Each year, about 1,000 children are born with sickle cell anemia in the United States. Also referred to as sickle cell disease, the condition is genetic and disproportionately affects individuals of African heritage. In sickle cell anemia, normal red blood cells will morph into hard sticky cells that are abnormally shaped like the letter "s," resembling a farm tool called a sickle. As the short-lived sickle cells die, they can clog blood flow, leading to serious and sometimes fatal complications including stroke and infection. The only cure for sickle cell anemia is a risky bone marrow or stem cell transplant.
As pain is a symptom of sickle cell anemia, there is growing hope that cannabis could help individuals cope with this blood disorder.
A modest amount of research exists on medical marijuana and sickle cell disease, and there is a strong need for large-scale studies.
How widespread is cannabis use among people with sickle cell anemia? A 2018 study published in Cannabis and Cannabinoid Research by Mary Ann Liebert Inc. found that 42 percent of patients surveyed had used medical marijuana for their sickle cell disease in the past two years. The findings led to researchers recommending further studies and the formal recognition of sickle cell disease as an ailment treatable by medical marijuana: “Explicit inclusion of sickle cell disease as a qualifying condition for medical marijuana might reduce illicit marijuana use and related risks and costs to both persons living with sickle cell disease and society.”
Not all studies, however, have shown that cannabis is beneficial for sickle cell anemia; some have reported adverse effects. For example, a 2017 study published in the same journal noted that cannabis use was linked to the frequency of hospitalization due to vaso-occlusive crises, or the onset of severe pain, associated with sickle cell anemia. However, it is unclear if the link between cannabis use and hospitalization was direct, or if other factors were involved. Regardless, researchers working on this study advised that the findings should be clarified through more controlled studies.
But can cannabis offer potential pain-relieving benefits to individuals with sickle cell disease? A clinical trial at the University of California, San Francisco (UCSF) is seeking to answer this question by testing the effects of vaporized cannabis on chronic pain linked to sickle cell disease. With the recruitment of participants completed in 2018, results should be available for analysis within the next two years.
Further, while it may remain unclear whether cannabis can treat pain specific to sickle cell anemia, medical marijuana is known to aid many people enduring pain from other conditions, such as fibromyalgia.
More clinical trials similar to the one in progress at UCSF will elucidate where cannabis might fit in on the spectrum of pain management for sickle cell anemia. In addition, cannabis may be able to assist in managing other symptoms of sickle cell disease, such as swelling of the hands and feet, as marijuana has shown in some cases to decrease inflammation.
It is challenging to quantify just how many people are using cannabis to treat sickle cell anemia. A Facebook group and nonprofit organization, Sickle Cell Warriors, lends a forum for firsthand accounts of the cannabis experience. SickleStrong Inc. is another Facebook page that connects people trying to remedy the blood disorder through natural methods including medical marijuana.
In fact, there are more informal social media blogs for sickle cell disease and cannabis than there are formal studies. The previously quoted 2018 study published in Cannabis and Cannabinoid Research was featured in Sickle Cell Anemia News in an article that discussed how common medical marijuana usage is among patients. Most patients, the article detailed, use medical marijuana to relieve a combination of symptoms, with pain at the top of the list. A significant majority of 79 percent of these individuals reported decreased usage of other pain medications while using cannabis. With the opioid crisis still in full effect, such revelations could prove lifesaving for patients.
What the Experts Say
Expert opinions diverge on whether cannabis is a safe and effective option for people with sickle cell anemia. But there seems to be consensus on one issue: African Americans, who bear the brunt of the disease, do not have adequate legal access to marijuana.
A 2019 article titled “African-Americans Missing Out on Southern Push for Legal Pot” was published on the Pew Charitable Trusts website and chronicles this struggle. Dr. Felicia Dawson, a board-certified physician from Georgia, has expressed concern that even with the legalization of marijuana in southern states, African Americans will still face a need for equitable opportunities to access the remedy. Dawson said, “Without that, it'll be more of the same. Legislators will keep people of color … from the benefits of cannabis.”
Pain and inflammation reduction are two of those benefits, but whether they outweigh the risks for individuals with sickle cell disease remains to be discovered.
The Bottom Line
Medical cannabis has been shown to be effective for pain as initial studies on its use for sickle cell anemia are promising, and more research will help elucidate the role of cannabis in treating this serious illness.