Fibromyalgia is a chronic pain syndrome that is difficult to diagnose and whose cause is unknown.  Patients have symptoms of musculoskeletal pain, chronic fatigue, and tender spots in the neck, spine, shoulders and hips.  Patients may also have morning stiffness, insomnia, and irritable bowel syndrome. The pain is often debilitating and not very well controlled by conventional medications. Subsequently, many patients also develop symptoms of depression and anxiety.  Fibromyalgia may be caused by immune system problems, disturbance in brain chemistry, sleep disturbances, Epstein-Barr Virus, stress, food allergy, or nutritional deficiencies.

Conventional medications used for fibromyalgia include painkillers (like Vicodin, Percocet, other opioids), muscle relaxers (like Soma or Flexeril), antidepressants, sleeping pills, and anti-anxiety medications.  Many patients have difficulty tolerating the adverse side effects that result from these medications.  Side effects include nausea, constipation, excessive drowsiness, lethargy, decreased libido and headache.

Although more studies are needed,  a recent study (published in The Journal of Pain Feb 2008) assessed the benefit of nabilone, a man-made form of cannabis, on pain reduction and quality of life improvement in patients with fibromyalgia.  Nabilone was found to significantly reduce pain with minimal side effects.  Many patients with fibromyalgia have found the same is true for medical marijuana.  They find that their pain is reduced or eliminated, their insomnia is cured, and their depression and anxiety are alleviated.  Many patients choose to use medical marijuana because they cannot tolerate the side effects of the medication prescribed by their doctor and simply must get relief from the daily pain of their disease.

You may have heard about a prescription marijuana pill called Marinol. Marinol is the brand name for the generic drug called dronabinol. It is a man-made form of THC. It was made available to patients (with prescriptions from their doctors) in 1986. It has primarily been used as an anti-nausea drug for chemotherapy patients. It is also approved for the treatment of wasting syndrome associated with HIV/AIDS.

Many patients prefer natural cannabis to Marinol for a number of reasons. A main limitation of Marinol is that it is available only as a pill that is taken orally. If you have nausea and vomiting, trying to swallow a pill can be a challenge. If you do manage to keep the pill down, you have to wait up to four hours for the Marinol to reach its peak effect. And only 5 – 20% of the medication is absorbed into the bloodstream. Another limitation of Marinol is that it contains only one compound – THC.  Natural cannabis contains 60 cannabinoids (THC is the main one) and it is the interaction of these compounds with each other that gives a good therapuetic effect.  Marinol contains only THC  so it has more psychoactive effects and less of the other medicinal effects that come from the other  cannabinoids. Some Marinol patients describe hallucinations and other disturbing side effects.  Marinol also is very expensive, costing about $500 – $1000 for a month’s supply.  One advantage of Marinol is that is it pure and does not contain any bacteria, fungi, or pesticides. You can avoid this problem not smoking the medication and choosing another method to take cannabis (vaporizer or tinctures).

Many patients make the choice to use cannabis with a vaporizer or tincture to treat their symptoms instead of using Marinol.  They feel that the natural form of the medication affords the best and most effective treatment of symptoms without the unwanted side effects of Marinol.  And by using a vaporizer or tincture, the unwanted side effects of smoking are avoided.

Marijuana can be used topically (on the skin) to relieve pain from certain conditions.  The medication can be a balm, lotion, ointment or rubbing alcohol solution.  This is not a new use for marijuana.  In fact prior to the time when most medication became available and people only had plants to use for medication, many patients would soak marijuana leaves in alcohol and apply them as a poultice to an arthritic or swollen joint.  It is not known how the topical treatment works as researchers have not fully studied how the medication passes through the skin.  Although much research is needed, what we do know is that many patients find pain relief through this method and even think there is an anti-inflammatory effect.  Patients with arthritis, muscle and joint pains can testify to the ease of the aches and pains that they feel on a regular basis.  Topical marijuana preparations provide only local relief and do not have any effect on the brain (there is no high).  This is helpful for those times when marijuana use is inappropriate (like when you have to drive your car) and you still need pain relief!  Topical preparations can be purchased or home-made.