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Ask Dr. David

Ask Dr. David: Can Medical Cannabis Be Effective at Treating Pain?

April 20, 2018

Medical cannabis has been effectively used for pain relief for thousands of years. Today, one of the most common reasons people seek out medical cannabis is to relieve various pain syndromes.

The active ingredients in medical cannabis (i.e., cannabinoids) relieve pain in many ways. In the short-term, cannabinoids can directly reduce pain through stimulation of endocannabinoid receptors. They can also bring about a long-term reduction of inflammation through their interactions with naturally-occurring opioids and neurotransmitters. Furthermore, unlike steroids and other anti-inflammatory medications, medical cannabis is also less likely to have significant  or irreversible side effects.

The Limitations of Treating Chronic Pain with Medical Cannabis

Although Florida law allows patients with chronic pain to be treated with medical cannabis if several criteria are met, the wording of the law is confusing, and the State has provided little to no guidance on how to interpret this portion of the law.

Specifically, one of the enumerated conditions that qualify for medical cannabis is “chronic nonmalignant pain,” which the State defines as “pain that is caused by a qualifying medical condition or that originates from a qualifying medical condition and persists beyond the usual course of that qualifying medical condition.” (https://www.flsenate.gov/Session/Bill/2017A/8A/BillText/er/HTML). This wording is convoluted and unhelpful from a clinical perspective. There is rarely a specified amount of time considered the “usual course” for how long pain will last for a given qualifying condition. Furthermore, if the pain associated with the underlying condition is expected to persist for the remainder of the patient’s life, does this mean the person has to be dead before they can qualify under “chronic pain” diagnosis? For these reasons, I have been hesitant to use this diagnosis when qualifying a patient.

Our Approach to Treating Chronic Pain

At Wholistic ReLeaf, we take a different approach to evaluating patients who suffer from chronic pain.  Under Florida law, a patient may be certified for medical cannabis treatment if they suffer from a medical condition of “same kind or class as or comparable to” one of the conditions listed in the statute. This provides more clinically-useful guidance than the State’s definition of “chronic  non-malignant pain.” When we evaluate a patient who suffers from chronic pain, we start by first distinguishing the type of pain to determine if it is “of the same kind or class as or comparable to” those listed in the statute (e.g., Multiple Sclerosis, cancer, Crohn’s disease, etc.)

Consider, for example, muscular pain, which entails “achy” types of pain, also known as myopathic pain or myopathy. In contrast, neuropathic pain, also knowns as neuropathy, is experienced as more of a shooting, electrical, or numb kind of pain. Both of these types of pain are similar to that experienced by patients with Multiple Sclerosis (MS), which is one of the qualifying conditions specifically in the law. Similarly, chronic headaches are often common in patients with MS. Other examples include bone pain and/or phantom pain (pain perceived at the site of a missing limb), which are common complaints from people battling cancer. Chronic abdominal pain can be similar to that which is seen in Crohn’s disease.

Based on the types of pains commonly associated with the statute’s stated diagnoses, many people who suffer from long-term pain could qualify for medical cannabis at Wholistic ReLeaf. For a full list of the specific conditions authorized by the State, please visit our eligibility webpage.

If you experience chronic pain and would like to find out if medical cannabis might help, call (813) 603-4425 or email info@WholisticReLeaf.com to schedule an appointment with one of our Wholistic ReLeaf providers today. Learn more about how to get started at Wholistic ReLeaf by visiting our “Getting Started” page, found here.

About Wholistic ReLeaf

Wholistic ReLeaf, founded in 2016 by Dr. David Berger of Wholistic Pediatric and Family Care, empowers families and patients to choose the best treatment approach available for their medical condition. The mission of Wholistic ReLeaf is to evaluate and certify qualified patients who meet the State of Florida legal requirements for receiving medical cannabis, and provide medical cannabis management and dosing consultations to patients certified by other Florida physicians. Wholistic ReLeaf is committed to providing patients with the best possible care, while also complying with the ever-shifting legal landscape of medical cannabis in the State of Florida.

For more information, or to find out if you or a patient you know may be eligible to use medical cannabis as part of a customized treatment plan, visit www.WholisticReLeaf.com.

Dr. David Berger (“Dr. David”), a Board Certified Pediatrician with over 20 years of experience as a clinician, has developed a national reputation in wholistic pediatric primary care. Dr. David is considered Tampa Bay area’s leading authority on medical cannabis for adults and children, and is one of the nation’s most experienced pediatricians using medical cannabis to help facilitate the treatment of children with chronic conditions.

Dr. David graduated from The Medical College of Pennsylvania in 1994 and completed his pediatric residency at the University of South Florida/Tampa General Hospital where he first began utilizing wholistic therapies. Dr. David has been in private practice since 1997 and in 2005 opened Wholistic Pediatrics & Family Care, his medical practice in Tampa, Florida. In 2010, Dr. David was appointed Assistant Professor at the University of South Florida College of Nursing. In 2016, he launched Wholistic ReLeaf to help qualified patients become certified to use medical cannabis.