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Fibromyalgia and Medical Marijuana

What the experts have to say about the use of marijuana for treating fibromyalgia.
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The uses of medical marijuana

"Medical marijuana has many uses," Abrams says. "It increases appetite while decreasing nausea and vomiting. It also 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."

Medical marijuana doesn't "cure" disease. But patients worldwide have used it to relieve a variety of symptoms, including:

  • increased intraocular pressure from glaucoma
  • nausea and vomiting from chemotherapy for cancer
  • pain, muscle spasticity, and insomnia from spinal cord injury
  • pain, stiffness, and muscle spasticity from multiple sclerosis
  • weight loss and loss of appetite from HIV

In 2003, Abrams published a study in the Annals of Internal Medicine on the interaction between medical marijuana and protease inhibitors in AIDS patients. "We showed that there was no real downside to smoking cannabis for these patients. It didn't interfere with their immune system. In fact, it might have been beneficial to their immune system in the end."

The pros and cons of medical marijuana for pain

Abrams found that medical marijuana worked for patients with HIV and peripheral neuropathy (painful, damaged nerves). That study was published in TheJournal of Neurology in 2007. "We did a randomized, placebo-controlled clinical trial that demonstrated that smoked cannabis was effective in this situation," says Abrams. "The people who say there's no evidence that smoked marijuana has any medicinal benefits really can't say that anymore. The drug was quite comparable to the best available treatment we currently have for painful peripheral neuropathy."

Not all doctors agree.

"I see no role for it in pain management," says Charles Chabal, MD. Chabal is a pain management specialist at Evergreen Hospital in Kirkland, Wash. "You'll certainly find doctors who'll be very supportive and write prescriptions for medical marijuana. But it's how the individual physician reads the data and the evidence. There's no doubt it makes you feel good, but so does alcohol."

Chabal continues, "Another problem I have with marijuana is that it's herbal, untested, and you never know what you're getting when you buy it."

Chabal doesn't bring up medical marijuana with his patients. "Some patients have asked me about it. They want me to write a prescription for medical marijuana. But that's not something I do. I don't want to be known as 'the medical marijuana doctor.' Already, doing pain management, one of the big things I need to sort out are the patients who are using pain medications appropriately versus those who are abusing them. We have a lot of social responsibility with that.

"I'm not aware of any evidence that medical marijuana is one of the tools we'd use to improve physical and social function, including interaction with loved ones and family -- all key determinants of quality of life," says Chabal.

 

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