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Marijuana for pain: Hype or hope?

Retired NFL defensive lineman Shaun Smith said for nine years, he fired up “two blunts before every game.” He appeared with other retired players on a Bleacher Report YouTube video about marijuana use in the NFL that’s been viewed 2.773 million times. And those guys estimate that 80 percent of players and staff smoke marijuana recreationally, if not right before taking the field. Their motive?

“We’re all big guys, and our bodies hurt,” said Smith. They use it as an alternative to opioid pain meds. Bo Scaife, former tight end for the Titans and the Bengals, said that in his career he had “an injury-plagued journey” and had been given pain pills and found himself in a dark place. “So it was easy for me to receive the benefits of marijuana as a viable option.” These days he uses topicals to ease pain and arthritis.

But does smoking marijuana really ease pain and treat chronic diseases? And does cannabidiol, or CBD — an active ingredient in marijuana (without the psychoactive effect of THC, its other much-touted ingredient) — really work topically to ease pain? Well, the players would say yes. But the science isn’t so clear. So, let’s review the reliable findings, pro and con, and offer our suggestions.

A word to the wise: If it’s legal where you live and marijuana for easing pain (as pill, edible, smokable or topical) is prescribed by a licensed doctor, you want to be sure it’s going to be effective. Remember, smoking anything has serious health repercussions, and masking pain instead of alleviating it only prolongs or worsens your discomfort.

WHAT STUDIES SUGGEST

>> A new study published in Neurology has found that THC in marijuana eases neuropathic pain, a complex, chronic condition caused by changes in nerve function or structure. Diabetes causes about 30 percent of neuropathy cases, but there are hundreds of diseases associated with neuropathic pain. FYI: THC binds to your body’s natural endocannabinoid system, which plays a part in regulating everything from digestion to temperature.

>> A textbook called Contemporary Health Issues on Marijuana published by Oxford Clinical Psychology lays it out pretty clearly: “Medical marijuana in the United States has bypassed the standard process of scientific investigation.” But they also say, “We conclude that some benefits of marijuana’s core elements — tetrahydrocannabinol and cannabidiol — are supported by a handful of controlled clinical trials for a very limited number of health problems.” Those health problems include two types of epileptic syndromes, for which the cannabis-based drug Epidiolex was approved by the Food and Drug Administration in June 2018.

>> The CBD potions available are derived from the hemp plant, and CBD does not cause a “high.” Some studies show that it helps reduce intraocular pressure in glaucoma. Others support its use in controlling Parkinson’s disease symptoms and easing post-traumatic stress disorder-related nightmares.

>> In July 2018, The Lancet Public Health published “Effect of Cannabis Use in People with Chronic Non-cancer Pain Prescribed Opioids: Findings from a 4-year Prospective Cohort Study.” Their conclusion after tracking more than 1,500 people was, “We found no evidence of a temporal relationship between cannabis use and pain severity or pain interference, and no evidence that cannabis use reduced prescribed opioid use or increased rates of opioid discontinuation.”

>> When it comes to CBD, either orally or topically, the preparations on the market seem pretty unreliable. A 2017 study in JAMA found that almost 43 percent of CBD products contained too little CBD; around 26 percent contained too much; and 20 percent contained the get-you-high pot chemical THC.

Our suggesion: If you have chronic pain, see a physical therapist and orthopedic doctor for joint and muscle pain. Explore use of ice baths and saunas/whirlpools and massage. Opt for anti-inflammatory food choices (ditch red meats, go for veggies and whole grains) and try stress management using deep breathing or meditation. Acupuncture may also help, as can cognitive behavioral therapy, which changes your response to pain.


Mehmet Oz, M.D., is host of “The Dr. Oz Show,” and Mike Roizen, M.D., is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email questions to youdocsdaily@sharecare.com.


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