Medical Marijuana Approved For Chronic Pain Patients In Minnesota

December 4, 2019 / Thomas Cohn, MD

Earlier this week, Minnesota regulators announced an expansion to the state’s medical marijuana program, as they added chronic pain and age-related macular degeneration to the list of conditions that can make a person eligible for treatment. The state’s Health Department also said they planned to expand to more sites so patients can have easier access to medical marijuana.

This is a large expansion for the relatively young medical cannabis program here in Minnesota, which began back in 2014. Back then, only nine conditions made the original list of approved conditions. Now, the program has expanded to include conditions like:

PTSD
Cancer
Sleep Apnea
Chronic Pain
Macular Degeneration

Health Commissioner Jan Malcolm said the new conditions were added to give individuals more ways to deal with debilitating illnesses.

“Minnesota’s medical cannabis program tracks patient experiences so we can learn about the real-world benefits and downsides of using medical cannabis for various conditions,” she said in a statement. “The bottom line is that people suffering from these serious conditions may be helped by participating in the program, and we felt it was important to give them the opportunity to seek that relief.”

How To Get Medical Marijuana For Chronic Pain

The changes don’t go into effect until August, so you’ll still need to wait until the second half of next year in order to get medical marijuana for chronic pain. Under the program’s regulations, you’ll also need to get a doctor’s diagnosis in order to be eligible for the medical cannabis program. The state believes it will be easier for patients to get medical approval for chronic pain than for intractable pain, which was already on the approved list, because intractable pain is defined as pain that cannot be removed, only managed, and many doctors are hesitant to slap the label of incurable on a patient.

The state’s acting medical cannabis program director believes there will be a sizable boost in the amount of patients in the program once August rolls around.

“We do know that 20 percent of the U.S. adult population suffers from chronic pain, and so we could apply those numbers to Minnesota’s population, and of course it would be a smaller subset of folks that would be even interested in trying our program,” said program director Chris Tholkes.

It’s interesting to note that while chronic pain and age-related macular degeneration made the list of approved conditions, four other conditions were rejected. Those conditions that didn’t make the cut were anxiety, insomnia, psoriasis and traumatic brain injury.

We’ll continue to share news related to this change as August approaches as we get ready for what we expect to be a sizable shift in how certain patients with chronic pain try to manage their condition.

Chronic Pain The Most Common Reason Patients Seek Medical Marijuana

February 14, 2019 / Thomas Cohn, MD

A new study found that chronic pain was the most common reason why individuals in state-approved medical marijuana programs turned to cannabis to help with their health condition.

The study looked at data from 15 states who have legalized marijuana for medicinal purposes. Here’s a look at the top three reasons why people turned to medical marijuana:

Chronic Pain
Stitfness related to Multiple Sclerosis
Chemotherapy-related nausea

“The majority of patients for whom we have data are using cannabis for reasons where the science is the strongest,” said lead author Kevin Boehnke of the University of Michigan.

Marijuana For Chronic Pain

More than 30 states allow the use of medical marijuana, but the conditions that are eligible for the product vary from state to state. For example, Minnesota allows medical marijuana to be used to alleviate symptoms from conditions like glaucoma, chronic pain, PTSD, seizures and much more. They are always evaluating which conditions meet the requirements, and Minnesota will add Alzheimer’s Disease to the list of approved conditions in July of this year.

When taking a closer look at the study results, researchers found that about two-thirds of the roughly 730,000 reasons listed for taking medical marijuana were related to chronic pain. Since patients could report more than one pain condition, researchers say the figure may be a little over-inflated, but it still speaks to how many people are looking for a better way to deal with their chronic pain condition.

“Cannabis is the first thing I’ve found that actually makes the pain go away and not leave me so high that I can’t enjoy my day,” said Brandian Smith, 37, of Illinois, who takes medical marijuana for her fibromyalgia.

Researchers also noted that in Arizona, Colorado, Nevada and Oregon, there was a noticeable decline in medical marijuana patients after those states legalized recreational marijuana. Currently there are about two million people in the United States who use medical marijuana for their pain condition.

Is you need help managing your pain condition, set up an appointment with a pain specialist like Dr. Cohn.

What Pain Professionals Are Saying About Marijuana

March 23, 2015 / Thomas Cohn, MD

Marijuana is a controversial topic in society. Some people want it legalized while others demonize the compound. The reality in the medical field is somewhat in the middle. The first thing that needs to be understood is that in most circumstances, medical experts are primarily interested in all the compounds in marijuana except for THC. That means most medical professionals are interested in what cannabinoids or cannabidiols (CBD) compounds are present and what medical purpose they serve. The major compound that is present in almost all available marijuana is THC, which also happens to be the compound responsible for the high one receives from marijuana.

For pain professionals, there is good understanding of the action and effects of THC. Most strains available in states that have legal marijuana, including strains that are “medicinal” in use have high amounts of THC, 10% or greater in amount, and virtually no other cannabidiols, or less than 2%. In the years of the hippie generation, the 1960’s and 1970’s, THC to CBD ratio was 1:1, and averaged 1-2%, while the really good stuff was just around 5%. Now available in legalized states, most available strains are minimum of 10% with up to 30% THC.

Medically, the best comparison of legal marijuana at this time, is to alcohol. The risk of dependence to THC is about 9%, including when using once a week (in reality this is a very strong way to become dependent), compared to alcohol which is 15%. Regular use, once a week, is known to increase depression, suicide, impulsivity, schizophrenia and psychosis, especially if use is started under the age of 20. It also leads to an 8-point loss of IQ in the young. Further, smoking does cause problems with the lungs. Recommending regular marijuana is no different for medical professionals to recommending drinking alcohol. The risks and associated problems are clearly out numbering benefits.

Need To Understand More

What we know about cannabidiols is just the beginning. In marijuana, we know there are over 100 different types. Our experience so far has found that they have some properties that may be helpful in about 30% of patients with neuropathic pain associated with MS and HIV. In low back pain, we’ve learned:

It has helped in anxiety but not with pain.

More people respond to acetaminophen then marijuana.

The future of cannabidiols is interesting for pain. It is unlikely that many professionals would be enthused to prescribe a substance that has the risk profile of THC. Once we can find the particular cannabidiols that have medical uses, it is likely that we will try to study them fully and make them commercially available for specific conditions. Cannabidiols may be helpful in the future, but we still don’t know enough right now to safely prescribe marijuana for a wide range of conditions.