Will your doctor approve a medical marijuana (MMJ) card for you? Two of mine will and one won’t.
The doctor who won’t, a primary care physician who works within a medical group, told me it’s the group’s policy. The problem, she explained, is that there are no guidelines. How do you know what to prescribe if you can’t determine the marijuana’s potency or understand how the balance between THC and CBD — the parts of marijuana that get you high and that calm you down, respectively — will affect a specific symptom? There are also no quality controls, as there are with traditional medications.
Is it enough to know it helps ease pain?
Though I’ve tried MMJ a couple of times, I’ve also been concerned by the lack of standards. So an article and accompanying editorial recently published in the journal Annals of Internal Medicine caught my attention. Researchers from Oregon Heath & Science University reviewed 25 trials and studies, involving nearly 15,000 people, and found that using cannabis products with a high THC-to-CBD ratio resulted in moderate, short-term improvements in chronic pain. However, these products were also associated with higher risks for adverse events, such as sedation and dizziness, and they produced few benefits in overall functioning.
MMJ and MS pain
Although some neurologists will disagree, there’s no doubt in my mind that multiple sclerosis (MS) can cause pain. There can be the facial pain, known as trigeminal neuralgia; burning pain in the legs from damaged nerves; and neck and back pain from muscles that are stressed by the abnormal gait associated with MS. A significant number of people with MS report pain early in their MS journey, and you can read patient reports of pain in nearly any MS-related Facebook group.
There are also studies that show that using cannabis specifically helps ease MS pain. If MMJ is reducing pain, shouldn’t doctors consider it as a treatment option?
Balancing medical standards and medical marijuana use
An email summary of an editorial in Annals of Internal Medicine, accompanying the Oregon study and written by two doctors at the University of Michigan Medical School’s anesthesiology department, suggests that clinicians should be “willing to provide compassionate guidance” to patients who want to use cannabis products to treat their symptoms.
To do that, they say a healthcare professional needs to know the patient well and know the effects cannabinoids can have. This includes understanding how to balance THC and CBD, understanding cannabis potency, and knowing the potential adverse effects that cannabis can have.
That seems pretty simple to me. What do you think?
(A version of this post first appeared as my column on the MS News Today website.)
(Featured image by nneem from Pixabay.)
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