Lancaster Physician Winter 2018 - 15

winter 2018

Medical Marijuana

P

atients with chronic pain often face
limited options when seeking pain
relief. The opioid crisis in PA has led
to greater scrutiny surrounding the
prescribing of opiates, and the Commonwealth
has begun to address the opiate misuse problem. Pennsylvania will receive $26.5 million
in a federal grant to combat opioid abuse
and ensure that opioids remain available as a
treatment option. However, another type of
pain relief medication has become the de facto
treatment for many patients: non-steroidal
anti-inflammatory medication (NSAID).
Although many people consider NSAIDs
relatively low-risk medications, a study by
the American Journal of Medicine found that
annually about 107,000 Americans are hospitalized for gastrointestinal (GI) complications
due to NSAID use.
An estimated 16,500 arthritis patients die
each year from NSAID related complications.
Recent data surrounding heart disease and
NSAID usage has led the FDA to require labeling for all NSAID medications. This includes
those sold over the counter in order to warn
patients of the potential cardiac risks. Several
studies have produced results demonstrating
that cannabinoids-the chemical compounds
found in medical marijuana-reduce pain and
are approximately 20 times more potent than
aspirin as an anti-inflammatory. Additionally,
the National Academics of Sciences, Engineering, and Medicine analyzed more than 10,000
studies on medical marijuana and found that
short-term use of medical cannabis brought
significant pain relief to patients, including
those suffering from muscle spasms caused
by multiple sclerosis.
Medical marijuana offers patients relief from
debilitating pain with minimal risk, particularly
when using strains low in THC-the main
mind-altering chemical found in marijuana. Additionally, cannabis poses no risk of
respiratory depression due to the paucity of
cannabinoid receptors on the brain stem. Many
patients use this medication with little or no
psychoactive effects, making this a viable option
for the treatment of chronic pain, muscle
spasms, and inflammation. In 2017, Governor
Tom Wolf and state legislatures enacted one
of the most comprehensive medical marijuana
programs in the nation. Medical cannabis has

been approved to treat 17 medical conditions
in patients of all ages. Chronic pain has been
included on the list of approved ailments. This
is an important step that may help reduce the
chronic use of NSAID.

Recent
publications
have suggested
that medical
marijuana
will decrease
the misuse of
opiates.
Recent publications have suggested that
medical marijuana will decrease the misuse
of opiates. PA has made every effort to implement stringent requirements to ensure safety
surrounding the production, sale, and use of
medical marijuana. It will only be available in
the form of pills, oils, topical creams, tincture,
and liquid, and, must meet the FDA regulations. Other forms such as vaporization and
nebulization will only be used when deemed
medically appropriate. Dry leaf or plant forms
commonly used for recreational use will not
be permitted for sale in PA. If an individual is
interested in obtaining medical marijuana from
an approved dispensary, he or she will need a
certification from a qualified physician confirming one or more of the approved medical
conditions. The patient will need to register
with the state and purchase a valid ID card.

LANCASTER

15

PHYSICIAN

For over 12,000 years, the cannabis plant
has provided humankind with food, fiber,
inebriation, and medicine. Cannabinoids
interact with the protein receptors of the body's
endocannabinoid system, located throughout
the body. Different varieties of cannabis
express different psychoactive trajectories.
Understanding the chemical ecology produced
within cannabis and how the body interacts
with that chemistry enables consumers to use
cannabis predictably and effectively.
The state has granted licenses for both
growers and dispensaries and is in the final
stages of providing certification to physicians,
distributing identification cards to qualified
patients, and having dispensaries built. Around
this time next year, Pennsylvania will be able
to offer patients a safe and effective form of
pain management. This treatment option will
hopefully reduce the number of complications
and deaths associated with the misuse and abuse
of both opioids and NSAIDs. Pennsylvania
residents should not have to sacrifice their
health in order to find relief from pain.



Table of Contents for the Digital Edition of Lancaster Physician Winter 2018

Lancaster Physician Winter 2018 - 1
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https://www.nxtbook.com/hoffmann/Lancaster_Physician/Fall2017
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