Pittelkow - Peering through the weeds: A perspective on pain and medical cannabis (marijuana)

Jan 11, 2019 | Thomas Pittelkow | @thomasppi | Comments (30)

cannabidiol

The use of cannabis (marijuana) as a medical treatment has been around for thousands of years. In its earliest form, the cannabis plant was utilized by medical healers to treat various diseases that did not have a cure, particularly challenging to treat pain syndromes, general illnesses, and rheumatism. Despite its routine use spanning the millennia, early in the mid-20th century, the regular use of cannabis as a medical treatment was disrupted by strong political influences. Ultimately, the stigma that was created from the taxation and illegality of cannabis use in the 1930s led to tight sanctions and regulations in 1970 with the creation of the Controlled Substances Act. This legislation placed cannabis on a list of drugs that were defined by the federal government to possess no acceptable medical use, have a high potential for abuse and remain illegal for general use.

Despite the tight control, advocates of the medicinal use of cannabis continued to pursue the science and understanding of the medical properties. It was eventually discovered that humans possess an intrinsic endocannabinoid system, much like the body’s natural opioid system, where certain neurobiologic chemicals were responsible for similar effects as using cannabis. When active, the neurochemicals in our body play a role in normal day-to-day processes such as inflammation, pain, and mood. Alterations to this natural system could occur if a person were to use cannabis producing the desired effects of mood enhancement, pain reduction, and muscle relaxation.

Scientific discovery and research has helped us understand that there are over 100 natural cannabinoids in the cannabis plant that likely play a role in controlling things in the body such as pain, mood, and metabolism. The two most well understood cannabinoids are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the cannabinoid most likely responsible for the psychologic effects or ‘high’ that people feel when using cannabis, but has also been shown to have pain relieving properties. CBD is the cannabinoid most likely responsible for the anti-inflammatory and pain reducing properties people experience. Despite the wholistic natural properties of plant-based cannabis, there are real serious health risks that are present with its use that can affect the body’s organs, including the heart, lungs, gastrointestinal system, and brain/nervous system.

The rich and storied history of cannabis use and illegality has been driven mostly by social and political factors and not science. Under the assertion of states’ rights, nearly 30 states and the District of Columbia have some form of medical marijuana program, despite the fact that the federal government still views cannabis as not medically useful and its use continues to be illegal under federal jurisdiction. It is encouraged that each patient understands the rules and regulations pertaining to medical cannabis use in the state in which they reside.  There are qualifying conditions that have been established (state-dependant) to obtain certified medical cannabis. Unfortunately, there are no universally accepted guidelines regarding the right time to consider medical cannabis for the treatment of pain. Given that we have very good data on most of the typical pain treatments to date, many practitioners consider medical cannabis as a last line therapy.

To summarize, the investigation, research and understanding of medical cannabis and its impact on pain continues to grow. Further studies are needed to evaluate the most appropriate doses, side-effects, and effectiveness of therapy in pain patients.

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I’ve been using cannabis specifically high CBD and low THC to ween myself off oxycodone for breath through pain. After needing 4-6 pills a day I’m down to zero. It took a year of trial and error but worth the benefit.

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@jenatsky

I’ve been using cannabis specifically high CBD and low THC to ween myself off oxycodone for breath through pain. After needing 4-6 pills a day I’m down to zero. It took a year of trial and error but worth the benefit.

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Yes, Amen 🙏… was able to get off pain meds, anxiety meds and sleeping meds and replace them all with just marijuana!! Just wish I would have known this a lot lot sooner!!!

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I’m 69 and been smoking cannabis since I was 16. The CBD component is the big deal and I no longer get buzzed. It’s not a big deal as the trade off is worthwhile

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@pinkylee1206

Yes, Amen 🙏… was able to get off pain meds, anxiety meds and sleeping meds and replace them all with just marijuana!! Just wish I would have known this a lot lot sooner!!!

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I have a ? When Ive tried THC in any oral form it always greatly increases my neuropathy pain. I haven’t tried smoking it.. Would the THC in the vaporizer (inhaler) still increase my neurological pain?

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@jenatsky

I’ve been using cannabis specifically high CBD and low THC to ween myself off oxycodone for breath through pain. After needing 4-6 pills a day I’m down to zero. It took a year of trial and error but worth the benefit.

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I'm 75, would you mind sharing your cbd and thc numbers, I do tinctures and gummies only, trying not to feel buzzed

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I’m 70 and no longer get buzzed from THC and I’ve been a cannabis user for over 30 years. I use a 10:1 CBD:THC tincture 0.5ml 4x day, I use a 5:1 CBD:THC 0.5ml and a full strength THC 0.5ml at nighttime to sleep. I vape a CBD heavy cartridge with some THC (entourage effect is important) throughout the day or mini-dose so I can maintain my levels. I haven’t needed any breakthrough pain meds in months and I still have 1/2 my oxycodone prescription from Oct. 2021. Good luck with your pain but what are you worried about at 75 and getting buzzed? You only live once and you might enjoy it.

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No one responded to my ? re why THC makes my nerve pain from Fibromyalgia worse or if anyone has had the same experience with THC. If I use CBD during the day I get sleepy and get nothing done. I have given up on finding an effective pain Med so I am going to have Ketamine IV’s in 2 1/2 weeks. Chronic pain is greatly impairing my health. has worn me down

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@jenatsky

I’m 70 and no longer get buzzed from THC and I’ve been a cannabis user for over 30 years. I use a 10:1 CBD:THC tincture 0.5ml 4x day, I use a 5:1 CBD:THC 0.5ml and a full strength THC 0.5ml at nighttime to sleep. I vape a CBD heavy cartridge with some THC (entourage effect is important) throughout the day or mini-dose so I can maintain my levels. I haven’t needed any breakthrough pain meds in months and I still have 1/2 my oxycodone prescription from Oct. 2021. Good luck with your pain but what are you worried about at 75 and getting buzzed? You only live once and you might enjoy it.

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You are a sweet man and I really really am glad that you shared with the connect, my buzz days are too far behind and when I realized I was buzzed I didn't drive for 3 days and just got buzzed, but I stopped and it just doesn't have my name on it anymore and I was looking forward to this being an answers to my pain, thank you

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Took me a year to find my sweet spot so don’t give up

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@jenatsky

Took me a year to find my sweet spot so don’t give up

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i'm 67 and recently found the flower of medical marijuana. what a blessing. i suffer from a lot of chronic pain so not only does this help but i still get buzzed which i've always liked.

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Good for you and congratulations on finding relief.

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I'm 67 also with chronic pain and several other health problems. I do not smoke and never have. So I use edible marijuana. If I use enough to help the pain I get very dizzy but not really buzzed. Also it makes me incredibly hungry and I've worked hard to keep my weight down. Do you think these problems would stop if I used the marijuana regularly? I have osteoporosis and have had some bad falls from the dizziness. It scares me.

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