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Cannabis as a Treatment Option

I often travel to conferences and meetings where I meet other patients living with rheumatoid arthritis (RA) or other chronic illnesses. In the course of getting to know each other, I almost always get asked where I am from. When I reply “Colorado,” I would say that at least 80% of the time the follow-up question concerns my thoughts on cannabis as a treatment option for RA.

Personally, I haven’t really pursued cannabis to alleviate my RA symptoms. For one thing, I’ve been pregnant three times in the last six years, and it isn’t something I want to experiment with while pregnant! For another, one of my biggest frustrations about life with RA is that it sometimes keeps me from being productive (yes, I am definitely more than a little Type A!) and cannabis isn’t something I generally associate with productivity. I do know that there are now more and more options for cannabis where “getting high” isn’t the main focus, so maybe it’s an option I would consider pursuing in the future.

In the meantime, as local governments move towards legalization of marijuana, many patients with RA and other chronic illnesses are curious about cannabis as a potential treatment option. What seems less clear, however, is how medical professionals feel about this possibility. For this reason, I was very interested to attend a talk at the 2017 American College of Rheumatology Annual Meeting called “Cannabis in Society and Medical Practice.”

The talk looked at the role of legalized marijuana in our society as well as in the practice of evidence-based medicine. In the United States, marijuana remains a Schedule I controlled substance at the federal level. However, 23 states and the District of Colombia have passed local laws allowing for the medical use of cannabis, and seven states and the District of Colombia have even legalized marijuana for recreational use.

Implications for society

The first speaker was Rosalie Pacula, a senior economist at the RAND Corporation, who launched the discussion by explaining that it took multiple decades for the scientific community to learn all that it currently knows about the health implications of tobacco and alcohol. In contrast, she argued, equivalent research on cannabis has been extremely difficult to complete because of its federal designation as a controlled substance. This means that researchers are having trouble getting legal access to cannabis to study, greatly slowing research progress and making much of the data that is available a lot less reliable.

Unfortunately, this means that many of the laws legalizing the use of cannabis have been passed faster than the scientific community can collect enough data to really help weigh the health, safety, and ethical ramifications of the laws. And given the huge tax revenue currently being made from cannabis sales in states where it has been made legal (for example, in 2016 Colorado reported $193.6 million) this trend isn’t likely to change in the future. Dr. Pacula concluded that there are still many more questions we need to understand about marijuana use before we can fully understand the implications for society.

Possibilities for treatment

Daniele Piomelli, director of the Institute for the Study of Cannabis at the University of California in Irvine, presented the evidence-based medical perspective on the use of cannabis as a possible treatment option. He discussed the effects of cannabinoids on central and peripheral nervous system function in great detail, and shared information on the diseases where cannabinoids have been formerly tested.

Dr. Piomellia argued that only a few therapeutic indications for cannabis are actually supported by data at this time. In January 2017, the National Academy of Sciences (NAS) released a report based on the review of 10,000 published studies. The report concluded there was substantial evidence of the effectiveness of cannabis for chronic pain, nausea and vomiting, and multiple sclerosis (MS).

But despite widely held assumptions about the other myriad benefits of cannabis, the NAS committee didn’t find enough evidence of effectiveness to support the use of cannabis for amyotrophic lateral sclerosis (ALS), epilepsy, Huntington’s disease, irritable bowel syndrome (IBS), or Parkinson’s disease. They actually found limited evidence of ineffectiveness for dementia, depression, and glaucoma. And for cancer there was insufficient evidence to support or refute the effectiveness of cannabis.

In conclusion, Dr. Piomelli maintained that the federal government needs to change the scheduling of marijuana to allow scientists to expand cannabis research and enhance data collection. Additional research might allow scientists to provide better insight on the implications of cannabis for society and to learn whether cannabis is an appropriate treatment option for the pain associated with RA.

 

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • Monica Y. Sengupta moderator
    1 year ago

    This has been something my father and I have talked about steadily since my diagnosis. I was at university in Colorado when marijuana was first legalized and now live near Washington DC. It’s an uncomfortable conversation with my rheumatologist but I don’t know yet if this is something I want to actively pursue.

    @1o07ygq mentioned it was good for sleep and I think that might be my biggest reason to try it. I have intermittent insomnia and I’m not keen on taking a lot of sleep medications.

  • Lawrence 'rick' Phillips
    1 year ago

    Indiana will no doubt be the 140th state (yes I understand the number of sates) to legalize cannabis . Given that we do not allow Sunday beer sales and presently CBD oil is illegal to sell or possess, I will be long gone before my state gets there. By then, we may know the outcome of research. I hope it works, I really do.

    By the way I possess CBD oil infused hand cream. I am such a radical, but if the police show up I will be rubbing my hands excessively and I may need a good lawyer.

  • Erin Rush moderator
    1 year ago

    As a fellow Hoosier, I can appreciate your observations! We can always hope that Indiana considers making changes sooner rather than later. Enjoy your hand cream (I won’t rat you out)! Best, Erin, RheumatoidArthritis.net Team member.

  • Sneed
    1 year ago

    It definitely help to sleep, a real benefit when pain is making sleep difficult or for those of us with perpetual insomnia. Since the thc interferes with ones thought process I do not find it helpful during the day. For me it also interferes with the quality of reading so it’s night time use only in my case. And I too am a Colorado resident.

    I have not tried the oils and other products with cbd, the non-psychoactive ingredient so can say nothing about that.

    I will also add that one can keep a loaded vape pen by one’s bed and just take hits as needed without lighting up at all and with no smoke involved. It’s a much cleaner way to use MJ.

  • Erin Rush moderator
    1 year ago

    Thank you for sharing, Sneed! I am glad cannabis helps you feel better. That’s great! Thank you again for sharing! Best, Erin, RheumatoidArthritis.net Team Member.

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