Medical Marijuana and Chronic Back Pain- This is what I (Mark) Have!
Chronic
Back Pain is one of the most common illnesses seen by physicians.
Almost everyone has back pain at some time in their adult life. Back
pain occurs most commonly between the ages of 30 and 50 due to the
aging process and due to a more sedentary lifestyle that begins in this
age group. The pain can be neuropathic or nociceptive. Neuropathic
pain is caused by damage to a nerve. This kind of pain is felt as a
sharp stabbing or burning. Nociceptive pain is caused by disease to
the tissues outside of the nerves. It is felt as a dull ache or sense
of pressure. Examples of these kinds of pain are a pinched nerve
(neuropathic pain), and arthritis (nociceptive pain). It is frequent
for patients to have both types of pain at once, called mixed pain.
Fifty percent of patients with back pain have experienced some type
of trauma, such as a sports injury or motor vehicle accident. But the
other fifty percent have no known cause of their back pain. Most
patients who seek care for their back pain will undergo some type of
evaluation that may include x-rays, CT scan, and/or MRI; occasionally
some patients will have a myelogram (dye injected into the spinal cord
area followed by x-rays) or bone scan (dye injected into the blood
which will then concentrate in an abnormal area of bone). Many times
no obvious cause of the pain is found.
Patients who have acute back pain will often improve or recover in
six to eight weeks. Patients with acute pain occurring more than three
times in one year or who experience longer episodes of back pain that
interfere with daily activities (e.g., sleeping, sitting, standing,
walking, bending, riding in or driving a car) are more likely to
develop a chronic back condition. Sometimes these chronic back pain
patients will have pain, numbness or tingling in their legs. Some
patients with chronic pain do not respond to conventional therapy and
have to find a way to live with their pain. Physicians have found that
living with chronic pain is extremely difficult and can lead to opioid
dependency (addiction), anxiety, depression, and insomnia.
Medical marijuana is increasingly becoming the treatment of choice
for many chronic back pain patients. Conventional treatment therapies
such as over the counter non-steroidal anti-inflammatory medications –
NSAIDS – (such as ibuprofen, naproxen sodium, or aspirin) can be
helpful but can cause side effects such as stomach upset, nausea,
gastric bleeding, and ulcers. Prescription medications like other
NSAIDS (like Celebrex) or opiates (like Vicodin or Norco) can be
effective at treating pain but can also cause many adverse and
unacceptable side effects. The addictive potential of opiates is very
concerning to patients who struggle with chronic pain and need relief;
it is this concern that leads patients to consider using medical
marijuana, a very effective treatment for chronic back pain.
In 1975, scientists began studying THC in cancer patients and found
that it was a very effective pain reliever without significant or toxic
side effects. Other studies followed and the conclusion was the same:
marijuana safely and effectively treats chronic pain with little to no
side effects. No nausea, no stomach upset, no ulcers, no addiction –
many patients jokingly only refer to an increased appetite (”munchies”)
the only “bad” side effect. Marijuana side effects of elevated mood,
improved sleep, and reduced anxiety are welcomed by most patients and
considered beneficial to having a good quality of life when you suffer
daily with chronic pain.
How can medical marijuana help your chronic back pain?
• You will reduce or eliminate pain, allowing you to continue being active
• You will reduce or eliminate the use of potentially addictive medications or dangerous medication side effects
• You will reduce or eliminate the anxiety, depression, and insomnia associated with chronic pain
• You will feel better knowing that you are using a natural treatment for the pain
• You will have better quality of life
Bipolar Disorder- Montana does not allow for medical marijuana use for this condition
What is Bipolar Disorder?
Bipolar disorder is a psychiatric diagnosis that describes a category of mood disorders, or mood swings, defined by the presence of one or more episodes of abnormally elevated mood clinically referred to as mania or, if milder, hypomania. Individuals who experience manic episodes also commonly experience depressive episodes or symptoms, or mixed episodes
in which features of both mania and depression are present at the same
time. These episodes are usually separated by periods of “normal” mood, but in some individuals, depression and mania may rapidly alternate, known as rapid cycling. Extreme manic episodes can sometimes lead to psychotic symptoms such as delusions and hallucinations. The disorder has been subdivided into bipolar I, bipolar II, cyclothymia, and other types, based on the nature and severity of mood episodes experienced; the range is often described as the bipolar spectrum.
(Wikipedia)
Marijuana Facts and Resources:
- The effect of extreme marijuana use on the long-term course of bipolar I illness: a single case study.
“Subjective reports by patients suggest an overall positive effect,
but these may be unreliable. We herein report a case in which mood data
was prospectively collected over two years of total substance
abstinence and two years of extreme marijuana use. Marijuana use did
not alter the total number of days of abnormal mood, however, marijuana
was associated with an increase in the number of hypomanic days and a
decrease in the number of depressed days. While not conclusive, the
data suggest that marijuana may indeed have an effect on mood in
bipolar patients that needs to be systematically examined.”
Anecdotal:
- The Use of Cannabis as a Mood Stabilizer in Bipolar Disorder
“The authors present case histories indicating that a number
ofpatients find cannabis (marihuana) useful in the treatment of their
bipolardisorder. Some used it to treat mania, depression, or both. They
stated thatit was more effective than conventional drugs, or helped
relieve the sideeffects of those drugs.” - Cannabinoids in bipolar affective disorder
“The cannabinoids Delta(9)-tetrahydrocannabinol (THC) and
cannabidiol (CBD) may exert sedative, hypnotic, anxiolytic,
antidepressant, antipsychotic and anticonvulsant effects. Pure
synthetic cannabinoids, such as dronabinol and nabilone and specific
plant extracts containing THC, CBD, or a mixture of the two in known
concentrations, are available and can be delivered sublingually.
Controlled trials of these cannabinoids as adjunctive medication in
bipolar disorder are now indicated.” - Recipe For Trouble
An article about a mother who uses medical marijuana to treat her–among other things–bipolar son.
Fibromyalgia Pain Reduced by Marijuana-based Drug
Patients
with fibromyalgia treated with a synthetic form of marijuana, nabilone,
showed significant reductions in pain and anxiety in a
first-of-its-kind study, published in The Journal of Pain.
Fibromyalgia syndrome has no cure, is difficult to diagnose, and
effective pain management strategies are a must to help patients cope
with the disease. An estimated 12 million Americans have fibromyalgia,
which is characterized by widespread muscle and joint pain and myriad
other symptoms. The condition is far more prevalent in women and the
incidence increases with age, reaching 7 percent among women 65 years
and older.
Forty subjects were selected for the nabilone trial, conducted by
researchers at the University of Manitoba Rehabilitation Hospital. They
were divided into nabilone and placebo groups and were treated for four
weeks. The authors noted this was the first randomized,
controlled-access trial to evaluate nabilone for pain reduction and
quality-of-life improvement in fibromyalgia patients. Nabilone is one
of two oral marijuana-based compounds, known as cannabinoids, available
in Canada and is approved for treatment of nausea and vomiting during
chemotherapy.
Results of the Manitoba study showed the nabilone group had
significant reductions in pain and anxiety, measured by comparisons
with baseline scores on the visual analogue scale for pain, the
Fibromyalgia Impact Questionnaire (FIQ) and the FIQ anxiety score. From
the data, the study concluded nabilone has significant benefits for
pain relief and functional improvement in fibromyalgia patients.
Although the improvement was significant, none of the nabilone-treated
subjects had complete relief of their fibromyalgia symptoms.
The drug was well tolerated by treated patients, which the authors
characterized as reassuring since fibromyalgia patients are sensitive
to most medications and have difficulty tolerating side effects. The
downside, however, is cost. In Canada, nabilone would cost about $4,000
for a year’s supply.
The authors believe their findings warrant consideration of nabilone as
an adjunct to current medical management of fibromyalgia.
Researchers at the University of Florida applied heat stimuli to the
hands of healthy controls and fibromyalgia patients. In contrast to
normal controls, fibromyalgia patients experienced a great amount of
cumulative pain from these stimulations, indicating abnormalities in
spinal cord pain processing.
Furthermore, the fibromyalgia patients experienced residual pain
when the stimuli were applied at intervals at which the healthy
controls were not affected. Normally, pain sensations quickly subside
after a single heat stimulus, but will accumulate with repetitions if
they occur frequently enough. This “pain memory” appears to linger for
an abnormally long period of time in fibromyalgia patients.
The researchers also found that the residual pain experienced by
fibromyalgia patients was widespread and not limited to a single area
of the body.
“Because the effect of the first experimental stimulus does not
rapidly decay in fibromyalgia patients, the effect of subsequent
stimuli adds to the first, and so on, resulting in ever increasing pain
sensations,” said lead investigator Roland Staud, MD. “Our findings
provide evidence for abnormal central nervous system mechanism of pain
in fibromyalgia patients and have significant implications for future
therapies, which need to target these abnormal central pain mechanisms.
Sources: Sciencedaily.com, American Pain Society