1. The Use of Cannabis and its Derivatives as an Alternative to Traditional Pain Relief Methods Matthew Matheny Spalding University

2. Pain and its subjective nature Pain relief is a major hurdle in the medical world. Pain is known to be very subjective from person to person, and can often vary significantly based on their condition and personality. Because of this, the options available to patients are wide and incorporate both pharmacological and non-pharmacological methods

3. Pharmacological methods The agents which are currently used span a variety of types, with the main purpose being to decrease the perception of the pain, either by masking the pain or decreasing a persons sensitivity. Unfortunately, many of these medications have been known to have major side effects, as well as addiction and overdosing being a possibility from long term medication usage. Because of this, a lot of patients are looking for new alternative methods of pharmacological pain management that minimize side effects

4. What is Cannabis? Cannabis is a plant that grows naturally and has served a variety of purposes for many cultures It has been documented for its medical applications, as well as its recreational uses throughout history Currently in the US, Cannabis has been illegal in all states until a few years ago, when it began to be decriminalized in many states throughout the country Now it is legal to own and use, both recreationally and medically, in several states

5. Cannabis Currently however, over half of the states in the US still do not allow any amount of cannabis usage, and possession is considered a criminal offense, with penalties ranging from state to state

6. Cannnabis history in the US Cannabis was first outlawed in 1937, and with the passage of the controlled substances act of 1970, was put into its schedule I classification. In the 90’s, multiple nursing associations began to put together resolutions asking for patient access to cannabis, followed by the American Nurses Association (ANA) in 2003 and the American Medical Association(AMA) in 2009. The stigma against cannabis use right now is a perpetuated myth, with people pointing to its addictive properties and risks, which, when compared to current pharmacological medications prescribed, are minimal at best.

7. Pain Management History Pain Management has been something that has been hard to understand and treat in the medical field, and because of this, it has been largely ignored in the medical field until more recently. Margo McCaffery, a pioneer nurse in pain management, gave the definition that “Pain is what the person says it is and exists whenever he or she says it does”, essentially stating that patient comfort should be the number one priority when treating pain in the individual. It is because of this approach to treating pain that I advocate for the use of cannabis as a pharmacological intervention for pain management

8. Research in cannabis effectiveness Palliative care has historically been a field that utilize innovative methods to manage pain and improve patient quality of life (QOL), which is the primary objective of pain management In palliative care for oncology patients, the side effects of chemotherapy and radiation are often difficult and hard to deal with. Cannabis has been approved in certain states as an antiemetic drug as well as an appetite stimulant in low to moderate doses, which are two of the biggest problems facing people going through chemo and radiation

9. Palliative Care Multiple Sclerosis (MS), has long been a candidate for cannabis therapy. Most of the studies done have demonstrated that while it may not help to reduce the progression of MS, a significant improvement in QOL has been noted. This disease being terminal, an increase in QOL for these patients is significant enough to warrant continued research As of now, the only cannabis derivative approved to treat MS is Sativex, which is given as a buccal spray for symptom relief

10. Palliative Care HIV-infect patients Cannabinoid receptors are a recent discovery in the medical field, and even more recently have been not only seen in the Central nervous system but in areas of the Peripheral nervous system as well In a study examining the effectiveness of cannabis on pain management and QOL, the group using cannabis reported increased pain relief, increased positive mood, and increased daily functioning. This shows that adding cannabis as a medical intervention in combination with other traditional methods can lead to an improved QOL for patients

11. Chronic Neuropathic Pain Chronic neuropathic pain, affects about 1-2% of the adult population and is often non-responsive to several of the traditional treatment options for pain management. Cannabinoid receptors are again part of the research into this field because they seem to play a crucial role in how pain is perceived and relayed in the body. During this study, 25mg of 9.4% THC was inhaled three times daily for five days, and was shown to reduced the intensity of the pain, improve sleep, and was tolerated with minimal side effects by the participants. A similar study was performed with Fibromyalgia, a specific type of neuropathic pain, and results were promising as it related to pain intensity and QOL for the participants.

12. Patient Centered Care Cannabis is a great and simple solution to helping patients who deal with chronic pain in their life. The simplicity of the drug, its cost effectiveness, and its quick reaction time make it optimal for easy access to people who often cannot afford other expensive alternatives. It can be grown by the person, allowing them to have control of their usage so that they can minimize the need for assistance in management of pain Additional research will need to be done, as research in this field is relatively new now that the proposition of cannabis as a medicine has been revitalized

13. Conclusion The benefits of adding cannabis to the medical field as a way to manage pain and increase QOL far outweigh any potential risks that we are currently aware of. Gives people another alternative to get the same type of relief they might be hesitant to rely on synthetic drugs for.

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