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Meds Cannabis and Pain

Whole-plant cannabis therapy for chronic pain relief
Studies show a variety of individual cannabinoids work against chronic pain—and work even better together

Chronic pain lasts for weeks, months and even years. Often caused by nerve damage (neuropathic pain) or chronic diseases (arthritis, cancer, diabetes, fibromyalgia, multiple sclerosis, etc.), chronic pain can be difficult to treat, frequently requiring treatments just to bring symptoms to a manageable level. Medications include opioid analgesics, anti-inflammatories, anti-epileptics, anti-depressants—and more recently, cannabis.

How cannabis can treat chronic pain
Various studies have examined the analgesic effects of cannabis, often focusing on tetrahydrocannabinol (THC), the cannabinoid, or active ingredient, associated with euphoria. A 2003 study showed that THC enhances the pain-killing effects of opioids, such as morphine.

This synergy between opioids and THC is also reflected in chronic pain models, specifically chronic inflammatory and neuropathic pain models. Studies examining THC’s ability to reduce pain show that it works by activating peripheral cannabinoid receptors in the body, namely the CB1 and CB2 receptors.

The role of cannabidiol
Cannabidiol (CBD) has also been examined for its potential as an analgesic, mainly due to growing evidence of its antioxidant, anti-inflammatory, and neuroprotective effects. Research shows that CBD doesn't treat acute pain, but is effective against pathological pain. A 2004 study demonstrated that CBD had potent analgesic effects in inflammatory pain only one hour after single, low dose administration, but no effect on acute internal organ pain.

How CBD works to reduce pain is not clearly known, although some research suggests it may lower levels inflammation-causing cytokines, or cell-signalling molecules. A more recent study suggests CBD may reduce neuropathic pain in rats by targeting amino acid receptors.

More cannabinoids and their effects on the body
Other cannabinoids have shown promise as potential therapeutic treatments for chronic pain. For instance, researchers have found that tetrahydrocannabivarin (THCV) is a CB2 receptor partial agonist—CB2 receptor agonists are effective against many types of pain, including inflammatory, neuropathic, postsurgical and cancer pain. Cannabigerol (CBG) also stimulates cell receptors, demonstrating potential as a pain-reliever in animal models.

What's most effective: extracts or the entire plant?
More research is needed to fully understand cannabis’ potential role in pain management, and to understand the individual impacts of each of its more than 100 different cannabinoids.

Evidence to support the benefits of whole-plant cannabis extracts instead of single pure cannabinoids is mounting. Studies have shown that extracts produced from the whole cannabis plant are more therapeutic than pure cannabinoid compounds. A 2006 study showed that CBD amplifies the pain-blocking effects of THC.

Another study demonstrated that cannabis extracts containing large amounts of CBD and small amounts of THC, as well as other minor cannabinoids and noncannabinoid components, like flavonoids and terpenes, provided more pain relief than a single pure cannabinoid. In this study, treatment was initially provided with a whole plant extract to gather baseline data. The treatment was then repeated with the same dose, but using only a single pure cannabinoid. The treatment was further repeated using an extract containing both THC and CBD, which also offered less pain relief compared to the whole-plant extract.

All of this suggests the various compounds in the cannabis plant are acting in concert to provide a more profound effect than when taken alone. This effect is referred to as the entourage effect and underscores the importance of the herbal form of cannabis in pain management.

So this goes along with our findings that tinctures that 'steep' for a long period and have whole plant material seem to work better for pain than those that are quick washed.
 
Evidence to support the benefits of whole-plant cannabis extracts instead of single pure cannabinoids is mounting. Studies have shown that extracts produced from the whole cannabis plant are more therapeutic than pure cannabinoid compounds.

Personally, I like dabs on the Liger for power, but follow up with a load of herb to round out and add dimensions to the effects.
 
Review on clinical studies with cannabis andcannabinoids 2010-2014
Mikael A. Kowal1, Arno Hazekamp1, Franjo Grotenhermen2
Bedrocan, Veendam, The Netherlandsnova-Institut, Chemiepark Knapsack, Industriestraße, D-50354 Hürth, Germany
Abstract
In 2010 a review by Hazekamp and Grotenhermen covered controlled clinical trials of the
years 2006-2009 on cannabis-based medicines, which followed the example of the review by Ben
Amar (2006). The current review reports on the more recent clinical data available from 2010-
2014. A systematic search was performed in the scientific database of PubMed, focused on
clinical studies that were randomized, (double) blinded, and placebo-controlled.
The key words used were: cannabis, marijuana, marihuana, hashish, cannabinoid(s),
tetrahydrocannabinol, THC, CBD, dronabinol, Marinol, nabilone, Cannador, nabiximols and
Sativex. For the final selection, only properly controlled clinical trials were retained. Open-label
studies were excluded, except if they were a direct continuation of a study discussed here.
Thirty-two controlled studies evaluating the therapeutic effects of cannabinoids were
identified. For each clinical trial, the country where the project was held, the number of patients
assessed, the type of study and comparisons done, the products and the dosages used, their efficacy
and their adverse effects are described. Based on the clinical results, cannabinoids present an
interesting therapeutic potential mainly as analgesics in chronic neuropathic pain and spasticity in
multiple sclerosis. But a range of other indications also seem promising. CBD (cannabidiol)
emerges as another valuable cannabinoid for therapeutic purposes besides THC.

Keywords: cannabinoids, cannabis, therapeutic potential, controlled clinical trial, efficacy, safety,
cannabidiol
This article can be downloaded, printed and distributed freely for any non-commercial purposes, provided the original work is properly
cited (see copyright info below). Available online at www.cannabis-med.org
Author's address: Mikael A. Kowal, m.kowal@bedrocan.nl
 
Cannabis Can Paradoxically Worsen Pain

Many people think of cannabis as a way to alleviate pain. After my friend was in a bike accident, she took cannabis edibles to escape the chronic pain that had developed in her back. Instead, she found that it made the pain unbearable. I dig into the cannabinoid research to find out why.


A case study in cannabis overdose worsening pain
A few months ago, I was getting ready to go out when I got a call from a friend. She sounded very spacey, as if she were high. She told me that she was calling from an ambulance. She had been hit by a car while riding her bike.

I rushed to the emergency room to meet her and after waiting for what felt like forever, I was allowed to go to her bedside. The doctor was just finishing up and said that she had a concussion, but that nothing was broken. She was released and I drove her home.

She remembered nothing of the accident. The police report suggested that she was hit by the car on her left side and was thrown onto the roof. She was left with significant pain, vertigo, and nausea.

“It would feel like I was being stabbed between my left scapula and spine. The pain radiated up and down from that spot. I also had a more constant dull pain in my lower back and right neck.


Unfortunately, she could find little relief from the pain.

“I was taking ibuprofen and tylenol around the clock. I tried therapeutic massage, acupuncture and a chiropractor. I didn’t want to take Vicodin because it makes me dizzy and I was already super nauseous and dizzy from the concussion. The pain lasted for months.”

Finally, at the recommendation of her friends (and even her acupuncturist!) she tried marijuana edibles. Her friends brought her cannabis extract-infused gummy bears. She started cautiously with a low dose and worked up to 5 gummies per day, a total dose of 50 mg THC.

However, she felt little effect from the gummies and decided to to switch products. This led to one of the most terrible experiences of her life. Her friend brought her a cannabis chocolate bar, from which she ingested one square of chocolate, a dose which contained 45 mg of THC.

“I thought I was taking less of a dose than the gummies. I wanted it to have some effect since I was feeling so dysfunctional. After an hour, I started feeling the effects, but then the shift to being not fun was very quick. I lay down and basically it felt like each of my vertebrae were grinding on each other as waves of searing pain shot up and down my spine. It was really excruciating. I felt like I was going to die.”

Paradoxically, the pain had worsened with her ingestion of cannabis. This is how she described the pain on a scale of 1 to 10 before and after ingesting the cannabis-laced chocolate:

“My pain was at a 7 or 8. After, the pain was some of the worst I have felt. It was a 10.”

My friend had obviously overdosed. This is an important lesson that different cannabis edibles can not only have varying potency, but may also be absorbed differently – this will be the topic of a future post.

But how can we explain this experience? Cannabis is used by many to treat pain, so how can it be that it can also increase pain? At first it seemed a bit incredible, so I did a quick Google search. Sure enough, there are message boards where people have reported similar effects.

Before I get into the scientific evidence for marijuana increasing pain, I need to explain some background information.

A primer on pain
Pain typically starts with either potential or actual tissue damage. There are specific neurons called C-fibers that sense this damage and send a signal from the damaged tissue to the spinal cord.

pain-signaling-interneurons-3.jpg


Within the spinal cord, the C-fibers connect with second-order neurons that relay the signal up the spinal cord to the brain. Where C-fibers and second-order neurons intersect are interneurons that can modulate this signal. Specifically, inhibitory interneurons can decrease the strength of the signal sent to the brain. The brain then interprets the signal and produces the negative emotional state we know as pain.

After an initial pain signal is sent, sensitization starts to occur. This makes the site of tissue damage even more sensitive to pain. Even the undamaged area around the tissue damage becomes more sensitive. This is called hyperalgesia. Think of someone slapping you where you have a sunburn. Maybe it would have hurt a little anyways, but with the sunburn it is majorly painful.

Often, ongoing sensitization processes can cause more problems than the initial pain itself. Acute pain can turn into long-lasting chronic pain. Pain signaling is a dynamic process which can be modulated at the level of the periphery, the spinal cord, and the brain. There are many different chemical mediators involved and cannabinoids are just one class. To get an idea, see below for an overview. It literally hurts my brain.



Pain-hypersensitivity-1024x664.jpg

Cannabinoids are in here somewhere, but I’m not going to try to find them.

Why the effects of cannabis on pain are difficult unravel
Pain signaling is already complicated, but cannabinoid pharmacology is complex in every way possible. Cannabis contains dozens of cannabinoids, which are a mix of agonists and partial agonists at cannabinoid receptors. The ratio of these is different depending on the cannabis strain and also the route of cannabis dosing. Furthermore, there are active metabolites, levels of which also change depending on dosing route. On top of that, cannabinoids have effects which are not mediated by either the cannabinoid CB1 or CB2 receptors.

It is likely that cannabinoids affect pain processing at all levels (peripheral, spinal, and brain), but through different mechanisms. For example:

  • Peripheral: Activation of CB2 receptors on immune cells reduces release of proinflammatory molecules
  • Spinal: Binding to glycine receptors in the spinal cord potentiates the pain-blocking effects of glycine
  • Brain: Activation of CB1 receptors in the brain modulates emotional processing of pain signals


Evidence for cannabis exacerbating pain
Without a doubt, the complexity of pain signaling and cannabinoids make it a difficult topic to study. However, there has been progress in understanding these mechanisms and how marijuana may increase pain. I am going to highlight two key studies:

Study #1: The relationship between dose and pain relief is an “inverted U”
There are pain studies that can be done directly in healthy humans instead of patients who already have existing pain. These are called Human Experimental Models of Pain. The abbreviation for this is HEMP. I swear I’m not making this shit up.

The HEMP used in the first study is the intradermal capsaicin model. You know when you bite into a chili pepper and your mouth is on fire? That’s because of a molecule in the chili called capsaicin. Imagine purifying this molecule and injected it directly into your skin. That’s the intradermal capsaicin model.



capsaicin-test-skin.jpg




Capsaicin causes an acute pain at the injection site, but also activates the sensitization mechanisms to cause hyperalgesia in surrounding skin areas. This makes it a good model to study the pain associated with these processes.

The first study used the capsaicin model to look at analgesia from marijuana cigarettes. Subjects received marijuana cigarettes with 0% (placebo), 2% , 4%, or 8% THC. Capsaicin was injected into the forearm skin 45 min after smoking the marijuana cigarettes and subject’s pain was assessed. Here are the results:

  • The low THC dose did not affect pain scores. The THC dose was probably too low to be active.
  • The medium THC dose lowered pain scores, demonstrating the analgesic effects of cannabis.
  • The high THC dose significantly increased pain scores. What the fuck!?


Capsaicin-THC-pain-1024x1024.png




These scientists were smart to administer different THC dose levels. To fully characterize the effect of a drug, you need to administer it over a range of doses. Typically, you expect that the higher the dose, the greater the response, until at some point the response reaches a plateau. This is called the “Emax” dose-response.

However, there are rare cases where as the dose goes up, the response goes up, reaches a peak, then comes down. In some cases there is even an opposite response at high enough doses. This is called the “inverted U” dose-response. It appears that cannabis fits the inverted U dose-response pattern for some types of pain.



Dose-response-models-pain-1024x512.jpg

Examples of dose-response relationships. An ideal pain drug would look like the Emax pattern on the left. Cannabis dose-response for pain relief looks like the pattern on the right (but only for some types of pain).



This study confirms that cannabis can both decrease and increase pain at different doses, but how is this possible? This study does not help us understand the mechanism through which this happens. Luckily, a subsequent study shed light on this mystery.

Study #2: Cannabinoids increase pain signaling in the spinal cord
I explained above how interneurons in the spinal cord regulate pain signaling of the main pain-transmitting neurons. Without the inhibitory interneurons being active, pain signaling can get out of control and even minor stimulation can be painful. These inhibitory interneurons are important for the development of hyperalgesia.

The second study, performed in mice, showed that inhibitory interneurons express the cannabinoid CB1 receptor. When the CB1 receptor is activated, the interneurons stop releasing the inhibitory neurotransmitters GABA and glycine. Without these inhibitory signals present in the spinal cord, pain signaling to the brain intensifies.



Interneuron-with-THC-cannabinoid-pain.jpg




Boom. A clear mechanism showing how it is possible that cannabinoids can increase pain. But following this logic, it would mean that blocking the CB1 receptor will decrease the same types of pain. These scientists also conducted a clinical study to see if this would happen.

They used rimonabant, which is a CB1 receptor antagonist (an antagonist is a molecule that blocks activation of a receptor.) At one point, it was developed as an obesity drug, but was pulled from the market due to serious side effects.


Side effects include anxiety, depression and suicidality. Bad things happen when you block your cannabinoid receptors!

Subjects were given either rimonobant or placebo prior to an intradermal electric shock. Although the acute pain from the shock was not changed, the hyperalgesia following the shock was significantly reduced.

These results confirm that a similar process occurs in humans as in in mice. Cannabinoids control the interneurons that regulate pain. Activating the CB1 receptor produces greater hyperalgesia and blocking the CB1 receptor reduces hyperalgesia.

Conclusions on cannabis exacerbating pain
The worsening of pain by cannabis is a real phenomenon. It was reported by multiple people and has been replicated in a laboratory setting.

One mechanism has been established and it occurs at the level of the spinal cord, where CB1 receptor activation decreases the effect of inhibitory interneurons on keeping pain in check. That’s not to say that there aren’t other possible mechanisms. For example, pain is modulated by your emotional state and the general dysphoria from a cannabis overdose may also increase pain levels.

It is important to realize that there are many different types of pain and cannabis can only exacerbate pain for certain types (otherwise this effect would be much more widely reported). CB1 receptor activation did not increase pain in animal models of inflammatory or neuropathic pain, which are some of the most common types of chronic pain. It is also dependent on the cannabis dose. Although there may be a dose level that causes pain relief, even a slightly higher dose may reverse the effect and worsen the pain.

If you are someone who has worsening pain with cannabis, it’s possible that blocking the CB1 receptor may help improve your pain. However, there are no CB1 receptor blockers that are currently commercially available. It may also be useful to carefully titrate your dose with a strain that is low in THC and high in CBD.
 
Marijuana a better pain reliever for men than women
Published Friday 19 August 2016

With legalization of marijuana increasing across the United States, there is more focus than ever on identifying the risks and benefits of the drug. A new study provides further insight, after finding men experience greater pain relief with marijuana use than women.
prescription-cannabis.jpg

Researchers found smoking marijuana led to no significant reduction in pain sensitivity for women.



Study co-author Dr. Ziva Cooper, of the Columbia University Medical Center (CUMC), and colleagues report their findings in the journal Drug and Alcohol Dependence.

As of June 2015, marijuana - or cannabis - has been legalized for medical use in 25 U.S. states and Washington, DC. In these states, marijuana can be prescribed to relieve pain, nausea and vomiting, and to stimulate appetite.

These effects are believed to be driven by the two main cannabinoids in marijuana: tetrahydrocannabinol (THC) and cannabidiol (CBD).

When it comes to pain relief, however, animal studies have suggested that marijuana's effects many differ between sexes, though Dr. Cooper notes that no studies have looked at whether this is the case for humans.

To address this research gap, the team set out to investigate the pain-relieving effects of marijuana use among 42 adults - 21 male and 21 female - who smoked the drug recreationally.


Marijuana posed no significant reduction in pain sensitivity for women

Participants were part of two double-blind, placebo-controlled trials, in which they were required to smoke either active marijuana - containing 3.56-5.60 percent THC - or a placebo form of the drug, which contained no THC.

Immediately after, subjects were required to take part in a pain response test, known as the Cold-Pressor Test (CPT). This involved each participant placing one hand in cold water - around 4°C - until they could no longer stand the pain.

Pain tolerance was measured by how long subjects were able to keep their hand in the water, and pain sensitivity was self-reported.

The researchers found that men who smoked active marijuana experienced a significant reduction in pain sensitivity, compared with men who smoked the placebo. However, no significant decrease in pain sensitivity was identified among women who smoked active marijuana, compared with women who smoked the placebo.

Both men and women showed an increase in pain tolerance with active marijuana use, though this effect was more prominent for men than women.

The team identified no differences in abuse liability - such as intoxication and drug enjoyment - between men and women who smoked the active marijuana.

Commenting on their findings, the authors say:

"These results indicate that in cannabis smokers, men exhibit greater cannabis-induced analgesia relative to women. As such, sex-dependent differences in cannabis's analgesic effects are an important consideration that warrants further investigation when considering the potential therapeutic effects of cannabinoids for pain relief."

Dr. Cooper says these findings emphasize the importance of including both men and women in clinical trials assessing the safety and efficacy of marijuana use, as the effects could vary between sexes.

Future studies should assess the underlying mechanisms by which cannabinoids affect pain in men and women, say the authors.
 
Wow @momofthegoons, you gals get screwed again....first you get a twibby instead of a putz, and now we find that your endocannibinoid system is out to lunch and under-performing! :yikes::thumbsup::razz::lmao:
 
...like many "debates" in contemporary america....common sense does not...appear to be part of the equation ..
 
@Baron23 here's one that might help that despondency you feel over the politicians.....


Federal agency announces first long-term study on marijuana’s effect on opioid addiction

A federal health agency is taking steps to examine whether medical marijuana can help end America’s addiction to prescription painkillers.

The National Institutes of Health (NIH) has announced a five-year, $3.8 million grantawarded to researchers at the Albert Einstein College of Medicine and Montefiore Health System to conduct the first long-term study to test whether medical marijuana reduces opioid use among adults with chronic pain.

“There is a lack of information about the impact of medical marijuana on opioid use in those with chronic pain,” says Dr. Chinazo Cunningham, associate chief of general internal medicine at Einstein and Montefiore and principal investigator on the grant. “We hope this study will fill in the gaps and provide doctors and patients with some much needed guidance.”

The study will mark the first federally funded attempt to research whether medical cannabis use can reduce opioid use over time, as well as the effects of pot’s specific chemical compounds — tetrahydrocannabinol (THC) and cannabidiol (CBD) — on pain, function, and quality of life.

“As state and federal governments grapple with the complex issues surrounding opioids and medical marijuana, we hope to provide evidence-based recommendations that will help shape responsible and effective healthcare practices and public policies,” adds Cunningham.

While an official link between cannabis and opioids is yet to be proven, prior studies have found that the rate of opioid overdoses is considerably lower in states with legal marijuana laws in place. Despite the lack of federal research, the Centers for Disease Control have instructed doctors to stop testing pain patients for marijuana use.
 
@Baron23 here's one that might help that despondency you feel over the politicians.....


Federal agency announces first long-term study on marijuana’s effect on opioid addiction

A federal health agency is taking steps to examine whether medical marijuana can help end America’s addiction to prescription painkillers.

The National Institutes of Health (NIH) has announced a five-year, $3.8 million grantawarded to researchers at the Albert Einstein College of Medicine and Montefiore Health System to conduct the first long-term study to test whether medical marijuana reduces opioid use among adults with chronic pain.

“There is a lack of information about the impact of medical marijuana on opioid use in those with chronic pain,” says Dr. Chinazo Cunningham, associate chief of general internal medicine at Einstein and Montefiore and principal investigator on the grant. “We hope this study will fill in the gaps and provide doctors and patients with some much needed guidance.”

The study will mark the first federally funded attempt to research whether medical cannabis use can reduce opioid use over time, as well as the effects of pot’s specific chemical compounds — tetrahydrocannabinol (THC) and cannabidiol (CBD) — on pain, function, and quality of life.

“As state and federal governments grapple with the complex issues surrounding opioids and medical marijuana, we hope to provide evidence-based recommendations that will help shape responsible and effective healthcare practices and public policies,” adds Cunningham.

While an official link between cannabis and opioids is yet to be proven, prior studies have found that the rate of opioid overdoses is considerably lower in states with legal marijuana laws in place. Despite the lack of federal research, the Centers for Disease Control have instructed doctors to stop testing pain patients for marijuana use.
Nah, I would bet anything that this $3.8 M (which is drop in the bucket for an NIH study) is being funded out of non-earmarked funds. I don't think this came from our ass-hat politicians, personally, even though its a good thing...just a start but still a better than nothing.
 
test


Little evidence shows cannabis helps chronic pain or PTSD


(Reuters Health) - Even though pain and posttraumatic stress disorder (PTSD) are among the most common reasons people use medical marijuana in the U.S., there isn’t much proof cannabis works for either one of these conditions, two research reviews suggest.

That’s because there hasn’t been enough high-quality research to produce conclusive evidence of the benefits or harms of cannabis for pain or PTSD, the two studies found.

Both studies were conducted by a team of researchers at the Veterans Health Administration and published in Annals of Internal Medicine.

“The current studies highlight the real and urgent need for high-quality clinical trials in both of these areas,” said Dr. Sachin Patel, a psychiatry researcher at Vanderbilt University Medical Center in Nashville, Tennessee.

“If cannabis is being considered for medical use, it should certainly be after all well-established treatments have failed,” Patel said by email.

One in 10 U.S. adults use cannabis, the researchers note. Medical marijuana is legal in 28 states and the District of Columbia even though it is illegal under federal law.

Between 45 and 85 percent of people seeking medical marijuana in the U.S. do so for pain management, according to the researchers. But when they examined 27 previously published studies on this topic, they found too little information to determine whether the drug helps most types of pain.

They found only low-quality evidence that cannabis may help nerve pain, and this wasn’t for smoking pot, it was for what’s known as nabiximols, or oral mixtures sprayed into the mouth.

A separate analysis of five previous studies of cannabis for PTSD found too little data to determine whether this would help relieve symptoms.

One of the studies in the analysis focused on veterans with PTSD and found a small but statistically meaningful decline in symptoms for patients who started using cannabis, however, compared with people who never tried it or quit.

Among the general population, not just people with pain or PTSD, the researchers concluded cannabis may carry harms including an increased risk of car crashes, psychotic episodes and cognitive impairments.

Both studies were commissioned and funded by the Veterans Health Administration.

Curt Cashour, press secretary for the Department of Veterans Affairs, declined to make the lead study authors available for comment on their research.

In a statement about cannabis earlier this year, Dr. David Shulkin, Secretary of Veterans Affairs, said “there may be some evidence that this is beginning to be helpful.” (bit.ly/2wY8Wuw)

“And we're interested in looking at that and learning from that,” Shulkin said in the May 2017 statement. “But until the time that federal law changes, we are not able to be able to prescribe medical marijuana for conditions that may be helpful.”

One area researchers are exploring is the use of cannabis to help ease mental health problems that can lead to suicide among veterans. Other conditions cannabis is used for include nausea, epilepsy, and traumatic brain injury.

Several countries, but not the U.S., have approved a cannabis-based drug to treat painful muscle spasms from multiple sclerosis.

It’s possible one group of cannabinoids, or groups of molecules in cannabis plants, may be responsible for both the high experienced by recreational users and the pain relief seen in some studies, said Dr. Winfried Hauser, a pain specialist at Klinikum Saarbrucken in Germany who wasn’t involved in the current studies.

The cannabinoid tetrahydrocannabiol (THC) affects regions of the brain involved in regulating pain, emotion, stress, and memory, Hauser said by email.

Even though cannabis is legal for medical use in Germany, Hauser said many doctors hesitate to prescribe it because there aren’t well-defined recommended doses available. Vaporizers are difficult for many patients, and cannabis smoked in combination with tobacco can have dangerous side effects, Hauser added.

“Medical cannabis is no magic pill,” Hauser said.
 
And as a counter to the above.... at least regarding pain. :biggrin:

BREAKING: Study says cannabis effective at treating nerve pain
Posted on August 14, 2017 by David Heitz

Research published today in Annals of Internal Medicine shows that cannabis is effective in combatting neuropathic pain, the type suffered by people with multiple sclerosis, HIV, diabetes and possibly some forms of fibromyalgia.

It’s a noteworthy conclusion given that cannabis is still scheduled as an illegal, class I controlled substance by the federal government, with “no currently accepted medical use in treatment in the United States,” to use the DEA’s own words.

Also today, Annals published research about cannabis and PTSD, although it essentially concluded nothing.

Despite the federal law, medical cannabis already is legal in more than half the states in America, with the above-mentioned conditions and chronic pain listed as qualifiers in many of those states.

“Investigators’ conclusion that there exists clinical evidence supportive of the efficacy of cannabis in the mitigation of neuropathic pain is consistent with both prior reviews and with the anecdotal reports of patients, many of whom are seeking a safer alternative to the use of deadly opioids, and it is inconsistent with federal government’s classification of the marijuana plant….” NORML Deputy Director Paul Armentano said in a statement to DavidHeitz.com.

NORML is a Washington-based marijuana advocacy group.

The research was published as part of a three-article package on cannabis that went live on the medical journal’s site at 5 p.m. Eastern on Monday.

Annals of Internal Medicine is published by the American College of Physicians, a tenet of the mainstream medical establishment. I attended the American College of Physicians Internal Medicine Meeting in San Diego in May, as a member of the credentialed news media.

The other articles published today in Annals concluded that there is not enough evidence to know whether cannabis is effective in treating PTSD (but that new information will be coming soon) and advised doctors that “the horse is out of the barn,” regardless.

Research cannabis looks like grass clippings

While the study found only “limited evidence” of cannabis’ efficacy on neuropathic pain, it’s important to understand that the cannabis being used for medical research is incredibly weak and not remotely representative of what’s available on the market to medical cannabis patients.

Because of the arcane federal law that classifies cannabis as being more dangerous than crystal meth or heroin, researchers at academic institutions studying the medicinal effects of cannabis on people must obtain the plant from the federal cannabis garden at the University of Mississippi.

This garden grows remarkably weak strains of weed with THC levels topping out at 8, 10, maybe 13 percent, depending on which reports you want to believe. Most cannabis available in medical dispensaries these days has THC levels of around 20 percent. Some have THC levels as high as 30 percent as far as flower goes and, with concentrates, THC levels can go into the 80 percent range and higher.

The weed out of the Mississippi garden is so vile that one researcher recently alerted the Washington Post. You can read here how PTSD researcher Sue Sisley got some nasty, moldy bud. After determining the mold levels would not be toxic to patients, she decided to use it anyway. It’s not like she has any other choice.

Read the Washington Post story for yourself and get a look at the nasty government “grass clippings” by clicking here.

I asked Armentano if he could fill me on the latest regarding the federal government’s ditch weed garden at the University of Mississippi. He sent me this link.

To the federal government’s credit, the ditch weed garden is evolving to include high CBD strains. Once upon a time, it grew only one nasty strain instead of five nasty strains.

The link is hilarious. The feds charge researchers $10.96 for a “marijuana cigarette.”

It could be worse. A “placebo cigarette” will set you back $13.94!

“Obviously, these products do not represent the broad scope of actual cannabis-based products that patients are using in the real world — a point that has been raised frequently by critics,” Armentano wrote in an email to me. “You are correct that any cannabis administered as part of a FDA-approved trial must be provided by the University of Mississippi.”

And yet, I bet when the 5 p.m. news reports the medical research coming out in Annals tonight they aren’t going to explain that the weed used in those studies is nothing like the medical cannabis available to people treating themselves for pain or PTSD.

The garden also completely ignores the science of terpenes, compounds in the plant that vary by strain and have medicinal qualities as well as an aromatic effect. You can learn more about terpenes by clicking here.

One wonders where the government even gets the seeds to produce the funky cannabis like what they dispense to medical researchers.

The truth is in our stories: Cannabis is saving lives

The Annals pain study actually was a review of research already published. It analyzed 27 chronic pain trials.

Its official conclusion: “Limited evidence suggests that cannabis may alleviate neuropathic pain in some patients, but insufficient evidence exists for other types of chronic pain.”

It then adds the always scary-sounding, “Among general populations, limited evidence suggests that cannabis associated with an increased risk for adverse mental health effects.”

To the researcher’s credit, the flaw in the research that renders much of it null and void in my opinion is listed: “The cannabis formulations studies may not reflect commercially available products.”

We know anecdotally, overwhelmingly so, that millions of Americans are effectively treating their pain with cannabis. Opioid overdose deaths are down in states where medical cannabis is legal. Fewer painkillers are being dispensed.

As I left the dispensary this morning, a woman shared with me how she ended up being hooked on fentanyl after a surgery. Now, with her medical cannabis card, she is off opioids completely.

Just as I am completely off benzodiazepines for my PTSD. You can read about that here.

Last week I wrote this blog post about how cannabis should be used to treat addiction. I have pinned the post to the top of my Facebook page. The conversation is so lively I can’t even keep up with it. The number of new likes to my Facebook page just this week, since I have written that piece, is well in excess of 300.

I also have been inundated with emails of personal stories. Just this week, two veterans receiving VA medical care informed me they have been put on notice for their illicit cannabis use. Both have been told if they “drop” (the VA urine tests veterans) for cannabis again, their medications will be revoked. One is on benzodiazepines for anxiety; the other is on opioids for pain.

This is shocking. Abrupt discontinuation of these highly addictive medications may result in death. And again, medical cannabis is legal in more than half the states.

You can read the VA’s medical marijuana policy here.

Medical establishment’s blessing would expedite cannabis availability

The medical cannabis blessing from the mainstream medical establishment would be an important first step toward getting insurance companies to pay for the treatment. That would make it more widely available.

But the establishment isn’t going to do that without further, more rigorous clinical trials. Expensive trials…where researchers are required to use government grass clippings.

“While more rigorous clinical trials of longer durations are arguably warranted, call for such trials should not overshadow the reality that tens of thousands of patients in the US are presently using therapeutic cannabis to safely and effectively address various hard-to-treat conditions, including chronic pain and post-traumatic stress — which is why well-respected advocacy groups like the American Legion and AMVETS are lobbying in support of greater patient access to marijuana,” Armentano said.

“Further, it must be acknowledged that the longstanding politicization of the cannabis plant, and its ongoing schedule I status, has greatly impeded researchers’ ability to conduct the sort of robust, large-scale, prolonged clinical trials that are typically associated with eventual FDA drug approval. Such trials are typically funded by private pharmaceutical companies seeking market approval, whereas cannabis research must be funded by academic institutions. These institutions possess limited funds and they are not in a position to — nor are they seeking to — attempt to bring the drug to market.”

In the Annals editorial accompanying the research meta-analyses, Dr. Sachin Patel of Vanderbilt Psychiatric Hospital in Nashville writes, “Although several well-designed trials are under way to address (treating pain and PTSD with cannabis), to some degree the horse is out of the barn – and unlikely to return. Even if future studies reveal a clear lack of substantial benefit of cannabis for pain or PTSD, legislation is unlikely to remove these conditions from the lists of indications for medical cannabis.”

Any medical cannabis patient with PTSD or chronic pain – and I suspect those two conditions make up most of us in many states, if not nationally – will tell you not only is it effective, it’s highly effective.

The Pharma medications for those conditions – benzodiazepines and opioids — churn out addicts and alcoholics (benzos are booze in a pill) every day. In the midst of a national opioid crisis, why aren’t the feds declaring pot legal as part of a national addiction emergency?

I bet that would solve Trump’s popularity problems quick. An executive order legalizing cannabis!

I’m going to end with a final quote from the Vandy doctor who wrote the editorial. I’ll warn you…it’s insulting. But I’m using it, and I’m ending with it, because it’s so incredibly ridiculous and out of touch with the realities of people suffering from pain and addiction that I hope it gets blasted around social media far and wide.

“As Nugent and colleagues note, patient characteristics associated with clinical response to cannabis products for pain are unknown,” Patel writes. “Another, more controversial explanation may be the complexity of chronic pain, with interrelated behavioral, emotional, and cognitive domains.

“Perhaps cannabis decreases the clinical effect of chronic pain in some way not readily operationalized by traditional pain rating scales. Of course, it’s also possible that cannabis’ effects on perceived pain are simply not robust, and such catch-all diagnoses as pain to justify legal access to cannabis may be overused.”

At the end of the day, the people of this country are only going to tolerate the mainstream medical establishment’s delusional “reefer madness,” to use the words of Berkeley medical researcher Amanda Reiman, for so long.

Grass clippings, folks.
 
@momofthegoons - I have permanent chronic neuropathy and on-going radiculopathy and can testify to the beneficial impact of MJ on my pain. Its just a simple fact to me.
 
This article is about cannabis helping with the pain crises from Sickle Cell Anemia...


Medical Marijuana Can Help Sufferers Of Sickle Cell Anemia
There are various theoretical as well as tested applications for medical cannabis in relations to sickle cell anemia.

By: Maria Loreto
  • Aug 11, 2017


sickle-cell-anemia-and-medical-marijuana.jpg

Photo by KATERYNA KON/SCIENCE PHOTO LIBRARY/Getty Images


Sickle cell anemia is a genetically transmitted physical ailment that is the result of restricted blood flow within the human body. To elaborate, studies report that sickle cell anemia manifests due to irregularly shaped red blood cells—the name “sickle” is literally derived from their “crescent moon” shapes. In turn, these misshapen red blood vessels easily get stuck within veins and resultantly trap smaller, healthy blood vessels. These blockages of healthy blood flow express in extremely painful episodes for sickle cell patients known as “pain crises”. These pain crises are the primary symptom of sickle cell anemia and can be life-long debilitating disorders. Moreover, once an individual contracts the disease, the only possible cure is “a hematopoietic stem cell transplant, which requires a well-matched donor”. Donor lists are often extremely long, to the point of being beyond individual’s reaches within a lifetime. As a result, virtually all treatments for sickle cell anemia, medical marijuana included, exist to better the lives of those who have contracted the disease.

There are various theoretical as well as tested applications for medical cannabis in relations to sickle cell anemia. To begin with, pain crises, also characterized under the umbrella term of “chronic pain,” are reportedly quelled through use of the herb— physical issues causing these pain crises include “vascular inclusion, tissue infraction, and inflammation”. To elaborate, a 2005 questionnaire presented to sickle cell anemia patients medicating with cannabis in the U.S. revealed that 52% of them reported pain reduction and 39% reported helped with anxiety and depression. Even more, medical marijuana acts as an inflammatory medication for those patients experiencing tissue swelling from the disease. Resultantly, with more research it is conceivable that medical marijuana use could be beneficial for sickle cell patients concerning both chronic pain and inflammatory issues. This notion ads to the already expansive medical uses for this profound natural medicine.

Case Study
In a fascinating story from the Jamaica, a middle-aged man with sickle cell anemia reported that he had not had a pain crises since he was 15 yrs. old—a 30 year time span. This notion is relevant to medical marijuana because this sickle cell patient reportedly smoked 5 cannabis joints a day for this entire pain crises free timespan. Interestingly enough, a majority of medical marijuana doctors rarely promote the smoking of cannabis, as edibles and vaporizers are far less obtrusive on the human airways. However, at least in regards to this case study from Jamaica, even extremely heavy, daily cannabis smoking is still beneficial in bettering the lives of sickle cell anemia patients. Nonetheless, every persons’ body reacts differently to experiences with cannabis and should be treated as such: in case-by-case scenarios.
 
Last year I helped a friend, who's father was dying of cancer, learn how to use cannabis to ease his pain and discomfort through vaporization, edibles, topicals and aromatherapy. Afterwards, she told me that she wished she had been willing to try it earlier. That it was the best couple of weeks with her dad; watching him smile and be able to eat a bit. It did my heart good to be able to help.

But what was even better is that this individual is a doctor....... and her view towards medicinal cannabis has totally changed seeing how successful it was in helping her dad.

This Hospice Is Hoping To Prove That Cannabis Can Make Dying Less Painful

The nation's first federally approved study to see if medical marijuana can ease pain for those with terminal illnesses is under way. Advocates hope it will make patients less reliant on opioids.

Posted on August 22, 2017

Alyson Martin

Ernestine Coon reclined in her hospital bed at The Connecticut Hospice with a colorful blanket covering her legs, watching seagulls soar over the water from her second-floor room. Longtime friends chatted with Coon as the slender, silver-haired grandmother prepared to do something she’d never done in her 70 years: Try marijuana.

One year ago, Coon visited the doctor and left with a diagnosis of ovarian and uterine cancer. Now, with doctors giving her about six months to live, she has constant pain in her abdomen and back, and has signed on as patient number five in the nation’s first federally approved trial to see if medical cannabis can sufficiently reduce pain in dying patients so that they can reduce their use of opioids. The study, which was announced in December and began in May, could change how millions of dying Americans treat severe pain, and open the door to alternatives to prescription painkillers blamed for a nationwide epidemic of addiction and overdose deaths. It’s expected to run for at least a year, and the goal is to enroll 66 on-site patients who are well enough to swallow capsules filled with cannabis extract, but whose pain is so bad that they require prescription medication to manage it — patients like Coon, one of the 1.3 million US hospice patients facing certain death and hoping to make it as pain-free as possible.

“You’re talking to someone who never did drugs,” Coon said, her voice scratchy. “It wasn’t my thing.”


sub-buzz-16920-1503346636-3.jpg


Christopher Capozziello for BuzzFeed News
Ernestine Coon

That has changed as her disease has progressed and her pain has worsened. Coon — an energetic woman who brags that she rarely was ill and was never hospitalized except when she gave birth — now has trouble walking, sitting up straight, or playing with her grandchildren. “Since I was diagnosed with this, I’ve probably taken medicines that in my wildest dreams I never even thought I would be taking,” Coon said, craning her neck to see her two friends, Fran and Ann, who were sitting nearby. Ann held Coon’s hand. Fran grabbed a photo from the windowsill that showed Coon at her happiest, healthiest self — grinning in the midst of a pile of grandkids.

“In fact, I’m going to give myself a dose,” Coon said as she pressed a button that looked like a buzzer. It pushed a small dose of Dilaudid, a powerful opiate, into her body through a pump.


sub-buzz-1587-1503347215-2.jpg


Christopher Capozziello for BuzzFeed News
A bouquet of flowers stands on the windowsill of Coon's room, which overlooks the Long Island Sound.

A “tree of life” is etched on the glass at the entrance to The Connecticut Hospice, which sits on the shore of Long Island Sound and serves 3,000 people each year. The nation’s first hospice, founded in 1974, treats pain in a variety of ways, from a visit with Lizzie, an eager golden retriever therapy dog, to some of the strongest painkillers available. But the drugs’ side effects — drowsiness, confusion, and nausea, among others — add to the agony of gravely ill patients and their relatives, who want their loved ones to be alert in their final days.

The cannabis study was designed in part by Wen-Jen Hwu, a Yale School of Medicine graduate and former fellow at the hospice, who watched families endure the misery that often accompanies conventional drug care, and who concluded that, sometimes, it’s more humane to address the symptoms rather than continue treating the disease.

“The tradition is narcotics, and more and more narcotics. But, that makes patients more lethargic, more confused, and have nausea, vomiting, and poor appetite and depression,” said Hwu, now an oncologist at MD Anderson Cancer Center in Texas and a board member at The Connecticut Hospice. “I do believe that the marijuana can definitely reduce the amount of the opiates that we need for our patients. More importantly, it can help them to feel better than they actually are.”


“The tradition is narcotics, and more and more narcotics."

Rosemary Hurzeler, CEO of The Connecticut Hospice, urged staff to take on the trial. She anticipates that the ripple effect could be “enormous.” “I think there’s going to be a big chance for other hospices to take a swing at this in their own state,” Hurzeler said. “But, it has to be standardized and that’s what the feds are doing in giving us this opportunity to demonstrate this.”

From start to finish, it took three years for Jim Prota, the hospice’s pharmacy director, and his colleagues to bushwhack through red tape to get the clinical trial off the ground. The idea of using marijuana for medical reasons isn’t new — the movement was born out of the AIDS crisis in the ‘90s, and 29 states and Washington, DC, now allow medical marijuana in some capacity. But in the eyes of the federal government, cannabis is an illegal drug, so the hospice had to gain approval from the Food and Drug Administration. It also needed the Drug Enforcement Administration to give its permission for the hospice to distribute a Schedule 1 drug, the category the federal government reserves for drugs it considers to have a high potential for abuse and no medical value.


“Maybe there is a drug beyond the opioids that can influence, a little bit, their quality of life.”

Decades of research support marijuana’s efficacy in treating pain. A RAND Corporation study found a link between legal cannabis dispensaries and a reduction in opiate-related deaths, which reached 33,000 in 2015. Sen. Elizabeth Warren has asked the Centers for Disease Control and Prevention to examine “the impact of the legalization of medical and recreational marijuana on opioid overdose deaths.” Nora Volkow, director of the National Institute on Drug Abuse, coauthored an article in July that said there is “strong evidence of the efficacy of cannabinoids” in pain treatment. The article said that medical cannabis could “provide a powerful new tool” in the fight against opiates.

Hurzeler agrees and hopes that the hospice staff’s research leads to broader use of marijuana as a “beautiful new drug” that lessens anguish for people suffering terminal illnesses.

“Maybe there is a drug beyond the opioids that can influence, a little bit, their quality of life,” she said. “And we always say that we want to add days to life and life to days.”


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Christopher Capozziello for BuzzFeed News
Left: A St. Simon Stock prayer card hangs in Coon's room. Right: one of Coon's medical cannabis capsules.

Hospice care providers across the country have said the same thing: Patients are talking about pot even in states — like Kentucky — that have highly restrictive medical cannabis laws. Brian Jones, director of Hospice and Palliative Care Programs at St. Elizabeth Healthcare in Edgewood, Kentucky, said more and more patients want to know if cannabis is available and legal, and how much might be enough to help with their symptoms.

Jones has noted an increased interest in cannabis and palliative care in the years since he gave a talk in 2014 on medical cannabis to a national group of hospice providers at the National Hospice and Palliative Care Organization. He’s hopeful about The Connecticut Hospice study. “If it’s shown to be effective in Connecticut and perhaps some other studies as well, you’ll see a greater interest. There’s no doubt,” he said.


“I truly believe that the cannabis is our solution."

But the law and science haven't caught up with public opinion about medical marijuana, and national hospice organizations haven’t come around to the idea either. NHPCO, the country’s largest organization representing hospice and palliative care programs and professionals, hasn’t taken a position on the use of medical cannabis, and “currently does not comment on the issue,” said Jon Radulovic, vice president of communications for the organization.

This is due in part to federal drug laws that make it nearly impossible for hospices to advocate for pot as a pain reliever. In 2011, a study in the Journal of Palliative Medicine found that health care workers in hospices “are generally in favor of legalization of marijuana and, if legalized, would support its use in symptom management for their terminally ill patients.” But hospices risk losing federal reimbursements and other funding if staff provide marijuana to patients as long as the government classifies it a Schedule 1 drug.


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Connecticut State Medical Society
Sen. Richard Blumenthal (right) at the news conference announcing the research trial with CT State Medical Society chair David Emmel, MD (left) and the head of the research trial Ted Zanker, MD (center).

The feds’ rules limit research on medical marijuana, which Hwu says makes some doctors uncomfortable with it, further hampering attempts to make it part of accepted palliative care. The Connecticut trial could help remove that stigma, she said.

“I truly believe that the cannabis is our solution. But I can’t say that to you, and convince anybody, until we have the clear evidence to show the facts, to tell people that it improves their quality of life in the end stage of their disease,” Hwu said.

With medical cannabis legal in Connecticut, the clinical trial has strong support from state elected officials. Gov. Dannel Malloy and Sen. Richard Blumenthal attended the news conference at which the trial was announced last December.

“There is a need for pain management, but there are better alternatives. And that’s why the research to be done here is so critically important. It is really groundbreaking. It can help save lives,” Blumenthal said, offering a challenge to any federal attempts to quash the medical marijuana movement. “And if any attorney general thinks he is going to turn back the clock, or roll back the progress we have made, he is in for a fight,” he said to loud applause.


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Christopher Capozziello for BuzzFeed News
A small framed photograph of Coon with her four grandchildren sits on her windowsill.

Whole-plant marijuana and its products are already used during palliative care outside of the traditional hospice and hospital settings. Santa Cruz, California, is home to the Wo/Men’s Alliance for Medical Marijuana, a cannabis collective that has been compared to a traditional hospice. Director Valerie Corral helped pass the country’s first medical cannabis law in part to help people die more peacefully.

WAMM members grow marijuana for themselves and one another to treat symptoms related to a variety of serious and terminal illnesses. Since a local ordinance approved the use of marijuana for medicinal purposes in 1993, WAMM volunteers have helped more than 500 people die using whole-plant marijuana. That’s a different form than the capsules being used in the Connecticut study, but the goal is the same: to make people more comfortable in their final days. Pot cannot replace drugs like morphine, said Corral, herself a medical cannabis patient, but it can help to distract a dying patient from the pain.

“Pain can trap one in the body. It can make it nearly impossible to get away from that deep suffering. So, cannabis can be helpful to amplify the usefulness of opiates,” she said.

Corral recalls one of the first members of WAMM, a man with cancer in his mid-forties who was hours from death in the early '90s and in a coma-like state. She shotgunned a joint, meaning she lit it and blew cannabis smoke into his nostrils as he inhaled. Corral recalled that, after the third time he breathed in marijuana, the man smiled, gave a thumbs up, opened his eyes, and talked to his family — before he died an hour later.

One challenge facing The Connecticut Hospice trial is that some patients still see marijuana as a street drug, unlike traditional therapies. And even though most of them are suffering from advanced cancer, end-stage Lou Gehrig's disease, and other painful illnesses, if they or their families have struggled with past drug or alcohol abuse, they’re hesitant to join because of concerns about relapse. “I’ve had problems with alcohol in the past. I guess once an alcoholic, always an alcoholic,” said Rick Wright, a thin 61-year-old who sat in a wheelchair puffing on a cigarette. Wright suffers from bowel and liver cancer and would have been a good candidate for the trial, which has so far enrolled patients aged 59 to 70, but he chose not to participate.

“I think maybe if I had seen a lot of other patients using it, I might have,” he said as a harpist plucked away nearby and other patients sat in their wheelchairs outside, taking in the ocean breeze.

Coon’s daughter, Tanya, helped her mother make the decision to take part in the study. She knew more about the possible benefits of medical marijuana than her mother, and discussed the trial with Prota. “I think the impression was that it would make her high,” Prota said of his conversations with Coon. “She didn’t know how she would feel since she never used it recreationally.”


"And toward the end of my life, maybe I can go out with my grandkids to the park and watch them run around.”

In fact, the medical cannabis pills don’t get people stoned. The clear capsules given to patients contain a dark, tar-like cannabis extract high in cannabidiol (CBD), known for its medicinal benefits. They are low in tetrahydrocannabinol, or THC, the ingredient in marijuana that gets people high.

Coon’s decision to participate had as much to do with managing her pain as trying to enjoy life as much as possible, given how little time she has left. Three times a day, she swallows a dose under the watchful eye of medical staff, who monitor her vital statistics and quiz her on her pain. Coon is still also taking opiates, and it’s too early to tell if the cannabis will enable her to taper her Dilaudid doses.

But Coon feels more in control of her treatment now that she’s working with the doctors on a scientific study. And she’s more hopeful than before — thinking that maybe in addition to relieving pain, medical marijuana will prove to have curative effects.

“I know my life expectancy, what they say, is not good. But if I could postpone it a month, a day, 10 months, three months, it will all be worth it if they can manage my pain,” Coon said. “And toward the end of my life, maybe I can go out with my grandkids to the park and watch them run around.” ●
 
@momofthegoons - this is not easy to write. My mother and I were the best of friends once I grew up and got my head out of my ass.

My mother died of cancer in 2004 in a hospice to toward which there is NO bounds to my gratitude and appreciation. I slept on a sofa bed in her room and held her in my arms as she took her last breath. At the end of her life, she looked a lot like that lady, Ms Coon. This is silly, I'm 64 y.o. and I'm sitting here crying thinking about those last days.

Since I retired, I have decided I need to have at least one day a week as a volunteer somewhere doing something meaningful and direct for other people. I think doing this type of thing is the true path to joy. I have a friend, a doctor, who is looking around to see if he can find a volunteer position for me at a hospice. I can't imagine it will be easy, but if given the opportunity, I am deeply committed to giving it my best shot. These are some of the thoughts I had reading this article.

The other thought I had is that I would gladly choke the living shit out of any fucking ass-hat politician or bureaucrat who works to deny dying people any comfort that we can give them, including MMJ if they want it. I can think of a few to choke right off the bat.

Thanks....I think people need to sometimes be reminding every once in a while of the far boundaries of MMJ patients and what is at stake for many.
 
Marijuana and Chronic Pain
OCT 27, 2017


Marijuana is an effective painkiller, and scientists believe it may help some people to quit opiates.
Chronic pain is becoming more and more common worldwide. Addictive opioid painkillers are frequently prescribed for chronic pain, leaving many patients dependent on them. These medications also pose a high risk of accidental overdose.

Marijuana is known to be an effective painkiller for many conditions. Studies have shown that marijuana can be used successfully in place of, or alongside opiates to treat pain.

The benefits of using marijuana to treat pain include its lack of overdose risk, and relatively mild potential for addiction.

Here, we explore the benefits of using marijuana to treat pain, and how it compares to opiate pain medications.

What is Chronic Pain?

Pain is an unfortunate, but universal human experience. Pain can be felt physically and emotionally, and can be acute (short-term) or chronic (long-lasting).

The top reasons people experience pain include injury, illness and disease, emotional trauma, and long-term wear and tear.

Chronic pain is becoming an increasing health issue in the modern world. It is defined as any pain lasting for more than 12 weeks.

One in five people in the world suffer from moderate to severe chronic pain, according to the World Health Organization.

Surgery is among the most common reasons for chronic pain. In Canada, 50% of surgery patients are left with chronic pain even after using prescribed pain medications. In the U.S., chronic pain is also a common symptom post-surgery.

Millions of people in the U.S. and Canada experience chronic pain annually.

Conventional Treatments For Pain
The most common treatments for chronic pain are pharmaceutical painkillers, often taken in pill form. Some common pain medications include:

  • Acetaminophen, such as Tylenol
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen (Advil)
  • Antidepressants
  • Corticosteroids
  • Opiate pain medications, such as hydrocodone (Vicodin), oxycodone (Percocet, OxyContin) and fentanyl
Can Marijuana Treat Pain?

Evidence suggests that marijuana is an effective painkiller when it comes to chronic pain and neuropathic pain. Compounds in marijuana have both pain-relieving and anti-inflammatory effects.

Some doctors may prescribe marijuana as an alternative to prescription painkillers.

Cannabinoids Can Relieve Chronic Pain
The Journal of American Medical Association (JAMA) published a 2015 study that found cannabis use for chronic pain and neuropathic pain is supported by “high-quality evidence.”

The study analyzed six trials that looked at a total of 325 patients with chronic pain and six trials that looked at 396 patients with neuropathic pain.

The study concluded that marijuana and cannabinoids are likely effective for these conditions.

Studies show that both THC and CBD have analgesic and anti-inflammatory effects.

Doctors Recommend Marijuana For Pain
Some doctors believe that medical marijuana is safer than opiates, because of its low risk of addiction and overdose. In fact, it is impossible to die from a cannabis overdose.

And while marijuana addiction is possible, it’s both less common and less severe than opiate addiction. Finally, marijuana has few side effects when compared with opioid drugs.

For these reasons, some doctors recommend the use of cannabis rather than prescription drugs for treating pain.

States with medical marijuana dispensaries have seen a 15-35% reduction in substance abuse admissions and opiate overdoses, according to recent data derived via public-health records.

Opiates and the Opioid Crisis

Opioid pain medications are closely related to the illicit drug heroin. These medications are highly addictive and come with severe withdrawal symptoms if used over time.

Common opiates include household names like morphine, codeine, Vicodin, Percocet, OxyContin, and fentanyl.

Opiates have a high potential for overdose, because the amount required to manage pain is very close to a lethal dose. They are also frequently overprescribed, meaning doctors give patients more than what they need, further increasing their risk.

Drug overdose is the number one cause of accidental death in the United States. Prescription painkillers are the leading cause of drug overdose deaths.

Opiate addiction has also been declared an epidemic in the U.S. and Canada. According to statistics from the American Society of Addiction Medicine, an estimated 2 million Americans have a prescription painkiller substance use disorder.

There are many problems with opiate pain medications. This leaves health professionals and policymakers searching for alternatives, and many are considering cannabis.

Marijuana vs. Opiates

Research suggests that marijuana can replace opiate drugs as a painkiller, or be used alongside opiates to reduce the need for these drugs. Marijuana is also thought to reduce the development of opiate tolerance and withdrawal.

While initial evidence is promising, scientists have only scratched the surface when it comes to looking at the potential for marijuana to replace opiates and other pain medications.

Cannabis is a Common Substitute for Opiates
A 2017 survey conducted by HelloMD and UC Berkeley investigated whether cannabis was a common substitute for opiate painkillers.

The survey was administered online to a random sample of over 100,000 patients in the HelloMD database with a mean age of 40.

16% of participants reported that pain was their primary condition, but when other conditions known to cause pain were taken into account — such as menstrual cramps, fibromyalgia, back pain, arthritis, etc. — that percentage increased to 63%.

The study concluded that cannabis substitution for opiate and non-opiate pain medications is common among pain patients. Overall, subjects reported that cannabis works well as a substitute for, as well as in tandem with, both opiate and non-opiate pain medications.

Cannabis and Opiates Work Better Together
A 2011 study at the University of California, San Francisco, led by Dr. Donald Abrams found that medical marijuana taken alongside opiates can help patients reduce their pain symptoms.

The study looked at the interaction between cannabis and opiates taken together and was the first of its kind.

The researchers concluded that the combination of cannabis and opiates reduced pain more effectively than using opiates on their own. Previous studies in mouse models found similar results.

Cannabis Can Help With Opiate Withdrawal
A 2012 review published in the Journal of Psychoactive Drugs found that marijuana can lead to greater pain relief when used together with opiates, which can lead to an overall reduction in the amount of opiates a patient uses.

The study also found that marijuana can reduce the development of tolerance, as well as withdrawal from opiates.

Other studies suggest that using marijuana can help reduce the severity of symptoms during opiate withdrawal.

Summary
Marijuana is an effective painkiller, and it shows promise as a replacement for opioid pain medications.

Studies show that marijuana may help reduce tolerance to opioids as well as withdrawal symptoms. Marijuana can also work together with opiates, helping them to be more effective at lower doses.

Opioid pain medications are widely prescribed to treat chronic pain, but these drugs pose the risk of addiction and overdose.

Marijuana shows promise as a safer alternative to treat pain, and may help some people avoid or reduce their use of dangerous painkillers.
 
Marijuana and Chronic Pain
OCT 27, 2017


Marijuana is an effective painkiller, and scientists believe it may help some people to quit opiates.
Chronic pain is becoming more and more common worldwide. Addictive opioid painkillers are frequently prescribed for chronic pain, leaving many patients dependent on them. These medications also pose a high risk of accidental overdose.

Marijuana is known to be an effective painkiller for many conditions. Studies have shown that marijuana can be used successfully in place of, or alongside opiates to treat pain.

The benefits of using marijuana to treat pain include its lack of overdose risk, and relatively mild potential for addiction.

Here, we explore the benefits of using marijuana to treat pain, and how it compares to opiate pain medications.

What is Chronic Pain?

Pain is an unfortunate, but universal human experience. Pain can be felt physically and emotionally, and can be acute (short-term) or chronic (long-lasting).

The top reasons people experience pain include injury, illness and disease, emotional trauma, and long-term wear and tear.

Chronic pain is becoming an increasing health issue in the modern world. It is defined as any pain lasting for more than 12 weeks.

One in five people in the world suffer from moderate to severe chronic pain, according to the World Health Organization.

Surgery is among the most common reasons for chronic pain. In Canada, 50% of surgery patients are left with chronic pain even after using prescribed pain medications. In the U.S., chronic pain is also a common symptom post-surgery.

Millions of people in the U.S. and Canada experience chronic pain annually.

Conventional Treatments For Pain
The most common treatments for chronic pain are pharmaceutical painkillers, often taken in pill form. Some common pain medications include:

  • Acetaminophen, such as Tylenol
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen (Advil)
  • Antidepressants
  • Corticosteroids
  • Opiate pain medications, such as hydrocodone (Vicodin), oxycodone (Percocet, OxyContin) and fentanyl
Can Marijuana Treat Pain?

Evidence suggests that marijuana is an effective painkiller when it comes to chronic pain and neuropathic pain. Compounds in marijuana have both pain-relieving and anti-inflammatory effects.

Some doctors may prescribe marijuana as an alternative to prescription painkillers.

Cannabinoids Can Relieve Chronic Pain
The Journal of American Medical Association (JAMA) published a 2015 study that found cannabis use for chronic pain and neuropathic pain is supported by “high-quality evidence.”

The study analyzed six trials that looked at a total of 325 patients with chronic pain and six trials that looked at 396 patients with neuropathic pain.

The study concluded that marijuana and cannabinoids are likely effective for these conditions.

Studies show that both THC and CBD have analgesic and anti-inflammatory effects.

Doctors Recommend Marijuana For Pain
Some doctors believe that medical marijuana is safer than opiates, because of its low risk of addiction and overdose. In fact, it is impossible to die from a cannabis overdose.

And while marijuana addiction is possible, it’s both less common and less severe than opiate addiction. Finally, marijuana has few side effects when compared with opioid drugs.

For these reasons, some doctors recommend the use of cannabis rather than prescription drugs for treating pain.

States with medical marijuana dispensaries have seen a 15-35% reduction in substance abuse admissions and opiate overdoses, according to recent data derived via public-health records.

Opiates and the Opioid Crisis

Opioid pain medications are closely related to the illicit drug heroin. These medications are highly addictive and come with severe withdrawal symptoms if used over time.

Common opiates include household names like morphine, codeine, Vicodin, Percocet, OxyContin, and fentanyl.

Opiates have a high potential for overdose, because the amount required to manage pain is very close to a lethal dose. They are also frequently overprescribed, meaning doctors give patients more than what they need, further increasing their risk.

Drug overdose is the number one cause of accidental death in the United States. Prescription painkillers are the leading cause of drug overdose deaths.

Opiate addiction has also been declared an epidemic in the U.S. and Canada. According to statistics from the American Society of Addiction Medicine, an estimated 2 million Americans have a prescription painkiller substance use disorder.

There are many problems with opiate pain medications. This leaves health professionals and policymakers searching for alternatives, and many are considering cannabis.

Marijuana vs. Opiates

Research suggests that marijuana can replace opiate drugs as a painkiller, or be used alongside opiates to reduce the need for these drugs. Marijuana is also thought to reduce the development of opiate tolerance and withdrawal.

While initial evidence is promising, scientists have only scratched the surface when it comes to looking at the potential for marijuana to replace opiates and other pain medications.

Cannabis is a Common Substitute for Opiates
A 2017 survey conducted by HelloMD and UC Berkeley investigated whether cannabis was a common substitute for opiate painkillers.

The survey was administered online to a random sample of over 100,000 patients in the HelloMD database with a mean age of 40.

16% of participants reported that pain was their primary condition, but when other conditions known to cause pain were taken into account — such as menstrual cramps, fibromyalgia, back pain, arthritis, etc. — that percentage increased to 63%.

The study concluded that cannabis substitution for opiate and non-opiate pain medications is common among pain patients. Overall, subjects reported that cannabis works well as a substitute for, as well as in tandem with, both opiate and non-opiate pain medications.

Cannabis and Opiates Work Better Together
A 2011 study at the University of California, San Francisco, led by Dr. Donald Abrams found that medical marijuana taken alongside opiates can help patients reduce their pain symptoms.

The study looked at the interaction between cannabis and opiates taken together and was the first of its kind.

The researchers concluded that the combination of cannabis and opiates reduced pain more effectively than using opiates on their own. Previous studies in mouse models found similar results.

Cannabis Can Help With Opiate Withdrawal
A 2012 review published in the Journal of Psychoactive Drugs found that marijuana can lead to greater pain relief when used together with opiates, which can lead to an overall reduction in the amount of opiates a patient uses.

The study also found that marijuana can reduce the development of tolerance, as well as withdrawal from opiates.

Other studies suggest that using marijuana can help reduce the severity of symptoms during opiate withdrawal.

Summary
Marijuana is an effective painkiller, and it shows promise as a replacement for opioid pain medications.

Studies show that marijuana may help reduce tolerance to opioids as well as withdrawal symptoms. Marijuana can also work together with opiates, helping them to be more effective at lower doses.

Opioid pain medications are widely prescribed to treat chronic pain, but these drugs pose the risk of addiction and overdose.

Marijuana shows promise as a safer alternative to treat pain, and may help some people avoid or reduce their use of dangerous painkillers.
I know this is true from personal experience.
 
I know this is true from personal experience.
I as well. My opioid consumption has gone to almost zero. And I am definitely in chronic pain. I've found that if I vape or dab (or a combination of both) it takes my mind off the pain significantly and can also diminish certain pain. Cannabis has been a life saver for me. Those damn opioids are a real slippery slope.
 

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