North Ridgeville resident Adrian Frederick said he’s had horrible leg pain for years, caused by a surgery he had involving cancer. The pain is constant, and gets worse at night.
“I’m just willing to try anything at this point,” Frederick said. “I’m just sick of being in pain all the time.”
Frederick is one of many chronic pain sufferers, in Ohio, who have tried everything to get relief – including taking prescription pain pills. One of the ripple effects of the opioid crisis is that laws now limit the number of prescriptions allowed, and some doctors and patients are looking for alternatives.
Frederick wants to use medical marijuana, but the former factory worker said he doesn’t want to wait until it’s available in Ohio. He plans to go to Michigan where medical marijuana dispensaries are already open.
So he went to Omni Medical Services, a company in Beachwood. Omni is not part of Ohio’s official medical marijuana program. The private company charged Frederick $200 for the doctor to examine his medical records. They also provided him with a letter and medical card he can use in other states to buy cannabis while Ohio gets its medical marijuana program up and running.
Medical marijuana is supposed to be operational in Ohio by September 8, but the state is still building the infrastructure such as marijuana grow sites and dispensaries.
When Ohio’s system is operational, the law will require patients to get a recommendation from a doctor, as well as a card obtained through the state’s website to participate in the program. Only people with certain conditions will qualify, such as Parkinson’s disease and Alzheimer’s, chronic pain, AIDS, cancer and several others.
Even though patients like Frederick are eager to use medical marijuana the medical community is still debating its potential usefulness.
“There is no consensus on whether or not it will help with chronic pain,” said Dr. Ted Parran, associate director of the addiction treatment program at St. Vincent Charity Medical Center.
“The efficacy of medical marijuana in chronic pain is unclear,” Dr. Parran said. “There are some poorly done studies which suggest that it might be useful.”
According to Dr. Parran, there have been no studies where medical marijuana has been tested against a placebo on patients, which doctors consider to be the gold standard of research. He said the marijuana plant has many components which may be useful.
Researchers have zeroed in on CBD, which many believe has the best chance to ease chronic pain. It can be separated from the part of cannabis called THC, which is what creates the feeling of euphoria or getting high.
“I don’t think many people are questioning whether CBD will be discovered to be useful in some things, chronic pain likely, but the research is not in yet on the dose, how much is toxic, and what’s the right dose for which condition,” Parran said.
Dr. Daniel Clauw, a medical marijuana researcher at the University of Michigan, said it has been difficult to research the correct dose of medical cannabis to treat pain because it’s still illegal at the federal level which has created barriers to research. Clauw also said that doctors by and large have received no training on medical cannabis, and it’s still perceived as a street drug. Because of this, the bias against it continues even in states where it is legal, he said.
“Every U.S. physician should be more OK with a patient using cannabis to treat their pain than they are using an opioid to treat chronic pain, Dr. Clauw said. “And a lot of U.S. physicians are still ok to prescribe opioids but cannabis is this evil weed like the reefer madness movie that was made in the 1930’s.”
Dr. Clauw said medical cannabis should only be used for pain management after patients have tried all other legitimate therapies. Then they should start with a low dose of CBD before gradually increasing the strength.
Meanwhile, as Ohio moves toward implementing medical cannabis, the medical debate continues. For example, the National Academies of Sciences, Engineering, and Medicine released a report last year which reviewed thousands of scientific documents published since 1999 on the health impacts of cannabis. The committee found evidence that patients who were treated with cannabis or cannabinoid mixtures such as CBD and THC were more likely to experience a significant reduction in pain symptoms.
There are other national studies, however, that are not as supportive of cannabis for pain relief. A U.S. Veterans Affairs Dept. report released last year found weak evidence that cannabis with a mix of THC and CBD has the potential to improve some pain from nerve damage but insufficient evidence it improves other kinds of pain.