Currently, 37 states and the District of Columbia have legalized it. More people are becoming aware of its alternatives, including edibles and India vs. Sativa strains (two of its strains). Rheumatoid arthritis (RA) sufferers and those with other rheumatic disorders are keen to give it a try. However, the amount of scientific knowledge regarding the use of cannabis-based medicines for treating rheumatic diseases might fit on the head of a pin.
The main finding of a review study on cannabis research for rheumatic disorders is that. The article appeared in Current Rheumatology Reports on April 29, 2022, and was published online.
Not Knowing More About Cannabis Is Not Surprising
W. Benjamin Nowell, Ph.D., the head of patient-centered research at the online arthritis community CreakyJoints and a primary author of the review, says of the poor quality of the studies, “I was disappointed but not surprised.”
According to Dr. Nowell, it is crucial to comprehend how cannabis might be used medicinally because patients and doctors frequently inquire about “whether individuals should use marijuana for pain and sleep difficulties connected to a rheumatic disease.”
Can It Aid in Pain Relief? Does It Help You Sleep? Cannabis Interest Among Ra Patients
When Nowell, a principal investigator on CreakyJoints’ patient-centered ArthritisPower Research Registry, polled people online several years ago, it became clear that people with RA have a strong interest in cannabis.
57 percent of survey participants reported trying marijuana or cannabidiol (CBD) for medicinal purposes, according to the findings, which were presented at the 2019 Annual European Congress of Rheumatology (EULAR) meeting in Madrid, Spain, with an abstract published in Annals of the Rheumatic Diseases.
Their use is primarily to treat symptoms, particularly pain, that other drugs were unable to treat. The reason that 18% of respondents who used cannabis indicated they did so was that all other attempts had failed.
Rheumatologists are frequently approached for advice on cannabis use because of the increased interest from persons with ankylosing spondylitis (AS), psoriatic arthritis (PsA), and other inflammatory disorders. This is crucial because, according to him, cannabis may interact negatively with the several pharmaceuticals that persons with chronic inflammation frequently use. Yet due to a lack of sufficient high-quality studies on cannabis’ ability to relieve pain, particularly for those with rheumatic conditions, doctors are unable to offer complete advice.
The Illegality of Cannabis Makes Education Difficult
The fact that cannabis is still illegal at the federal level, despite the fact that it is legal in many states, is a significant factor in the lack of study. According to Nowell, this makes it challenging for researchers to obtain financing and approval for their projects as well as reliable, high-quality cannabis for use in the study.
“I’m expecting the federal government will alter, perhaps in response to growing patient demand and advocacy from medical organizations, as its current legal position is making matters more difficult. Without a deeper grasp of how this product actually functions, doctors cannot uphold their oath, claims Nowell.
Recent Years Have Seen Little Research on Cannabis for Joint Pain and Inflammation.
The review study looked at studies on the use of cannabis to treat rheumatic diseases or to treat common symptoms like pain. It discovered research demonstrating that cannabinoids lower levels of pro-inflammatory cytokines in lab settings as well as mouse experiments in which cannabis products reduced pain and inflammation.
However, there was just one randomized clinical trial, which is regarded as the gold standard in medical research, and it was small, with only 31 RA patients randomly assigned to the medicinal cannabis group and 27 to the placebo group. However, despite not affecting pain intensity or stiffness, the study did discover that cannabis generated statistically significant improvements in pain during movement, during rest, and on sleep quality.
We require prospective investigations, which include randomized clinical trials, according to Nowell. “Rheumatic disorders now have a significant knowledge gap when it comes to the information that doctors need to provide to patients from reliable research.”
Some New Research Is Being Conducted.
According to the government website ClinicalTrials.gov, various, albeit minor, trials are now being prepared. While one study is already recruiting participants, the CBD testing trial has not yet started.
Cannabis Users Have Been Surveyed for Other Studies.
The patient experience has been examined in a few published research, however, these are not randomized controlled trials. For instance, Israeli researchers reported in September 2021 in Pain Research and Management that the majority of 300 patients using medical cannabis at an outpatient rheumatology clinic experienced significant improvements in pain levels and sleep (with those taking the highest dosage, 36 grams, reducing pain the most, at 83 percent)
Similar results were reported by Chilean researchers that looked into related studies, who concluded that “the evidence is highly questionable” in the Journal of Clinical Rheumatology in March 2022 after finding only one randomized clinical trial and the majority of patient reports.
Additionally, researchers reported in Cureus in January 2022 that an analysis of one group of 40 individuals with pain from osteoarthritis—as opposed to RA—found that their use of opioids decreased once they began taking medical cannabis.
Although the data are not yet accessible, another survey on cannabis use in patients with chronic inflammatory arthritis (RA, psoriatic arthritis, or ankylosing spondylitis) has been conducted.
Other Negative Effects of Cannabis Included Tiredness and Constipation
The review study makes it apparent that no research has been done on how cannabis interacts with other medications that people with RA frequently take, such as DMARDs, gabapentin, and antidepressants.
Additionally, it lists the negative effects of cannabis use, including diarrhea, weariness, which may be more prevalent in RA patients, driving impairment, and, less frequently, heart rhythm problems and psychosis.
One Subgroup Must Definitely Abstain from Medical Marijuana
People under 25 should not use medicinal cannabis, according to Nowell, due to changes in teenage brain development and impairments to neonates when pregnant women consume it. When doctors discuss cannabis with their patients, the patients feel more at ease
People want to be able to discuss this choice with their doctors because they trust them and because doctors are aware of their symptoms and current medications, according to Nowell. In fact, according to the ArthritisPower poll, 10% of those who had been taking medical marijuana had stopped because their doctor did not approve.
Cannabis Is Not a Dmard Replacement
The review article offers recommendations for doctors based on comparable guidelines provided by the Canadian Rheumatology Association.
It emphasizes the idea that doctors should approach the subject in a compassionate, nonjudgmental way, but first should present other, more effective solutions for managing pain, such as non-drug techniques like cognitive behavioral therapy (CBT) and mindfulness.