cbd for phantom pain

In January 2016, days after medical marijuana became legal in the District of Columbia, my primary care physician advised me that he was enrolling me in the program, because he was tired of seeing me suffer. “The worst that’ll happen is you’ll get the munchies,” he laughed. “There’s anecdotal evidence that this can help. You’ve failed everything else, and cannabis can’t hurt; no one’s ever died from a cannabis overdose. It’s medicine, Meredith. Use it.”

An Ancient Cure: A Modern Option?

Medical cannabis use is not like recreational consumption. Yes, I medicate with cannabis all day, every day. But I am rarely “high.” I take small amounts every few hours for pain control. Two years in, I take 70 percent fewer opiates than in 2016. I may never fully get off narcotics, but such a dramatic decrease has reduced their side effects.

There are several treatment options for phantom pain, including gabapentin (what I call the “workhorse” of my pain regimen), Lyrica, mirror therapy, cognitive-behavioral therapy, NSAIDs, biofeedback, hypnotism, acupuncture, surgery, and even ketamine infusions, but they all failed, adding to my despair.

Phantom pain results from psychogenic and physiological (mental and physical) activity and post-amputation changes in the residual limb and the brain. The prevalence of phantom pain in the first two years post-amputation is 65-80 percent; however, severe, chronic phantom pain past the second or third year affects only 5-10 percent of amputees.

So, Do I Get High All Day?

Cannabis is now medically or recreationally legal in 29 states and the District of Columbia. Ninety-one percent of Americans support legalizing medical marijuana, and 58 percent support legalizing recreational cannabis nationwide, even though cannabis remains federally illegal.

See also  cbd legislation 2021

A Foot No Longer There, a Pain That Never Leaves

Neuropathic pain is difficult to treat effectively, with only a minority of people experiencing a clinically relevant benefit from any one intervention (Kalso 2013; Moore 2013b). A multidisciplinary approach is now advocated, combining pharmacological interventions with physical or cognitive (or both) interventions. The evidence for interventional management is very weak, or non‐existent (Dworkin 2013). Conventional analgesics such as paracetamol and nonsteroidal anti‐inflammatory drugs (NSAIDs) are not thought to be effective, but without evidence to support or refute that view (Moore 2015a). Some people may derive some benefit from a topical lidocaine patch or low‐concentration topical capsaicin, although evidence about benefits is uncertain (Derry 2012; Derry 2014). High‐concentration topical capsaicin may benefit some people with PHN (Derry 2017). Treatment is often by so‐called pain modulators such as antidepressants (duloxetine and amitriptyline; Lunn 2014; Moore 2017; Moore 2015b; Sultan 2008), or antiepileptics (gabapentin or pregabalin; Moore 2009; Moore 2014b; Wiffen 2013). Evidence for efficacy of opioids is unconvincing (Gaskell 2016; Sommer 2015; Stannard 2016).

See also Appendix 3: GRADE: criteria for assigning grade of evidence.

Why it is important to do this review

some (‐ 1) or major (‐ 2) uncertainty about directness;

Subgroup analysis and investigation of heterogeneity

Withdrawals due to adverse events (tolerability);