Medical Cannabis is Safe and Effective for Fibromyalgia Treatment, Suggests New Review
Medical cannabis can be a safe and effective treatment for fibromyalgia-related pain, according to a new literature review published in the Cureus Journal of Medical Science.
The review, authored by researchers at the California Institute of Behavioral Neurosciences & Psychology, examined 22 recent research articles that investigated the use of cannabis in the treatment of fibromyalgia symptoms. They found several common limitations in these articles, namely issues regarding dosages or the standardization of treatment regimens. However, on the whole, these studies presented evidence supporting the use of medical cannabis as a pain relief treatment for fibromyalgia with few adverse effects.
Finding a cure for fibromyalgia symptoms
Fibromyalgia is a common pain disorder that is thought to affect between 3-6 percent of people worldwide. It is primarily characterized by widespread chronic pain and is also frequently accompanied by extreme levels of fatigue, poor cognition, and sleeping problems.
Despite its prevalence, very little is definitively known about the pathophysiology of the condition. As a result, identifying effective treatments for people with fibromyalgia is a significant challenge. The US Food and Drug Administration has approved just three drugs for use in treating the symptoms of fibromyalgia: two antidepressant medications and one antiepileptic drug. The European Medicines Agency, though, has no drugs approved for treating the condition, due to a lack of conclusive evidence supporting pharmacological treatments. So for many patients, treatment is limited to opioid pain medications, sleep aids, and non-drug interventions such as physical therapy.
Partly due to this paucity of fibromyalgia medications, medical cannabis has quickly become a promising option for many people living with the condition. Indeed, many of those who self-medicate with cannabis do report significant improvements in their pain and overall quality of life after using the drug. But these anecdotes and reported effects need to be confirmed and studied in proper clinical trials before medical cannabis can be formally endorsed by relevant care authorities.
Medical cannabis is safe and effective – but needs further study
In this latest review, the researchers set out to analyze the role of cannabis and the endocannabinoid system in the treatment of fibromyalgia, focusing on review articles, randomized clinical trial results, and other observational or retrospective studies published within the past five years.
Many of the older review articles found inconclusive results, with others showing limitations relating to the incidence of certain adverse effects or low tolerability to two synthetic THC drugs, nabilone and dronabinol. However, the newer reviews covered by this literature review did demonstrate that cannabinoids could be used safely and effectively to alleviate fibromyalgia symptoms. Multiple studies covered by these newer review articles found cannabinoid treatments to have promising analgesic effects. Nabilone, specifically, was found to be superior to a placebo and showed reductions in the visual analog scale (VAS) for pain.
Overall, the new clinical trials and other experimental studies looked at by the Cureus review found very promising results supporting the use of medical cannabis for fibromyalgia symptoms.
In one randomized, double-blind, placebo-controlled clinical trial, ingestion of a THC-rich cannabis oil was seen to reduce Fibromyalgia Impact Questionnaire (FIQ) scores compared to placebo values, with no intolerable adverse effects. One prospective observational study saw median pain intensity scores drop from 9 out of 10 at baseline to 5 out of 10, following treatment at a specialized medical cannabis clinic.
In another observational study, 50 percent of participants reported improvements in anxiety and depression scales when using medical cannabis in addition to their concomitant analgesic treatments for fibromyalgia. In addition, 47 percent of the participants also reduced or suspended their use of this concomitant analgesia over the course of the study period, showing that medical cannabis could also hold promise as an adjunct medication for fibromyalgia treatment.
“At this point, the data suggest that the use of cannabinoids and cannabis carries limited side effects in the treatment of FM [fibromyalgia], and they can also improve some common and debilitating symptoms associated with FM, thus making them an adequate potential treatment option, when other treatment lines have been exhausted,” the review authors wrote.
“Ultimately, we believe that the use of cannabis and cannabinoids for pain relief in fibromyalgia has shown great potential and maybe a source of hope for those suffering from chronic pain associated with this condition, and for the physicians treating them; however, benefits need to be weighed against the harmful effects, and more research into this area should be conducted, for longer periods, to assess for long-term efficacy, adverse effects, and dependence.”
In light of the promising findings supporting the use of medical cannabis for fibromyalgia-related pain, the review authors also recommend that additional trials be carried out to assess the effect of different THC:CBD ratios on pain, and to evaluate the associated dose-response relationship.