerous time in the past, pain medications can play an important part in your treatment, but a doctor will be more receptive to your care if you show an interest in active treatments instead of passive treatments like opioids. When you ask what you can do to help manage your condition with active treatments, it showcases that you’re willing to put in the work and aren’t just looking for the easiest solution.

5. Come To Dr. Cohn – Finally, if you’re sick and tired of not having your pain condition taken seriously, connect with Dr. Cohn and his team. Pain is highly individualized, and we promise to give you the personalized attention you need to figure out what’s going on and the best way to treat it. We strive to go the extra mile for each one of our patients.

For more information, or for help with a specific pain condition, reach out to Dr. Cohn’s office today at (952) 738-4580.

New Ways To Tackle Your Chronic Pain In The New Year

December 28, 2022 / Thomas Cohn, MD

If you hope that the new year will bring you chronic pain relief, know that this process won’t just happen on its own. If you’ve been struggling to find relief from your chronic pain, it’s time to switch up your current treatment plan. With that in mind, we wanted to share some new ways that you can try to better manage your chronic pain condition in the new year.

New Ways To Approach Your Pain Condition

If you want 2023 to be the year you get control over your chronic pain condition, you may need to adjust your current approach. Here are some new techniques for conquering your pain condition in the new year.

1. Consult With A Pain Specialist – Many people turn to their family doctor or a general practitioner for help with their pain condition, and while that’s a fine place to start, they likely won’t be your best resource for pain care. This year, resolve to connect with a pain management specialist who can give you the individualized attention that you and your pain condition deserve. Pain is complex, and it is best addressed by a professional who specializes solely in pain management.

2. Take Up One New Active Hobby – Chronic pain oftentimes responds to exercise and movement, but we understand that jumping into an exercise routine if you have chronic pain isn’t easy. While we still recommend an exercise routine, you may find that you have more success by finding an active hobby that you enjoy. An active hobby can give you the benefits of exercise without feeling like a traditional workout. Consider cycling, swimming, hiking, or yoga in the new year, and you may just notice an improvement in your chronic pain condition.

3. Reset Your Sleep Cycle – Quality sleep can help you get more control over your pain condition, and the opposite is also true. Poor sleep can make pain sensations feel more intense, and it can also leave you feeling tired and without the motivation to exercise and move. In the new year, really make it a point to reset your sleep schedule so that you get 7-9 hours of continuous sleep. Strive to go to bed earlier and at the same time each night so that your body can get into a better sleep rhythm. As your sleep improves, so too will your pain condition.

4. Journal – Finally, consider starting a pain journal in the new year. It’s much easier to get a true understanding of what affects our pain condition for the good and the bad if we write down our experiences so that we can reflect on them later. Write down how you’re feeling, how active you were, what you ate and drank and how quality your sleep was the night before. Odds are patterns will begin to emerge that will allow you to make more informed choices going forward that will help you better control your pain condition.

If your current approach to pain management isn’t working, try something new in the new year. For more information, or for help with your pain issue, reach out to Dr. Cohn and his team today at (952) 738-4580.

Six Tips For Managing Chronic Pain In The Winter

December 22, 2022 / Thomas Cohn, MD

The snow is here to stay in Minnesota, and while it may look pretty, the winter weather can lead to more chronic pain flareups if we’re not careful. Managing your chronic pain condition takes a little more intentional effort during the winter, but it’s certainly not impossible to keep chronic pain at bay during the cold season. Below, we share six tips for managing your chronic pain condition this winter.

Preventing Chronic Pain During The Winter

Winter is officially here, and while you may want to curl up in a ball for the next three months until everything starts to thaw, that’s only going to lead to more pain and discomfort, because your body craves activity that helps to make it healthier. Instead, here are some of the ways you can keep your chronic pain at bay and work towards a healthier version of yourself during these winter months.

1. 45 Minutes A Day – Prioritize movement and activity every single day. We understand that you may not want to go out in the cold in order to go for a walk or head to the gym, but you need to find a way to stay active. Exercise and activity strengthens key muscles and keeps soft tissues working properly, and this can help to ward off painful inflammation. Whether it’s in the form of some exercises in the basement or walking on a treadmill while watching a show, you need to challenge your body with movement for at least 45 consecutive minutes each day.

2. Hydrate – It can be easy to overlook the importance of water during the winter months, even when we are surrounded by its frozen version when we look outside. Blood can’t reach structures as easily when we’re dehydrated, and that can lead to functional issues like cramps or spasms in our muscle groups. Keep a big glass of water nearby at all times during the winter, and strive to finish your glass multiple times each day.

3. Diet And Your Immune System – You can help to give your immune system a boost by eating a range of healthy foods, like vegetables, whole grains, fruits and good fats. The more color you have on your plate, the better. Carbohydrate-dense and sugary foods are pro-inflammatory, and that can lead to chronic pain flare ups, so be mindful of your diet this winter.

4. Use Heating Pads Carefully – Heating pads can help to calm inflamed joints and help blood flow in and out of an area more easily, but you’ll want to be smart when using heat, because high settings can lead to burns. Use heat on low or medium settings for 20-30 minutes at a time, or soak in a warm bath so that your whole body can get the benefits of heat.

5. Layer Up – Speaking of staying warm, it’s essential that you dress for the weather to help keep your body warm. Our joints don’t work as well when we’re cold because of how the temperatures can affect the synovial fluid in our joints. If your chronic pain is in your joints, then the cold weather is likely your enemy. Dress in multiple layers so that your body stays warm when you’re out in the cold this winter.

6. Limit Alcohol Use – Alcohol will cause your blood vessels to dilate, which can cause your body to lose heat, and that can be a problem for your chronic pain condition. Alcohol can also be pro-inflammatory, leading to more inflammation in our joints. And while it may seem like alcohol can help you fall asleep, it tends to lead to less restful sleep. Your body relies on this restorative sleep to rid itself of toxins and other waste products that can contribute to chronic pain. Instead of consuming holiday spirits this season, drink a hot tea or soup to help warm you up.

We hope you have a great holiday season and an enjoyable winter season, and if you need any help overcoming a chronic pain issue that you’re facing, reach out to Dr. Cohn and his team today at (952) 738-4580.

COVID-19 Vaccine Science Could Help Tackle Chronic Pain

December 16, 2022 / Thomas Cohn, MD

The COVID-19 pandemic forced medical experts to explore different ways to help slow the spread and create vaccines, and one of those techniques involved the infusion on monoclonal antibodies to help patients fight infections. Monoclonal antibodies are lab-made antibodies that help the patient overcome infections and illnesses, but the hope is that the same technology may eventually be able to replace opioids and help calm chronic pain conditions.

Research is currently being led by Vladimir Yarov-Yarovoy and James Trimmer, two professors in the Department of Physiology and Membrane Biology at the University of California Davis School of Medicine. They’ve also employed several experts to work on their team, including members who have worked to turn tarantula venom into pain medication. The team was awarded a $1.5 million grant earlier this year by the National Institutes of Health’s HEAL Initiative, which hopes to develop solutions for the nation’s opioid crisis.

Hoping To Curb Opioid Use

Addictive opioids are a problem here in the US and worldwide. According to the CDC National Center for Health Statistics, there were 107,622 drug overdose deaths in 2021, up from 93,655 in 2020. Researchers hope that alternative therapies can help to quell chronic pain without turning to potentially dangerous medications.

“Recent breakthroughs in structural and computational biology — using computers to understand and model biological systems — have set the stage for applying new approaches to create antibodies as superior therapeutic candidates to treat chronic pain,” said Yarov-Yarovoy. “Monoclonal antibodies are the fastest growing sector of the pharmaceutical industry and have many advantages over classical small molecule drugs,” added Trimmer.

Trimmer and his lab team have created thousands of different mononclonal antibodies for various purposes over the years, but this will be the first time he turns his attention towards creating antibodies designed for pain relief. And while the prospect of treating chronic pain with the help of monoclonal antibodies may be new, the technology is already being used to treat other ailments. The Food and Drug Administration has already approved monoclonal antibodies to help prevent and treat certain types of migraines.

“Nerve cells are responsible for transmitting pain signals in the body. Voltage-gated sodium ion channels in nerve cells are the key transmitters of pain,” explained Yarov-Yarovoy. “We aim to create antibodies that will bind to these specific transmission sites at the molecular level, inhibiting their activity and stopping the transmission of pain signals.”

If successful, researchers say the antibodies will fit into these sodium ion channels like a lock into a key. These antibodies will then stop the channels from sending pain signals but not interfere with other signals sent through the nerve cells.

So while there is optimism that these antibodies could be harnessed to help treat chronic pain, researchers say that viable human antibodies are still years away. First they’ll need to create antibodies to be tested on lab-created neutral tissue, so hope for a “pain vaccine” is still years away.

One of the most exciting aspects of monoclanal antibodies is that they can circulate in the bloodstream for an extended period before they are broken down by the body. While non-steroidial anti-inflammatory medications are broken down quickly by the body, researchers believe monoclanal antibodies will remain in a person’s system for a month or longer before they are broken down by the body. The team hopes that this means that patients would only need to self-inject with the monoclanal antibodies once a month.

“For patients with chronic pain, that’s exactly what you need,” Yarov-Yarovoy said. “They experience pain, not for days, but weeks and months. The expectation is that the circulating antibodies will be able to provide sustained pain relief for weeks.”