Cannabis could be a treatment option for fibromyalgia, one of the most common chronic pain conditions in the world, according to a new Israeli study.
Characterized by widespread musculoskeletal aching, fatigue, poor sleep quality, and cognitive difficulties, fibromyalgia has no specific causes and no known cure, but a prospective observational study, “Safety and Efficacy of Medical Cannabis in Fibromyalgia,” has given fibromyalgia patients some hope. The researchers found significant improvement in pain intensity and fibromyalgia‐related symptoms among patients after six months of medical cannabis therapy.
“It's commonly accepted that chronic pain can be treated with cannabis, but there has been less evidence to support the role it plays in specifically treating fibromyalgia,” said Lihi Bar-Lev Schleider, one of the lead authors on the study and head research scientist at the Tikun Olam research department in Tel Aviv, Israel, where it was conducted.
“Our data indicates that medical cannabis could be a promising therapeutic option for the treatment of fibromyalgia, especially for those who failed on standard pharmacological therapies. We show that medical cannabis is effective and safe when titrated slowly and gradually,” concluded the study, published in June 2019 in the Journal of Clinical Medicine.
Cannabis as a Promising Option
Dr. Iftach Sagy, co-author and researcher at Soroka's Clinical Research Center, explained that the study found significant improvement in pain intensity, fibromyalgia-related symptoms and overall quality of life after patients received six months of medical cannabis.
“To the best of our knowledge, this is the first and largest trial to use herbal cannabis in fibromyalgia patients,” Sagy said. Nearly 80% of the study participants were female, a proportion that corresponds to the general population of fibromyalgia sufferers.
Fibromyalgia affects an estimated 10 million people in the U.S. and an estimated 3% to 6% of the world population. The National Fibromyalgia Association (NFA) calculates that 75% to 90% of patients are women.
The study, which involved 367 fibromyalgia patients, found:
- 81.1% reported overall treatment success;
- 73.4% reported improved sleep;
- 80.8% reported improved depression‐related symptoms;
- 61.9% reported improved "quality of life" components including appetite and sexual activity.
“We also witnessed an improvement in depression‐related symptoms, sleep problems, improvement in appetite and sexual activity,” Bar-Lev Schleider said.
Patients in the study were treated with science-backed varietals developed by Tikun Olam, Israel's largest cannabis producer and research organization.
Cannabis: No Significant or Negative Side Effects
Eighty-one percent of the participants reported moderate improvement with no adverse side effects.
“The implications of these findings for fibromyalgia patients are that they may now have an additional treatment option,” Bar-Lev Schleider told Weedmaps News. “The study adds a piece of information on safety and efficacy of medical cannabis to treat their symptoms.”
Bar-Lev Schleider noted that 59.7% of the participants were taking opioids for pain at the beginning of the study. A follow-up survey of participants after six months found that 22% stopped or reduced their opioid and benzodiazepine usage.
“There are patients who have or will in the future stop taking pharmaceutical drugs and their sole treatment will be medicinal cannabis,” Bar-Lev Schleider said.
Few Effective Treatments Available
Fibromyalgia sufferers are generally limited to a combination of pain medications, antidepressants, and sleep aids. Commonly used first-line medication brands such as Cymbalta and Lyrica tend to provide insufficient relief from fibromyalgia symptoms. Patients often complain of side effects associated with these medications.
Medical marijuana has been the subject of other studies on treatments for fibromyalgia. In a 2018 retrospective review study, co-author Dr. George Habib also found medical cannabis was an effective alternative treatment for fibromyalgia.
“In general, the impression [from the study] was that this type of [cannabis] medication is more effective than pregabalin and duloxetine,” said Habib, a rheumatologist in Netanya, Israel. The former drug is prescribed to treat nerve and muscle pain, the latter depression.
In addition to prescription drugs, the NFA also recommends lifestyle adaptation involving exercise, diet, physical therapy, and psychological support.
Patients as Doctors
“That's what I did. I researched cannabis for two years,” said Tonya Sanders of Dennison, Ohio, who has suffered from fibromyalgia and lupus for most of her adult life. “Only one doctor out of dozens I'd been seeing mentioned it once for two seconds then swept it under the rug,” she said.
Sanders, a mother of two daughters, had to leave her nursing job because of her illnesses.
“My pain was so bad, I couldn't even stand the feel of clothing on my body. Prescription medications were ruining my life as much as my illnesses were,” she said. “At first I tried CBD oil in a dropper but needed something more. It was the full entourage effect that finally helped. The first time I smoked cannabis and my horrific symptoms faded, I took off my last fentanyl patch.”
It took six to eight weeks to fully withdraw from all pharmaceutical medications, she added. “I'm in full remission from lupus and have no fibromyalgia pain or symptoms now,” said Sanders, who volunteers with the Green Nurse Group, a no-profit organization comprising professionals and nurses who educate the public on the safe use of medical cannabis in states where it is legal.
Sanders also is involved with the International Women's Cannabis Coalition.
“I'm finally able to live my life, function as a nurse, a mom, and a wife. All things I couldn't do for all those years until I started using cannabis to treat my illnesses,” Sanders said. “Now I am trying to educate people.”