Fibromyalgia – Medical Marijuana Research Overview

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Fibromyalgia is a disorder characterized by intense musculoskeletal pain that affects 5 million Americans. Studies have shown marijuana effectively lowers pain levels and improves quality of sleep in patients.

Overview of Fibromyalgia

Fibromyalgia is a common disorder characterized by widespread pain and fatigue that primarily affects women. The disorder can greatly affect a person’s abilities to perform daily activities and causes sleep problems. According to Mayo Clinic, having fibromyalgia affects the way the brain processes pain signals and makes painful sensations feel amplified.

In addition to pain, fatigue and sleep problems, those with fibromyalgia may also experience cognitive and memory problems, headaches, morning stiffness, painful menstrual periods, numbness or tingling, restless legs syndrome, temperature to sensitivity, irritable bowel syndrome, and depression.

The causes of fibromyalgia remain unknown, but the National Institute of Arthritis and Musculoskeletal and Skin Diseases notes that many people associate their fibromyalgia to a physically or emotionally stressful or traumatic event. Repetitive injuries or illnesses are also commonly associated to fibromyalgia by patients. Others claim the disorder developed spontaneously.

There is no cure of fibromyalgia, so treatment focus is on controlling symptoms with pain relievers, antidepressants, exercise and therapy.

Findings: Effects of Cannabis on Fibromyalgia

The cannabinoids contained in cannabis have both analgesic and sleep-promoting effects to help fibromyalgia patients manage symptoms. Studies have found that cannabis is effective at improving sleep disruption, pain, depression, joint stiffness, anxiety, physical function and quality of life in individuals with fibromyalgia (de Souza Nascimento, et al., 2013) (Russo, 2004).

While fibromyalgia is known for causing intense and unrelenting musculoskeletal pain, cannabis has proven effective at offering fibromyalgia patients relief. Fibromyalgia patients treated with cannabis and assessed over a seven-month period experienced significant pain intensity improvements and were able to reduce their doses of opioids (Weber, et al., 2009). One study discovered that after four weeks of cannabis treatment, fibromyalgia patients experienced significantly less pain and anxiety whereas a placebo group saw no improvements (Skrabek, Galimova, Ethans & Perry, 2008). Another study reported significant reductions in pain and stiffness, an enhancement of relaxation and an increase in somnolence and feeling of well being in fibromyalgia patients two hours after they smoked or orally consumed cannabis (Fiz, et al., 2011).

Cannabis has also been found to be effective at improving sleep quality in patients with fibromyalgia (Ware, Fitzcharles, Joseph & Shir, 2010).

States That Have Approved Medical Marijuana for Fibromyalgia

Only the states of Arkansas, Illinois, North Dakota and Ohio have approved medical marijuana specifically for the treatment of fibromyalgia.

However, several states have approved medical marijuana specifically to treat “chronic pain,” a symptom commonly associated with fibromyalgia. These states include: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New Mexico, Ohio, Oregon, Pennsylvania, Rhode Island and Vermont. The states of Nevada, New Hampshire, North Dakota, Montana, Ohio and Vermont allow medical marijuana to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania and Washington have approved cannabis for the treatment of “intractable pain.”

Sixteen states have approved medical marijuana for the treatment of spasms. These states include: Arizona, Arkansas, California, Colorado, Delaware, Florida, Hawaii, Maryland, Michigan, Minnesota, Montana, Nevada, New Hampshire, Oregon, Rhode Island and Washington.

A number of other states will consider allowing medical marijuana to be used for the treatment of fibromyalgia with the recommendation by a physician. These states include: California (any debilitating illness where the medical use of marijuana has been recommended by a physician), Connecticut (other medical conditions may be approved by the Department of Consumer Protection), Massachusetts (other conditions as determined in writing by a qualifying patient’s physician), Nevada (other conditions subject to approval), Oregon (other conditions subject to approval), Rhode Island (other conditions subject to approval), and Washington (any “terminal or debilitating condition”).

In Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment.

Recent Studies on Cannabis’ Effect on Fibromyalgia
  • Fibromyalgia patients experienced significant reductions in pain and stiffness, an enhancement of relaxation, and an increase in somnolence and feeling of well being, two hours after smoking or orally consuming cannabis.
    Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life.
    (http://www.ncbi.nlm.nih.gov/pubmed/21533029)
  • Cannabis medication found effective at improving sleep quality and was well tolerated by fibromyalgia patients.
    The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial.
    (http://www.ncbi.nlm.nih.gov/pubmed/20007734)
References

Chiari malformation and syringomyelia. (n.d.). Mayo Clinic. Retrieved from http://www.mayoclinic.org/medical-professionals/clinical-updates/neurosciences/chiari-malformation-syringomyelia.

de Souza Nascimento, S., Desantana, J.M., Nampo, F.K., Ribeiro, E.A., da Silva, D.L., Araujo-Junior, J.X., da Silva Almeida, J.R., Bonjardim, L.R., de Souza Araujo, A.A., and Quintans-Junior, L.J. (2013). Eficacy and safety of medicinal plants or related natural products for fibromyalgia: a systematic review. Evidence-Based Complementary and Alternative Medicine, 2013. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23861696.

Fibromyalgia. (2014, February 20). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/fibromyalgia/basics/definition/con-20019243.

Fibromyalgia. (2014, July). National Institute of Arthritis and Musculoskeletal and Skin Diseases. Retrieved from http://www.niams.nih.gov/health_info/fibromyalgia/.

Fiz., J., Duran, M., Capella, D., Carbonell, J., and Farre, M. (2011, April). Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life. PLoS One, 6(4). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21533029.

Russo, E.B. (2004, February-April). Clinical endocannabinoid deficiency (CECD): can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions? Neuro Endocrinology Letters, 25(1-2), 31-9.

Skrabek, R.Q., Galimova, L., Ethans, K., and Perry. D. (2008, February). Nabilone for the treatment of pain in fibromyalgia. Journal of Pain, 9(2), 164-73.

Ware, M.A., Fitzcharles, M.A., Joseph, L., and Shir, Y. (2010, February 1). The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial. Anesthesia and Analgesia, 110(2), 604-10.

Weber, J., Schley, M., Casutt, M., Gerber, H., Schuepfer, G., Rukwied, R., Schleinzer, W., Ueberall, M., and Konrad, C. (2009). Tetrahydrocannabinol (Delta 9-THC) Treatment in Chronic Central Neuropathic Pain and Fibromyalgia Patients: Results of a Multicenter Survey. Anesthesiology Research and Practice, 2009. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20798872.

Wissel, J., Haydn, T., Muller, J., Brenneis, C., Berger, T., Poewe, W., and Schelosky, L.D. (2006, October). Low dose treatment with the synthetic cannabinoid Nabilone significantly reduces spasticity-related pain: a double-blind placebo-controlled cross-over trial. Journal of Neurology, 253(10), 1337-41.

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