Fibromyalgia and Medical Marijuana
What the experts have to say about the use of marijuana for treating fibromyalgia.
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