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Medical Marijuana For Chronic Pain

MISSISSIPPI MEDICAL MARIJUANAS UPDATE

QUESTION:

Can I Get Medical Marijuana For Chronic Pain In Mississippi?

ANSWER:

Yes. But, you must be certified for treatment by a Mississippi Department of Health (MDOH) credentialed medical cannabis practitioner. The Mississippi Medical Cannabis Act allows patients to be certified for medical marijuana treatment if they have a “debilitating medical condition”, which includes the following:

A chronic, terminal or debilitating disease or medical condition, or its treatment, that produces one or more of the following: cachexia or wasting syndrome, chronic pain, severe or intractable nausea, seizures, or severe and persistent muscle spasms, including, but not limited to, those characteristic of multiple sclerosis; or any other serious medical condition or its treatment added by the Mississippi Department of Health, as provided for in Section 9 of The Mississippi Medical Marijuana Act:

The MDOH hopes to begin credentialing physicians no later than June 3rd, 2022. A list of credentialed doctors will be available then. After being certified you will then apply for your medical cannabis identification card through the Mississippi Department of Health. Products may not be available for purchase until late fall 2022.

After being certified you will then apply for your medical cannabis identification card through the Mississippi Department of Health.

Our Goal is to be the most trustworthy resource of reliable, easy-to-find, and impartial information for patients and families suffering from Chronic Pain and other qualifying medical conditions who are considering medical cannabis.

Medical Marijuana For Chronic Pain

Know The Facts About Medical Marijuana & The Treatment Of Chronic Pain.

Mississippi’s medical cannabis laws allow only MDOH credentialed practitioners to prescribe medical cannabis.

Marijuana strains vary in their amounts of THC or CBD. By state law, the flower cannot contain more than 30% THC, and all other forms not more than 60% THC.

And, as with any medication, there are risks and side effects to consider. That is why it is so important to talk to your MDOH credentialed medical cannabis practitioner, pharmacist, and medical cannabis dispensary agent to help you consider:

  • The possible side effects you may experience.
  • The right strain (indica, sativa, or hybrid) for you.
  • The right “Start Low and Go Slow” micro-dosing plan for you.

Medical Cannabis (Medical Marijuana) and Chronic Pain

Chronic pain is a widespread public health issue across the U.S. It is estimated that at least 38 million adults in the U.S. suffer from chronic pain, and at least 12 million have used cannabis as a treatment.

For patients in pain, the goal is to function as fully as possible by reducing their pain as much as possible, while minimizing the often-debilitating side effects of the pain therapies. Failure to adequately treat severe and/or chronic pain can have tragic consequences. Chronic, unrelieved pain can cause depression and despair, and can also cause patients to discontinue potentially life-saving procedures, like chemotherapy or surgery. In such dire cases, anything that helps to alleviate the pain will prolong these patients’ lives. 

Persistent and debilitating pain can have numerous and multiple causes. Among them are:

  • Cancer
  • AIDS
  • Sickle cell anemia
  • Multiple sclerosis
  • Defects or injuries to the back, neck and spinal cord
  • Arthritis and other rheumatic and degenerative hip, joint and connective tissue disorders; and severe burns.

Cannabis can serve two important roles in safe, effective pain management.

  1. It can provide relief from the pain itself (either alone or in combination with other drugs used to achieve relief from pain).
  2. It can control nausea associated with taking opioid drugs, as well as nausea, vomiting, and dizziness that often accompanies severe, prolonged pain.

In addition, cannabis can significantly enhance the effectiveness of opioid therapies.

Cannabis (Medical Marijuana) In Treatment For Nausea Associated With Opioids For Chronic Pain Treatment

Opioid therapy is often an effective treatment for severe pain. However, all opiates have the potential to cause nausea. The intensity and length of this nausea can cause tremendous discomfort and added suffering, leading to malnourishment, anorexia, wasting, and a severe decline in a patient’s health. Some patients find the nausea so hard to handle that they are willing to discontinue the pain treatment, rather than endure the nausea.

Depending on the treatment form and severity of the pain, medical marijuana can provide almost immediate relief for this nausea, with significantly fewer adverse effects than orally ingested nausea relief medications, like Marinol—a synthetic (man-made) form of THC, which is an ingredient found in marijuana.

Research Proving The Effectiveness Of Cannabis (Medical Marijuana) In Pain Management

Cannabis has been used as an effective pain reliever for at least 5,000 years. Patients often report significant pain relief from cannabis, even in cases where pharmaceutical or conventional pain therapies have been ineffective.

In 1997, after reviewing a series of trials, the U.S. Society for Neuroscience concluded that “substances similar to or derived from marijuana could benefit the more than 97 million Americans who experience some form of pain each year.”

In 1999, a study commissioned by the White House and conducted by the Institute of Medicine (IOM) recognized the role that cannabis can play in treating chronic pain, saying, “After nausea and vomiting, chronic pain was the condition cited most often to the IOM study team as a medicinal use for marijuana.”

Between 1975 and 2009, there were more than 300 studies showing that cannabinoids and cannabis can help patients experiencing chronic pain.

Cannabis (Medical Marijuana) Uses In Treatment of Chronic Pain

Injuries including loss of limbs often result in chronic pain that can be extremely difficult to treat. As of December 2012, military operations in Iraq and Afghanistan alone resulted in 1,715 amputations. In 50-80% of amputees, “phantom limb” pain occurs, a serious neuropathic pain condition. Phantom limb pain can occur during the first year after amputation and remains chronic over months or years with either no improvement or increase in pain. Common treatments include physical, behavioral, and medical approaches, including opioids.

A 1984 survey of 5,000 US veterans with amputations reported that 78% had phantom limb pain, yet only 1% had experienced relief from any treatment. This level of difficulty in relieving pain is common to other types of chronic neuropathic pain that can result from cancer, HIV/AIDS, or diabetes.

The effectiveness of cannabis and cannabinoids in relieving neuropathic pain has been demonstrated in dozens of preclinical and clinical trials. It is often effective when opioid painkillers have failed to provide relief. Many studies have concluded that medical marijuana can be effective for neuropathic pain even at low doses.

According to the IOM Report and numerous independent research articles, several areas in the brain that have a role in sensing and processing pain respond to the effect of medical marijuana, adding that cannabinoids have been used successfully to treat cancer pain, which is often resistant to treatment with opiates.

A 1999 article reviewing scientific animal research concerning the pain-relieving effects of marijuana concluded that there is now “unequivocal evidence that cannabinoids are antinociceptive (capable of blocking the transmission of pain).”

The report further concluded that multiple cannabinoids and non-cannabinoid components can serve as anti-inflammatory agents, with the potential to prevent and reduce pain caused by swelling (such as arthritis).

In short, the research community recognizes the potential benefits of cannabis for certain patients, including:
  • Chemotherapy patients, especially those being treated for mucositis, nausea, and anorexia.
  • Postoperative pain patients (using cannabinoids as an opioid adjunct to reduce the nausea and vomiting).
  • Patients with spinal cord injury, peripheral neuropathic pain, or central post-stroke pain.
  • Patients with chronic pain and insomnia.
  • AIDS patients with cachexia, AIDS neuropathy, or any significant pain.

Chronic Pain Medications

Possible Side Effects of Medical Cannabis
The side effects associated with medical marijuana are usually mild and are classified as “low risk.” Serious complications are extremely rare and are not usually reported during the use of cannabinoids for medical indications. Euphoric mood changes are among the most frequent side effects. Cannabinoids can exacerbate schizophrenic psychosis in predisposed persons, though it can also provide symptomatic relief in refractory schizophrenia. Cannabinoids impede cognitive and psychomotor performance, resulting in temporary impairment. Chronic use can lead to the development of tolerance. Tachycardia and hypotension are frequently documented as potentially adverse events in the cardiovascular system. A few cases of myocardial ischemia have been reported in young and previously healthy patients. Inhaling the smoke of cannabis cigarettes induces side effects on the respiratory system. Cannabinoids are contraindicated for patients with a history of cardiac ischemias.

Possible Side Effects of Other Chronic Pain Medications
According to the Institute of Medicine, “All of the currently available analgesic (pain-relieving) drugs have limited efficacy for some types of pain. Some are limited by dose-related side effects and some by the development of tolerance or dependence.”

Opioid analgesics commonly used to combat pain include codeine (Dolacet, Hydrocet, Lorcet, Lortab); morphine (Avinza, Oramorph); oxycodone (Vicodin, Oxycontin, Roxicodone, Percocet, Roxicet); propoxyphene (Darvon, Darvocet) and tramadol (Ultram, Ultracet). These medicines can cause: Psychological and physical dependence, constipation, dizziness, lightheadedness, mood changes, nausea, sedation, shortness of breath and vomiting.

Taking high doses or mixing with alcohol can slow down breathing, a potentially fatal condition.

Patients in pain are often prescribed muscle relaxants such as Robaxin and Flexeril; anti-anxiety agents such as Valium, Sinequan, Vistaril, Ativan and Xanax; hypnotics such as Halcion, Restoril, Chloral Hydrate, Dalmane and Doral and anti-emetics such as Zofran, Compazine, Phenergan, Tigan and Marinol.

Robaxin’s side effects include: abnormal taste, amnesia, blurred vision, confusion, dizziness, light-headedness. drop in blood pressure and fainting, drowsiness, fever, flushing, headache, hives, indigestion, insomnia, itching, nasal congestion, nausea, pinkeye, poor coordination, rash, seizures, slowed heartbeat, uncontrolled eye movement, vertigo, vomiting, yellow eyes and skin.

Flexeril can cause: abnormal heartbeats, aggressive behavior, agitation, anxiety, bloated feeling, blurred vision, confusion, constipation, convulsions, decreased appetite, depressed mood, diarrhea, difficulty falling or staying asleep, difficulty speaking, disorientation, double vision, excitement, fainting, fatigue, fluid retention, gas, hallucinations, headache, heartburn, hepatitis, hives, increased heart rate, indigestion, inflammation of the stomach, itching, lack of coordination, liver diseases, loss of sense of taste, low blood pressure, muscle twitching, nausea, nervousness, palpitations, paranoia, rash, ringing in the ears, severe allergic reaction, stomach and intestinal pain, sweating, swelling of the tongue or face, thirst, tingling in hands or feet, tremors, unpleasant taste in the mouth, urinating more or less than usual, vague feeling of bodily discomfort, vertigo, vomiting, weakness, and yellow eyes and skin.

Newer antiemetics, like Anzemet, Kytril and Zofran, are serotonin antagonists, can cause rare side effects, including: fever, fatigue, bone pain, muscle aches, constipation, loss of appetite, inflammation of the pancreas, changes in electrical activity of heart, vivid dreams, sleep problems, confusion, anxiety and facial swelling.

Reglan, a substituted benzamide, increases emptying of the stomach, decreasing the chance of developing nausea and vomiting due to food remaining in the stomach. Side effects include: sleepiness, restlessness, diarrhea and dry mouth. Rarer side effects are rash, hives and decreased blood pressure.

Haldol and Inapsine are tranquilizers that block messages to the part of the brain responsible for nausea and vomiting. Possible side effects include: decreased breathing rate, increased heart rate, decrease in blood pressure when changing position and, rarely, change in electrical activity of the heart.

Compazine and Torecan are phenothiazines, the first major anti-nausea drugs. Both have tranquilizing effects. Common side effects include: dry mouth and constipation. Less common effects include: blurred vision, restlessness, involuntary muscle movements, tremors, increased appetite, weight gain, increased heart rate and changes in electrical activity of the heart. Rare side effects include: jaundice, rash, hives and increased sensitivity to sunlight.

Benadryl, an antihistamine, is given along with Reglan, Haldol, Inapsine, Compazine and Torecan to counter side effects of restlessness, tongue protrusion and involuntary movements. Its side effects include: sedation, drowsiness, dry mouth, dizziness, confusion, excitability and decreased blood pressure.

Benzodiazepine drugs Ativan and Xanax are prescribed to combat the anxiety associated with chronic pain. Ativan causes amnesia. Abruptly stopping the drug can cause anxiety, dizziness, nausea and vomiting, and tiredness. It can cause drowsiness, confusion, weakness and headache when first starting the drug. Nausea, vomiting, dry mouth, changes in heart rate and blood pressure and palpitations are possible side effects.

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