Fibromyalgia is a
chronic disorder that causes widespread muscle and joint pain. Estimates
suggest that about five million adults in the U.S. are diagnosed with
the condition each year, with women affected at least eight times more
often than men.
The exact cause of the condition is unclear, but it seems that stressful
or traumatic life events, such as injuries and viral infections, may
play a role. People with fibromyalgia experience symptoms that can range
in duration and severity. The main symptoms are pain and fatigue, but
other common symptoms include memory problems, sleep disturbances,
headaches, temperature sensitivity, and stiffness upon waking. Often,
fibromyalgia coexists with another chronic pain condition, such as
chronic fatigue syndrome, inflammatory bowel disease, or
temporomandibular joint dysfunction.
Conventional Treatments Cause Adverse Effects
There is no known cure for fibromyalgia, but a combination of treatments
can help patients manage the symptoms. Three medications — duloxetine
(Cymbalta), pregabalin
(Lyrica), and milnacipran
(Savella) — have been approved by the U.S.
Food and Drug Administration (FDA) as a treatment for fibromyalgia.
However, these medications often put patients at risk for a variety of
side effects, including serious allergic reactions, suicidal thoughts or
behaviors, dizziness, sleepiness, blurred vision, feeling "high," and
swelling of the hands, legs, and feet. Thus, there is a need for new
treatments that relieve the symptoms of fibromyalgia with fewer side
effects.
Marijuana Offers Effective Relief from Pain
An online
survey
of more than 1,300 people with fibromyalgia conducted by the National
Pain
Foundation
revealed that medical marijuana, or cannabis, is more effective than
conventional fibromyalgia treatments. Of the patients who reported
marijuana use, 62 percent ranked it very effective at relieving their
symptoms, 33 percent said it helped a little, and five percent said it
did not help at all. In comparison, among those who tried Lyrica, 10
percent ranked it very effective, 29 percent said it helped a little,
and 61 percent said it did not help at all. Not only is marijuana more
effective, it is also associated with fewer side effects. The only
adverse effect shared by Lyrica and cannabis is feeling "high." However,
strains of cannabis with lower ratios of tetrahydrocannabinol (THC), the
chemical responsible for much of cannabis’s psychoactive, or
mood-altering, effects, to cannabidiol (CBD), a chemical that modulates
these effects, have been shown to relieve pain without affecting
cognition.
Researchers Investigate Marijuana’s Therapeutic Effects
Research has yet to reveal the exact mechanisms by which the chemicals,
or cannabinoids, in cannabis exert their medicinal effects. But evidence
suggests that they work on the endocannabinoid
system,
which mediates several physiological functions, including pain and
inflammation. Studies supported by the [National Institute of Arthritis
and Musculoskeletal and Skin Diseases
(NIAMS)](https://www.niams.nih.gov/health_info/Fibromyalgia/# h) suggest
that fibromyalgia results when endocannabinoid system imbalances disrupt
the feedback loop that inhibits pain signals, causing altered pain
processing, or more specifically, increased sensitivity to stimuli that
do not normally provoke pain. Perhaps the result of constant pain, these
imbalances
could also explain why people with fibromyalgia do not respond as well
to conventional pain medications.
Research Reveals Similarities Between Marijuana-Derived Cannabinoids and Endocannabinoids
The cannabinoids in cannabis are structurally similar to endogenous
cannabinoids,
naturally occurring chemicals that send messages between nerve cells
throughout the brain and spinal cord, affecting pain sensation. Because
of this similarity, it is hypothesized that they can attach themselves
to molecules called cannabinoid receptors on nerve cells and activate
them,
resetting
or blocking pain processing. Research reveals that cannabinoids may
provide greater therapeutic effects in combination than alone: a
phenomenon termed the entourage
effect.
Thus, taking the whole cannabis plant may modulate pain better than an
oral medicine derived from one or two of cannabis’s chemical components.
Evidence for Marijuana’s Effectiveness Grows
Evidence for cannabis’s therapeutic effects may be mounting, but the
FDA has
yet to approve cannabis as a safe and effective treatment for
fibromyalgia. As a result, many people are being denied access to a
potentially life-changing therapy. About 70 percent of the fibromyalgia
patients who responded to the National Pain
Foundation
survey said they had not tried cannabis as a treatment for their
symptoms, which is not surprising, given that federal
law
still classifies marijuana as a Schedule I drug with no medicinal
benefit.
Proponents of Medical Marijuana Lobby for Changes to Law
Proponents of medical marijuana are
lobbying for a change to the law so that the millions of Americans who
live with fibromyalgia could legally buy marijuana for personal use from
a safe source. Twenty-three states and Washington, D.C. have already
legalized smoked marijuana for medicinal purposes. However, a bill
decriminalizing
cannabis
at the federal level has yet to be signed into law. Currently, more than
60 national and international health
organizations,
including the American Academy of Family Physicians and the American
College of Preventive Medicine, support a move towards granting patients
immediate legal access to medical marijuana under a physician’s
supervision. Legalization would enable people with fibromyalgia to
manage their symptoms more effectively without worrying about potential
legal repercussions.
