Cannabis and Pain
Pain is second only to severe joint damage as the most devastating symptom of rheumatoid disease. But unlike joint damage, joint pain is something that everyone who has the disease experiences.
Pain is a feeling. This can be a problem when it comes to relieving rheumatoid disease symptoms. A damaged joint is tangible. An x-ray or MRI will show and prove it. Sometimes, you can even see the damage beneath the skin; the joint is obviously deformed and distorted. It doesn’t look “normal” anymore.
But you can’t see pain. It doesn’t show up on an x-ray or MRI. It’s invisible, even though it may be so huge that the person who’s experiencing it can’t think of anything else; so overwhelming that all she can do is gaze into the middle distance, moan, and rock. Whether it’s minor or severe, pain is terribly hard to quantify. For many people with rheumatoid disease, the only real (although temporary) relief from the frequent, often unrelenting pain it causes comes from prescription opioid analgesics like Vicodin, Norco, or Percocet.
Doctors have become more sensitive about treating pain as more than a transient annoyance, and they’ve started prescribing opioids more frequently over the last 30 years. And of course, the opportunities to abuse these drugs grew as well. Since 1990 the number of drug overdose deaths in the U.S. have tripled. The majority of those deaths were from prescription drugs, and the majority of those were opioid painkillers. These drugs are dangerous--even deadly--when not taken as prescribed and with an abundance of care.
Of course, there is one possible solution to the problem of illegal prescription drug abuse: marijuana, or cannabis, a name that has fewer sharp, controversial thorns sticking out of it.
I’m a boomer. Back in my young adult hippie days, I smoked weed--and it wasn’t for pain relief, either, although I was never a stoner. But then I grew up. I got a real job with real responsibilities, I got married, had a beautiful little girl, and I just didn’t have the time or the inclination to use recreational cannabis anymore. In addition, buying, selling, possessing, and using it was illegal, a fact that was far more important to me as a young mother and a professional woman with a career that was just beginning to take off than it was when I was younger.
But I cheered when first one state, then another, started legalizing marijuana for medical use. At first I was like most people: I said “Right … medical use …!” and I’d snort and roll my eyes because I’d never heard of such a thing and we all knew what “medical” use meant. You smoked marijuana to get high, that’s all.
But I was wrong. We all were. Anecdotal evidence says that marijuana--cannabis--has properties that can relieve nausea in cancer patients and in other chronic sufferers. It may reduce the pressure in the eyes of glaucoma patients, or calm the anxiety of someone with Alzheimer’s disease. It can relieve neuropathic and trigeminal pain, relieve the pain of osteo- and rheumatoid arthritis, and reduce epileptic seizures--among many other things. And it does all this safely. You can’t overdose on weed.
Imagine! Cannabis may safely relieve the pain caused by rheumatoid arthritis! No more dangerous opioid painkillers! Full disclosure: I’ve tried cannabis with a doctor’s prescription. For me, it didn’t work very well, but it’s smart to keep in mind that there are many different strains and strengths of this versatile plant. The one I tried may not have been the best for my RD pain—and as we all know, everyone’s RD is a little different from the next person’s. What works for me might not work for you, and vice-versa. The strain of cannabis I tried also made me too high—not something I wanted—so if I used it, I needed to wait until I had no other responsibilities pending. Since I’m my mother’s caregiver, this didn’t leave much opportunity for self-medication.
My prescription ran out after a year, so I need a get another before I can try again. But I do plan to. I’ll try a different strain and ask about its “euphoric” qualities. I’d much rather use cannabis than hydrocodone if I can.
Twenty-three states have now made medical cannabis legal to grow in small quantities, sell under state license, and use to relieve or treat a medical condition, all with a legitimate prescription from a doctor. Eleven others have legislation pending. But the Federal Drug Administration hasn’t changed with the times, and marijuana is still considered an illegal, Schedule I controlled substance, considered as dangerous as heroin and LSD. And because it’s illegal, researchers and scientists have been unable to carry out many of the kinds of large, methodical studies and rigorous testing that might prove cannabis’s beneficial, benign use as a safe alternative to opioids for pain relief, etc. Such studies would take cannabis’s medical benefits out of the range of anecdote and into the range of fact.
Harvard Medical School’s Emeritus Professor of Psychiatry, Lester Grinspoon, MD, wrote in a March 1, 2007 editorial in the Boston Globe that “While few such studies have so far been completed, all have lent weight to what medicine already knew but had largely forgotten or ignored: Marijuana is effective at relieving nausea and vomiting, spasticity, appetite loss, certain types of pain, and other debilitating symptoms. And it is extraordinarily safe -- safer than most medicines prescribed every day. If marijuana were a new discovery rather than a well-known substance carrying cultural and political baggage, it would be hailed as a wonder drug."
The US Surgeon General Vivek Murthy recently spoke about marijuana’s potential benefits, saying: “We have some preliminary data showing that for certain medical conditions and symptoms, marijuana can be helpful.”
On a scale of 1(low) to 5(high), how difficult is it for you to talk about having RA?