Can marijuana help treat fibromyalgia?Risks and cautions

By:Jayne Leonard

People know marijuana as a recreational drug, but it has played a medicinal role for thousands of years. Some studies and anecdotal evidence suggest that marijuana or its extracts may help with the symptoms of pain, including the pain that occurs with fibromyalgia.

In the United States, the use of marijuana (also known as cannabis) remains illegal in many states.

However, marijuana contains many substances, including at least 120 active ingredients, some of which show promise for treatments. These include cannabidiol (CBD) and tetrahydrocannabinol (THC).

The use of CBD may be legal, although sometimes a prescription is necessary.

THC is the psychoactive ingredient in cannabis. CBD does not have psychoactive properties. Both CBD and THC appear to have useful medicinal properties.

One possible use of these chemicals could be as a pain reliever. As such, they might have benefits for people with fibromyalgia.

Marijuana and fibromyalgia

People who live with fibromyalgia may experience pain, headaches, and nausea, among other symptoms. Studies have shown that active ingredients in marijuana can improve these symptoms in some people.

However, few studies have focused on marijuana or its extracts to treat fibromyalgia specifically, and the existing literature shows mixed results.

Research published in 2011 indicated that the use of cannabis may have beneficial effects on some of the symptoms of fibromyalgia.

The study looked at people who were “using cannabis” rather than focusing on a medicinal extract or specific chemical.

A 2016 review of studies found there was too little evidence to recommend any marijuana-based treatments for managing symptoms in people with rheumatic diseases, such as fibromyalgia.

In 2018, an Australian study did not find that using cannabis reduced pain or the need for opioids among people with various conditions. However, this study, too, focused on recreational use of marijuana rather than medical use.

Considering that up to 90 percent of those with fibromyalgia are women, it is interesting to note that at least one study has found marijuana to be a better pain reliever for men than women.

There is evidence that some of the ingredients in marijuana may help relieve chronic pain, nausea, and muscle spasms and nerve pain associated with multiple sclerosis (MS).

It may emerge that cannabis is effective in easing similar symptoms in those with fibromyalgia.

Medical marijuana
Medical marijuana may be an option for people with fibromyalgia. It contains compounds that could offer relief from some of the symptoms.

The ingredients THC and CBD have received the most attention.

THC is similar to cannabinoid chemicals that occur naturally in the body.

It works by stimulating cannabinoid receptors in the brain. This activates the brain’s reward system and decreases pain levels.

At least one study suggests it may help relieve headaches.

It also influences the areas of the brain associated with memory and coordination.

Unlike THC, CBD is not psychoactive. It does not bind to cannabinoid receptors and it does not produce the “high” associated with THC.

Marijuana-based medication

The U.S. Food and Drug Administration (FDA) have not approved the use of the whole plant for any condition.

However, in June 2018, the FDA did approve a purified form of CBD, under the brand name Epidiolex, to treat two conditions: Lennox-Gastaut syndrome and Dravet syndrome.

These conditions involve seizures that do not improve with other medications. A prescription is necessary.

Synthetic THC is also present in treatments that have approval for nausea and vomiting and some kinds of anorexia.

In some countries, Sativex (nabiximol) is available on prescription as an oral spray for people with multiple sclerosis (MS) whose symptoms have not responded to other treatments. It contains CBD and THC, and it treats pain and muscle spasms. Sativex is not available in the U.S.

Scientists are continuing to conduct research and clinical trials to find out whether medical marijuana is safe and effective for a range of conditions.

What conditions can marijuana be used for?
People use marijuana for a wide range of conditions, although research has only confirmed that it is beneficial for a few.

Currently, there is good scientific evidence for its use in treating chronic pain, including nerve pain and muscle spasms.

According to the National Institute on Drug Abuse, research is under way to find out if compounds in marijuana might help with the following:

appetite loss and anorexia
conditions that affect the immune system, including HIV
multiple sclerosis
substance use disorders
mental health conditions
Mouse studies have indicated that purified extracts of marijuana may slow the growth of cancer cells in one kind of brain tumor. A combination of CBD and THC extracts helped kill cancer cells in mice during radiation treatment.

More research is necessary to confirm these uses.

Risks and cautions
People who would like to try marijuana as a treatment for pain symptoms for fibromyalgia should check their state’s laws in relation to the use of cannabis.

Since FDA approval is lacking for marijuana and most of its related products, consumers should take care when obtaining and using a product, as there is no regulation of the quality or ingredients of the goods.

It is worth remembering that people grow marijuana as a plant. They do not synthesize it carefully in a laboratory. Therefore, the amounts of potentially beneficial compounds present vary from one batch of plants to another. Symptom relief may also vary as a result.

People should consult their doctor for advice about using any alternative or complementary therapy, including marijuana, because it may not be safe and effective for everyone. For example, the ingredients in marijuana could interact with other medications.

There is also some danger of contamination. Marijuana products may have fungus or mold that can do serious harm to the lungs and overall health. Manufacturers and vendors might add other drugs.

A health provider may also be able to recommend a reputable source or product.

Possible side effects of marijuana use
Adverse effects associated with marijuana use include:

dependence, when a person needs to use more to gain the same effect
for some people, addiction
withdrawal symptoms
increased heart rate
breathing problems
impaired reaction times
issues with concentration, learning, and memory
mental illness in those predisposed to it
interactions with other drugs
These effects increase with long-term use. However, the use of some individual substances — such as CBD — may not carry all these risks.

Clinical trials did not find any sign that people using the CBD-based Epidiolex, for example, developed a dependency.

Therapies that receive FDA approval will likely be safe, due to the long and rigorous process of clinical trials. Even then, however, it is important to read the patient information leaflet, as all drugs can have side effects.

Lifestyle remedies for fibromyalgia
The following lifestyle modifications may help relieve symptoms of fibromyalgia:

Exercise: Gentle exercises such as walking, swimming, and pilates may help to decrease pain symptoms.
Stress reduction: Meditation, progressive muscle relaxation, and breathing exercises can help reduce stress.
Massage: The National Fibromyalgia and Chronic Pain Association state that massage therapy can improve chronic pain and fibromyalgia symptoms.
Acupuncture: Some research indicates that tailored acupuncture can ease symptoms in some people.
Sleep: Sleeping and waking at the same time each day, can help to ease fatigue. A doctor may be able to suggest other options.
Behavior modification therapy: A therapist can help a person with fibromyalgia to learn new coping skills and define and set limits. This can improve quality of life and self-esteem.
Medical treatments
Fibromyalgia can involve a wide variety of symptoms, so a single treatment will probably not work for all. Treatments also vary in effectiveness between individuals.

For most people, a combination of medication and lifestyle changes is most beneficial.

Drugs that can help to relieve symptoms include:

pain relief medication, either over-the-counter or on prescription
antidepressants, which may help with pain, fatigue, and depression
Anyone who is considering using marijuana or another complementary treatment should speak to a doctor first, to ensure the treatment and product are safe to use.


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