My latest blog post examined the current legal and medical status of the use of marijuana as a medication. But how about specifically to treat the symptoms of fibromyalgia?
Many of my patients with fibromyalgia report that medical marijuana / cannabis reduces pain and improves sleep. A study of 28 patients with fibromyalgia reported that two hours after the use of cannabis they had a significant reduction in pain and stiffness.
The use of cannabis to relieve the symptoms of fibromyalgia is not new. Around 2000 BC, Chinese emperor Shen-Nun described marijuana’s ability to decrease pain and inflammation and noted that it “undoes rheumatism” (an antiquated term for fibromyalgia). Fast forward to the United States in the early 1900s and found medicinal cannabis extracts marketed by Merck, Bristol-Meyers and Eli Lilly, among other pharmaceutical companies, along with medical textbooks that list numerous indications of cannabis, including joint pain and the muscles.
But then the use of cannabis was banned in 1936. All access for medical purposes was lost until 1996, when California became the first state in the United States. UU In legalizing the use of medical marijuana. So now we are 60 years behind in the medical understanding of the cannabis plant.
We know that the two main active ingredients of cannabis are THC and CBD (cannabidiol). THC is a strong analgesic (analgesic) and is also very anti-inflammatory; in fact, it is 20 times stronger than aspirin! THC is responsible for the psychoactive or “high” effects of cannabis. CBD also has some analgesic and anti-inflammatory properties, along with strong anxiolytic and muscle relaxation effects. CBD has the effect of reducing the psychoactive effects of THC, so that cannabis with equal amounts of CBD to THC tends to be the most effective from the medical point of view in providing the desired pain relief with less than “high” undesirable.
But currently we do not have standardized medication options beyond the two medications prescribed only with THC, dronabinol and nabilone, which are expensive and tend to cause many side effects. Pharmaceutical companies are now competing to find better ways to produce standardized ingredients and cannabis dosing ..
In Canada and Europe, a medical extract based on cannabis is approved for use as an oral spray (Sativex). It is completely derived from a specially cultivated plant with extensive quality control and balanced amounts of THC and CBD, and has been shown to significantly reduce pain and improve sleep for rheumatoid arthritis, with few side effects. This product is currently in clinical trials in the USA. UU And hopefully it will be available in the coming years.
But for now, patients who want to try medicinal cannabis for fibromyalgia, or any health condition, are at the mercy of knowledge of the dispensary or growers who are providing them with cannabis. This is a scenario that I see quite often: a patient receives a medical marijuana card and goes to a dispensary. There, employees are the only guide to tighten and administer doses. It is the equivalent of someone who enters a pharmacy with a blank prescription and asks the cashier what medicine to buy. Some dispensary employees are fairly well informed, but they are often more recreational marijuana enthusiasts who have no idea what to recommend for a patient with fibromyalgia.
One of my patients, who is 65 years old and had never used marijuana in her life, went to a dispensary and was ordered to buy a cookie that contained a large amount of THC. An hour later she was hallucinating and so terrified that she called 911!
Is there anyone who should not try cannabis? There are some people for whom it is absolutely a bad idea, including those who suffer from uncontrolled psychiatric disorders characterized by psychosis or abuse of active substances. Marijuana can also increase pulse rate, so it should be used with caution in people with heart problems such as atrial fibrillation.
In general, you want to look for strains with an approximately equal ratio of THC to CBD. Start with very low doses; One study found that while low to moderate doses decreased pain, high doses actually increased pain! Avoid smoking cannabis, as it is harmful and irritating to lung tissue. Instead, consider groceries, tinctures (liquid cannabis extracts), or topical balms or balms. My patients with fibromyalgia report that the balms and balms of cannabis applied topically to sore muscles can be a very effective analgesic with little or no “high” brain.
If you really want to try cannabis as a medicine, you must first educate yourself, as your doctor or your production / dispensary staff may not be able to give you much guidance. I highly recommend the book Cannabis Pharmacy: The Practical Guide to Medical Marijuana by Michael Backes. Another useful resource is the website www.leafly.com, which is like Yelp de la marihuana, with user reviews about different varieties.
Remember, we are just beginning to discover exactly how to use the cannabis plant safely and effectively.