For nearly a decade, I’ve been working with my healthcare team to find an effective management strategy for my rheumatoid arthritis (RA). My team includes a rheumatologist, a pain management specialist and, soon, a pain doctor specially licensed to prescribe medical marijuana, which recently became legal in Pennsylvania where I live.
Medical marijuana (and CBD products, which I’ve also tried) hasn’t been studied for the treatment of arthritis or other chronic conditions because it is classified by the U.S. Food and Drug Administration as a Schedule 1 drug. It can’t legally be studied with the same rigor as is required of FDA approved medications, which take years to come to market as they are studied in carefully designed studies to test their safety and effectiveness to treat specific symptoms or cure a disease.
However, that hasn’t stopped many people in the arthritis community, including me, from trying medical marijuana.
In fact, CreakyJoints, the digital patient organization for people with all forms of arthritis, recently presented new survey results at a major medical meeting finding that more than half of the arthritis community has tried medical marijuana or CBD products and nearly 90 percent of participants reported perceiving benefit. Clearly, there is an appetite and need for new treatment options.
I tried medical marijuana (in addition to my medications) at the suggestion of friends, family and peers in the arthritis community because they knew that my prescribed RA medications were not adequately addressing my symptoms. For nine years, I sequentially tried different complex biologic medicines, which are designed to reduce inflammation and prevent long term joint damage. Everyone responds to these medicines differently and despite best efforts, my pain was always with me and it’s impacted by ability to work and participate in other activities that I enjoy.
My doctors didn’t have a lot of advice to offer me about trying medical marijuana. There simply isn’t good evidence to reference. Therefore, my most recent vacation in the summer of 2018 was to Amsterdam so that I could try different strains of medical marijuana in the easily accessible legal dispensaries. After some trial and error, it was a revelation to find a strain that provided relief from pain without side effects related to feeling high or tired. I returned home hopeful, but without relief because securing a prescription to medical marijuana with my diagnosis and in my state requires a significant amount of paperwork. Nearly a year later, I hope to have my medical marijuana ID card this summer, which will allow me to finally get a prescription.
Thanks to state-specific legislation, medical marijuana is becoming increasingly available depending on where you live in the United States. CBD products are even more widely available thanks to a change in the federal 2018 Farm Bill. I’m thankful that Pennsylvania has created a path to help me access this treatment, but I also want to know more. Medical marijuana and CBD products ought to be studied so that we can truly call them medicine rather than supplements. It’s time for marijuana to be rescheduled and then for the FDA to approve studies that help us understand how it ought to be dosed and administered, safely, and in combination with prescribed and over-the-counter medicines. Important to patients is the added bonus that FDA approvals might also lead to insurance coverage of these products. It is expensive for me to secure a medical marijuana ID card, see a physician and then pay out of pocket monthly for my prescription.
The CreakyJoints survey also revealed that one-third of participants did not talk to their health care provider about trying these products. That reluctance is understandable, given that these products fall into a gray area of legal vs. illegal. Random drug tests and a misunderstanding of what a person may or may not be taking could have significant consequences. I’m lucky that my healthcare team is becoming more supportive of my integrating this product into my arthritis management strategy. I want it to be part of my electronic health record and taken into account as my treatments inevitably change over time. I will continue to advocate for more understanding of these products so that people with chronic diseases, like arthritis, can make informed decisions about trying them.