
- The use of medicinal cannabis for the treatment of chronic pain is far more common.
- Patients should not be afraid to discuss this issue with their doctor.
- They should take a professional approach and inform patients about the potential risks and benefits.
Introduction
There are few topics that evoke stronger emotions among doctors, scientists, researchers, creators, politicians, and the public than medical marijuana.
Is it safe? Will it be legal? Decriminalized? Is its effectiveness really proven? Under what conditions can it be used? Is it addictive? How do we keep it at a safe distance from teenagers? Is it really a "wonder drug," as many describe it? Is medical marijuana just a step toward full legalization of cannabis?
These are just some of the many questions on this topic, questions I want to avoid so that we can focus only on two specific areas: why patients find it useful and how they can discuss this topic with their doctor.
Marijuana is currently legal in 29 states and in Washington DC. From the perspective of the federal government, however, it is still illegal. The Obama administration did not prosecute medical marijuana. President Donald Trump has promised not to interfere with people who use medical marijuana, although his administration is currently threatening to change the policy.
About 85% of Americans support the legalization of medical marijuana, and it is estimated that at least several million Americans currently use marijuana.
Marijuana without an euphoric state
The least controversial is an extract from the cannabis plant known as CBD (or cannabidiol), since this component of marijuana has few (if any) narcotic properties. Marijuana alone has more than 100 active ingredients. THC (tetrahydrocannabinol) is a chemical that induces an euphoric state that occurs when using marijuana. CBD-dominant strains contain only low or minimal amounts of THC, so patients show no or only minimal changes in behavior.
However, patients agree on many benefits of CBD, from relieving insomnia, anxiety, spasticity, and pain to treating potentially life-threatening conditions such as epilepsy. A form of childhood epilepsy, Dravet syndrome, is almost incurable but responds dramatically to CBD - a dominant marijuana strain called Charlotte's Web.
Use of medical marijuana
The most common use of medical cannabis in the USA is pain relief. Marijuana is not strong enough for postoperative pain or bone fractures, but it is relatively effective in relieving chronic pain. It is also clearly safer than opiates (it is not possible to overdose and it is much less addictive) and can replace NSAIDs such as Advil or Aleve when they cannot be used, for example due to kidney problems or ulcers.
Marijuana improves multiple sclerosis and nerve pain in general. This is an area where there are several other options, and ones such as Neurotin, Lyrica, or opiates are strongly sedating. Patients claim that marijuana allows them to continue their previous activities without feeling completely exhausted or tired.
Marijuana can also relieve tremors in Parkinson's disease. It is also relatively successful in fibromyalgia, endometriosis, interstitial cystitis, and most other conditions where chronic pain is a common symptom.
Cannabis can be used to treat nausea and weight loss and to treat glaucoma. A promising area of research is the use of PTSD in veterans returning from combat zones. Many veterans and their therapists report drastic improvements and have sparked discussions about further studies and easing state restrictions on those studies.
Medical marijuana is also helpful in treating patients with HIV-related pain syndrome, as well as irritable bowel syndrome and Crohn's disease.
None of the above statements are intended as a comprehensive list, but rather to provide a brief overview of the types of pain for which medical marijuana can provide relief. As with all medicines, efficacy and care should be viewed critically.
Talk to your doctor
Many patients find themselves in a situation where they want to learn more about medical marijuana but are ashamed to talk to their doctor about it. This is partly because the entire medical community rejects marijuana as an alternative. Doctors are now keeping up and trying to stay one step ahead of their patients in terms of knowledge. Other patients are already taking medical marijuana but do not know how to tell their doctor because they fear being criticized or even blackmailed.
My advice for patients is to be completely open and honest with their doctor. Consider the discussion on this topic as part of your care and expect to be informed and at least directed to the information you need.
My advice to doctors is that patients will use it regardless of whether you are for or against medical marijuana. Although we do not have precise studies and no "gold standard" for the benefits and risks of medical marijuana, we need to learn more about it and think openly about it, otherwise patients will seek another, less reliable source of information. They will continue to use it, they just will not tell you, and there will be much less trust and strength in the patient-doctor relationship.
I often hear complaints from other doctors that there is not enough evidence to support medical marijuana use, but there is even less scientific evidence that allows us to keep our heads in the sand.
Source: Article , image: www.blog.ourcrowd.com



