medical marijuana chronic pain

New Study Suggests Medical Marijuana Ineffective For Most Chronic Pain Patients

/ Thomas Cohn, MD

medical marijuanaA new study published in the British Medical Journal concluded that while some chronic pain patients find helpful relief through medical marijuana, the treatment is unlikely to benefit most patients.

To get a better understanding of the effectiveness of medical marijuana for chronic pain sufferers, an international group of researchers analyzed three dozen medical cannabis studies. Overall, they found that only a small percentage of participants reported “an important improvement” in chronic pain, physical function or sleep quality when taking oral or topical cannabis treatment.

“When we look at the overall evidence for therapeutic cannabis products, the benefits are quite modest,” said lead author Jason Busse, associate director of McMaster University’s Michael G. DeGroote Centre for Medicinal Cannabis Research in Ontario. “So medical cannabis is not likely to be a panacea. It is not likely to work for the majority of individuals who live with chronic pain. We do have evidence that it does appear to provide important benefits for a minority of individuals.”

Chronic Pain and Medical Marijuana

We have talked up the potential benefits of medical marijuana for chronic pain on this blog in the past, but at the same time, we’re not entirely surprised by the findings for a number of reasons. Here’s why:

Chronic Pain Is Complex And Individualized – Chronic pain is not like a broken arm. A chronic pain condition is highly individualized to the patient, and what works for one patient may not work for others. When it comes to chronic pain, there is no one-size-fits-all answer to chronic pain. Expecting medical marijuana to treat all different forms of chronic pain would be foolish.

Medical Marijuana Is Complex – Even though medical marijuana is highly regulated, there are so many different cannabis strains, and they can each affect a user differently. It’s not like taking 400 milligrams of Ibuprofen. Chronic pain treatment effectiveness may simply be lacking because of the differences between cannabis forms and strains.

Early Stages Of Understanding – We’re still in the early stages of learning about the effectiveness of medical marijuana for chronic pain. Moreover, federal regulations oftentimes make it difficult to research medical cannabis. We’re trying to learn more and increase its effectiveness, but we’re in the early stages, and access to data isn’t always easy to come by.

Certain Side Effects – Even if medical marijuana did help with a patient’s pain, the treatment can also come with some side effects that can leave people questioning whether it is the right treatment for them. Minor or mild pain improvements may not be worth it if they find that they are dizzy, anxious or have the sensation of being “high,” which have been reported in some users. Again, more research could help limit these unwanted side effects in some patients, but the research is lacking for a number of reasons.

There are also plenty of benefits associated with medical cannabis. Aside from it’s potential to unlock chronic pain, it’s also much less likely to become addictive or physically harmful like opioids – another common chronic pain condition treatment. Simply put, we’re not ready to give up on this potential solution to chronic pain, and we hope that this study only makes it clearer that more funding and research on the potential benefits and best practices for administering medical cannabis for chronic pain is needed.

New Laws on Chronic Pain and Medical Marijuana in Minnesota

/ Thomas Cohn, MD

Medical Marijuana chronic pain minnesotaEarlier this month Minnesota added intractable pain to the list of conditions that qualify for medical marijuana. It was a decision made by the Commissioner of Health, Dr. Ehlinger, in accordance to provisions of the legislation passed. In August of next year patients will be able to obtain prescription cannabis through the state approved pharmacies if they have been qualified. The exact rules are not yet in place, but there are some clear indicators of restrictions will be present. It is also not homegrown marijuana or any other marijuana; it is just from approved dispensaries that are strictly controlled.

Intractable pain in the State of Minnesota is chronic pain that has failed to be adequately managed by traditional medical care. This means that one has to have tried to manage the pain, gone through what is considered acceptable and approved treatment regimens, likely medication, physical therapy and possibly invasive management, and these treatments have been unsuccessful. One cannot just say they have pain, not have a diagnosis, and not go through standard treatments and expect to be able to obtain medical cannabis. Lastly, it is likely that two qualified medical providers (not just one) will both have to evaluate you and approve, and that the pharmacist at the dispensary also will have to agree.

Intractable Pain and Medical Marijuana

If you have chronic, intractable pain, it will not be easy to obtain medical marijuana. There will be good providers who will consider it an option as part of treatment. However, it is likely to be a choice only after one has failed reasonable standard treatments. The patient will have to be psychologically stable, and for most practitioners, it is likely that they will want them to be well controlled if they do have depression. Many providers will also look into any potential past substance abuse, and receiving both opioids and medical marijuana is likely not to occur. The better pain providers will likely want to closely monitor the patient receiving the alternative treatment and be in touch with the dispensary and pharmacist to know what is exactly being prescribed.

Medical marijuana is not a panacea. It is another possible treatment that may have benefit for some patients. The science and effectiveness behind its use is just in its infancy. Like all other medications there are side effects and problems. It is not an FDA or DEA approved substance and is very much considered experimental. Therefore it is not approved at this time by any insurance. Expect all management and treatments associated with its use to require cash (not credit card or check) payment up front for any services including doctor as well as pharmacy visits. Treatment is likely not to be cheap and it very well may not be readily available. Many physicians may be reluctant to be involved with this treatment, and as a patient, if you are at all mean, abusive, obnoxious, inappropriate, or otherwise difficult with a provider or their staff, this would likely close the door for further management with that office.

The State of Minnesota over the next several months will likely clarify the rules and regulations of medical marijuana for patients in the state. There will likely be a number of hurdles to climb to obtain the high quality pharmaceutical cannaboid for pain management. If it is the correct management tool when all else has failed, it may be worth the effort. It is not a simple solution, and it is not going to be a legal way to just get street quality marijuana for personal recreational use.