Is Marijuana the Holy Grail for Pain Medication? by @LynnRWebsterMD
Is marijuana the holy grail for pain medication?![The Painful Truth, Lynn Webster, MD, Marijuana, Chronic Pain](http://thepainfultruthbook.com/wp-content/uploads/2015/12/weedXpixabayX.jpg)
You might think so by reading the popular press.
An ideal drug therapy is one that is highly effective for a multitude of pain disorders and has low to no toxicity regardless of duration of exposure. Marijuana flirts with this profile—but it is a Trojan horse.
Depending on where you live, it may be legal for you to get a prescription for marijuana. But before you rush to your doctor’s office with your request, remember that all drugs have risks. It is a clinician’s responsibility to evaluate the potential benefit, relative to the potential risk, of each drug option. Marijuana products have fewer risks than opioids. Still, marijuana should be used judiciously and with awareness that it could be harmful.
Here are five things to think about:
- Marijuana is a plant, not a drug, and it has many active chemicals. We need to know which of the chemicals are therapeutic, and for which specific pain diseases, and at what doses.
- Some people get addicted. A small percentage of people who use marijuana get hooked on it. The younger you start, the more likely you are to become addicted. Children or adolescents who use marijuana are more likely than most adults to develop an addiction.
- Tetrahydrocannabinol (THC) alters brain function. There was once a lot of hype, fed by Hollywood, about how marijuana can drive a person insane. Most of that was exaggeration and even false. It’s true, however, that tetrahydrocannabinol can override your ability to feel sensation, reduce your access to memories, restrict your ability to move, and even trigger psychosis. Marijuana users today are at greater risk of side effects than those in the past because of the increased potency of THC in recent years.
- Long-term use can be problematic. Using marijuana over time can cause mental health problems for many. Even those who do not become addicted can experience hallucinations and paranoia. Some users can experience anxiety, depression, and even suicidal tendencies. Also, teens’ use of marijuana can interfere with the healthy development of their brain. And for pregnant women, marijuana use could affect the brain of their fetus.
- Marijuana increases heart and breathing problems. TCH, the same chemical in marijuana that affects your brain, can also adversely affect your heart. It has been linked to heart attacks in adults. Smoking marijuana can lead to many of the same breathing problems, including lung infections and coughing, as smoking cigarettes.
Risks
The point to remember is that all drugs used to treat disease, including chronic pain, come with risks. That means our approach to drug therapy should be thoughtful and wide eyed, not blind. I am not making an argument against marijuana but rather am encouraging greater understanding of marijuana’s potential risks.
Considering the current opioid crisis, marijuana may be a safer alternative in some clinical situations. But we must be aware of the potential harm if it is used. Although marijuana may offer a solution to some people with pain, it is not the Holy Grail of analgesics.
Purchase my book The Painful Truth: What Chronic Pain Is Really Like and Why It Matters to Each of Us (available on Amazon) or read a free excerpt here.
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If you are going to use the word “addiction”, as a physician you need to keep to the medical definition, and also be aware of the distinction, medically, between addiction and dependence.
Laurence I am not sure where you feel I used the terms incorrectly. Addiction is a brain disease that is characterized by compulsive use despite harm. Dependence is an adaptation of the central nervous system to an exogenous substance. Dependence is present in addiction but dependence is not addiction and can exist without behaviors of craving and use despite harm.
Perfect explanation! Wish more docs understood the difference between addiction & dependence! The info being put out is that pot is harmless & not at all addictive, however what you wrote is exactly right & people need to take an active part in their own health care. I am a patient advocate w/ a back round in psychology & addiction, that also happens to suffer from chronic pain & I fully support legalizing pot & decriminalizing ALL drugs; but I also believe that patients need to know all the pros & cons of ALL treatment options in order to make an informed decision. For some, pot can be just as addictive as opioids, in fact you can become addicted to anything whether it is considered addictive or not.
I have been on opioids on & off for 20yrs. yet I have NEVER gotten addicted to them; I did get addicted to white chocolate covered reese cups & had a terrible time giving them up & have relapsed many times especially during the holidays!
Thanks so much doc for this honest & informative report!
Used as a tea I found incredible relief from spasms with no side effects..its legal in my state, but I still stopped using it until the feds ok it so I won’t affect my social security
Used in a butter form has been a life saver for me and I would rather do that then take more pills but the doctors around here freak out if you use it … Instead they give you more pills???? Can we say kick back from pharmaceutical companies???? It’s a bunch of shit! Have been suffering for 15 years 7-10 in pain 24/7 and no one can help…,,
Amy it is difficult for doctors to condone marijuana because the DEA can hold it agains a physician. It is illegal by the federal government so physicians find it risky to authorize it. As for kick-backs, I would like to know how that occurs? Never heard of such thing. I hope you get the treatment you deserve.