As
a Colorado native, people often ask me my opinion on the use of medicinal
marijuana. Even some of the patients at my physical therapy clinic use cannabis
creams and oils for chronic pain relief when nothing else seems to work. We’ve
all heard the arguments that marijuana use-even for medicinal purposes-will “make
you stupider,” and the damaging effects of long term use to memory and overall
cognitive function has been widely cited [1,2]. However, short term use has not
shown a significant decrease in cognitive functions [2], and could be a valid
treatment option when it is regulated by physicians.
Although
studies have shown efficacy of marijuana in patients with chronic pain, not enough
research has been done on the potential benefits and adverse effects to allow for
physician involvement. A recent study in Canada [1] has begun to pave the way
to answering the big question of short term usage side effects.
This
study dispensed cannabis products with 12.5% THC to chronic
pain patients who were failed by current treatments options. Safety and
efficacy parameters were measured over a year time span. Safety considerations include
normal blood, liver, kidney, and hormone functions, as well as, the larger
concerns of brain and lung function.
Although
there was no significant difference in the occurrence of serious side effects,
this study showed a higher incidence of non-serious adverse events in the
patients using THC as opposed to those who did not receive treatment with
cannabis.
However,
all of the aforementioned safety considerations and the neurocognitive and
pulmonary functions showed no significant changes, and chronic pain intensity
decreased overall after a year of cannabis treatment. This combined with the
improvement in physical functioning and mood of cannabis treated patients
demonstrates an improvement in quality of life.
This
study shows that there still are side effects to medicinal marijuana use, but
the overall quality of life improvement may be worth it. This subject requires
more research in order to compare benefits and side effects between common
treatments for chronic pain (opioids-Percocet, Vicodin, etc.). Additionally, dosages
will need to be optimized to provide benefits and minimize side
effects-especially since legislation in the US has not fully recognized its use
for medicinal purposes. Only research can tell us if “Mile High” medications will
be the best solution to chronic pain.
Here is a
link to the study if you want to know more: http://www.jpain.org/article/S1526-5900(15)00837-8/fulltext#sec3.2
References:
1. Ware, M.,
Boulanger, A. et al. Cannabis for the Management of Pain: Assessment of Safety
Study (COMPASS) 2015. The Journal of Pain
2. Cognitive
functioning of long-term heavy cannabis users seeking treatment.JAMA. 2002; 287: 1123–1131
As we are all entering the health care profession I think medical marijuana use is definitely somewhat of a “hot topic.” I know cannabis is often used for treating patient with chronic pain among other issues, but THC is the psychoactive part of marijuana, but use of cannabidiol the non-psychoactive part delivers similar efficacy in pain relief. Which makes me wonder if the cannabidiol would be a safer option that THC. Obviously there is still a lot of research that needs to be done, but it will be interesting to see how cannabis shapes modern medicine.
ReplyDeletehttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202504/
It is astute to consider the balance between overall quality of life and the side effects of medical marijuana when it comes to chronic pain manifestations, especially when considering serious medical conditions. I have had experience working with someone who uses medical cannabis to help with their Multiple Sclerosis symptoms, and this person definitely feels that any side effects they experience are far belittled by the relief they receive from the cannabis. MS is a debilitating immune-mediated disease where the body essentially attacks it's own myelin sheaths within the CNS, causing the patient to lose motor function. There are treatments for the "relapsing" forms of MS, but the person who I know has the "progressive" form, for which treatments are still being investigated (http://www.nationalmssociety.org/What-is-MS/Types-of-MS). As such, medical cannabis is often used by these patients to improve their quality of life since there is no established treatment for their condition. It has been found in recent studies that cannabis ingested in a capsule form (a common way this patient uses cannabis) can relieve a multitude of MS symptoms (http://www.mayoclinic.org/cannabis-for-ms-can-it-help-treat-symptoms/expert-answers/faq-20112500). In my opinion, a drug is a drug, and if it will put a patient out of a debilitating amount of pain and help them have a better life, they should have access to it without the potential obstacle of having to go to another state to get it, especially if you can't move so well on your own.
ReplyDelete