Maybe the Marijuana Myth... JAMA and University of Chicago

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Clearwater AL

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Some people suffering pain from cancer and other chronic diseases turn to marijuana to ease their suffering, but much of that relief may come from simply believing weed will help, a new study found.

“The placebo response amounted to 67% of the pain relief associated with genuine cannabinoids,” “Factors such as patients’ expectations of relief are likely to play a role in the analgesic effects associated with cannabis-based treatments,”

The results of the recent study, published November 28 in the journal JAMA Network Open, echo those of another large 2021 analysis of the available evidence by the International Association for the Study of Pain. Based on those findings, the association issued a statement against the use of marijuana for pain.

A 2020 study, for example, found using marijuana before entering the hospital for a surgical procedure made pain during recovery significantly worse. People who used weed beforehand also needed more anesthesia during surgery, and undergoing anesthesia can be risky for some people, such as older adults or those with chronic illnesses such as diabetes. Marijuana users also needed more opioids during recovery.

“I think we set up patients to expect a certain kind of outcome,” said experimental psychologist Harriet de Wit, a professor of psychiatry and behavioral science at the University of Chicago who studies the placebo effect.

The new research examined 20 studies using cannabis for pain control in over 1,450 people between the ages of 33 and 62. All the studies were conducted as double-blind, placebo-controlled clinical trials — meaning that even the researchers did not know which study participant received cannabis or a dummy treatment.

“It’s really hard to say where people get their information of what they expect marijuana will do,” de Wit said. “I don’t think you can explain the placebo effect or blame it on social media. But you could say that’s where they got the expectation that this drug would relieve their pain — there’s a lot of social media saying cannabis is good for everything under the sun.”

I know someone who swears by marijuana... but would beg/steal or kill if he didn't have his Hydrocodone
10-325 Mg three times a day. :)
 
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I think pain is the least of what cannabis helps.

The FDA already approved Epidiolex, which is basically CBD, for the treatment of seizures. It works.

FDA also approved Marinol and Syndros for therapeutic uses in the United States, including for nausea associated with cancer chemotherapy and for the treatment of anorexia associated with weight loss in AIDS patients. Marinol and Syndros is THC. It's very common to prescribe it off label to patients in nursing homes that won't eat and can't sleep. It's also frequently prescribed for neurological pain.

My pain management neurologist has had success getting people off narcotics with cannabis. It takes a consistent, fairly high dose, but, in his opinion, it works. He makes all his patients take urine tests every time he writes an RX.

Every drug has a placebo effect in many patients. That is a good thing, if it relieves them from pain and misery.

Some people, myself included, can't tolerate a high enough dose of THC to relieve pain.
 
I echo Kim’s comment. I use MM tincture for calmness and to aid with sleep, not for pain. Indirectly, though, being calmer helps my muscles relax so I feel a little less pain. Not enough to give up my Tylenol and occasional Vicodin, but it helps in that regard. I know many people that gave up any type of pain medication after starting on MM.

Is it a placebo effect? Maybe, but as Kim said if a person perceives benefit it doesn’t matter. My PCP is of the same opinion (not about MM specifically). He recommended that my wife start taking Vitamin D3/K2 because of her age and for a minor deficiency. He takes it as well but not because his vitamin D level is low. He is in his 60’s and plays tennis so he mostly wants to support his bone health. After taking that supplement every morning he says he feels better. I said “do you think it’s a placebo effect“ and he replied “so what? I feel that it helps me so it doesn’t matter.”

Of course he wasn’t talking about prescription drugs, and to get new drugs approved trials that contain placebos are essential. But for things like weed and supplements the placebo effect can be very positive.
 
I'll chime in on MM. I've been using a tincture at night for the last 3 years. Does it actually help? I'd tend to say for me, yes it does. I won't smoke it or vape it for the concerns of compromising my lung function. A small dose at night helps me sleep without waking with cramps and spasms throughout the night .Prior to using MM I would take 10mg of Ambien. Although it helped me sleep it did nothing to alleviate the cramps and spasms.

Placebo effect or not if I believe its beneficial than so be it.
 
Also, I've spoken to more than one neuromuscular specialist who recommended cannabis. One believes it is neuro protective.
The other (Johns Hopkins) said it helped some of his patients with pain.
 
Kim, just curious... how is it you speak to so many neuromuscular specialists, and other specialists?
I have ALS and I've only talked to two. :)
 
I’ll stand by my original post… which has truth unless JAMA and the University of Chicago are without
any credit.

Those people who are hard marijuana believers (pot heads)… no one will change their minds.
Of course doctors, specialists and neuromuscular specialists will gladly go along with it… it takes an appointment(s) to get it, that isn’t free, blood work isn’t free, writing the prescription isn’t free, follow
ups aren’t free The marijuana growers love it $$, the processors love it $$, the dispensers love it $$
and of course the end users love it spending big $$... (the lone spenders of the chain.)
(Just like doctors and neuros now love Dr. Google and the internet, some love new marijuana fad.) Money.

It’s really all about money… BIG MONEY. That’s a powerful influence, Just like money can influence
elections. Millionaires don’t donate millions of their dollars without expecting some return.
Money can influence the medical industry too.

Glad my post generated some new conversation. Didn't mean to cause anyone pain. :)

*Nikki, your link is not the article I copied from. It was CNN Health…
“Pain relief from marijuana comes from a belief it helps, study finds”

Whatever… :)
 
From your post

The results of the recent study, published November 28 in the journal JAMA Network Open

As I said the link I posted is that paper referenced from November 28 JAMA I like to read the papers that trigger articles in the popular press so I shared it in case others were also so inclined.
 
Just to make it easy for some folks... copy and paste on Google search bar...

“Pain relief from marijuana comes from a belief it helps, study finds”

Easier reading, simple... brief. Whatever... again. :)
 
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But Al, the vast majority of cannabis consumed in this country is black market, illegal weed. In California the percentage of cannabis that is black market is between 80 to 90%, which means doctors and Big Pharma are NOT profiting in the same way as the drugs with fancy names. So the Big Money argument doesn't work. Obviously money is a huge factor in the proliferation of prescription drugs, but it is the opposite with cannabis. Cannabis historically has always been a grassroots movement (pardon the pun). From a financial standpoint, doctors and pharmaceutical companies would MUCH rather we all be on the prescription drugs that have commercials with annoying jingles.

I am not a big cannabis guy, though I have used MM at times. Not sure if it does anything for me personally, but I am convinced it does help many for a variety of things, and I like that it is a natural product. I'm glad it is losing its "hippy" stigma as more and more states (i.e. laboratories of democracy) make cannabis legal.
 
Dr Bedlack returns my emails even though I am not his patient. I have a care team at Mayo Clinic and also have been seen by Dr. Rothstein at Johns Hopkins. Bedlack and Pulley (University of Florida) both read one of my papers on ALS awareness.

I also had a close friend who was a neurologist and he read and interpreted EMGs that were done locally. Sadly, he passed away in 2020 from multiple myeloma. He shared Greg’s paper with some neurologists he knew. I also showed my pain management neurologist, Alyn Benezette, Greg’s paper and it helped him understand the importance of cannabis in his practice. He is now certified in medical cannabis and he is the doctor who has had success in getting patients off narcotics.
 
Big Pharma will continue to fight hard against Federal legalization of cannabis. They have their synthetic versions of it but medical users are buying from dispensaries.

Al, for the record, I never smoked weed and stopped social drinking in my early 20s. I use very little THC but a lot of CBD. The topical THC cream works better, for me, than Volteran, which use to be Rx but now OTC.
 
I guess it's opinion... everyone has one. Thanks for the replies on a new conversation.

Side note some what unrelated... i have never been supportive of states legalizing the
recreational use of marijuana. What comes to my mind is two parents constantly stoned
raising their children. And... stoned drivers, even worse stoned and on their phone.

Being from Florida (the 60s, 70s and 80s) I am very familiar with marijuana, I was not
a big pot smoker, very very little compared to friends ( job situation made it a no no) but
because of my side gig with the bar I've actually seen 100 pound bales. Couldn't
get away from the location fast enough. Even then I saw friends ruin their lives,
lost jobs, fall into near poverty, divorces, arrests ending up with criminal records
making all worse.

Maybe now it's just I'm an old man set in his ways and thoughts. Whatever... :)
 
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