At least eight states explicitly allow individuals with spinal cord injuries access to their medical cannabis programs, while most others include language allowing those with “debilitating conditions” or “chronic pain,” both symptoms of a spinal cord injury, to become a medical cannabis patient. The most severe spinal cord injuries cause paralysis while lower grade injuries – such as bruising – cause a loss of sensation and decreased strength, which can be permanent.
About 300,000 Americans are living with spinal cord injuries and 12,000 new cases are reported annually. At least one study, at the University of Washington’s Department of Rehabilitation Medicine, concluded that cannabis paired with massage therapy was second only to opioids in providing pain relief to patients; however, the researchers noted that study participants who had used opioids “were unlikely” to continue using them after they had tried them.
In addition to the paralysis and pain, many patients experience mental health problems, such as depression, anxiety and develop sleep disorders – all of which are conditions that are commonly cited among medical conditions for which cannabis is a worthwhile therapy.
CBD and THC for spinal cord injury
Patients with spinal cord injuries also often experience a loss of bladder control and a 2003 study purported that cannabis with both THC and CBD improved bladder control in some of the study participants.
Cannabis is safer and better tolerated than many prescription drugs – especially opioids. It Cannabis relieves pain and most states with a medical cannabis program include chronic pain among their qualifying conditions. It doesn’t suppress breathing and it is impossible to overdose – unlike opioids. And, according to Dr. Gregory T. Carter, the medical director for St. Luke’s Rehabilitation Institute, it doesn’t cause constipation or a physical addition.
“In fact, cannabinoids have a weakly stimulatory effect on the gut,” he said at the 2014 Spinal Cord Injury Wellness Summit, adding that “there is a psychological addiction if it’s being used solely for the intoxicating effect but there is no harsh physical withdrawal like there is with opioids or even nicotine because cannabis leaves the body so slowly.”
Carter suggests that patients seek products that are low in THC but high in CBD and CBN.
Cannabis for spasticity
In addition to quelling pain, cannabis reduces muscle spasticity – a condition in which certain muscles are continuously contracted that is often associated with spinal cord injury. A 2011 study from the University of Arizona found cannabis had a 70 percent success rate in reducing muscle spasms. A 2012 preclinical study out of Brazil found that rats with spinal cord injuries treated with 20 milligrams of CBD exhibited higher rates of motor function.
In a May 2013 American Medical Association Journal of Ethics article, Dr. Igor Grant outlined several studies that found cannabis “may represent a reasonable alternative or adjunct to treatment of patients with serious painful peripheral neuropathy for whom other remedies have not provided fully satisfactory results” – a statement which many spinal cord injury patients can attest.
CBD vs THC for pain
Being that THC-rich cannabis products appear to be quite effective in treating the symptoms, and adjacent negative effects, of spinal cord pain it’s important to start low and go slow. During his remarks Dr. Carter suggests using a vaporizer in lieu of smoking because it provides more immediate relief than edibles. Additionally, patients could use CBD-rich topicals to aid in pain reduction and inflammation. Nevertheless, cannabis could treat many of the symptoms of a spinal cord injury at once, providing much needed pain relief, sleep, and reduced depression for the patient population.
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