Cannabis Medicine can help with Neuropathy
Clinical features of neuropathic pain are allodynia
(perception of pain in the absence of painful stimuli, merely pressure or
temperature change), hyperalgesia (an exaggerated response to painful stimuli),
or a group of sensations called dysethesias (feeling “pins and needles”,
electric shock, cold, burning, and numbness).
Communication of pain throughout the body is mediated by
endocannabinoids interacting with cannabinoid and other receptor-based
signaling systems. Background pain levels appear to be modulated by the
endocannabinoid system. Plant cannabinoids, like those found in cannabis, work
by activating or blocking the signaling through CB1 and CB2 receptors – both of
which are important in modulating persistent neuropathic pain.
Cannabis has a history of use for pain management. In the
Middle East, Cannabis has been used for thousands of years to treat a variety
of forms of pain, including neuropathy. In the 19th century,
physicians had discovered that cannabis (aka Indian Hemp Tincture) could also
be used to relieve neuropathic pain, often called neuralgia, which was
otherwise difficult to treat. In the Dublin
Medical Press issue of March 1843, Sir James Murray treated a case of
neuralgia in the arm with 10 drops of Cannabis indica tincture.
Several small clinical studies have shown that cannabis acts
as a moderately effective analgesic for intractable neuropathy. A recent
systematic review of human studies indicated that short-term and intermediate-term
use of cannabis medicines to treat neuropathy, unresponsive to conventional
medications, should be considered. https://www.ncbi.nlm.nih.gov/pubmed/26830780
Cannabis is an effective treatment for a variety of
neuropathies. A recent review by Dr. Igor Grant, director of the Center for
Medical Cannabis Research at the University of California, compared the
effectiveness of cannabis against tricyclic antidepressants, gabapentin,
anticonvulsants, and selective serotonin reuptake inhibitors. Cannabis was not
quite as effective as tricyclics at reducing neuropathy, but more effective
than the other types of drug intervention. https://journalofethics.ama-assn.org/article/medicinal-cannabis-and-painful-sensory-neuropathy/2013-05
An early study by Dr. Donald Abrams indicated similar
results in HIV-associated neuropathy. https://www.ncbi.nlm.nih.gov/pubmed/17296917
A 2014 study showed that CBD reduced chemotherapy-induced
neuropathy. Another 2014 study with Sativex showed the THC/CBD combination was
effective for treatment-resistant neuropathy.
HIV/AIDS and multiple sclerosis patients with neuropathic
pain found dramatic relief with smoked cannabis, a benefit subsequently
demonstrated in control trials. https://www.ncbi.nlm.nih.gov/pubmed/25777363
Higher doses of
inhaled cannabis offer no more pain relief than lower doses. The use of higher
doses of cannabis may cause more negative cognitive side effects. Cannabis is
effective in low or medium doses. With cannabis, less is more.
Animal studies of chemotherapy-induced neuropathy indicate
that CBD is likely to be effective alone, or in combination with THC. Animal
studies and observational accounts both indicate that THC is effective against
neuropathic pain in cancer patients. https://www.ncbi.nlm.nih.gov/pubmed/27863159
The key to treating neuropathies effectively with cannabis
medicines is finding the correct dosage. The dosage should be effective as an
analgesic, yet not cause unwanted adverse effects, such as excessive levels of
psychoactivity, sedation, or dizziness.
A study led by Mark A. Ware showed that a single inhalation
of smoked cannabis decreased pain intensity in post-traumatic or
post-surgery-induced neuropathic pain. This is a dose of about 2 mg of THC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2950205/
Oral cannabis is quite
effective for increasing the quality of rest and sleep, and for providing
longer-lasting analgesia for patients with pain. Taking cannabinoids orally
typically takes about 45 minutes to 1 hour to be felt, however, oral cannabis medicine provides up to 4 to
6 hours of relief. For quicker relief, inhaled
forms are felt immediately, while sublingual or sprays take about 20
minutes to be felt.
Tinctures provide the
best of both worlds, with some immediate absorption through the tissues
lining the mouth, plus the relief of most of the dose of the tincture being
swallowed and converted by the liver into a potent pain-relieving metabolite.
2.5 to 7.5 mg THC
taken orally, every 4 hours, to manage low level to moderate pain.
The addition of CBD
to the THC dose can reduce the intensity of THC psychoactivity while providing
a measure of neuroprotection.
Vaporization and smoking are both effective for treating
neuropathy, and have the advantage of rapid onset and ease of dose titration.
2.5 to 7.5 mg of vaporized or inhaled THC is recommended for faster onset than
with oral administration.
Cannabis-naïve patients should start with no more than 2.5
mg of THC, and wait 15 minutes before adding more. With the combination of CBD
and THC the adverse effects will be decreased.
CBD and THC topical applications may provide a local
anti-inflammatory effect that may reduce or relieve neuropathic pain in about
half of patients. Choose high-concentration salves and massage them well into
the painful areas.
High-CBD varieties work particularly well for neuropathic
pain, while high-THC varieties may be better for general distraction from
conventional pain or sleep support.
Extremely low THC/high CBD varieties, such as ACDC, can help
with neuropathic pain. Cannabis types such as Skunk that produce small amounts
of CBG may also increase the medicine’s analgesic effect.
Myrcene, a terpene in some cannabis cultivars, has known
analgesic and sedating properties. Beta-caryophyllene is also a powerful
anti-inflammatory and is synergistic with THC. Caryophyllene has also been
confirmed to lessen pain and had also been shown to be effective with CBD in
providing anti-inflammatory effects.
Always talk to a Trusted Medical Professional who
understands cannabis, the endocannabinoid system and your personal condition.
Caution must be used when using cannabis is medicine. Cannabis is not for
everyone, it helps some people but dose not work for everyone. If experimenting
for the first time with cannabis, remember to start with very small doses, use
medicines with both THC and CBD, do not operate heavy machinery.
All information in
this article was taken from my favorite book:
Cannabis Pharmacy: The practical Guide to Medical Marijuana
By Michael Backes,
fwd by Andrew Weil, M.D. and Jack McCue, M.D.
I highly recommend this book. If your Doctor does not have
it, they may like to read it and educate themselves. Find it on Amazon *here*
For more studies done on cannabis and Neurodegeneration,
please visit the amazing website ProjectCBD.org - https://www.projectcbd.org/condition/36/Neurodegeneration
Please use caution when consuming cannabis. You assume risk.!So talk to a trusted medical professional who understands, has experience, and can help!
