Chronic Pain


Severe chronic pain is usually treated with opioid narcotics and various synthetic analgesics, but these drugs have many limitations.

December 3, 2009 – Opioids are addictive and tolerance develops. The most commonly used synthetic analgesics – aspirin, acetaminophen (Tylenol), and nonsteroidal antiinflammatory drugs (NSAIDs) like ibuprofen -are not addictive but they are often insufficiently powerful. Furthermore they have serious toxic side effects including gastric bleeding or ulcer and in the long run a risk of liver or kidney disease. Stomach bleeding and ulcers induced by aspirin and other NSAIDs are the most common serious adverse drug reactions reported in the United States. These drugs may be responsible for as many as 76,000 hospitalizations and more than 7,600 deaths annually. Acetaminophen is increasingly prescribed instead because it largely spares the digestive tract, but it can cause liver damage or kidney failure when used regularly for long periods. Medical researchers have estimated that patients who take one to three acetaminophen tablets a day for a year or more account for about 8% to 10% of all cases of end-stage renal disease, a condition that is fatal without dialysis or a kidney transplant.

Given the limitations of opioids and non-addictive synthetic analgesics, one might have expected pain specialists to take a second look at cannabis, but the medical literature again suggests little recent reconsideration. Cannabis may be especially useful for the kinds of chronic pain that people who survive catastrophic traumatic accidents have to live with the rest of their lives.

Martin Martinez is such a patient:
High school friends of mine made a daily springtime habit of smoking marijuana just outside the principal’s office windows, purposely blowing in billows of pungent smoke on the afternoon breeze. Being chased out of the yard by irate school officials heightened the drug’s effects as young hearts raced to join their buddies bursting with laughter. An outsider among outsiders, I was not fond of such games. Nor was I interested in the use of pot for purely social or recreational uses. Marvelous insights captivated my mind when stoned. As I grew older my use of cannabis developed beyond intuitive meditation and became the catalyst of many profound mystical experiences. Later in life I found that the moderate use of cannabis did not interfere with demanding physical tasks and skills such as building construction and home remodeling. While a large dose of marijuana would tend to make me feel less active, a smaller dose invigorated my vitality. I also rode a motorcycle in my youth. I felt that a small dose of marijuana actually increased my motor skills. By the age of 27 I had driven many thousands of miles while mildly stoned and had never caused an accident. Then one night a reckless driver swerved into my lane and crashed into me at a combined speed of 60 miles per hour. I was not expected to survive.

I suffered dozens of severe injuries in the crash, including 25 orthopedic fractures and massive skull fractures which severely crippled several cranial nerves. Two months after the crash I lay in bed a crumpled mass of pain. My IV fed me up to 10 milligrams of morphine every 7 minutes, 24 hours a day, but still I had trouble sleeping because the pain was so intense. I was told that I was not going to recover mobility and that I would spend the rest of my life connected to a medical facility. I could barely speak due to the nerve damage to my voice and throat. The constant pain in my eyes was excruciating. I was given morphine and other narcotics which incapacitated me, but did not reduce the pain in my eyes. Swallowing was a challenge which often resulted in choking and coughing fits lasting many minutes. As the weeks went by I began to suspect that the medications I was given were actually contributing to my neurological impairments by inhibiting concentration and depressing neurological responses. In addition, I was painfully aware that narcotics had a disastrous effect on my intestines.

One day I was visited by an outpatient who had AIDS. He told me a little about the medical uses of marijuana and he gave me a joint. I waited till late at night when the nurses were busy elsewhere. I smoked the joint in secret and my heart raced so much I feared that I might burst the scars of my recent surgery. But then the contraband was gone, the scent was dissipated, and outraged nurses still had not discovered me, so my heart rate slowed to a comfortable purr. I felt relaxed and at ease, but not stupefied. I could still sense the deep scars of my damaged nerves, but I was somehow mentally distanced from the pain in a way that morphine did not offer. I slept that night more soundly than I had since the crash.

I left the primary hospital as soon as I could talk my doctors into releasing me. I returned to my hometown and became an outpatient at a facility there. I continued to use narcotics and other pain medications prescribed by my doctors, but over the months and years I gradually replaced several prescription medicines with the use of cannabis. Nearly all of the drugs I had been given by doctors seemed to depress my mind and body, and the addictive quality of narcotics created numerous unpleasant psychological effects. Unlike narcotics, cannabis use imparted positive mental and physical stimulation, called euphoria, that encouraged my rapid recovery.

With the use of cannabis replacing sensory-depressive narcotics, I found myself recovering far beyond the expectations of my first 27 doctors. Five years after the crash I took some college courses and then began to work again. By the time I was well enough to maintain a full time carpentry job I was smoking hundreds of dollars worth of cannabis per month. Ten years after the crash, having spent in excess of $10,000 per year on unreliable qualities of cannabis, I was arrested for growing my own.

In my trial the prosecution proved that I was growing what they considered to be a “huge” amount of marijuana. The fact that I had possession of 88 plants was assumed to be evidence that I was a drug dealer. I proved that I had a legitimated medical necessity for the use of marijuana and that I also had a very substantial income in real estate development which precluded a profit motive. Using the harvest estimates of the Drug Enforcement Administration agent who testified against me and the consumption estimates of the physician who testified for me, the amount of cannabis seized might have lasted me up to two years and saved me up to $20,000. Eight of the jurors in my trial were sympathetic and voted to acquit me on the grounds of medical necessity. Four of the jurors agreed with the State’s contention that I had intended to sell my medicine. A mistrial was declared and I remained free.

Two months later police officers returned to my home. They held me and searched the premises without a warrant, discovering a much smaller cannabis garden than they had seized the year before. A vindictive State prosecutor arrived at my house and intentionally confiscated confidential communications to and from my attorneys. I spent a second birthday in a row deathly sick in bed after having been released from jail. Physically, emotionally, and economically bankrupt, unable to afford the enormous cost of another trial, and unable to obtain a public defender due to my ownership of severely over-mortgaged real estate, I accepted a “no jail-time” plea bargain deal which was broken the day before sentencing. The medical affidavits of Dr. Grinspoon and four additional physicians had no apparent influence on the imperious court. I was sentenced to 90 days in jail for the criminal act of cultivating cannabis for my own medical use.

I was on the brink of catastrophe, about to begin the second worst three months of my life, when a marvelous thing happened. Hundreds of people, including doctors, medical marijuana activists, other medicinal cannabis users, and other concerned citizens, started an organized telephone, fax, and letter-writing campaign which forced the State to review and reevaluate its disposition of my case. Thanks to the sincere efforts of numerous concerned persons all jail time was then commuted to 240 hours of community service and the imposition of urine analysis testing was waived. Although the criminal actions against me cost me two years of terrible hardship, at least the State eventually decided not to further endanger my health. By: Martin Martinez. Source.

November 29, 2009 – Marijuana used for medicinal purposes has a history that dates back all the way until 2737 BC. The issue of Marijuana being used as medicine has been a long debated topic where people have been fighting for both sides and very little has been accomplished. People such as politicians have been fighting to say that marijuana is an illegal drug no matter the benefits. Marijuana offers a remedy to medications and treatments that have extremely painful and long lasting side effects.

Some states have taken action on the matter and voted to decriminalize the use of medicinal marijuana for people with serious illness’ that would benefit from the drug. With this came serious regulations dealing with the distribution, possession, and who can receive the product. Medications with side effects such as loss of appetite and vomiting leave patients with more pain and potentially additional health problems than the disease its self causes. With all of the advantages that Marijuana offers medically, and how enormously effective the drug works with reducing pain, it should be obvious that medicinal marijuana should be legalized for the purpose of treating patients that are unable to deal with their pain.

Cannabis, commonly known as marijuana, has a history that dates back to ancient times. The first recorded use of marijuana came in 2737 BC, when Emperor Shen-Nung of China prescribed cannabis to people to help treat illnesses such as constipation, gout, and malaria. Marijuana was used quite frequently in ancient times for uses in medicine, and it is believed that Gautama Buddha survived by eating nothing but cannabis seeds. Medical Marijuana in the United States of America is not a new discovery. In 1850, Marijuana was added into United States Pharmacopeia, a publication that contains legally recognized standards of every aspect of a drug, and was prescribed for numerous medical conditions including labor pains, nausea, and rheumatism until 1941 when it was removed from the publication.

During the time period between 1850- 1930, cannabis was beginning to lose its image of a medicine and was starting to be viewed as an intoxicant and was looked down upon. In the mid 1930’s, the U.S. Federal Bureau of Narcotics started an initiative to depict marijuana as a controlling addicting substance that could possibly lead to addiction.

With the gaining support of the people, along with the encouragement from the press, the federal government passed the marijuana tax act in 1937, which federally prohibited the smoking of marijuana for any purpose. In 1970, the government passed an additional bill known as the controlled substance act, which created five categories based on drugs usefulness. Marijuana was considered as a Schedule 1 drug which said that cannabis had a high potential for abuse, and no medicinal purposes. (Booth)

As states began to legalize medicinal marijuana, conflicts between federal and state laws became evident. Although marijuana was legal in the state of California, patients that were prescribed the drug were being arrested because medicinal marijuana conflicted with both the controlled substance act, and the marijuana tax act, and federal law always overrides state law. Not until the court case of Gonzales v. Raich did users of medical marijuana have protection against being arrested for breaking federal law.

The issue presented to the court asked, is the Controlled Substances Act a constitutional use of the Commerce Clause? The court voted 6-3 in favor of the defendant and stated that, “the Controlled Substances Act is an unconstitutional exercise of Congress’ Commerce Clause authority,” and finally users of medical marijuana were protected under law from being arrested for breaking federal law. (Gonzales v. Raich)

Marijuana is widely known as one of the safest, low risk active substances if used properly. To this day, there have been no recorded deaths due to an overdose, and there are very few dangerous side effects. In addition, there is no evidence to show that marijuana carries a risk of true addiction to the body.(Gottfried) The same cannot be said for other medications that are used to treat diseases such as AIDS, cancer, glaucoma, multiple sclerosis, and epilepsy.

Serious life threatening diseases require extreme amounts of medication on a daily basis that have the potential of causing the body extreme harm and great amounts of pain. For example, when an individual is diagnosed with cancer, one of the only effective treatments for the drug is known as chemotherapy. The drug is delivered to the patient through an IV causing symptoms such as nausea, vomiting, loss of appetite, and extreme pain are all side effects of the drug and coping with the pain can put a person through hell. (McMahon) The main chemical in marijuana known as delta-9-tetrahydrocannabinol or TCH, is known to stimulate a person’s appetite when the drug is broken down by the body. Not only does TCH stimulate the body’s appetite, but it also helps alleviate the symptoms such as nausea, vomiting, and pain that come along with the chemotherapy treatment.

Additionally, marijuana serves as an effective and long lasting treatment for glaucoma. Glaucoma is a disease when excessive pressure builds up on the eyeball, and almost always leads to loss of vision completely. Treatments for the disease include several different eye drops and oral medications, but with time the body builds an immunity to the drugs and they become ineffective. It has been proven that when smoked; marijuana reduces pressure on the eyeball making cannabis an excellent and long lasting way for glaucoma patients to deal with their pain. (Williams)

Similar to the treatment of cancer, hepatitis C also requires a long term treatment with medications that have very similar side effects to that of chemotherapy. Treatment for hepatitis C requires six months of therapy with the combination of two extremely potent drugs identified as interferon and ribavirin. Side effects of the treatment leave patients with severe fatigue, nausea, muscle aches, loss of appetite and depression. A recent study was conducted with the combined efforts of scientists at the University of California at San Francisco, and the Oakland substance abuse center. Researchers closely monitored the progress of 71 patients who were taking interferon and ribavirin to watch their progress. Out of the 71 patients, 22 of them smoked marijuana on a consistent basis to help ease the pain caused by the treatment. At the end of the six months, 19 of the 22 patients that used marijuana to help manage the effects of the treatment successfully completed the agonizing treatment while only 29 of the 49 people who chose not to use marijuana successfully completed the course. Months after the treatment, researchers went back to follow up and found that 54 percent of the group that were using marijuana during the treatment had no signs of the virus while only 18 percent of the non smokers achieved the same result. Although there was no documented evidence that shows the marijuana acted as a medicine itself to cure the illness, it appears that the people that chose to use marijuana were able to deal with the side effects and complete the treatment that many people are unable to endure. (Weiss)

Today in the United States of America, there are hundreds of laws prohibiting the use, possession, and distribution of marijuana. In the State of New Hampshire, possession of any useable amount is considered a misdemeanor and is punishable by up to one year in jail, and a fine of no more than 2,000 dollars. To this date, there have been 12 states that have decriminalized marijuana strictly for medicinal use. These states include Alaska, California, Colorado, Hawaii, Maine, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont and Washington. Although medicinal marijuana has been decriminalized in these states, laws have been put into effect to strictly regulate when a person can be prescribed and how much of the drug they will receive. In state of California, you must obtain written permission from a physician stating that you have a disease or illness that would benefit you from the use of marijuana. Under the law, eligible patients or their personal care givers are able to possess up to eight ounces of marijuana and no more than six marijuana plants. Patients are allowed to obtain more than state law allows under special circumstances if a physician decides that their patient would benefit from it. Frequent conditions that allow a physician to prescribe medicinal pot include cancer, anorexia, AIDS, chronic pain, glaucoma, arthritis, and migraines. (Akhavan)

Medical Marijuana is a largely debated topic that brings serious questions up. There have been thousands of studies conducted over the past century to find out if indeed marijuana has medicinal values. Marijuana has been shown to greatly reduce effects of medications that are given to patients with serious illnesses. Effects such as loss of appetite, nausea, and even depression are quite often side effects of treatments that could decide the fate of an individual’s life. Legalizing marijuana for medicinal purposes leave some people thinking that the drug will be available to anyone who wants to get their hands on it. These views that people seem to have are completely irrational because such regulations have been placed on the drug that it is still almost impossible for people who are suffering to obtain medicinal marijuana legally.

Often times, people become so desperate because they have been suffering for so long, that individuals risk being arrested and take matters into their own hands and search out the drug illegally. People that need medical marijuana didn’t chose to have an illness that they are suffering from, it came upon them and there is nothing that anyone can do to cure it a lot of times. The fact that people are being arrested and punished because they are despite enough to risk going to jail to obtain medicinal marijuana saddens many people. Many states have realized how they are preventing their own citizens from obtaining medication that is only going to help, and have decriminalized the use of medicinal marijuana. With all the evidence that has been presented by world renown scientists that show the positive medical uses of marijuana, you would think that all 50 states would allows their citizens to obtain medical marijuana if they were suffering enough, not just 12. Source.