December 5, 2009 – Cannabis, otherwise known as marijuana (or marihuana), has been a topic of debate for many years, not only in Canada, but also in several other countries including the U.S. and the U.K. However, while marijuana for recreational use has not been legalized in Canada, medical marijuana use can be granted for medicinal needs.

The Definition of Chronic Pain

Although “chronic pain” seems all encompassing and thus easily used as a reason for medical marijuana use, the organization of Health Canada very clearly defines what can be considered severe enough pain for medical marijuana. With that said, there are many suffering from chronic pain – due to a variety of reasons – with grants for the medical use of cannabis.

Arthritis, headaches and back pain are the most common, but fibromyalgia, carpal tunnel syndrome, neuropathy and phantom limb pain are also common reason for chronic pain. Continuing pain can also be caused by debilitating illnesses such as MS (multiple sclerosis), scoliosis, osteoporosis and others.

Original Treatments for Chronic Pain

For many, medical marijuana use is a “last resort”, used only after several pharmacologic treatments fail. Typically, the first treatments include pain relievers such as aspirin or ibuprofen. Unfortunately, long-term use can cause serious side effects; even if there is pain relief, it can only be in short periods due to the need for short-term use of the “first line” of treatments.

Should the first treatments fail, narcotic opioids such as codeine, morphine and oxycodone are generally prescribed. Although often highly affective, the concern for these types of narcotics is that they have a high possibility for addiction and abuse. As well, their use is also limited, due to possible side effects in higher doses. The withdrawal symptoms for addictive pharmaceuticals can be mild to painfully severe.

Medical Marijuana for Chronic Pain

For those that don’t respond to the first or second line of treatments, medical marijuana may be prescribed. As well, there are those who prefer not to use man-made pharmaceuticals that have a high rate of addiction or serious side effects.

According to Health Canada, “Dependence is unlikely to be problematic when cannabis is used therapeutically, although withdrawal affects may be uncomfortable. These include restlessness, anxiety, mild agitation, irritability, tremor, insomnia and EEG/ sleep disturbance, nausea, diarrhea and cramping.”

Relief from chronic pain, however, far outweighs the possibility of addiction for many:

– Migraines – Severe, incredibly painful and often lasting as long as 72 hours, migraines can cause serious debilitating issues such as nausea, vision changes, vomiting and a high sensitivity to light and sound. Many of the pharmaceuticals used to either stop or lessen the amount of migraines cause the same issues as the onset of the migraines themselves. Often, sufferers stop treatment because it doesn’t work or because the side effects are too severe.

Medical marijuana, on the other hand, has been a well-documented treatment for many years – even throughout the nineteenth century. Cannabinoids have often demonstrated anti-inflammatory effects, as well as dopamine blocking. It is believed by some that one of the causes of migraines is the lack of natural endocannabinoids in the body, which might explain why cannabis works to decrease the pain as well as the symptoms.

– Multiple sclerosis (MS) – MS is a degenerative disease that attacks myelin in the brain and spinal cord. If you imagine nerves to be like electrical wires, myelin is the insulating, protective sheath around the nerves. The autoimmune system treats myelin as a foreign invader, destroying patches of it and leaving nerve fibers exposed, interrupting their normal function. It is debilitating and painful, causing such symptoms as tingling and numbness, painful muscle spasms, tremors, paralysis and more.

Prescribed pharmaceuticals can cause severe, debilitating medical issues such as seizures, abdominal cramps, dizziness, mental disturbances and other problems. Many MS sufferers prefer to self-medicate with marijuana, and have noticed that cannabis helps them control tremors, spasms and bladder control. Tests have also shown that THC helps reduce pain intensity and sleep disturbance significantly.

Although these two illnesses are common for the use of medical marijuana in relieving chronic pain sufferers, the same can be said for rheumatoid arthritis, spinal cord injuries and even phantom limb pain. While more studies need to be performed to explain exactly how cannabinoids and medical marijuana work, the fact that they do work is clear. Source.

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May 30th, 2009 –
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Chronicle/Cory MorseDan Higgins, 34, is pictured with marijuana he grew. Higgins has a prescription for marijuana to treat back pain, claiming it is a better alternative than conventional medication which makes him nauseous.

Dan Higgins heaved a sigh of relief last November when he learned Michigan residents voted to legalize medical marijuana.

The new law meant the disabled U.S. Army veteran wouldn’t have to smoke marijuana, which he uses to treat severe nausea and back pain, in secret.

“It’s about compassion,” said Higgins, a 34-year-old Grand Haven resident who suffers from severe nausea caused by the high-powered pain killers he uses to treat his injured back.

However, the celebration was short-lived.
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Nearly two months after Michigan’s medical marijuana law — which voters approved in last November’s presidential election — went into effect, both patients and law enforcement officials say they have more questions than answers.

What constitutes an “enclosed, locked” marijuana grow facility? How does a patient who’s to sick to grow marijuana find the substance? Is a patient who has received a doctor’s note but not a state identification card breaking the law by using medical marijuana?

Clear answers don’t appear to be coming anytime soon.

“We are simply in the state of confusion, and everyone is searching for some propper guidelines,” said James Houston, a criminal justice professor at Grand Valley State University.

Passing the buck

As a registered user and caregiver who legally can grow up to 60 marijuana plants for five registered patients, Higgins has a lot of questions.

He wants to know how secure his marijuana garden needs to be so he can be in compliance with the Michigan Medical Marijuana Act. Both state officials and local law enforcement have been unwilling to give him an answer, saying they also don’t know.

The act says marijuana must be grown in a “closet, room, or other enclosed area equipped with locks or other security devices.” Those who violate the rule are subject to legal action.
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Chronicle/Cory MorseDan Higgins inhales marijuana to treat his back pain.

It’s a definition Higgins says is too vague.

“I feel like I’m being set up for failure,” he said.

He’s not alone.

Greg Francisco, executive director of the Michigan Medical Marijuana Association, says he’s heard similar complaints from other medical marijuana users.

They range from how medical marijuana users find seeds to grow the plants, what constitutes a secure grow area, and how medical marijuana users who don’t want to grow their own find the substance, he said.

“We would like some clear guidelines,” Francisco said.

State offers little guidance

Don’t turn to the state for direction, said James McCurtis, spokesman for the Michigan Department of Community Health, the state agency charged with implementing the Michigan Medical Marijuana Act.

He said the department has a narrow set of duties, mostly limited to reviewing applications submitted by patients or caregivers who wish to use medical marijuana. Beyond that, it’s up to the courts, not the state, to clarify the law, he said.

To use medical marijuana, patients must submit an application to the department of Community Health showing they have a debilitating medical condition — such as cancer, Aids, severe nausea or chronic back pain — and a physician certifying that medical marijuana may help treat the condition.

After the state certifies patients, they receive a state-issued identification card showing they are legally using medical marijuana.

“A lot of these things are going to end up in the legal system because there is some confusion,” McCurtis said, referring to issues such as whether it’s illegal for patients to grow marijuana before they have their identification card in hand.
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Chronicle/Cory MorseDan Higgins exhales marijuana smoke inside his Robinson Township home. Higgins has a prescription for marijuana to treat back pain.

He urges patients and caregivers with questions about the new marijuana law to contact their attorney or the Michigan Medical Marijuana Association.

It’s a road that has led Higgins nowhere.

He says he’s contacted numerous organizations, including the Ottawa County Sheriff’s Office, his state senator, the Michigan Attorney General’s office and still hasn’t received any direction on how to interpret the law.

“I’m seeking clarification and nobody will give it to me,” Higgins said.

Law enforcement confused, too

Patients aren’t the only ones complaining about the medical marijuana law. It’s drawn heavy criticism from law enforcement officials, too.

Muskegon County Sheriff Dean Roesler said the law is poorly written, leaving police to sort through many gray areas.

“In terms of giving law enforcement guidance, it’s a poorly written-out proposition,” he said.

He points to the area covering how secure a marijuana garden must be and confusion over whether deputies must care for medical marijuana plants they seize.

“That’s going to be subject to interpretation at this point,” Roesler said. “It’s trial and error at this point.”

Lt. Mark Bennett of the Ottawa County Sheriff’s Department said deputies will consult with the prosecutor’s office when working through thorny legal issues such as whether medical marijuana patients are receiving the substance in a legal manor.

There’s “more legal ambiguities than most laws,” he said. “There are some areas that will take legal cases to decide.”

Issues patients and law enforcement officials are wadding through likely won’t become clear until several cases move through the legal system.

There’s been no shortage of legal and legislative tussles since the law went into effect last April.

One of the most high-profile cases is taking place in Madison Heights, a Detroit suburb where a couple is facing charges of illegally growing 21 marijuana plants.
Chronicle/Cory MorseDan Higgins displays his home-grown marijuana.

While the couple had doctors’ notes allowing them to use marijuana for medical purposes, they lacked state identification cards saying they could use the substance. At issue is whether medical marijuana patients were prohibited from growing the substance until the state implemented the identification system in April or after voters passed the law in November.

Other pending cases include a Shiawassee County man who was arrested earlier this month for growing marijuana in an unsecured area outside his home, a violation of the Michigan Medical Marijuana Act. Police and prosecutors say the man faces one count of manufacturing marijuana, according to news reports.

Add to that numerous city and townships ordinances that would prohibit marijuana from being grown in residential areas, and you have the potential for a confusing set of laws, said Francisco, of the Michigan Medical Marijuana Association.

Bills have also been introduced in the state legislature, including one by state Sen. Gerald Van Woerkom, R-Norton Shores, that would prohibit patients from growing medical marijuana. Instead, the substance would be distributed by pharmacists with a doctor’s prescription, an act that’s currently illegal under federal law.

“We’re ending up with a hodgepodge of policies,” he said, adding many of the proposed regulations will face court battles. “It’s really been a failure by the state to put out guidelines.” Source.