Fibromyalgia and Medical Marijuana

By Gooey Rabinski - Jun 29, 2015

Along with the wave of cannabis legalization sweeping the nation, the medical efficacy of this versatile herb has generated a significant amount of media attention. Millions who only a decade ago believed government propaganda regarding the dangers of marijuana now are at least aware that the plant delivers medical efficacy for at least some diseases.

Even cynics must recognize a 1999 report issued by the Institute of Medicine called Marijuana and Medicine. In it, the organization concluded that cannabinoids — the magic molecules that convey the medical benefits of the plant — provide relief of pain, appetite stimulation, and the relief of nausea and vomiting.

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Fibromyalgia, a chronic pain syndrome that is difficult to treat and has no cure, is no exception. Affecting an estimated 5 to 12 million Americans, the condition is relatively untreatable with conventional pharmaceutical medications. In fact, only 35-40 percent of sufferers gain any relief whatsoever from mainstream drugs.

Cannabis treats not only the pain associated with fibromyalgia, but other symptoms of the condition as well, including insomnia, fatigue, restless legs syndrome, depression, and anxiety. While the root cause of fibromyalgia remains a mystery, it is understood that it involves a disturbance in how the central nervous system, including the brain, spinal cord, and nerves, sends and receives messages. It is estimated that the disease afflicts four to seven times as many women as men.

Long History of Pain Relief

Cannabis actually has a long history of pain relief. Available until the late 1930s as a tincture in every pharmacy in the United States, marijuana was considered a staple of middle class medicine cabinets throughout the 19th century and until it was outlawed by the federal government. Before aspirin — a drug that kills thousands of people every year — became popular in the 1920s, an eyedropper full of a cannabis tincture applied to the tongue was how people dealt with everything from headaches to sore muscles to broken bones.

Said Donald Abrams, an oncologist and director of clinical research programs at the UCSF School of Medicine in San Francisco:

“[Cannabis] works against pain and may be synergistic with pain medications, helps people sleep, and improves mood. I think it’s a shame that we don’t allow people to access that medicine.”

Cannabis is an especially good pain killer (analgesic) due to the widespread presence of cannabinoid receptors throughout the nervous system. Unlike many conventional pain treatments, cannabinoids — the miracle molecules like THC and CBG that are responsible for the medical efficacy of marijuana — are able to modulate pain signals sent from both peripheral nerves and the spinal cord.

The Studies

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A 2014 online survey of more than 1,300 fibromyalgia sufferers (96 percent of which were female) conducted by The National Pain Foundation revealed that, while the minority of sufferers have tried cannabis to treat their condition, the majority of those who have report gaining significant relief. 379 participants reported that they had used cannabis therapeutically for fibromyalgia.

Interestingly, 43 percent of survey participants felt their physician was “not knowledgeable about the disorder.” Perhaps this is driven somewhat by the fact that cannabis provides such significant efficacy for the condition, yet doctors in most parts of the country are unwilling to either recommend or prescribe it because of federal-level illegality and the fact that they could, in theory, lose their medical license.

The National Pain Foundation survey revealed the following data:

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Proof of the lack of efficacy of conventional treatments was revealed in a 2012 study that investigated the use of marijuana for fibromyalgia. The study discovered that about 13 percent of participants were using cannabis to help relieve their symptoms,  more than 80 percent of whom were using it illegally. The willingness to engage in illegal activity to gain relief from their condition is a sign that pharmaceutical treatments are often ineffective at dealing with the pain and insomnia associated with fibromyalgia.

A study conducted in Manitoba, Canada in February 2008 announced that a marijuana-based compound, nabilone — typically used to treat nausea during chemotherapy — reduced pain and anxiety for 40 fibromyalgia patients.

According to one fibromyalgia sufferer:

“I would use [marijuana] when the burning pains started down my spine or my right arm, and shortly after, I found I could continue with housework and actually get more done. I was desperate to find something for the burning pain so I could function. I’m glad that I made this decision, because it works for me.”

A 2006 study by the University of Heidelberg in Germany revealed that oral THC significantly reduced chronic pain in patients with fibromyalgia. Subjects were administered daily doses of 2.5 to 15 mg of THC and received no other pain medication during the study. All participants reported significant reductions in daily pain. This was the first clinical trial assessing the efficacy of cannabinoids in the treatment of fibromyalgia to be conducted (largely due to the Schedule I status of cannabis that prevents such research in the U.S.).

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The study reported that patients gained relief from marijuana not only for their pain, but also nearly all other symptoms caused by fibromyalgia. The authors claimed that cannabis delivered “significant relief of pain [and] stiffness, relaxation, somnolence, and perception of well-being.”

The authors of the study concluded:

“All patients who completed the delta-9-THC therapy…experienced pain relief of more than 50 percent.”

The results of all four studies are good news for fibromyalgia patients, the majority of whom report gaining little or no benefit from conventional pain therapies and pharmaceutical treatments. For treatment-resistant conditions, such as intractable epilepsy and fibromyalgia, cannabis holds special promise for those patients (and their doctors) who have tried all other treatments and are desperate for pain relief and a good night’s sleep.

Doctor Opinions

Phillip Leveque, a 92-year-old Oregon-based physician who died in May, had been a long-time advocate of medical cannabis for the treatment of many conditions, including fibromyalgia. He was one of the first doctors in Oregon to prescribe medical cannabis following the state’s legalization in 1998. “I have about 100 fibromyalgia patients using marijuana/cannabis very effectively,” wrote Leveque.

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In a 2013 article, Leveque was critical of pharmaceutical company Eli Lilly’s introduction of a new synthetic, non-cannabis drug for fibromyalgia. “Eli Lilly was once a leading producer of cannabis medicines. I think they should go back to that; it works.” (Leveque was referring to the fact that Eli Lilly produced cannabis-based products, typically tinctures, for a variety of conditions prior to federal-level prohibition in 1937.)

M. Joyce Elders, the Surgeon General from 1993 to 1994, was a strong proponent of medical cannabis for the treatment of common symptoms of multiple diseases, including pain management. Said Elders:

“The evidence is overwhelming that marijuana can relieve certain types of pain, nausea, vomiting, and other symptoms caused by such illnesses as multiple sclerosis, cancer and AIDS — or by the harsh drugs sometimes used to treat them. And it can do so with remarkable safety.”

Caused by Cannabinoid Deficiency?

Some researchers and medical cannabis experts theorize that diseases like fibromyalgia and multiple sclerosis are caused by something called cannabinoid deficiency. This is a condition in which the body’s internal cannabinoids, called endocannabinoids, are not being produced in the proper quantities or ratios.

Because cannabinoids from cannabis (called phytocannabinoids) fit perfectly into receptors in the human brain, nervous system, and immune system, supplementation of the endocannabinoid system with the more than 110 cannabinoids found in marijuana may introduce homeostasis, or balance. In this respect, cannabinoids may either directly treat the symptoms of major diseases or repair the body’s immune system so that it can better deal with the disease itself.

Strains for Fibromyalgia

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It is important for fibromyalgia patients to select strains for cultivation or purchase that will best treat their condition. Varieties effective at dealing with pain and insomnia are the best suited for fibromyalgia.

Pain relieving strains that also promote relaxation and sleep:

Sleep-inducing strains:

Daytime pain relief strains:

 

Photo credit: Phillip Leveque