Summary: A new study shows that medical marijuana may help manage the chronic pain of sickle cell anemia. Unlike CBD products sold in stores, medical marijuana is high in THC, the part that causes the high. But THC is also why it kills pain better. Studies show that medical marijuana, or cannabis, can help with many health conditions. It is especially good for managing chronic pain. These findings matter even more because wider use of medical cannabis may help fight the opioid epidemic.
For thousands of years, people have used cannabis to make cloth and oil, for fun, in religious ceremonies, to treat disease, to ease pain and more. Traditional healers knew cannabis could help with many health conditions. But all that changed in the early 20th century. The narrow view of some researchers and lawmakers led to a total ban. Growing, owning and using cannabis became illegal.
Still, people in many countries kept using and studying cannabis. In the end, researchers saw that a total ban was a mistake. Many countries have now made cannabis legal. Most have legalized only low-THC hemp extract rich in cannabidiol (CBD). But many governments are now legalizing even high-THC cannabis strains.
CBD pain treatment works well. It can help lower anxiety, spasticity (muscle stiffness), pain and seizures, help manage metabolic disorders, and more. But new studies suggest that THC, the part of cannabis that causes the high, also has many good health effects. And when several cannabinoids are used with THC, they seem to have more significant health benefits. That is due to the entourage effect. It happens when mixing several plant compounds creates a new kind of health effect.
The entourage effect is possible because the cannabinoids in the cannabis plant seem to have different properties. Sometimes they even have opposite effects. For example, some cannabinoids may curb appetite, while others boost it. Now new research indicates that high-THC cannabis, or marijuana extract, may be quite good for managing pain in sickle cell patients. Of course, using marijuana or whole-plant high-THC cannabis extract is not new. Science has long known that marijuana is excellent for severe and chronic pain.
Does cannabis help sickle cell pain?
Sickle cell is a rare genetic disorder that mostly affects people of African and Hispanic descent. As the name suggests, a person with it has red blood cells shaped like a sickle. In sickle cell anemia, these red blood cells are brittle and carry less oxygen. They starve tissues of oxygen, which causes bouts of severe pain.
Of course, cannabis high in THC would not help manage severe problems from sickle cell disease. It will not change the course of the disease. But a new study suggests it is an effective and safe way to treat the chronic pain that comes with it. It was a pilot study of 23 adults with sickle cell anemia and chronic pain. Researchers at UC Irvine and UC San Francisco wanted to see if cannabis could help treat sickle cell anemia. They were looking for safer options than long-term opioid use.
In the study, researchers gave patients vaporized cannabis with equal amounts of CBD and THC. They compared it with a placebo. Cannabis helped bit by bit. It significantly improved quality of life and lowered chronic pain. For example, people who inhaled the cannabis extract had lower pain scores after five days. They also slept better, walked better and had fewer mood problems from chronic pain.
Doctors say these are early findings, but they matter, because America is struggling with the opioid epidemic. So researchers are looking for other good ways to treat chronic pain. And doctors are now wary of prescribing opioids for chronic pain.
Note that medical cannabis high in THC is legal in 33 US states, though you can only get it with a doctor’s prescription. But there are still hurdles. Only four states in the US allow prescription marijuana for sickle cell pain. Still, this study is a step forward. It shows that cannabis can help treat pain in many health conditions, including sickle cell disease.
Frequently asked questions
What causes sickle cell pain?
In sickle cell anemia, red blood cells take on a sickle shape. These cells are brittle and carry less oxygen, so tissues are starved of their oxygen supply. That shortage is what triggers the episodes of severe pain that define the disease. Sickle cell is a rare genetic disorder that mainly affects people of African and Hispanic descent.
Can cannabis treat sickle cell disease itself?
No. Cannabis high in THC does not change the course of sickle cell disease and will not manage its severe problems. Its role is narrower: the chronic pain that comes with the condition. Researchers at UC Irvine and UC San Francisco studied it for exactly that reason. They were looking for a safer option than long-term opioid use.
What is the difference between CBD and medical marijuana for pain?
Store-bought CBD comes from low-THC hemp and can help with anxiety, spasticity (muscle stiffness), pain and seizures. Medical marijuana is high in THC, the compound that causes the high. THC is also why it kills pain better. The sickle cell pilot study used vaporized cannabis with equal amounts of CBD and THC, compared with a placebo.
Can cannabis be used as a pain reliever?
Medical cannabis has long been used for severe and chronic pain, and newer research shows THC has health effects of its own. Several cannabinoids taken together with THC may work better than any one alone. This is called the entourage effect. That pain relief is also why wider use of medical cannabis may help fight the opioid epidemic.
Dr. Gurpreet Singh Padda, MD, MBA, MHP
