Herbal cannabis not recommended for rheumatology patients

Patients with rheumatic conditions are in need of symptom relief and some are turning to herbal cannabis as a treatment option. However, the effectiveness and safety of medical marijuana to treat symptoms of rheumatic conditions such as rheumatoid arthritis, lupus, or fibromyalgia is not supported by medical evidence. A new article published in Arthritis Care & Research, a journal of the American College of Rheumatology (ACR), explores the risks associated with using herbal cannabis for medicinal purposes and advises healthcare providers to discourage rheumatology patients from using this drug as therapy.

The reason for the medical interest in herbal cannabis is that the human body has an extensive cannabinoid system comprising molecules and receptors that have effects on many functions including pain modulation. Medical cannabis is commonly used to self-treat severe pain associated with arthritis and musculoskeletal pain. In fact, previous research reports that 80% of marijuana users in a U.S. pain clinic are treating myofascial pain with the drug. In population studies in the U.K. and Australia, up to 33% of individuals report using marijuana to treat arthritis pain. As of June 2013, estimates from the office of Information Commissioner of Canada list "severe arthritis" as the reason the 65% of Canadians who are allowed to possess marijuana for medicinal purposes.

"With the public outcry for herbal cannabis therapy, governments around the world are considering its legalization for medicinal use," explains lead investigator Dr. Mary-Ann Fitzcharles, a researcher and rheumatologist at the McGill University Health Centre (MUHC) and the Research Institute of the MUHC in Quebec, Canada. "Physicians caring for patients who are self-medicating with marijuana need to understand the health implications of using this drug. Our study aims to provide health care professionals with that medical evidence related to medical marijuana use in patients with rheumatic conditions."

In the U.S. twenty states, including the District of Columbia (DC), have legalized cannabis for medical purposes. The present study examines the dosing, administration, efficacy and risks of herbal cannabis in pain management for patients with rheumatic conditions. The health issues with recreational marijuana use in this patient population are not covered.

Concentrations of tetrahydrocannabinol (THC)—the substance found in Cannabis sativa that provides pain relief and alters brain function (psychoactive effect)—vary in the plant material by up to 33% and absorption rates are between 2% and 56%, making the dosing of herbal cannabis unreliable. While cannabis may be ingested, most users prefer to inhale the compound for a quicker response. However, smoking a "joint" is not recommended by the medical community due to adverse effects on the respiratory system from hydrocarbons, tar and carbon monoxide.

Furthermore, there is no formal short-term or long-term study of the effectiveness of herbal cannabis in patients with rheumatic diseases. Studies that show good efficacy of cannabinoids for cancer and neuropathic pain may not be extended to rheumatic diseases because of the differing mechanism in the types of pain.

The study authors highlight that use of medical marijuana comes with inherent risks such as compromised cognitive and psychomotor function. Long-term use of cannabis may lead to mental illness, dependence, addiction and memory issues. In fact, a prior U.S. study of 8,000 adults who used cannabis in the previous year found that the odds of depression were 1.4 times higher in cannabis users compared to non-users.

"At this time, we cannot recommend herbal cannabis for arthritis pain management given the lack of efficacy data, potential harm from the drug, and availability of other therapies for managing ," concludes Dr. Fitzcharles. "Physicians should discourage rheumatology patients from using as a therapy."

More information: Arthritis Care and Research; Published Online: March 3, 2014. DOI: 10.1002/acr.22267

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chiefsfan37
not rated yet Mar 03, 2014
Has anyone here looked into topical pain management to fight arthritis pain? These prescription pain gels provide relief when and where you need it with no side effects or pills. I highly suggest looking into it. If you want to know more, please ask or look up A&R Pharmacy. They answered all my questions and got me on the path to living normally again.
Ormond Otvos
5 / 5 (1) Mar 03, 2014
First, this article says nothing specific, and uses all the common scare tactics. The reason that so many people use cannabis is exactly that it works. Perhaps not absolutely predictably, but very commonly.

Second, smoking is not the preferred method for long-term medical application, vaporization with a balloon-type machine such as a Volcano gives much more predictable effects, without the noxious gases like carbon monoxide, carbon dioxide tars and benzene.

The mere fact that the studies don't mention vaporizers make the whole article suspect.

Note that depressed people tend to smoke cannabis, which neutralizes the likelihood that cannabis causes depression. Quite as likely cannabis helps with depression.

Also not mentioned is that medical cannabis is currently being selectively bred for cannabidiol, the medically active fraction, not for THC, the psychoactive fraction that makes one "high".

Bad article, drug war propaganda again.
Woobie
not rated yet Mar 08, 2014
The authors apparently did not do their reading-up before publishing. Cannabis smoking has been found not to increase lung disease risk and has been found to be the dosing format most easily titrated by the user, making the unstandardized nature of whole-plant medicine much less relevant. There is absolutely no causative link between cannabis and schizophrenia demonstrated despite much searching, and in fact epidemiological data tend to argue against it. On top of it all, cannabis can still be medicinal without any THC content to speak of. There are over 80 cannabinoids known at this time, and all seem to have bioactivity. NB: This summary of the article never once states that cannabis is INEFFECTIVE for rheumatic pain. Because it is effective.

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