What is Arthritis?
Before we address the question “Can cannabis treat arthritis?”, it is first important to understand the disease and assess whether or not cannabis would be a treatment option that actually reverses the disease or if it would simply act as a symptom alleviator.
Believe it or not, about 1 out of 5 adults in the US have been diagnosed with some form of arthritis — an incurable disorder. These diagnoses include osteoarthritis, rheumatoid arthritis, lupus, fibromyalgia, and gout. Arthritis is typically caused by joint inflammation. This inflammation can lead to bones rubbing against each other and interfering with regular muscular function.
Thus, common symptoms of arthritis include pain, aching, stiffness and swelling of the joints. While the elderly are at higher risk for arthritis, two-thirds of people with arthritis are younger than 65. (Ref. 1) Most individuals suffering from arthritis are in near constant pain, with a notable increase of pain in the mornings or when it rains.
Arthritis has been treated thus far with anti-inflammatory medication, pain relievers, or steroids. Physical therapy is also a common treatment option. It is encouraged that arthritis patients maintain an active and healthy lifestyle, as heart disease, diabetes, high blood pressure, and obesity are all highly correlated with arthritis.
While there are common treatment options, most of the medicine prescribed simply treats the symptoms and does not get to the root of the cause: inflammation. This is akin to how a regular, over the counter allergy medication works. Your body has a histamine response that causes your eyes to puff, throat to swell, and nose to get runny. Anti-histamines will help with these symptoms, but don’t address the fact that you are still allergic to whatever it is you are allergic to. With anti-inflammatories, you are alleviating the problem of inflammation, but not what caused the inflammation in the first place —- the true objective of medicine.
Furthermore, nonsteroidal anti-inflammatory drugs could have negative side effects including heartburn, stomach ulcers, increased risk of blood clots, heart attack and stroke.
Can Cannabis Treat Arthritis?
Cannabinoids are probably most touted for their anti-inflammatory properties. Seeing as most medical ailments have some form of inflammatory counterpart, it’s no surprise that so many patients have met success when using cannabis to treat their symptoms. Since arthritis is directly an anti-inflammatory condition, this instantly suggests that cannabis may be a good treatment option for patients with arthritis.
THC, CBD, CBG, and CBC are all cannabinoids active in marijuana that possess anti-inflammatory properties. (Ref. 2) The diversity of cannabinoids which help inflammation could make cannabis an effective treatment option. Furthermore, THC is an analgesic with strong pain killing capabilities. Thus, at first glance, it seems logical that cannabis could be particularly effective at alleviating the symptoms of arthritis with less side-effects than current treatment options.
However, speculation tells us nothing. Let’s turn to scientific research. As early as 2000, a study was done on using CBD as a treatment option for arthritis. (Ref. 3) The study noted that taking CBD orally was effective. The authors posit that, due to its immunosuppressive and anti-inflammatory properties, CBD has a potent anti-arthritic effect. In 2005, research showed that genes that code for CB2 receptors are related to human osteoporosis. (Ref. 4) While the CB1 receptor did not affect bone mineral density, the study showed that the CB2 receptors do. What this means is that an inaccurate genetic coding of CB2 receptors (which are present all throughout the body) could result in less bone density. Since cannabinoids target CB2 receptors, they could up-regulate the system and perhaps encourage bone growth. Furthermore, this suggests that cannabis is positioned to act as a treatment for arthritis, not just a symptom alleviator.
In the same year, the first clinical trial of cannabis-based medicine was performed. (Ref. 5) A THC/CBD extract known as Sativex was used. The results showed general pain relief during movement and rest. Patients also benefited from an increased quality of sleep. Disease activity was also significantly reduced.
GW Pharmaceuticals in the UK has provided a lot of valuable research into the use of cannabis-based medicine. However, since they are a pharmaceutical company, they typically perform studies with synthetic or isolated cannabinoids, rather than the naturally grown plant. Thus, while Sativex does show some promise, it doesn’t speak to the efficacy of cannabis as a whole; cannabis is most potent when presented with its full suite of cannabinoids and terpenes in what is known as the entourage effect. Ethan Russo, who wrote a paper on the entourage effect also wrote a review article of using Sativex to treat many conditions, including arthritis. (Ref. 6) Sativex is not the first cannabinoid extract used for its anti-inflammatory properties. A synthetic cannabinoid acid HU-320 was shown to also have anti-inflammatory properties. (Ref. 7)
In 2006, a survey was done in the UK with 2969 participants. (Ref. 8) Out of the respondents who used illicit cannabis for rheumatoid arthritis, 100% stated that cannabis made them feel either “much better” or a “little better”. These participants would have probably responded “yes” to the question “can cannabis treat arthritis?”. However, actual treatment efficacy is still unclear. Using cannabis for symptom alleviation of arthritis does definitely seem to have benefits. After all of these studies, it is no surprise that another study found that the CB2 receptor has potential inhibitory effects for rheumatoid arthritis. (Ref. 9) Since CB2 receptors are spread out throughout the whole body, including regions affected by arthritis, activation may help decrease inflammation.
Can cannabis treat arthritis? Out of the respondents who used illicit cannabis for rheumatoid arthritis, 100% stated that cannabis made them feel either “much better” or a “little better”.
This collection of research shows that there is significant evidence suggesting that CB2 receptor activation is an effective method for treating arthritis. However, many doctors still refuse to recommend cannabis in its plant form, due to its negative stigma. Doctor’s also hesitate to prescribe medical marijuana to elderly patients (who suffer the most from arthritis) due to its psychoactive effects.
Fortunately, CBD binds to the CB2 receptors and is non-psychoactive, so patients who are looking to medicate in a natural way do have options: high-CBD, naturally grown cannabis like the ones found in our Medicate category. In particular, ACDC may be a great strain for patients with arthritis that want more medicinal effects and less psychoactivity. ACDC is known to have a whopping 20% CBD, with only 1% THC.
The experts at WoahStork have never seen a strain with such a high CBD/THC ratio.
Fortunately, as more and more research on cannabis-based medicine is being conducted, doctors and patients are starting to open up to what was only once considered an alternative treatment option. As of July 2014, 23 states and the District of Columbia allow for legal cannabis use for medicinal purposes. (Ref. 10) With 20% of U.S adults affected by arthritis, providing a source of relief with little to no side effects is of insurmountable importance! Arthritis is still an incurable illness. When asking the question “can cannabis treat arthritis?”, remember that while the research is still in progress, cannabis serves as a potent symptom alleviator that has far less side effects than the alternatives. We hope to one day edit the title of this article to be Can Cannabis treat arthritis? — Yes! Along with dozens of other diseases.
References for Can Cannabis Treat Arthritis:
(2) R Brenneisen, Chemistry and Analysis of Phytocannabinoids and Other Cannabis Constituents, Marijuana and the Cannabinoids, Chapter 2, Part of the series Forensic Science And Medicine pp 17-49. http://link.springer.com/chapter/10.1007%2F978-1-59259-947-9_2
(3) A Malfait, et al., The nonpsychoactive cannabis constituent cannabidiol is an oral anti-arthritic therapeutic in murine collagen-induced arthritis, PNAS August 15, 2000 vol. 97 no. 17 9561-9566. http://www.pnas.org/content/97/17/9561.short
(4) M Karsak, et al.., Cannabinoid receptor type 2 gene is associated with human osteoporosis, Hum Mol Genet. 2005 Nov 15;14(22):3389-96. Epub 2005 Oct 4. http://www.ncbi.nlm.nih.gov/pubmed/16204352
(5) D Blake, et al., Preliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis, Rheumatology (January 2006) 45 (1): 50-52. http://rheumatology.oxfordjournals.org/content/45/1/50.short
(6) E Russo, et al., Cannabis, Pain, and Sleep: Lessons from Therapeutic Clinical Trials of Sativex, a Cannabis-Based Medicine, Chemistry & Biodiversity, Volume 4, Issue 8, pages 1729–1743, August 2007. http://onlinelibrary.wiley.com/doi/10.1002/cbdv.200790150/abstract
(7) P Sumariwalla, et al., A novel synthetic, nonpsychoactive cannabinoid acid (HU-320) with antiinflammatory properties in murine collagen-induced arthritis, Arthritis & Rheumatism, Volume 50, Issue 3, pages 985–998, March 2004. http://onlinelibrary.wiley.com/doi/10.1002/art.20050/full
(8) S Wright, et al., The use of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis, Rheumatology (June 2006) 45 (6): 781. http://rheumatology.oxfordjournals.org/content/45/6/781.1.short#
(9) H Gui, et al., Expression of cannabinoid receptor 2 and its inhibitory effects on synovial fibroblasts in rheumatoid arthritis, Rheumatology (2014) 53 (5): 802-809. http://rheumatology.oxfordjournals.org/content/53/5/802
(10) Arthritis: A Note from Americans for Safe Access. http://www.safeaccessnow.org/arthritis_booklet
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