Medical Marijuana For Short-Term Chronic Pain Relief

November 17, 2020 / Thomas Cohn, MD

Medical marijuana is a topic we’ve written about on the blog numerous times in the past, and one point we’ve always hammered home is that we want more scientifically-backed research on the subject. As more research comes out, the more we expand our knowledge of the subject and can better treat our patients.

Recently, we read about a study that looked at the short-term benefits of medical marijuana use to control chronic pain symptoms. We share the results of that study in today’s blog.

Short Term Chronic Pain Relief With Medical Cannabis

The research was originally published in Volume 20, Issue 6 of Practical Pain Management, and it explored how medical marijuana could be used to help provide pain relief in patients with certain types of chronic pain. Patients for the study were at least 25 years of age, had experienced chronic pain for at least three months, and were willing to provide accurate reports about their chronic pain levels both before and during treatment. Treatment, in this instance, was taking medical cannabis after being informed of proper administration guidelines from a physician.

The most common chronic pain conditions that affected patients in this study were back pain, osteoarthritis, fibromyalgia and chronic headaches. Patients were asked to rank their pain at the beginning of the study and then again at 1-month, 3-month and 6-month intervals. Here’s what they found:

Patients in the study found that medical cannabis treatment was associated with significant improvements in pain symptoms and quality of life within one month of initiating treatment.
These effects were sustained at the three- and six-month intervals.
The only adverse effects patients reported were dry mouth, increased appetite and the sensation of feeling “high.”

After looking at the totality of the study, researchers stated that medical marijuana, when administered under the care and supervision of a healthcare professional, can be a safe and effective option for short-term pain relief for patients with varying types of chronic pain.

At our clinic, we always say that we want patients to find a solution to chronic pain that works for them. It won’t always be easy or passive, but we want you to find a solution that works for you. If medical marijuana or other treatments like the Daith piercing can help you find relief, we’re all for it. We’re also here to provide you with care or treatment recommendations if you want to pair your current treatments with a more professional approach. We’ll happily walk you though some of the more standard options like physical therapy or other lifestyle interventions, but we can also discuss alternative options and give you some more information so you can make the best decision for your health.

For more information about different ways to treat your chronic pain, or to set up a consultation with a specialist, reach out to Dr. Cohn’s office today.

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.

Opioids, Medical Marijuana and Chronic Pain

April 10, 2019 / Thomas Cohn, MD

When it comes to managing chronic pain, we’re always looking for new and better ways to help patients control their discomfort. If you’re a regular follower of our blog, you probably know that we’ve written a number of blogs on opioids and medical marijuana, but a recent study decided to take a look at what happened when these two treatment plans were used simultaneously. You might be surprised at the findings.

According to research presented at the 2019 American Pain Society Scientific Meeting, individuals with chronic pain who used both prescription opioids and recreational marijuana showed higher levels of mental health and substance abuse problems than those who use opioids alone. Now, the study makes a big distinction noting that patients were using marijuana recreationally and not medicinally, but it still shines a light on how problems can occur when people try to supplement their opioids with other substances.

Study Results

Those weren’t the only findings that were of concern according to researchers. The team said that anxiety and depression scores were also significantly higher for patients who used both opioids and recreational marijuana, as were measurements of opioid dependence severity and alcohol and cocaine involvement. Researchers also noted that there was no difference in pain severity or pain disability between the group of individuals just using opioids and those using opioids and recreational marijuana.

“The things psychologists would be most worried about were worse, but the thing patients were using the cannabis to hopefully help with — namely pain — was no different,” said Andrew Rogers, University of Houston, who worked on the study. “Co-use of substances generally leads to worse outcomes. As you pour on more substances to regulate anxiety and depression, symptoms can go up.”

Abhiram Bhashyam, MD, MPP, of Massachusetts General Hospital in Boston, who was not involved with the study, said the findings provide even more evidence that patients shouldn’t assume that recreational marijuana will help with the effects of their chronic pain if they are already on opioids.

“This study provides further evidence that cannabis may not be an effective substitute or alternative to opioids for pain management,” said Dr. Bhashyam. “Studies like these are important for clinicians as patients increasingly ask about opioid-cannabis co-use for managing their pain. We lack robust evidence to provide appropriate guidance due to a paucity of research on this topic at present.”

Both opioids and medical marijuana can be helpful if you’re dealing with chronic pain, but it’s important to realize that there’s a significant difference between regulated medical marijuana and recreational marijuana, so don’t assume that what you pick up on the street will be beneficial in combination with opioids for your pain. As this study suggests, it doesn’t appear to help and it can certainly make some problems worse. If you’re considering medical marijuana or another treatment plan for your pain, consult with a physical medicine specialist first to ensure you’re making the right choice for your individualized 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.

Medical Marijuana For Stress, Anxiety and Depression

April 26, 2018 / Thomas Cohn, MD

In a first-of-its-kind study, researchers at Washington State University examined how people’s self-reported levels of stress, anxiety and depression were affected by smoking different amounts and strains of cannabis at home.

The study, published in the most recent version of the Journal of Affective Disorders, found that smoking marijuana can significantly reduce levels of depression, anxiety and stress in the short term, but they also believe it may contribute to worse overall feelings of depression in the long term.

“Existing research on the effects of cannabis on depression, anxiety and stress are very rare and have almost exclusively been done with orally administered THC pills in a laboratory,” said Carrie Cuttler, clinical assistant professor of psychology at WSU and lead author of the study. “What is unique about our study is that we looked at actual inhaled cannabis by medical marijuana patients who were using it in the comfort of their own homes as opposed to a laboratory.”

Medical Marijuana and Stress

For the study, researchers tracked the varying concentrations of the chemical compounds tetrahydrocannabinol (THC) and cannabidiol (CBD) in different strains of medical marijuana. Patients smoked set amounts of different strains and self-reported feelings of stress, anxiety and depression twenty minutes after smoking. The study was conducted from the comfort of the participants’ home in hopes of mitigating any stress that may come with being in a lab setting. Here’s what else the study found:

One puff of cannabis that was high in CBD and low in THC was optimal for reducing levels of depression.
Two puffs of any type of cannabis was sufficient to reduce symptoms of anxiety.
10 or more puffs of cannabis high in CBD and high in THC produced the largest reduction in stress.
Women reported a significantly greater reduction in anxiety following cannabis use.

Researchers say their findings help to shine a light on the importance of monitoring both CBD and THC levels.

“A lot of consumers seem to be under the false assumption that more THC is always better,” Cuttler said. “Our study shows that CBD is also a very important ingredient in cannabis and may augment some of the positive effects of THC.”

Cutter and colleagues used a multilevel modeling system to analyze more the different strains and the reported levels of anxiety and stress.

“This is to my knowledge one of the first scientific studies to provide guidance on the strains and quantities of cannabis people should be seeking out for reducing stress, anxiety and depression,” Cuttler said. “Currently, medical and recreational cannabis users rely on the advice of bud tenders whose recommendations are based off of anecdotal not scientific evidence.”

This is fascinating research, and any study that improves our knowledge of treatment modalities and can better help patients manage their physical or mental conditions is wonderful. WSU has more cannabis studies planned in the future, and hopefully they’ll continue to better our understanding of the effects of the substance in individual patients.