The following information is presented for educational purposes only.
Medical Marijuana Inc. provides this information to provide an understanding
of the potential applications of cannabidiol. Links to third party websites
do not constitute an endorsement of these organizations by Medical Marijuana
Inc. and none should be inferred.
Neuropathy is the damage to the sensory, motor or automatic nerves that
occurs from an underlying cause. Studies have shown cannabis is effective at
significantly reducing neuropathic pain.
Overview of Neuropathy
Peripheral neuropathy, which is often simply referred to as neuropathy, is a
condition where nerves are damaged, causing weakness, numbness and pain.
Among the most common causes of neuropathy is diabetes mellitus, but the
condition can also be caused by infections, alcoholism, traumatic injuries,
autoimmune diseases, medications, infections, tumors, and inherited
The symptoms associated with neuropathy depend on what types of nerves are
damaged. Damage to sensory nerves, which receive sensation and damage, can
cause tingling and stabbing or burning pain. Damage to motor nerves, which
control how the muscles move, can cause muscle weakness and a lack of
coordination. If damage occurs in autonomic nerves, which control functions
like blood pressure, heart rate, digestion, and bladder processes, an
individual can experience heat intolerance, bowel and bladder problems,
digestive issues and changes in blood pressure. Neuropathy can also increase
the risk of infection and burns and other skin traumas because one may not
realize they’re injured or feel temperature changes and pain.
Neuropathy treatment focuses on managing the underlying condition that is
causing neuropathy and relieving symptoms. Medications are often used to
manage pain. Transcutaneous electrical nerve stimulation (TENS), plasma
exchange and intravenous immune globulin, and physical therapy can also help
Findings: Effects of Cannabis on Neuropathy
Cannabis has been shown to be highly effective at relieving neuropathic pain
(Jensen, Chen, Furnish & Wallace, 2015) (Baron, 2015) (McDonough, McKenna,
McCreary & Downer, 2014). Two major cannabinoids found in cannabis,
tetrahydrocannabinol (THC) and cannabidiol (CBD), activate the two main
cannabinoid receptors (CB1 and CB2) of the endocannabinoid system within the
body (Fine & Rosenfeld, 2014). These receptors regulate the release of
neurotransmitter and central nervous system immune cells to manage pain
levels (Woodhams, Sagar, Burston & Chapman, 2015).f
In numerous studies, cannabis has demonstrated the ability to significantly
lower pain levels in patients sufering from neuropathic that had previously
proven refractory to other treatments (Boychuck, Goddard, Mauro & Orellana,
2015). It’s been shown to specifically reduce neuropathic pain caused by
diabetes (Wallace, et al., 2015). Multiple sclerosis and central neuropathic
pain patients experienced pain relief with only mild to moderate adverse
effects while undergoing two years of THC and CBD treatment (Rog, Nurmikko &
Young, 2007). CBD was shown to significantly reduce neuropathic pain in
cancer patients without diminishing nervous system function or adversely
effecting chemotherapy effectiveness (Ward, et al., 2014). One study found
that in HIV-positive patients, 94% reported an improvement in muscle pain
and 90% reported an improvement in nerve pain after cannabis use (Woolridge,
et al., 2005). In another study, 12 of 15 chronic pain patients who smoke
herbal cannabis for therapeutic reasons reported an improvement in pain
(Ware, Gamsa, Persson & Fitzcharles, 2002).
Because of cannabis’ effectiveness at reducing pain, its use is prevalent
among the chronic pain population (Ware, et al., 2003). Luckily, studies
indicate that long-term cannabis use for managing pain is safe. After a year
of regular use, patients with chronic pain were found to be at no greater
risk of serious adverse effects than non-cannabis users (Ware, et al.,
States That Have Approved Medical Marijuana for Neuropathy
Currently, Arkansas, Montana, New
York and Pennsylvania have
approved medical marijuana for the treatment of neuropathy. In Washington
D.C., any condition can be approved for medical marijuana as long as a
DC-licensed physician recommends the treatment. In addition, a number of
other states will consider allowing medical marijuana to be used for the
treatment of neuropathy with the recommendation from 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”).
have approved medical marijuana specifically to treat “chronic pain,” a
symptom commonly associated with neuropathy. 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
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.”
Recent Studies on Cannabis’ Effect on Neuropathy
Using cannabis has been shown to significantly improve
neuropathic pain that had proven refractory to other treatments.The
effectiveness of cannabinoids in the management of chronic
nonmalignant neuropathic pain: a systematic review.(http://www.ncbi.nlm.nih.gov/pubmed/25635955)
Patients with multiple sclerosis or central neuropathic pain
receiving THC and CBD treatments for two years saw significant
reductions in pain, with only minor side effects.Oromucosal
delta9-tetrahydrocannabinol/cannabidiol for neuropathic pain
associated with multiple sclerosis: an uncontrolled, open-label,
2-year extension trial.(http://www.ncbi.nlm.nih.gov/pubmed/18035205)
Baron, E.P. (2015, June). Comprehensive Review of Medicinal Marijuana,
Cannabinoids, and Therapeutic Implications in Medicine and Headache: What a
Long Strange Trip It’s Been… Headache,
Boychuck, D.G., Goddard, G., Mauro, G., and Orellana, M.F. (2015 Winter).
The effectiveness of cannabinoids in the management of chronic nonmalignant
neuropathic pain: a systematic review. Journal
of Oral & Facial Pain and Headache, 29(1), 7-14.
Fine, P.G., and Rosenfeld, M.J. (2014, October). Cannabinoids for
neuropathic pain. Current
Pain and Headache Reports, 18(10), 451.
Jensen, B., Chen, J., Furnish, T., and Wallace, M. (2015, October). Medical
Marijuana and Chronic Pain: a Review of Basic Science and Clinical Evidence. Current
Pain and Headache Reports, 19(10),
McDonough, P., McKenna, J.P., McCreary, C., and Downer, E.J. (2014,
October). Neuropathic orofacial pain: cannabinoids as a therapeutic avenue. The
International Journal of Biochemistry & Cell Biology, 55, 72-8.
Peripheral neuropathy. (2014, December 2). Mayo
Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/basics/definition/con-20019948.
Rog, D.J., Nurmikko, T.J., and Young, C.A. (2007, September). Oromucosal
delta9-tetrahydrocannabinol/cannabidiol for neuropathic pain associated with
multiple sclerosis: an uncontrolled, open-label, 2-year extension trial. Clinical
Therapeutics, 29(9), 2068-79.
Wallace, M.S., Marcotte, T.D., Umlauf, A., Gouaux, B., and Atkinson, J.H.
(2015, July). Efficacy of Inhaled Cannabis on Painful Diabetic Neuropathy. Journal
of Pain, 16(7), 616-27.
Ward, S. J., McAllister, S. D., Kawamura, R., Murase, R., Neelakantan, H., &
Walker, E. A. (2014). Cannabidiol inhibits paclitaxel-induced neuropathic
pain through 5-HT1A receptors
without diminishing nervous system function or chemotherapy efficacy. British
Journal of Pharmacology, 171(3),
Ware, M.A., Gamsa, A., Persson, J., and Fitzcharles, M.A. (2002, Summer).
Cannabis for chronic pain: case series and implications for clinicians. Pain
Research & Management, 7(2), 95-9.
Ware, M.A., Wang, T., Shapiro, S., and Collet, J.P. (2015, September 15).
Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS). The
Journal of Pain. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/26385201.
Woodhams, S.G., Sagar, D.R., Burston, J.J., and Chapman, V. (2015). The role
of the endocannabinoid system in pain. Handbook
of Experimental Pharmacology, 227, 119-43.
Woolridge, E., Barton, S., Samuel, J., Osario, J., Dougherty, A., and
Holdcroft, A. (2005, April). Cannabis use in HIV for pain and other medical
of Pain and Symptom Management, 29(4), 358-67.
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