A few years ago we talked about ways that you can use CBD (cannabidiol) as part of your treatment plan for Fibromyalgia ( and other chronic pain disorders). In today’s article, we’re going to look at ways that some people decide to use Cannabis (THC) either with or in the place of CBD in their Fibromyalgia treatment.
There are a few reasons I’ve expanded on my original article on CBD. For one, I have found that the entourage effect from the combination of THC and CBD is a powerful preventative option for me. However, cannabis is becoming a viable treatment option for more and more as states across the country turn to legalization. This is a change that has been a long time coming, but it’s one I welcome. I have found cannabis to be a fantastic treatment option. It helps not only with Fibromyalgia but also with my ADHD and the symptoms that I experience because of PTSD.
In this post, we’ll look at the reasons people choose to use cannabis to treat chronic pain disorders, the different ways that you can incorporate cannabis into your daily routine, and different things that you should be mindful of when considering the use of cannabis for pain management.
However, it is important to note that nothing in this article should be seen as medical advice. Everyone is an individual and has a complex medical makeup. So it is incredibly important to discuss changing your treatment plan with a medical professional who knows you and your unique body/conditions. Never change your treatment plan without carefully discussing it with your doctor first.
There are many reasons an individual may choose to use cannabis to treat things like chronic pain or anxiety. For many, cannabis offers an option that provides relief without all the side effects that can come from many prescription medications that are considered a first-line treatment for the conditions that cause chronic pain.
Anyone who’s been to a pain management clinic can tell you just how debilitating it can be to start an opioid prescription. The side effects are not fun, and the stress that comes with being a “pain patient” can certainly add to things.
For some, cannabis can be a great medication to add in addition to those you are already taking. Of course, it is important to discuss this carefully with your doctor or pharmacist, as serious (and sometimes life-threatening) interactions can occur with some medications.
CBD (and cannabis in edible form) is processed through a certain liver enzyme that is also used in the metabolism of many other medications. Having these receptors stopped up as they process THC or CBD can cause more of our other medications to build up in our bloodstream, which can cause negative effects even with what we consider a safe dose.
Those who experience pain as a side effect of mental struggles, such as a symptom of anxiety or a trauma response, often find cannabis to be a fantastic treatment option. Not only is it often helpful in staving off the pain, but it’s also a great way to calm down and let go of the stress before it builds up into pain.
What form of Cannabis is Best for Me?
There are many ways you can consume cannabis these days. Of course, the traditional flower is available at dispensaries across the country. In addition, one can often find things like distillate vapes, edibles, tinctures, or even capsules. Briefly, we’ll go over a few of the pros and cons of each form of cannabis.
- Flower: This is the part of the cannabis plant that is often smoked. There are many strains of flower that have a unique profile of terpenes that can be helpful for different symptoms that you are experiencing. We’ll go over terpenes in another post, but Leafly is always a great resource for learning more about what terpenes would be best for your particular needs. A dry herb vaporizer can be used to inhale flower without the combustion of traditional smoking.
- Edibles: There is a world of cannabis edibles available to medical marijuana patients these days. More popular ones include gummies, hard candies, baked goods, and even things like cooking oil or sodas. It’s important to pay attention to dosing on cannabis edibles and go slow if you are new to using them. They can take a little longer to work but will generally provide a longer, stronger effect than smoking flower.
- Concentrates: I am using this heading to talk about two forms of THC here which are “dabs” and distillate vapes. There are many forms of THC concentrates, including wax, budder, and others that contain high levels of concentrated THC. The distillate vape is somewhat similar as it has concentrated THC, but the vape is a much more portable and user-friendly version of this. This is generally not going to be a good option if you are just starting with using cannabis, but it can be a good option if you’re looking for high levels of THC.
- Tinctures: A tincture is a form of cannabis that is held in an alcohol or oil suspension to be absorbed sublingually under the tongue. It is very similar to CBD oil in how it enters the bloodstream. This is the form of cannabis that I commonly use, as I find it easier to use for micro-dosing, and I can use a tincture that is half THC and half CBD.
- Capsules: A capsule can be a great option if you aren’t a fan of the taste of cannabis. Many will fill a capsule with things like a tincture, FECO (full extract cannabis oil), or even RSO (Rick Simpson Oil ). They are a great way to manage your dose carefully and ensure that you are getting the same amount of cannabis or CBD each day, which is important when you are using it medically.
- Suppositories: Much like capsules, the suppository is a condensed form of cannabis that can be taken rectally. This is a great option for those who deal with severe nausea and find it difficult to ingest cannabis orally.
Of course, smoking anything isn’t a great option in the long run. Although it is not believed to contribute to lung cancer in the same way that tobacco does, there is some information pointing to cannabis smoke causing or contributing to respiratory conditions like COPD.
Ultimately, the type of cannabis that you use should be based on your needs, your abilities, and the form that you are comfortable using. For many, things like edibles and tinctures are a great way to go because they offer relief without all the smell and added cleanup needed with other forms. However, these forms do have the downside of taking a little longer to metabolize through the system and start working.
What is Micro-dosing?
Micro-dosing can be a great way to get the benefits of cannabis (and CBD) without having many of the psychological or physiological side effects that can often come with many strains in “normal” doses. An average 1-gram joint contains about 60 to 150 mg of THC, whereas a microdose is anywhere from 5 to 10mg of THC and/or CBD. This can be a great option if you’re using cannabis but still need to remain fully alert, or if you experience severe side effects such as anxiety, paranoia, or even physical things like palpitations with cannabis use.
There are several fantastic resources out there for finding the optimal microdose for your particular needs. This number will be a little different for everyone and, just like with CBD, there is an aspect of trial and error that you will need to go through to find the optimal dose for you.
In my case, a microdose is about 5 to 8 mg of a tincture that is half THC and half CBD. At first, I thought that there was no way that this minimal amount could do anything to help. However, after giving this dose a good trial period, I found it was working wonderfully as a preventative for my fibromyalgia and chronic migraines. It also helps to lower my anxiety and ADHD symptoms throughout the day by lowering my stress levels and helping me to be more mindful of the way I go about my day.
Indica or Sativa?
One of the first obstacles many come across when they are new to cannabis is figuring out whether they should use an Indica strain or a Sativa strain. Of course, a hybrid strain that is a mixture of the two can be a fantastic option as well! As it turns out, it’s a lot more complicated than just choosing India or Sativa. Ultimately, you want to look at the terpenes in a particular strain to find one that is good for your needs. That said, choosing an Indica or Sativa can be a good place to start narrowing things down.
The most important thing to consider when deciding whether to try an Indica or a Sativa is the condition you are trying to treat. Indica strains have a calming “couch-lock” effect that can be more of a body feeling than a head feeling. These strains can be great for things like pain, muscle tension, and spasticity. Sativa strains will give you more of a head high. These strains often cause an individual to feel mentally aroused and ready to take on the world. Unfortunately, they can also cause issues for those with anxiety and certain mental illnesses.
One way that some medical users approach things is to use a Sativa strain for daytime use and an Indica strain for nighttime use. The alertness, creativity, and increased energy that can come from a Sativa strain can be great for helping you get through the day. On the other hand, the relaxation and pain relief achieved with an Indica strain are wonderful for a good night’s sleep.
What is the Entourage Effect?
The entourage effect is the combined power of all the parts of the cannabis plant working in union to better benefit your body as a whole. This can refer to the various terpenes in a strain (or combination of different strains). It can also refer to the combination of different parts of the cannabis plant, such as THC, CBD, and even compounds, such as CBN or CBG.
Although the actual mechanism of the entourage effect is somewhat disputed, many anecdotally have found that the combination of CBD and THC or the perfect blend of terpenes can have fantastic results in the management of various pain and anxiety-causing conditions. Unfortunately, the fact that marijuana is still considered a schedule 1 drug has made it hard to get any definitive proof one way or another on this idea. However, as the country moves ever closer to full legalization, perhaps one day we will have real answers to these questions.
Personally (and anecdotally, of course) I find benefits from the combination of THC and CBD. For one, because of my extreme anxiety issues and heart condition, I find that the addition of CBD helps to minimize the negative side effects of THC. However, I also see an increase in the preventative capabilities of cannabis when I regularly use something with both CBD and THC.
Limitations of Cannabis
I have found cannabis to be incredibly helpful as a preventative treatment for my pain and anxiety-related symptoms. However, it is no cure for these conditions. When I have to stop my cannabis use for a period of time, my symptoms always return within a few weeks to a month.
I also feel that cannabis is not the best option for me to treat breakthrough pain or acute symptoms of my conditions. Put simply, the dose I take will not stop a migraine or pain flare once it has started. However, when used regularly, it does help me go from 13 to 15 bad pain days a month down to an average of about three pain flare days a month. Some may find acute pain relief from higher doses, but again, this takes some trial and error.
Who Shouldn’t Use Cannabis?
Overall, cannabis is a relatively safe substance. There have been no reported cases of overdose deaths from cannabis alone. However, it can contribute to unsafe conditions when combined with other drugs and even some prescription medication. Some medical conditions may predispose one to have a difficult time with cannabis use as well.
Those who take medications that work as a central nervous system depressant may want to limit cannabis use. Similar to alcohol, cannabis can have a synergistic effect combining with CNS depressant medications to cause issues such as slowed breathing, slowed heart rate, and even loss of consciousness.
As mentioned above, it is important to at least space out the dosing of THC/CBD and other medications by at least 2-3 hours if you are using a form that is metabolized through the liver.
This is because we metabolize THC and CBD with the cytochrome P540 enzyme. This enzyme handles the metabolism of many other drugs and substances (especially those that have an interaction with grapefruit juice). There are many interaction lists online, but it is best to discuss with your doctor if you don’t know whether your medications are processed through the Cytochrome P540 enzyme.
Some medical conditions may cause issues with cannabis use as well. For example, if you’re living with a respiratory disorder such as COPD, then smoking anything probably isn’t in your best interest. However, if you’re living with things like liver damage, then anything that metabolizes through the digestive tract may not be a good option for you.
I’ve said it a few times in this article, but it is so important to discuss with your doctor if you’re thinking of adding cannabis into your treatment arsenal for chronic conditions like fibromyalgia. While it can be a wonderful tool in helping with pain and anxiety, it is not a one size fits all treatment. You and your doctor are the only ones who truly understand your condition and who can give advice based on your individual needs.
Do you use cannabis to help with a chronic pain condition like fibromyalgia or chronic migraines? What strains have you found most helpful for your condition? Leave us a comment and let us know how you incorporate cannabis into your day! We love to hear how our readers are finding innovative ways to not let their chronic illness dictate their lives!