CANNABIS-MEDICINE PIONEER TELLS PHYSICIANS: LISTEN TO PATIENTS ABOUT PAIN.

Just listen to your patient, he is telling you the diagnosis.” Canadian physician Sir William Osler (1849 – 1919)

Neurologist and cannabis-medicine pioneer Ethan Russo knows a thing or two about cannabis medicine, especially for the treatment of pain.

His recent editorial in Pain Medicine (Sept. 2019) covers a lot of ground and draws on the research and opinions of medical experts on pain and addiction as well as his own decades-long experience.

The evidence that cannabis works for pain is “so extensive,” says Dr. Russo.

It is also robust enough to get a rare endorsement (for cannabis) by the National Academies of Sciences, Engineering and Medicine.

VIRTUALLY ZERO RISK OF ADDICTION WHEN USED A MEDICINE

“The benefit of cannabis in pain management is most apparent in patients with chronic conditions,” says Russo.

He says cannabis holds almost zero risk of addiction when it is used as medicine.

SCIENTIFIC EVIDENCE

That cannabis works for chronic pain is a fact proved by scientific research and multiple studies.

The part of the brain that rules the perception of pain is rich in cannabinoid receptors, says Russo.

It’s the anecdotal evidence from patients and their caregivers, though, that seems to be the most compelling for the renowned neurologist.

ANECDOTAL EVIDENCE FROM PATIENTS AND CAREGIVERS

Russo says: “The patient experience is of paramount importance.”

Physicians must listen to what their patients are telling them,” he says, and they need to accept that millions of people are using cannabis for pain, “whether anyone likes it or not.”

“This is not a matter of collective delusion, nor some conspiratorial smokescreen,” he says.

Russo points to a study of 19 people with chronic pain.

Most expressed a “sigh of relief” after taking cannabis medicine, it says.

MEASURED DOSES

In the therapeutic setting, Dr. Russo prefers that cannabis extracts be taken orally or in spray form.

This allows for “measured doses,” he says, “which are more easily titrated to achieve pain control without untoward effects.”

More information about dosing is available in Practical considerations in medical cannabis administration and dosing, a paper Russo co-authored with Canadian internist Caroline MacCallum. (Dr. MacCallum has the first “real-world” evidence showing the therapeutic benefit of cannabis in depression and anxiety.)