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Can Medical Marijuana Treat Arthritis?

Cannabis has been used to treat arthritic-related conditions for thousands of years, dating back to 2700 B.C.E where the clinical use of cannabis was first documented in the Pen Ts’ao (The Herbal), Chinese pharmacopoeia. However, it wasn’t until the 19th Century that cannabis first reached Western medicine. British physician Sir William Brooke O’Shaughnessy learned about medicinal cannabis in India and introduced it to England. In India, cannabis had been used to treat numerous ailments including pain and inflammation.

O’Shaughnessy meticulously documented his experiments on animals and humans; his research included three case reports on cannabis as a treatment for rheumatoid arthritis. O’Shaughnessy claimed two of three three patients experienced significant relief and were “cured” in three days. According to O’Shaughnessy,  the third patient (who didn’t experience relief), was “habituated to the use of gunjah in the pipe,” possibly meaning he had developed a tolerance to cannabis.

O’Shaugnessy generated considerable interest in England and cannabis was enthusiastically integrated into western medicine. Russell Reynolds, Queen Victoria’s personal physician, believed cannabis to be one of the most effective treatments available.

What is Arthritis?

We hear the term “arthritis” all the time. The word arthritis comes from “ortho” meaning joint and “itis” meaning inflammation. We think of it as chronic joint pain condition that is a common part of aging. However, arthritis is not a homogenous disorder. In fact, an “umbrella term,” it refers to a diverse group of more than 100 joint-related pain conditions and diseases. Arthritis can affect any joints (and surrounding tissues), including weight-bearing joints such as the hips, knees, and spine, or non-weight-bearing joints such as the fingers or elbows.

Contrary to what many people think, arthritis doesn’t just affect the elderly (although it does affect this population disproportionately). Individuals at any age, even children, can experience arthritic symptoms. The spectrum includes mild to severe (often debilitating) forms of arthritis including tendinitis, bursitis, and gout to rheumatoid arthritis, systemic lupus erythematosus; fibromyalgia is often characterized as an arthritic-related condition.

Arthritis can be broadly divided into two types of conditions:

  • Rheumatoid arthritis (RA): RA is an autoimmune disease that often progresses to nearly all of a person’s joints.
  • Osteoarthritis (OA): OA is a condition that can be attributed to a number of factors, including injury and overuse, obesity, and genetics.

Both RA and OA can cause stiffness, inflammation, swelling, mobility issues, and significant pain.

How Can MMJ Help Treat Arthritis?

Clinical cannabis expert, Dr. Sunil Aggarwal, and a team of University of Washington physicians and scientists authored a scientific paper published in the Journal of Opioid Management. The concluded:

It is clear that, as an analgesic, cannabis is extremely safe with minimal toxicity. Unlike opioids, cannabinoid medicines to not promote appetite loss, wasting and constipation, but instead can be used therapeutically to treat these symptoms.

The team also noted that compounds in cannabis produce a synergistic effect — the “entourage effect — in which various compounds in cannabis work together to create effects superior to individual compounds.

Of the hundreds of cannabinoids, terpenes, essential oils, and flavonoids, terpenes, found in cannabis, many seem to be able to alleviate pain and inflammation. Evidence also suggests cannabis may be useful by itself or in conjunction with opioid-based painkillers. In fact, evidence suggests cannabinoids can potentiate the effects of opioids, improving and extending their efficacy, while allowing pain sufferers to reduce their intake of opioids.

CBD, the most prominent (largely) non-psychoactive ingredient in cannabis may be able to alleviate morning stiffness, reduce inflammation and improved mobility. When CBD is metabolized, it produces an anti-inflammatory compound that produces comparable effects to indomethacin (commonly prescribed for gout and other arthritic conditions) without the associated gastrointestinal side effects.

THC’s analgesic effect appears to be partly mediated through delta and kappa opioid receptors, suggesting an intimate connection between opioid and cannabinoid signaling pathways that mediate pain sensation. Several studies suggest cannabis can potentiate (increase efficacy) the effect of opioids, thereby allowing patients to reduce opioid intake.

In a study of medical marijuana and pain, Canadian researchers at the Centre for Addictions Research of BC concluded:

  • A growing body of evidence supports the use of clinical cannabis as a substitute or adjunct to prescription opiates for treating chronic pain.
  • Used as an adjunct to prescription opiates, cannabinoids lead to greater cumulative relief of pain. The increased efficacy may allow patients to decrease opioid intake while reducing the accompanying side effects of opiates.
  • Cannabinoids may be able to inhibit tolerance to opiates and decrease opioid-induced withdrawal symptoms. In fact, cannabinoids may also be able to “rekindle opiate analgesia after a prior dosage has become ineffective.”

Moreover, cannabis seems to be helpful in three distinct ways:

  • Analgesic effects: The analgesic effects of cannabis are well-established. Cannabinoids produce analgesic effects in a manner similar, but pharmacologically distinct from opioids. Research shows cannabis decreases pain intensity and sensitivity while increasing pain tolerance.
  • Antinociceptive effects: Cannabinoids are known to block pain sensation (antinociceptive effects) in various inhibitory pathways influencing nociception and pain.
  • Anti-inflammatory and autoimmune actions: The anti-inflammatory and immunomodulatory effects of cannabis have been documented for thousands of years. Because cannabinoids exert immunomodulatory and anti-inflammatory effects, cannabis could be useful not just in managing arthritic symptoms, but treating the underlying causes.

If you have arthritis and are new to MMJ, know that finding the right strain and intake method can be confusing at first. Some people prefer edibles, while others find inhalation to work better — and, some patients may find a combination works best. Likewise, you may find you prefer high CBD strains over high THC strains — or, vice versa. Just keep in mind, it may take a little trial and error to find your optimal treatment protocol.

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