The Benefits and Drawbacks Of Medical Marijuana

Minnesota Medical Marijuana BenefitsRecently, the National Academies of Sciences, Engineering, and Medicine did a comprehensive review of the information available on the use of marijuana. The study looked at research published since 1999, and they came up with a number of conclusions. One of the most important findings is the current lack of good scientific information on marijuana. There is a clear need for good scientific research to guide healthcare professionals on the risks and benefits associated with marijuana use. Currently, to study marijuana or any of its derivatives, the federal bureaucratic hoops one must go through makes it extremely difficult to perform. The information available and the quality of the research at this point are limited. The conclusions are based mostly upon case report studies with limited controls.

The Complexity of THC and Marijuana

In Minnesota, medical marijuana is available to treat several specific conditions, and this year chronic pain was added to the list of approved conditions. The recent study also supports the idea that marijuana may be helpful to treat some people with chronic pain. For some it seems the non-THC (THC is the component that is responsible for the “high”) may help for pain. Since there are multiple causes of pain, it definitely is not indicated for everyone. Further, no studies have been done to determine what types of pain may be helped by components of marijuana, and it is not clear which of the 80 or more different compounds in marijuana are helpful. It is also known to be helpful for nausea from chemotherapy, and spasticity in multiple sclerosis. Marijuana may help in appetite with HIV, and there is limited evidence for help with bowel disorders, epilepsy, and Parkinson’s disease.

Potential Drawbacks

There are multiple potential harms that may be caused by marijuana. There is strong evidence that its use can lead to schizophrenia and psychosis, especially among young and frequent users. It may also lead to depressive disorders. The claim that it can make you a better driver is simply false, as statistics have shown that it leads to inattentive driving, a main contributor to traffic accidents. In pregnancy, use can lead to low birth weight in infants. Smoking pot can also cause and worsen any respiratory condition. There is weak evidence that smoking marijuana can increase the risk of heart attacks. One can also develop an addiction to marijuana. Conclusions cannot be drawn with regards to school achievement, unemployment, or social function and marijuana use.

Understanding It All

The overall scientific conclusion so far is that marijuana may have some reasonable medical uses. However, the scientific research on the compound is extremely limited at the moment. In the United States, it has been classified as a compound with no medical value and harmful to society. What needs to happen is that national legislation is needed to reclassify marijuana as a controlled substance, then good medical research can be done to determine what compounds in this plant are helpful or harmful. Once good research is done, then the use of compounds can occur with everyone understanding appropriate risks and benefits like with any other drug now available.

New Report Examines Benefits and Drawbacks Of Medicinal Marijuana

Medical Marijuana statsWe’re still in the early stages of managing how medicinal marijuana is used to treat certain health conditions. However, since the door has been opened, millions of dollars in funding has been given to explore the benefits and drawbacks of medical marijuana for treating specific health ailments. A new report from the National Academic of Sciences, Engineering and Medicine reveals some areas of potential and some points of concern when it comes to medicinal marijuana. We explore what the report found in today’s blog.

Medical Marijuana For Ailments

One of the major points the review found was that medicinal marijuana has beneficial effects for the treatment of chronic pain. The review committee found evidence that patients who were treated with marijuana for their chronic pain were more likely to experience a significant reduction in pain symptoms. A similar finding was made for individuals suffering from muscle spasms, and for patients suffering from chemotherapy-induced nausea and vomiting.

Furthermore, researchers found no evidence that smoking marijuana was related in an increased risk of cancer development, but they stated that more research was needed to see if there was a correlation between marijuana use and an increased risk of heart attack, stroke or diabetes.

Drawbacks of Medicinal Marijuana

So while medicinal marijuana can be helpful for some patients with chronic pain, it is not without its drawbacks. According to the review, there was evidence that cannabis slightly increased a person’s risk of developing schizophrenia, social anxiety disorders, and to a lesser extent, depression. Heavy marijuana users are also more likely to report thoughts of suicide compared to non-users, and cannabis use increased a person’s risk of being involved in a motor vehicle accident. There were also increases in the number of marijuana overdoses among children who accidentally ingested the drug compared to states where recreational marijuana use was not legal.

Marijuana could also make certain ailments worse. Researchers stated that regular cannabis use was related to an increase in episodes of chronic bronchitis and other respiratory ailments, like chronic coughing and phlegm production. They did note that is unclear if marijuana use worsens symptoms from respiratory conditions like COPD or asthma.

Potential Abuse & Other Drug Problems

Finally, researchers suggested that marijuana could lead to abuse or other drug problems. Evidence suggests that with greater frequency of use, there is an increased likelihood of developing problem cannabis use, and there was moderate evidence to suggest that there was a link between marijuana use and the development of substance dependence of marijuana or other substances like alcohol, tobacco or illicit drugs.

So while medical marijuana is certainly an interesting avenue for controlling pain, it is not without its drawbacks. Identifying these potential pitfalls is the first step. Now we need to learn how to mitigate these risks so chronic pain sufferers aren’t exposed to danger when pursuing medicinal marijuana for their pain.

Minnesota Expands Medical Cannabis To Chronic Pain Sufferers

Medical Marijuana Minnesota Chronic Pain IntracableThis past Monday, Minnesota expanded its medical cannabis program to include individuals who are suffering from severe, chronic and intractable pain. Opening the doors to these patients could bring relief to thousands of people whose pain has not been quelled by traditional treatment techniques.

Before the program opened up to intractable pain, the Office of Medical Cannabis announced that they had 1,827 active patients receiving medical marijuana. Although the numbers haven’t been released yet, likely because it will take some time to sift through all the applications and medical material, state planners project that the number of participants may jump to 5,000 or more.

Proponents hope that the influx of patients will ensure those in pain will get the treatment they need, while current members hope their presence will help lower what some feel are extremely high prices.

Watching Closely

While it’s certainly exciting that people with chronic conditions will have another potential treatment avenue, many doctors are hesitant to fully embrace medicinal marijuana for chronic pain. Many champion marijuana as safer than opioids, which cause more than 300 overdose deaths in Minnesota each year, but we really don’t understand all the compounds in marijuana. It may not lead to overdose deaths, but until we know more about all the compounds in cannabis, we’re not going to be able to treat any patients with pain with any degree of certainty.

Minnesota is one of 25 states that have legalized medicinal marijuana, and the vast majority of those states list chronic pain as a qualifying condition. Studies have also shown that overdoses have fallen in those states with medicinal marijuana, and doctors in those states are writing fewer prescriptions for potentially dangerous opioids.

Hopefully those who truly need relief will be approved and find help through the state’s medical marijuana program. I hope the state reinvests some of the profits into future studies to ensure we are doing everything in our power to keep our patients safe, and so we can better understand how cannabis and pain are related.

For more information about the program, including a list of eligible conditions or how to apply, click here.

The Complexity of Chronic Pain

chronic pain treatment mnRecently the Star Tribune published an opinion piece titled “How not to treat chronic pain” by Ellen Stern.  The article was quite interesting, but seems to miss the mark in understanding pain and its management.  The author suffers from chronic low back pain.  She tried treating it conservatively with the traditional route of management from medications, to therapy, to injections – none were very successful.  She eventually underwent lumbar fusion and this also did not relieve her pain.  Despite all the treatment she continues to be in significant pain.

The Complexity of Pain

Chronic pain is very complex.  All of my patients understand the nature of pain and how difficult it is to find a good management option.  Furthermore, since I have chronic low back pain with significant spondylolisthesis and severe stenosis, and have close family with pain problems, I have a very deep understanding of all these issues.

Rule number one in pain management is that there is no magical treatment. Chronic pain is “managed” and not cured.  Complaining about the medical community may feel good but does not move you forward.  Adjust your attitude, if necessary get professional help, and concentrate on all the things that you can do and not on the negative.  If the physicians you are seeing are not helpful, it may be necessary to find someone who works with you better.

Opioid Abuse

The issue with opioids and abuse is nationwide.  It is now as much of a problem with accidental deaths as automobiles used to be and is ever increasing.  As the country has become more aware of the problem, all prescribers of these medications have become more cautious.  There are numerous ways to reduce abuse of opioids, and all patients who receive them are scrutinized.  As a prescriber, we are constantly trying to determine if a patient is appropriate for opioids.  Since our licenses and livelihoods are on the line when prescribing opioids, most of us are cautious when prescribing.  We all can tell stories of success as well as ultimate disasters, so please understand close monitoring of the patient receiving opioids comes with a certain level of danger.

Medical Marijuana

Medical marijuana in general is another complex issue.  As with all treatments for chronic pain, it is just another management tool.  Like any other compound, it works only for certain people and definitely not for everyone.  Further as noted in multiple previous writings, the science behind medical marijuana has been minimally studied.   There is very little rigorous research similar to any other drug that has been approved for medical use.  Many physicians are reluctant to recommend a compound that has not been adequately analyzed and has solid research behind it.  Many compounds in medicine have come on the market and we later find significant serious dangers caused by the compound.

Treating chronic pain is extremely complex.  There is no silver bullet of a cure.  There is much more that the medical community does not understand about pain than what we really know in detail.  The majority of the tools we use today are often quite crude and old.  Surgery is often quite brutal, and changes the body often in the wrong way.  Morphine and its opioid derivatives are the same concoctions that we used to treat pain over 150 years ago.  Research is slowly bringing medicine better understanding of pain.  Physicians are struggling with the problems of pain and its treatments and a lack of new and better solutions with good scientific basis.  Hopefully more funding and research will lead to better solutions in time since chronic pain does affect over 30% of the population worldwide.

Minnesota Doctors Not Sold on Marijuana

Medical Marijuana in MinneapolisThe Minnesota medical community is, according to January 12, 2016 article in the Star Tribune, not sold on medical marijuana. In reality, this is not very surprising. There are probably many reasons, but the most obvious reason is the idea that medical professionals like to base all their care on a scientific basis. From taking a history, to performing an exam and determining the tests and treatment, medicine is more of a science and depends on evidence for diagnosis and treatment of problems. If there is not evidence to support a treatment, medical professionals are trained to be skeptical of its use and purpose. Currently, medical marijuana definitely falls into this category.

Most important to the debate on medical marijuana is that there is very limited scientific research supporting many of the claims of usefulness. The research with regards to the management of most medical problems is related to a few small studies, and there are hardly any definitive studies that show significant positive value, and the study designs are often not blinded/controlled with any large number of participants. For pain management there is mostly incidental case report-type studies without mentioning which specific cannaboids are effective. Since cannabis plants contain over 100 different cannaboids and other compounds, using so many chemicals at once in a relative uncontrolled mixture is not a scientific approach to treatment. In a way it is like throwing a grenade at a problem and hoping everything does not blow up in your face.

Fixing The Marijuana Issues

The proponents of medical marijuana often bring to the table multiple examples of the wonderful help that various individuals have experienced with its use. However these are individual cases, and not necessarily what will occur with every individual. When a new drug is brought to market, we all want to have extensive testing performed to make sure it is safe, to ensure it performs correctly and that the same effect will occur each time it is taken. With medical marijuana we do not know most of these things. We have no idea what exactly is in the extracts, and we have no studies on how animals or humans will react to the compounds over time. Any other drug besides marijuana with this lack of scientific research would never even be considered to be used widely as an intervention. It is not surprising most medical professionals have a huge degree of skepticism about certifying patients to use medical marijuana and endorsing treatment.

In pain management there are many treatments available that have been shown to be reasonably effective. A pain management expert often can help a person through the maze of management options and help find an effective plan. There are a portion of patients with extremely complex problems without great solutions to control symptoms at this time. Failure of standard treatments may be a reason to want to try medical marijuana. Those who do go this route need to know at this time it should be considered truly an experimental treatment, and that the short and long term side effects and problems are not really known. There are a huge number cannaboids contained in medical marijuana, and while some may be helpful, others can be harmful. It may be a significant risk to use these compounds and until they are better studied and understood, and it is unlikely that the medical field will endorse such treatment without serious reservation.