As medical director for Medical Cannabis of Southern California I frequently evaluate patients with neuropathic pain. Neuropathic pain results from damage to the actual nerves in the peripheral or central nervous system rather than stimulation of pain receptors. Diagnosis is suggested by pain out of proportion to tissue injury, pain described as burning or tingling and nerve damage detected on neurological exam. This type of pain can result from damage to any level of the nervous system. Specific syndromes include post herpetic neuralgia, post-surgical pain (postthoracotomy syndrome, postmastectomy syndrome), phantom pain (pain experienced after amputation of a limb), diabetic neuropathy, HIV-associated sensory neuropathy and complex regional pain syndrome (reflex sympathetic dystrophy and causalgia). Tumors and herniated vertebral disks can also compress the nerves and cause neuropathic pain.
Many treatment options for neuropathic pain range from medications to nerve blocks to TENS (transcutaneous electrical nerve stimulation). Because patients with neuropathic pain typically do not respond well to opiates (Percocet, Vicodin, Hydrocodone) there are other classes of drugs that are typically used. Anticonvulsants such a gabapentin (neurontin), anti-depressants such as amitriptyline and corticosteroids such as prednisone are just three of many different drugs that patients typically try. Most patients experience limited relief with this approach. It is extremely important that the psychological effects of chronic pain are also addressed.
Many patients are unaware of the clinical research supporting the use of cannabis (marijuana) to treat neuropathic pain. The Center for Medicinal Cannabis Research at the UCSD has completed three clinical research studies demonstrating the efficacy of cannabis in treating neuropathic pain. In the first study by Dr. Donald Abrams (Cannabis for treatment of HIV associated peripheral neuropathy) demonstrated that cannabis reduced daily pain by 34% vs 17% with placebo. 52% of patients using cannabis experienced a 30% reduction in pain compared to 24% in the placebo group. For more clinical trials please visit the CMCR website at www.cmcr.ucsd.edu
In addition to cannabis’s analgesic (pain reduction) properties it also can improve patients mood from its euphoric properties. This is an extremely important component in the overall care of pain patients. Cannabis also has a safety profile which is unprecedented when compared to other treatment modalities. It is a fact that there has never been one documented overdose from using cannabis. In addition it does not cause a physical addiction like many other pharmaceuticals. It will improve a patients appetite, assist with falling and staying asleep and eliminate the nausea often caused by opiate analgesics. Once patients are educated on the safety and efficacy of marijuana (cannabis) they will be more likely to give it a try. In the majority of cases the benefits of trying it clearly outweigh the risks.
Lastly, patients do not have to smoke to get the immediate benefits of cannabis. Vaporization is way to inhale cannabis without producing any smoke. It is essentially smoke free.
For more information on how to determine if you may benefit from the medicinal use of cannabis please visit our website at www.mcsocal.com and pre-qualify for free online. To schedule an appointment to meet with Dr. Breen simply call 877-721-0047. We have three convenient office locations in Southern California (Long Beach, Irvine and Encinitas)
Western medicine has found many challenges in treating this type of pain and often patients with neuropathic pain have given up on ever living a pain free life. They typically have concominant depression as a result of the daily pain that they suffer from.
