Medical Marijuana for Fibromyalgia: What Does the Research Say?
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Fibromyalgia is one of the most common chronic pain conditions in the world, affecting around 10 million people in the US alone and 3-6 percent of people worldwide.
Living with the condition can be incredibly painful. The most common symptoms include widespread musculoskeletal pain, extreme levels of fatigue, problems with cognition, and very poor sleep quality. And, unfortunately, there is no cure.
Medical treatment options are often limited to a combination of pain relief medication, anti-depressants, muscle relaxants, and sleep aids. Sometimes physiotherapy or other lifestyle changes, such as low-impact exercise, are also recommended. But these treatments don’t work for everyone and sometimes the medication prescribed can come with a raft of unfortunate side effects.
Because of these limitations, many fibromyalgia patients have continued to experiment with different methods of managing their pain, such as cannabis. But is the popular plant really an effective treatment for fibromyalgia? If one were to just consider anecdotal evidence, it seems the answer would be a firm yes.
Carly Barton, who suffered a stroke which left her with severe fibromyalgia in her mid-twenties, is the deputy director for United Patients Alliance, a UK-based medical cannabis advocacy group.
After shunning prescribed opiates for cannabis, the campaigner reported an almost immediate increase in her pain relief.
“I went upstairs [afterwards] and my partner said to me, ‘are you alright?’ and I was saying, ‘something’s missing, something’s odd, something’s off.’ I couldn’t put any words to it. And then I realized that the feeling that I had was just no pain,” Barton explained in an interview with Cannabis Aficionado.
But anecdotes are one thing and research another. What do clinical studies have to say about cannabis’ effect on fibromyalgia?
Well, while cannabis treatment for fibromyalgia is already allowed in some locations, there are surprisingly few studies in the medical literature describing the effects of cannabis on fibromyalgia symptomology.
One 2011 study reported a significant improvement in pain relief, stiffness, relaxation, and perception of well-being after cannabis consumption. Another study, published last year, surveyed people who use cannabis to temper chronic pain conditions, such as fibromyalgia. Participants generally reported that the drug resulted in net health benefits and many singled out improvements in their pain levels and sleep quality.
However, other studies have been unable to verify this information. A 2018 study, published in the Lancet Public Health, looked at the effects of cannabis use on the symptoms of people with chronic pain who had been originally prescribed opioid medication. As opioids can be highly addictive, finding alternative medicines is an active area of research. But the study was unable to find any evidence that cannabis use was able to improve patient outcomes, or that its use increased opioid discontinuation.
It is important to note that all these studies focused on people with fibromyalgia who choose to use cannabis or cannabis derivatives recreationally or who self-administer the drug for medical purposes. As the cannabis or cannabis products were not been prescribed by a physician, it’s difficult to accurately monitor either the type or the exact amounts of cannabis being used by each study participant.
But in August 2018, researchers from several research hospitals and universities in Israel did conduct a study that focused on people with fibromyalgia who had been using licensed medical cannabis as prescribed by their doctor.
Patient data were analyzed from the medical records of consenting adult patients with fibromyalgia and who were prescribed medical cannabis. These data included relevant demographic information, as well as clinical information, such as the time since diagnosis, and specifics surrounding the cannabis treatment program, like dosage and method of consumption. Patients were also contacted and asked to complete a questionnaire assessing the impact that fibromyalgia had on their quality of life and were invited to describe their experience living with fibromyalgia before and after starting cannabis treatment in their own words.
On the whole, patient feedback was hugely positive when describing their experiences and the use of medical cannabis was associated with favorable outcomes in every item evaluated by the questionnaire. The researchers include selected quote in their paper to illustrate some of the dramatic responses they received.
“I returned to be the same person I was before,” responded one patient. “This is a miraculous treatment,” said another.
Researchers also found that the patients were only taking relatively low doses of the drug. They noted that patients who receive medical cannabis treatment for cancer pain are often using around 60g of cannabis per month, but the many of the fibromyalgia patients were consuming less than 1 gram per day to control their symptoms. Side effects were also relatively mild; a dry mouth, redness of the eyes, and feeling hungry were the most frequently reported effects.
While the retrospective nature of the study limits its power somewhat, the researchers do note that only a relatively small number of medical cannabis requests for fibromyalgia treatment are approved in Israel, so it would have been impractical to give all prospective patients an additional questionnaire before being approved for treatment. There is a potential that similar studies, perhaps in other geographic locations, could make this a more realistic possibility.
Still, the study is a good first assessment of the impact of licensed medical cannabis on fibromyalgia symptoms and does also appear to warrant further study of the effects of the drug on chronic pain disorders.