n the 2014 book, “A Nation in Pain,” Judy Foreman offered a stunning picture of America’s growing problem with chronic pain.
Tucked quietly within that volume is Chapter 10, “Marijuana: The Weed America Loves to Hate.” In it Foreman concludes: “to put it bluntly, marijuana [for pain] works. Not dazzlingly, but about as well as opioids. That is, it can reduce chronic pain by more than 30 percent. And with fewer serious side effects.”
The same conclusion has been reached by many Americans. Marijuana Business Daily recently reported that chronic pain comprised 64.2 percent of patients in those medical cannabis states that track a registrant’s medical condition. If you apply that percentage to the estimated 100 million adults living in chronic pain you can quickly see that nationwide availability to medical cannabis could have a profound impact on the nation’s health, improve the quality of life for millions, and, not incidentally, vastly expand the medical cannabis market.
Access to Medication
Of the 27 state laws that allow medical access to cannabis, 22 specifically mention “chronic,” “intractable,” or “severe” pain as a qualifying condition. An additional three — Illinois, New Hampshire, and Massachusetts — give the physician sufficient leeway to recommend cannabis for pain. In Connecticut, Florida and New Jersey a patient with chronic pain must be certified as terminally ill. In Florida, just to make things harder, the patient must be certified as specifically having less than a year to live.
Another 17 states have the so-called CBD-only laws but, in most cases, use is restricted to pediatric epilepsy patients and most of these laws have barely gotten off the ground.
Opponents of medical cannabis are quick to single out the chronic pain patient as some kind of pariah, implying that pain is an “excuse” to abuse drugs. They will say there is no research to support the use of cannabis in pain therapy when, actually, quite the opposite is true.
A Google Scholar search using the exact phrase “cannabis and pain” reveals 27 studies between 2000-2016. Another 40 studies appear when the phrase is changed to “marijuana and pain.”
Nearly all present a positive view of the use of cannabis in treating pain, especially neuropathic or nerve pain.
A particularly thorough review prepared in 2013 for the American Academy of Pain by Ethan Russo observes that these studies, “provide provocative direction to inform modern research on treatment of pain and other conditions, [but] it does not represent evidence… that is commonly acceptable to governmental regulatory bodies with respect to pharmaceutical development.”
And therein lies the rub. Without a pharmaceutical advocate, cannabis will never win a government seal of approval for prescribed use. Still, the research speaks volumes to pharmaceutical companies at work on cannabinoid drugs , as well as patients in medical states.
Natural = Better
For many the concept of cannabis parsed and packaged as a pharmaceutical product is abhorrent. They point to the well-known “entourage effect,” i.e. cannabinoids work better together rather than in isolation. And their argument is backed by science.
In 2015, Israeli scientists reported findings involving synthetically produced, single molecule CBD vs. naturally occurring CBD derived from a cannabis strain that is rich in CBD (17 percent) but also has a small percentage of THC and several other cannabinoids. The scientists found this strain, called Avidekel, “superior over CBD for the treatment of inflammatory conditions.” Synthetic CBD had a clear threshold of therapeutic effect but Avidekel has “increasing responses upon increasing doses, which makes this plant medicine ideal for clinical uses.”
Marijuana as a Medical Right
The battle for legal access to cannabis for pain treatment has made great strides in the past two decades. Research supports it and common decency demands it. Judge Gustin L. Reichbach wrote in May 2012 in an op-ed piece of The New York Times, “When palliative care is understood as a fundamental human and medical right, marijuana for medical use should be beyond controversy.”
Judge Reichlich, a cancer patient, died two months later.