We are no longer surprised when a chronic pain patient sings the praises of Medical Cannabis. Chronic pain is the leading complaint among patients seeking Medical Cannabis Cards in Utah. Even so, skepticism remains. Perhaps a new study out of Australia can help alleviate at least some of that skepticism.
The study was a longitudinal one that followed more than 2300 patients over the course of 12 months. Roughly half of them were being treated for more than one condition. Researchers were specifically looking at how Medical Cannabis impacted chronic pain, anxiety, depression, and sleep disorders.
Following the patients over 12 months allowed researchers the opportunity to gauge results at several increments throughout. Data was gathered from patients through voluntary surveys taken at numerous intervals. The data from the surveys was compared against information provided via an initial questionnaire that patients completed at the start of the Australian study.
Without getting into all the details, the three-month results showed tangible improvement in all conditions except sleep disorders. Chronic pain patients reported significant improvement in their pain levels. They also reported better quality of life.
We are still waiting for the results from the 12-month follow-up surveys. Those results will tell us more about Medical Cannabis’ long-term impact on chronic pain. But from where we stand, things look very promising. It seems reasonable that patients should experience the same benefits at month 12 as reported at month 3.
We mentioned earlier in this post that the Australian study was a longitudinal one. There is significance to that. So much so that we don’t want to let it escape without discussing it.
There are multiple ways to structure scientific studies. Researchers choose a particular structure based on the type of data they are hoping to gather. In the case of a longitudinal study, the goal is to gather data on repeated observations of the same variables over an extended period of time.
Put another way, a longitudinal strategy collects and analyzes the same kind of data over the entire length of the study. A pain study designed to be conducted over 12 months would dictate giving patients the exact same surveys at every follow-up interval. Using identical surveys serves the purpose of asking identical questions in order to measure the same data.
The choice to make the Australian study longitudinal demonstrates a genuine interest in learning how patients are affected by Medical Cannabis over the long term. By contrast, a small-scale clinical study based on the randomized clinical trial model would utilize a very small test window on a one-off basis.
To be honest, we are not surprised by the results the Australian researchers observed. History records people using cannabis medically as a pain treatment for centuries. We know it works. Science is just catching up to that knowledge now.
At any rate, pain is a qualifying condition for medical Cannabis in Utah under two qualifications. The first is chronic pain. Patients who experience pain daily, or almost daily, for more than three months are eligible to obtain a Medical Cannabis Card after consulting with a medical provider.
The second is acute pain that medical providers and patients expect would be otherwise treated with prescription medications. If an acute pain patients meet certain qualifications, he or she can elect to use Medical Cannabis over other pain meds.
Chronic pain continues to be the number one driver of Medical Cannabis consumption in both Utah and across the country. What does that tell you? It tells us what science is just now starting to prove: Medical Cannabis works.
As with just about every other state with an active Medical Cannabis program, Utah considers chronic and acute pain qualifying conditions. Of course, there are restrictions in place. Not every form of pain can be legally treated with Medical Cannabis. That leads to a question: does menstrual pain qualify?
Pain associated with a woman’s monthly cycle can range anywhere from mildly uncomfortable to quite severe. Treating it with Medical Cannabis could offer significant relief. Fortunately, the condition could qualify for obtaining a Medical Cannabis card.
To be clear, the female menstrual cycle is not a qualifying condition in and of itself. It would be tough for a Qualified Medical Provider (QMP) to simply list “menstrual pain” on a patient’s electronic record and leave it at that. There needs to be further justification. Chronic pain is that justification.
Utah’s Medical Cannabis statute defines chronic pain deemed appropriate for Medical Cannabis treatment as “persistent pain lasting longer than two weeks that is not adequately managed” by way of prescription opioids or a physical intervention.
The chances of a doctor prescribing opioid pain medications to treat minimal menstrual pain are not very high. But serous and recurring menstrual pain is another matter.
For the purposes of defining who qualifies for a Medical Cannabis card in Utah, chronic pain is broadly defined. This benefits patients of all types who, without being able to list chronic pain as a qualifying condition, would have no other choice but to seek approval from the state Compassionate Use Board.
Chronic menstrual pain not relieved by other pharmacological treatments or physical intervention certainly qualifies for Medical Cannabis. Still, a basic understanding of how approval from the Compassionate Use Board works might be helpful to our readers.
The board has the legal authority to approve Medical Cannabis cards for patients who do not meet the standard qualifications. This includes not only people whose conditions aren’t on the list, but also minors who would otherwise not be allowed to consume the drug. The Compassionate Use Board could look at the totality of information provided by both patient and QMP and ultimately determine that Medical Cannabis treatment is appropriate.
Knowing what we know about menstrual pain suggests that it would be worth considering as a qualifying condition, both in Utah and elsewhere. According to The Cannigma’s Jessica Reilly, some 91% of all women report menstrual pain as a normal part of their monthly cycle. Approximately 29% say the pain is severe.
Unfortunately, those same women report that over-the-counter (OTC) pain relievers offer only minimal relief. Yet history records women using cannabis to relieve menstrual pain long before governments around the world began banning cannabis.
If menstrual pain is a normal part of your monthly cycle and OTC pain relievers don’t help, you can always speak with your doctor, physician assistant, or nurse practitioner about it. Your pain might be severe enough to be considered a chronic pain that qualifies for Medical Cannabis therapy.
Chronic and acute pain are among the most common reasons to use Medical Cannabis. The thing about pain is it that it comes “in all shapes and sizes,” so to speak. Medical Cannabis laws do not easily accommodate that reality right now, but things are changing.
In Utah, a patient’s first Medical Cannabis Card expires after six months. Once the card is renewed, it lasts for another six months. After one full year in the program, the patient may be eligible for annual, rather than semi-annual, renewals. Your Qualified Medical Provider (QMP) or Limited Medical Provider (LMP) will decide if annual renewals are appropriate.
We are always on the lookout for new study data demonstrating whether Medical Cannabis is a truly effective medicine. We are happy to report that a recently released study out of Florida State University (FSU) seems to suggest that cannabis is a possible substitute for opioids as pain medications.
If subsequent studies find the same thing, we will not need to say just how big it will be. Anyone who has used opioid pain medications and had a bad experience would probably welcome an alternative painkiller. If that alternative is cannabis, then having more than three-dozen states with Medical Cannabis programs in place puts us ahead in the game.
The survey study asked some 2,100 participants about their use of both opioid medications and Medical Cannabis. Researchers gathered data on patients using cannabis to treat:
Not surprisingly, nearly 89% of the respondents said that medical cannabis consumption was “important to their quality of life.” They said it was either “very” or “extremely” helpful in treating their conditions.
We should also point out that more than 60% of the respondents had been taking opioid medications prior to being offered Medical Cannabis. Some 79% were able to either reduce or completely eliminate the opioids.
All of that is good news, but we’re not done yet. The survey also showed that:
The primary side effects reported by survey respondents included drowsiness, dry mouth, and increased appetite.
As far as observational studies go, this was pretty definitive. It’s not like we’re hovering on the border at 50-50. We are talking percentages in the high 80s which, under most circumstances, would amount to definitive proof. The only reason we cannot deem this study conclusive is its observational nature. We need clinical studies to do that.
Still, the study gives us a lot of confidence in helping patients who come to us with using Medical Cannabis to manage chronic or acute pain. While we’re talking about it, let’s discuss acute pain in more detail.
If you are not intimately familiar with Utah’s qualifying conditions list, you should know that acute pain was added during the 2022 legislative session. Acute pain can now be treated with Medical Cannabis under certain circumstances.
We will not get into the details here but imagine scheduling knee replacement surgery for later this year. As long as your medical provider was willing, and your circumstances met the conditions, you could utilize Medical Cannabis during your recovery as a substitute for opioids.
We think that’s huge. Why? Because we have talked to a lot of patients who have come looking for their Medical Cannabis Cards because they were tired of the way opioids made them feel. Given the highly addictive nature of most opioids, recommending cannabis as a substitute for opioids seems like a no-brainer.
Thanks to the COVID-19 pandemic, the opioid epidemic has practically disappeared from our cultural radar. If nothing else, the FSU study is a reminder that the opioid epidemic still exists. It also provides compelling evidence that Medical Cannabis can be an amazingly effective tool in fighting the opioid problem.
If you are currently taking opioid meds and would rather find an alternative, make an appointment to visit any one of our clinics. We can help you obtain your Medical Cannabis Card so that you can take an honest shot at getting off those opioids.
Pain continues to be one of the leading conditions people list on their Medical Cannabis Card applications. It is the leading medical motivation for using cannabis nationwide. That being the case, there is an almost endless number of things capable of causing chronic pain. In women, endometriosis is one of them.
Endometriosis is a fairly common condition that affects about 10% of adult women. Each woman suffering with it experiences a unique level of pain. There are some who present an advanced form of the disease and yet feel no pain at all. There are others whose cases are minor but present with excruciating pain. That is one of the reasons that endometriosis is so hard to treat.
The owner of a Las Vegas pain clinic, Dr. Page Bady, says he has patients who successfully treat endometriosis pain with cannabis. Bady is a former ER doctor and a member of an opiate task force established by former governor Brian Sandoval. He is now involved in conducting a double-blind study designed to understand the impact of replacing opioid painkillers with Medical Cannabis.
Bady swears by Medical Cannabis as an effective pain treatment. He is confident it helps his endometriosis patients. One of his patients, who agreed to talk to KLAS TV, described her endometriosis pain as “pain you that you can’t describe.” She went on to say that Medical Cannabis doesn’t completely eliminate her pain, but it does allow her to lead a normal life with considerably less pain to interfere.
At this point, it is important to point out that it’s not always THC that gives pain sufferers the relief they are searching for. Both THC and CBD interact with the human endocannabinoid system. There are other cannabinoids in cannabis plants as well. And of course, do not forget terpenes.
We recommend that Medical Cannabis patients not worry so much about chasing THC or finding a particular strain. Rather, a better approach is to speak with an experienced Qualified Medical Provider (QMP) or Pharmacy Medical Provider (PMP) who can advise on some products to try. Different cannabinoid and terpene combinations offer different levels of pain relief that vary from one patient to the next.
The challenge with endometriosis is identifying the exact origin of pain and dealing with it. Endometriosis is a condition in which endometrial tissue, the same tissue that grows in the uterus as a normal part of the female fertility cycle, grows in locations other than the uterus. This tissue grows, thickens, breaks down, and bleeds just as if it were growing in the proper location.
Endometrial tissue growing outside of the uterus usually affects the fallopian tubes, ovaries, and pelvis. In addition to the pain caused by the constant cycle of tissue growth and degeneration, the condition can also cause other problems – like scarring of the ovaries.
If you suffer from endometriosis and your pain is chronic, you are probably eligible for a Medical Cannabis Card in Utah. You would need to make an appointment to see a QMP or Limited Medical Provider (LMP) with prescribing authority in the state. As long as that medical provider diagnosed your condition and agreed that Medical Cannabis was the most appropriate way to treat your pain, your card would be approved.
We encourage you to at least look into the possibility. Many patients report finding relief from endometriosis pain by using In Medical Cannabis. You deserve relief from your pain, too.
Researchers at Oregon Health & Science University recently undertook a systemic review of thousands of pieces of literature they hoped would shed light on cannabis as an effective treatment for pain. They concluded that some forms of cannabis might offer short term pain relief but, beyond that, there wasn’t enough scientific data to reach any further conclusions.
This is not surprising to those of us who follow Medical Cannabis. While the OHSU researchers were clearly surprised by a lack of scientific data, most of us in the Medical Cannabis field have been lamenting that fact for years. There is so little clinical research into Medical Cannabis as a pain treatment that it is extremely hard for skeptical doctors to make a decision.
If nothing else, the OHSU study reveals how desperately we need Washington to take the shackles off and begin encouraging large high-scale clinical studies.
Researchers looked at more than 3,000 studies published in scientific literature. Their first surprise came when they found only twenty-five that offered scientifically valid data. Eighteen of those were randomized and controlled studies; the other seven were observational studies that lasted a minimum of four weeks.
The good news is that their analysis revealed data suggesting that Medical Cannabis does offer short term pain relief. An exact definition of “short term” was not forthcoming. Nonetheless, even if short term pain relief only lasts a day, using Medical Cannabis on a daily basis should provide patients with a measure of relief.
It should also be noted that the limited amount of positive data the researchers uncovered related to 100% THC products or alternatives with equal amounts of THC and CBD. The researchers found no evidence that 100% CBD oils offered any pain relief whatsoever.
It is unfortunate that the OHSU researchers didn’t uncover more scientifically valid data in support of Medical Cannabis as a pain treatment. Small scale studies are out there, as we have demonstrated in numerous blog posts. But we are still lacking even a single comprehensive study enrolling thousands of patients and tracking their results over many months.
Until we have such data, your best bet is to talk with your medical provider about using Medical Cannabis to relieve chronic pain. Both chronic and acute pain are now on the Utah list of qualifying conditions.
Doctors, nurse practitioners, physician assistants, and podiatrists with prescribing authority in the state of Utah can apply to become Qualified Medical Providers (QMPs). Being certified as a QMP allows a medical provider to recommend Medical Cannabis to up to six hundred patients.
In addition, Utah’s Limited Medical Provider (LMP) program allows any of the previously mentioned medical providers to recommend Medical Cannabis to up to fifteen patients without having to become a QMP. That means your provider, if amenable, could recommend you for a Medical Cannabis Card. Talk with your medical provider and see what kind of response you get.
Assuming you are able to obtain your card, we want you to know that your experience will probably be unique to some degree. Endless numbers of patients report that Medical Cannabis relieves their pain. However, they do not all necessarily report the exact same experience with the drug.
We invite you to consider getting your Medical Cannabis Card if don’t yet have one and you struggle with chronic pain. Medical Cannabis could be the best treatment for your pain. Meanwhile, here’s hoping the powers that be remove the shackles so that we can start producing some real research data with large-scale studies.
Israeli researchers recently published the results of a study looking at the effectiveness of aerosolized THC as a treatment for chronic pain. Though the study is considered small scale, its results were what many expected: patients reported less pain and a higher quality of life after inhaling microdoses of THC with a specialized inhaler.
What makes the results of this study so encouraging is the fact that the researchers could use such small amounts of THC and still achieve positive results. The amount of THC delivered via their aerosolized inhaler are “a fraction of the amount of MC [medical cannabis] compared with other modes of delivery by inhalation,” according to the published report accompanying the study.
Researchers enrolled 143 patients between the ages of 17 and 62; 54% were male and 46% were female. All were diagnosed with chronic neuropathic pain. The neuropathic pain qualifier is important because of the nature of this type of pain. Neuropathic pain is the result of nerve damage caused by trauma, disease, or an underlying health condition.
Participants were provided with the inhaler and medicine and instructed to use it over several months. Some patients reported mild side effects during the initial stages of the study, but those side effects subsided over time. As the months passed, patients gradually reported less pain and a higher quality of life.
The results led researchers to speculate that low-dose THC delivered via an aerosolized inhaler could offer long term pain relief for chronic pain patients. As in most other cases, the researchers were quick to point out the small scale of their study indicated the need for more research to verify their findings.
The implications of this research are important on many levels. Right off the top is the difference between aerosolized THC and cannabis smoke. Here in Utah, smoking Medical Cannabis is illegal. Plant material can only be used as a medicine by dry heating it or using it to make edibles at home.
Dry heating is the process of heating plant material in a specialized vaporizer in order to decarboxylate it. Decarboxylation activates cannabinoids and releases them from plant material. In order for this delivery method to work, the plant material needs to get hot enough to release cannabinoids – but not hot enough to combust.
In an aerosol environment, THC and other cannabinoids are suspended in a pressurized liquid. Forcing that liquid through a nozzle upon release transforms it into an aerosol that can be inhaled. The process is similar to forcing liquid window cleaner through a small nozzle to create a mist.
The main benefit to this sort of delivery method is that there is absolutely no risk of inadvertently creating toxic chemicals that could be inhaled along with the THC. Patients are getting just the medicine they need and nothing more.
We are excited to hear about this research out of Israel. It could ultimately lead to an entirely new delivery method for the future. Giving patients yet another choice allows them the ability to find the delivery method that works best for them. We are fully on-board with that.
Here’s hoping future research shows similar effectiveness of low-dose THC via aerosolized inhalers. If we can help patients find the relief they need with the lowest possible doses of THC, we will be advancing the cause of Medical Cannabis as an effective treatment for chronic pain. That can only be a good thing for pain patients in the long run.
Years of experience in the Medical Cannabis arena have taught us that it is easy to chase THC levels in the pursuit of pain relief. It’s easy to believe that more is better. In reality, a patient’s choice of strain for pain treatment could have more influence on pain relief than the actual volume of THC consumed.
It is generally accepted among Medical Cannabis professionals that Type I and Type II are the best strains for pain relief. In addition, some patients seem to do better with certain terpene profiles. Linalool, pinene, beta-caryophyllene, limonene, and myrcene immediately come to mind.
What does this mean for medical marijuana pain patients in Utah? It means that treating with Medical Cannabis should involve ongoing consultations with a Pharmacy Medical Provider (PMP) for the purposes of determining the best strain and dosage. It doesn’t hurt to understand the differences between Type I and Type II strains either.
Type I cannabis is easily the most popular type among Medical Cannabis users. A Type I strain is purposely bred to ensure that THC is the dominant cannabinoid. Type I plants generally have a THC level of 0.3% or more and a CBD volume of 0.5% or less.
How high can THC levels go in a Type I plant? That is a good question. We have heard of plants with THC content as high as 30%. However, such potent plants are the exception to the rule.
A Type II strain is bred by the grower to contain balanced amounts of both THC and CBD. If both levels are above 0.3%, you have a Medical Cannabis plant. If both are below that threshold, you are looking at industrial hemp. Either way, the point is that the two cannabinoids are balanced. One does not dominate to an extreme degree.
Though Type III cannabis is rarely recommended for pain relief, it is worth discussing briefly. As you might have figured out by now, a Type III plant is CBD dominant. In nearly every case, it is going to be classified as industrial hemp with a THC volume of less than 0.3%.
What you have read thus far constitutes generally accepted guidelines within the Medical Cannabis community. But don’t forget that you are a unique individual. How you respond to any given strain will largely determine what products offer you maximum pain relief. Maintain an open mind. Be willing to try different strains, delivery methods, and dosages in your search for the best treatment.
Also keep an open mind about microdosing. We know of at least one study that suggests microdosing could be a viable pain relief strategy for patients dealing with chronic neuropathic pain. The microdosing mindset calls for starting out with smaller doses to see how they work. You ideally want to use the smallest dose possible to achieve the desired effect.
As you work with your PMP to figure out strain for pain treatment and dosage, tracking your results will help considerably. Write things down. Create a paper journal or write a digital note on your phone. The point is to track every time you use Medical Cannabis, how you consume it, and how it makes you feel. Such information is invaluable to your PMP.
Remember, chasing THC volume is not necessarily the best way to treat pain with Medical Cannabis. It is more important to find a strain that works for you. You are most likely going to want a Type I or Type II strain with a particular terpene profile. Your PMP can probably make a few recommendations.
Most of the study data we have on treating pain with Medical Cannabis relates to neuropathic pain. This sort of pain is generally the result of nerve damage. Diabetes patients are among those most likely to experience it. Fortunately, a study done a couple of years ago shows that Medical Cannabis can offer relief. And for some people, microdosing is the key.
Perhaps you’ve heard people complain about microdosing only being a way for manufacturers to make more money. We will not address microdosing in the recreational realm, particularly because Utah law only allows medical consumption, but studies do suggest that microdosing can be a valid medical strategy.
Though microdosing can be practiced with CBD, it is most often discussed in terms of THC. Microdosing is a strategy that calls for utilizing the least amount of THC possible to achieve the desired effect. It is a strategy that makes a lot of sense, especially given the high cost of Medical Cannabis in most states.
As for the previously mentioned study, it was published in 2020. Its researchers determined that just 0.5 mg of THC provided significant pain relief when compared to baseline. More pain relief was reported when they boosted the volume to 1.0 mg. As Qualified Medical Providers (QMPs) we can tell you that 1.0 mg is not very much.
The head of the organization that commissioned the study went on to hail microdosing as a possible way to help medical providers better treat their patients through more tightly controlled dosing. This is the primary advantage of the microdosing strategy.
Imagine a neuropathic pain patient who consumes copious amounts of Medical Cannabis to find relief. That’s fine. With a valid Medical Cannabis Card from the state of Utah, that patient is free to treat in whatever way they and their QMP determine is best. But what if the patient could achieve relief using much smaller doses?
Microdosing ultimately leads to consuming less. The same amount of Medical Cannabis goes much further, extending the amount of time between pharmacy visits and, ultimately, saving the patient money. Furthermore, the patient’s QMP can start with the smallest dosage possible and work up from there. If there is no net benefit to exceeding the dosage at which the patient finds relief, then they don’t go any higher.
The 2020 neuropathic pain study is just one piece of research. We obviously need more studies to either corroborate or refute its findings. And of course, we still have a lot to learn about cannabis and its ability to modulate pain signals.
Are you suffering from neuropathic pain? Have you discussed with your medical provider the possibility of treating with Medical Cannabis? Most cases of neuropathic pain are chronic, and chronic pain is on the state’s qualifying conditions list. Ask your medical provider about at. And while you’re at it, ask about microdosing.
We would like to close by reminding readers that more doctors, advanced practice nurses, and podiatrists can now recommend Medical Cannabis thanks to recent changes in the law. Even if a medical provider doesn’t want to go through the process of becoming a state certified QMP, state law also allows for Limited Medical Providers (LMPs). These are medical providers with prescribing authority in Utah. They can recommend Medical Cannabis for up to fifteen patients.
Data suggests that Medical Cannabis can be an effective treatment for neuropathic pain. Microdosing may be the key. We encourage you to learn more about it before discussing it with your medical provider.
Pain is one of the leading conditions people cite when applying for their Medical Cannabis Cards in Utah. That should be no surprise. Why? Because pain sucks. It can keep you from enjoying daily life the way you otherwise would if you were pain free. With that in mind, let us take a look at knee pain. Can cannabis help relieve it?
We have a growing body of evidence showing that cannabis is an effective pain reliever. If you want more information on some of the studies, we recommend this excellent article found on the Cannigma website. As for studies specifically involving knee pain, they are limited; we don’t have a lot to go on for this particular type of pain. However, we do know that the endocannabinoid system is partially responsible for regulating pain signals.
It turns out that all vertebrates have an endocannabinoid system. That system is involved in regulating all sorts of biological functions. The endocannabinoid system influences mood, sleep, nervous system response, and more. It is definitely involved in pain regulation.
The interesting thing is that human beings naturally produce their own cannabinoids. The way those cannabinoids interact with brain receptors determines how effective they are at regulating bodily functions. If we can modulate the endocannabinoid system – and we can with cannabis – we can also modulate its regulatory capabilities.
In simple English, some cannabinoids found in cannabis plants bond to CB1 and CB2 receptors in such a way as to influence pain signals. Science hasn’t figured out all the details yet, so the question is being worked on. But we do know that plenty of patients report significant pain relief after beginning a Medical Cannabis regimen.
In the arena of knee pain, there are plenty of things that can cause it. Osteoarthritis is a big one. In an osteoarthritis situation, cartilage in the knee joint has gradually worn away over time. Without enough cartilage to cushion the bones, they grind on one another. It can be a debilitating condition.
We are encouraged by anecdotal reports suggesting that osteoarthritis patients find pain relief in Medical Cannabis. But what about other conditions? Knee pain can be caused by a soft tissue injury, like a damaged ligament or tendon. It can be the result of bone damage. Even conditions like bursitis can cause pain in the knee.
For medical providers, the trick is determining what is causing the pain before deciding whether Medical Cannabis is the most appropriate form of treatment. There are other ways to treat bursitis, for example. Not only that, but traditional bursitis treatments also tend to be rather successful, so you probably would not need Medical Cannabis for this particular condition.
We should point out that acute pain was recently added to Utah’s qualifying conditions list for Medical Cannabis. That means patients can plan ahead if they know they will be experiencing severe knee pain that would otherwise be relieved through opioid prescriptions – due to surgery, for example. They can apply for temporary Medical Cannabis cards in advance of the scheduled procedure, then have their medicine ready to go afterward.
Whether your knee pain is acute or chronic, you may find relief through Medical Cannabis. Talk to your medical provider about it. Also remember that all the providers at our numerous locations are Utah Qualified Medical Providers (QMP). Stop in to any one of our clinics for help obtaining your Medical Marijuana Card. We know the EVS and the regulations inside and out. We can help you get hooked up with Medical Cannabis in Utah.