{"componentChunkName":"component---common-build-question-tags-template-js","path":"/question-tag/chronic/12","result":{"data":{"allQuestion":{"edges":[{"node":{"id":"Question_10667-markdown","title":"I have Severe Rheumatoid arthritis and Fibromyalgia. What solution is best to relive my chronic pain?  ","slug":"i-have-severe-rheumatoid-arthritis-and-fibromyalgia-what-solution-is-best-to-relive-my-chronic-pain","content":"\n_____________________\nCannabis may be useful in the treatment of both rheumatoid arthritis (RA) and fibromyalgia.  Cannabis has both immune modulating properties and anti-inflammatory properties in addition to analgesic effects. Because both RA and fibromyalgia are systemic illnesses, most patients administer either vaporized or ingested cannabis. Strains or products with a higher CBD/THC ratio have been effective in alleviating chronic pain while lessening psychoactive effects of the medicine. \n\nAlso, for musculoskeletal discomfort in general, many patients have found topical salves to be beneficial in treating localized joint or muscle pain. One benefit of this approach is that most, if not all, of the cannabis does not enter the blood stream, so their are no systemic effects; therefore, topical can be used comfortably during the day as well as the night. \n\ndredmunds","image":null}},{"node":{"id":"Question_10602-markdown","title":"I am trying to understand if cannabis can be bad for the liver. And if the method of ingestion matters to the liver.","slug":"i-am-trying-to-understand-if-cannabis-can-be-bad-for-the-liver-and-if-the-method-of-ingestion-matters-to-the-liver","content":"\"I use cannabis for pain management but am also managing a chronic liver disease at the same time. Ironically of course, pharma drugs make things worse for the liver. I have been experimenting with methods of ingestion and sometimes feel like the liver does not love edibles.\"\n_____________________\nCannabis is not bad for the liver, and in fact has been shown to protect the liver from damage. However a few studies have shown that THC activation of the CB1 receptor can increase fibrosis and other pathological processes, and that CB2 receptor activation has a protective effect. I might not reccomend edibles in your condition, and would instead go with tinctures with a high level of CBD. I would try to find the most pure, chemical and additive free cannabis products, and continue to monitor your reaction to varying ratios of CBD:THC and unique strains.\n\nandrewvanmd\n_____________________\nI discourage the use of edibles when you have known liver disease because anything that goes into the stomach will immediately be picked up by the liver to start processing the medication out of the body. For the best results you want to increase the amount of time the cannabis is in your body before it's picked up by the liver. Western pharmaceutical drugs tend to be stressful to the point of being harmful to the liver and that includes acetaminophen and most of the pain medicines do contain acetaminophen. Alcohol and to much protein also have the potential to harm the liver in cases of liver disease. If you have liver disease consider doing high CBD cannabis as well as silymarin, the active ingredients in the herb milk thistle and the only substance known to reverse liver disease, to start reversing your liver disease. If you are eating substances that are harmful to you, recognized this and change your ways since you have the option of creating health by being responsible. Using high CBD will calm anxiety and inflammatory disease in your body so I do recommend taking high CBD cannabis in a nonalcoholic tincture twice daily.\n\ndrolson","image":null}},{"node":{"id":"Question_10583-markdown","title":"Friends have told me that marijuana can help me with chronic pain. Isn't it a 'gateway drug' though? ","slug":"friends-have-told-me-that-marijuana-can-help-me-with-chronic-pain-isnt-it-a-gateway-drug-though","content":"\"I've been taking pharmaceuticals for pain for years but want to stop as the negative side effect are too much for me now. I'd like to try pot but I'm concerned that it may lead to other things. Even though it is legal in my state, I am a little concerned about how it may effect me or what may happen.\"\n_____________________\nIn a recent blog post on our Health & Wellness blog, Pamela Hadfield discussed whether marijuana is a gateway drug.\n\n\"A recent article in Newsweek elaborates on findings that conclude that marijuana is NOT a gateway drug. However, new evidence supports that alcohol IS a gateway drug. “The common government stance within the US is that alcohol is a gateway drug. This means that a user first starts drinking and then moves on to harder substances, such as cannabis and heroin, later on in life.” We grew up being told a very different story than this, so mentally it is hard for many people to absorb this new finding.”\n\nhttps://www.hellomd.com/health-wellness/5716bfd5e1d0c0000c000013/why-moms-should-support-marijuana-legalization\n\nAnd yes, marijuana can help you with chronic pain. Everyone is different.\n\nmark","image":null}},{"node":{"id":"Question_10562-markdown","title":"I seem to be very sensitive to the effects of THC and I never feel euphoric. How can I get pain relief without smoking?","slug":"i-seem-to-be-very-sensitive-to-the-effects-of-thc-and-i-never-feel-euphoric-how-can-i-get-pain-relief-without-smoking","content":"\"I know marijuana can help with my pain, but whenever I have smoked it, I don't feel good. What other ways can I help manage my chronic pain?\"\n_____________________\nIt has been shown that cannabis can help relieve pain. Since most strains of cannabis can contain various concentrations of THC and CBD, people can react differently to each of the various strains. Everyone has a different level of tolerance to each of components of cannabis and smoking is only one way to help treat your pain.\n\nUsing tinctures and capsules are another way to find the right combination to help alleviate painful symptoms. Each of them can be found with varying levels of THC and CBD. While CBD has the anti-inflammatory component, some products add a small amount of THC for the best relief of symptoms. You can use edibles as well that, while taking 1-2 hours to take effect, can last longer then other methods. While you can feel the effects of smoking or vaping within minutes, these other methods may be better since they will have a more gradual onset and can be more pleasant to help with your pain relief.\n\nPerry Solomon, MD\n_____________________\nI never really recommend smoking if you are looking to control pain. Inhalation is a fine method for pain relief as the analgesic effects are very quick to take effect, but I always recommend vaporizing if you plan to inhale cannabis. \n\nVery generally, cannabis is made up of CBD and THC. THC is the part of the plant that is psychoactive and can result in the ‘high’, the euphoria or even paranoia depending on how you, personally react to it. CBD is the part of the plant that has been identified as being useful in the treatment of pain and inflammation. \n\nIf you smoke bud or flower, you have no way to separate out the THC from the CBD and will be subjected to the psychoactive effects of the THC contained in the strain you use. If you don’t like these psychoactive effects, you could use a product that has been manipulated to contain larger quantities of CBD than THC. These ‘CBD heavy’ products often still include a small quantity of THC. In studies, it has been shown that CBD products with a small amount of THC are more effective at reducing pain that products that contain CBD alone.\n\nHere are some examples of CBD heavy products:\nTopical applications such as creams, salves, balms and lotions, which I find particularly helpful for pain control during the day when you need to be functional and not high. When applied to the skin there is not enough absorption of THC into the blood stream to result in any psychoactive effects. \n\nTinctures can also supply larger amounts of CBD in relation to THC. Some examples are 20:1 or 30:1, CBD:THC.  These are placed on or under the tongue usually and are absorbed through the oral mucosa. They useful for medium term pain relief with the effects starting anywhere from 15-45 minutes usually, they can provide pain relief for 4-5 hours in some cases. Tinctures are also, often nicely labelled with the amounts of CBD in milligrams, making dosing and evaluation of effectiveness easier. \n\nIngested cannabis or ‘edibles’ can also be made into CBD heavy products. These can provide longer term pain relief, sometime for 8-10 hours making them particularly useful for twice daily dosing. Again, they are often nicely labelled with the amounts of CBD in milligrams, making dosing and evaluation of effectiveness easier. \n\n\n\ndrbluto\n_____________________\nI like the tinctures, you can start at a low dose and work your way up until you feel comfortable.the 4:1 ratio is good,\n\nbooboogin","image":null}},{"node":{"id":"Question_10558-markdown","title":"Can I use cannabis as a replacement for Vicodin?","slug":"can-i-use-cannabis-as-a-replacement-for-vicodin","content":"\"I suffer from chronic back pain and have been using vicodin. However, my doctor has stated that I need to end my reliance on this drug, and I am looking for a replacement. Advill and others don't provide the relief I am looking for. What cannabis products might be a good choice for me?\"\n_____________________\nCannabis has had more and more positive feedback in people trying to cut down or eliminate their opioid use. Every day in the United States about 44 people die as result of opioid overdoses. There has never been a reported death from cannabis use. Donald Abrams, MD, a professor of medicine at University of California, San Francisco, has studied the effects of medical marijuana on pain since the mid-1990s. In 2011, he published a small study of 21 patients that found that the addition of marijuana to a twice-daily opioid regimen led to a 25 percent reduction in pain. It suggests cannabis could allow pain patients to lower their opioid dosage and still get pain relief.\n\nIt seems that patients can get short term pain relief from cannabis that contains only 1.3 percent tetrahydrocannabinol (or THC), the ingredient that gives marijuana its psychotropic effects. Pot used for recreational purposes has 6 to 12 percent THC, but can go as high as 20 percent. A  higher concentration of cannabidiol (CBD) mixed with a little THC seems to be the best bet for decreasing opioid use. There is one called “20:1,” named for its ratio of CBD to THC. \n\nThe fastest way to obtain relief is by smoking or vaping the cannabis product. Tinctures or capsules are effective as well as using an edible that can last the longest.\n\n\n\nPerry Solomon, MD\n_____________________\nThe short answer is, yes!\n\nI have had many patients decrease their reliance on opioids such as Vicodin, Percocet and oxycodone for pain relief by substituting often large quantities of opioids with medicinal cannabis. I strongly urge this be done under close medical supervision, guided by a physician familiar with both opioid pain medication and cannabis use. \n\nFor a longtime I struggled with my chronic pain patients for whom Tylenol and Nonsteroidal anti-inflammatories such as ibuprofen and Naprosyn didn’t offer enough pain relief. It seemed like the next step was opioids and there was very little in between to offer patients. These days I spend less time transitioning patients off their opioids and more time convincing them to try cannabis first. Using cannabis, many of my patients have avoided the whole opioid epidemic. \n\nThe choice of cannabis product for your back pain should be tailored to your individual pain relief needs. It will depend on whether your pain is constant or intermittent. Whether your pain is predominant throughout the day or whether it affects your sleep as well. It will depend on your personal situation such as your need to drive or work. \n\nVicodin is a short-term opioid that relieves pain for hours at a time. As such, it often needs to be dosed several times a day. The equivalent short term method for pain relief with cannabis could be inhalation such as vaporizing or using a vape pen. Pain relief starts within 5-10 minutes usually but only lasts 2-4 hours. \n\nOther methods of cannabis provide longer coverage of pain relief and you may find topicals, tinctures and edibles more useful. I rarely find one cannabis product fits all and often different products at different times works best. Also, it is important to understand that everyone reacts differently to cannabis products.\n\nIf you are new to cannabis use, I would recommend trying a topical CBD cream or lotion directly on the skin over you back initially, as there is no high associated with CBD topicals with perhaps time release patches being the theoretical exception. I would then likely recommend a 20:1 CBD:THC tincture in addition. If your pain was preventing sleep, I might introduce a different product such as a 1:1 THC:CBD tincture for night time pain relief and sleep enhancement.\n\n\ndrbluto\n_____________________\nIt's so frustrating when you can't get a good nights sleep! Many factors come into play but if it is your back that's keeping you awake at night that's fairly easy to resolve.\nIf you have been doing Sativa in the evening, to go to sleep you need to add CBD (Oral spray tincture works well to stop the brain chatter) but if you are doing Indica and you suffer with brain chatters the same technique works because you tend to sleep much better when your CBD and THC are in a one-to-one or equal balance. I also suggest that you may want to do a CBD dominant topical salve rubbed into your back just before bedtime to keep you out of pain and muscle spasm through the night. If you wake up in the night you can vaporize off a 1:1 vapor pen to go back to sleep. If your sleep problems are actually from an accumulation of stress and anxiety throughout the day please, consider using the low-dose CBD (an 8:1, CVD: THC should work well and does not make you high) a couple of times during the day to keep yourself calm and even with your emotions and you will actually sleep better.  Some people just don't sleep well with high THC so please be aware of that and you may need to balance with CBD. Good luck, a good night sleep is worth making some changes.\n\ndrolson\n_____________________\nLimiting your exposure to opiate medications is a great way to improve your overall health and limit the risks that come with this class of medications. Many patients experience side effects such as nausea, constipation, drowsiness, and poor appetite not to mention the long-term risks of abuse and addiction.\n\nThere are several options for pain control depending on the specific underlying cause of your pain. You may consider non-steroidal pain medications like ibuprofen, naproxen, and meloxicam. Local pain treatment with a lidocaine patch or voltaren gel is also an option with lower risk of side effects. Of course, there are non-pharmaceutical options, which is likely the reason for your question on this site.\n\nThe same principles that apply to traditional medications apply to cannabis. A topical cannabis-infused product is recommended as the first approach to pain control. This could include a cannabis-infused patch, lotion, balm, or ointment applied directly to the skin or massaged into the skin. Higher CBD content products tend to work well for this since there is an anti-inflammatory property associated with CBD.\n\nPain can also be treated with as needed vaporized cannabis products. Vaporizers work well for immediate relief since they take 5 minutes or less to feel the effect. Again, a higher CBD product is preferred due to its anti-inflammatory properties. THC can be effective but tends to be more of a way to distract from pain as opposed to treating the inflammation associated with pain. You own trial and error is important when treating pain. Just remember to use as little as needed for relief without overdoing it.\n\nFinally, don't forget about conservative pain management using physical therapy, massage therapy, heat and cold packs, and acupuncture which can be very effective for certain individuals depending on the underlying cause of the pain.\n\nsankmd\n_____________________\nFibromyalgia affects a large number of Americans, and medical marijuana can be an effective alternative to traditional pharmaceutical products.  Generally, a balanced product with both THC and CBD is a good choice for chronic pain, while avoiding excess side effects.  Products that are ingested/swallowed have a longer duration of action, so you can experience a gradual, steady pain relief effect.  There are a few articles on fibro in our Health & Wellness section that you can check out for more details, including some recommended strains.  Best of luck to you in finding improved pain relief!\n\ndrbultman\n_____________________\nThis question is a real challenge because I have different answers for different parts of the body and do you want to be awake or asleep? \nI love the topical CBD dominant salve for most all pain in my body and so far I have enjoyed many brands but my favorite is Canna Care because it is very effective at relieving pain especially the ~2:1 ratio. \nFor vaporizing, I think it is hard to beat AC/DC because it is fast and effective and it does not leave me with any psychoactive effect and no anxiety as it quickly relieves the pain. \nI personally tend to avoid edibles due to the carbs and the edibles are so regional, any recommendation would be of little benefit but I am certain another doctor might be able to give advise on edibles. \nI like a variety of tinctures but I tend to like to spray the tincture in my mouth or hold it under my tongue so that makes the strong alcoholic tinctures too hot for me but the alcohol extracted tinctures are still excellent products. \nWe have many fine products on our website so please, explore the products.\n\ndrolson\n_____________________\nConsider CBD for pain since it works well and usually very little if any side effects as long as the THC is low. Once the ratio of CBD to THC is more than 8 parts CBD to 1 part THC, it is unlikely you would notice any psychoactive effect.  If you are in pain and you want to go to sleep try a 4:1 CBD dominant or even a 2:1 or 1:1 but you will notice the psychoactive effect before you go to sleep. It will take some experimenting, go low and slow and you will find your perfect dose but do not be afraid, cannabis tends to be much more gentle than pharmaceutical narcotics or benzodiazepines.\n\ndrolson\n_____________________\nPain is one of the most common uses for medical marijuana.  Whether it's inflammation, headaches, neuropathic pain, muscle soreness, spinal injury, fibromyalgia or cramps, people have seen varying degrees of success with cannabis.\n\nwendynp\n_____________________\nI believe the best relief for severe back pain are the CBD topical salves in a 2:1 ratio, applied every hours during your waking hours to keep the pain in remission, take a high CBD oral spray or tincture in addition so you are treating yourself inside and outside And within one week you should have a profound reduction in your pain level. If you are still experiencing pain within one week please, be sure to have your vitamin D blood level checked and take vitamin D3 in order to get your blood level above 55 MG/ML for optimum pain relief.\nStay well hydrated and pay attention to your posture. If your posture is poor, the nerves can't call you on the phone to scream, \"Get off me!\" and you will experience pain. \nYou must do everything to get better or except the fact that you're not going to get better until you do everything. The body likes to be healthy and well and wants to be healthy and well and now you have the tools to get healthy and well. You cannot get enough sunshine to make enough vitamin D to correct your problem.\n\ndrolson\n_____________________\nMany good answers here, and I'd just like to mention that there is clear published medical science demonstrating that cannabis improves the pain relieving effects of opioids.  This has allowed many people to use cannabis to reduce their Vicodin dosage while maintaining adequate pain relief. \n\ndrelkind\n_____________________\nWhether it's Vicodin, Percocet or another opioid, cannabis typically works well as an alternative to these pain killers. Marijuana can either reduce opioid use or eliminate it altogether.\n\nHere's an excerpt from the above video: \n\nPamela: Dr. Solomon I love this next question because it's so timely with what's going on in the news today. Can cannabis be replaced by Vicodin?\n\nDr. Solomon:  We certainly hope so and more and more studies are showing that it absolutely can. Dr. Donald Abrams, a professor of medicine at UCSF has shown in a study that people who had been using Vicodin showed a 25% decrease in their Vicodin use when they started using cannabis to replace it. It's just remarkable how many people are seeing that the side effects of cannabis are so little compared to the side effects of Vicodin and as you know the new demands by the government are saying that people can't even get Vicodin for their chronic pain.\n\nPamela: Yeah so it's so hard to get and people are also recognizing [they] don't want to be on opioids anymore [they] want an alternative.\n\nDr. Solomon: And the dangers of opioids are huge, with suicides, overdoses, etc. As a matter of fact the 24 in the country now that have legalized medical cannabis have shown a 25-30% decrease in the opioid overdoses that occur, causing death. \n\nPamela: And my own personal story, I know that I was able to replace Vicodin with cannabis in my own pain management, so personally I do believe that it works.\n\nDanielle Lim ","image":null}}]}},"pageContext":{"limit":12,"skip":132,"numPages":12,"currentPage":12,"id":5112,"name":"Chronic","slug":"chronic","country":"US"}},"staticQueryHashes":["3949754563","4179947113","4202924991"]}