What to know about medical marijuana (cannabis)

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Medical cannabis has been gaining traction as a potential treatment for rheumatoid arthritis (RA). This chronic autoimmune disease can affect various parts of the body, causing inflammation and pain in the joints. RA can also lead to other health problems.
As there is no cure for RA, developing treatments to help reduce the symptoms and improve an individual’s quality of life is essential. Although experts do not fully understand the exact mechanism by which medical cannabis works to relieve the painful symptoms of RA, some evidence suggests that it can be effective.
This article looks at medical cannabis for RA in more detail, including its benefits and risks and how to use it to ease RA symptoms.
Can cannabis treat RA?

Until recently, the legal status of medical cannabis has limited the number of studies looking into its health benefits, but research is now gaining momentum.
RA is an autoimmune disease, meaning that the immune system mistakenly attacks healthy cells. The resulting damage causes inflammation in the affected areas, which are often
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the joints.
A 2021 systematic review of animal studies found that certain cannabis compounds, including cannabidiol (CBD), cannabigerol (CBG), and a combination of CBD and delta-9-tetrahydrocannabinol (THC), could consistently reduce pro-inflammatory cytokines. Cytokines are molecules that drive the inflammatory process. However, THC alone did not have this effect. THC is the primary intoxicating compound of cannabis.
In another 2021 study
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, researchers looked at the effects of medical cannabis on 319 participants with RA and other health issues. They used questionnaires to assess how medical cannabis use affected the participants’ pain and sleep quality. The researchers concluded that medical cannabis had a favorable effect on these parameters.
These results expanded on earlier work from 2006
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involving Sativex, a cannabis-based medication containing CBD and THC. The researchers found that it significantly improved specific pain parameters and sleep quality compared with a placebo. Additionally, the treatment group reported only mild or moderate adverse effects. However, the Food and Drug Administration (FDA) has not yet approved Sativex as a treatment in the U.S.
In addition, a research review
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suggested that cannabinoids are a safe and modestly effective treatment option for chronic non-cancer-related pain.
However, not all of the research supports these findings. A 2017 overview article
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concluded that there was insufficient evidence to recommend cannabinoids as a treatment for chronic pain in rheumatic disease.
A 2018 review agreed, finding only low quality evidence to support cannabis as effective for the treatment of non-cancer-related pain. However, it is important to note that these studies focused on chronic pain of many types rather than that specifically due to RA.
Overall, some research suggests that cannabis and cannabis compounds could modify the chronic pain of RA, improve people’s sleep, and support their well-being. However, further large-scale clinical studies investigating the effects of medical cannabis on RA would help doctors better understand the benefits of this plant-based treatment.
Benefits
The primary benefit of medical cannabis for people living with RA is that it can ease chronic pain. One of the largest reviews to date considered more than 10,700 studies on the potential health benefits and risks of cannabis.
The review concluded that cannabis and its compounds effectively relieved chronic pain, a significant symptom
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of RA.
Another potential benefit of medical cannabis for people with RA is that it may boost mental health. As RA causes inflammation and pain, it can negatively affect a person’s quality of life and mental well-being.
In fact, depression and anxiety are common among individuals living with RA. A 2017 study found that about 30% of people develop depression within 5 years of an RA diagnosis. Another 2017 study
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reported a significantly higher rate of depression among those with RA, at 39%. The authors also noted that about 20% of individuals with RA experience anxiety.
Some people may find that cannabis helps ease challenging mental health problems. For example, a 2017 review of cannabis as a treatment for mental health found that it could help relieve depression and post-traumatic stress disorder (PTSD) symptoms. However, the authors caution that medical cannabis is inappropriate for certain mental health conditions, such as bipolar disorder and psychosis.
The review also highlighted some evidence suggesting that medical cannabis could alleviate social anxiety. Conversely, though, other research has found that cannabis users could have an increased risk of social anxiety.
Anyone living with RA and considering the use of medical cannabis should discuss the potential benefits and risks with a doctor to determine its suitability.
Risks and side effects
Although medical cannabis may provide some health benefits, there are also potential risks, including:
Mental health symptoms: Moderate evidence
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links cannabis use and suicidal thoughts. The drug may also increase the risk of depression.
Some cancers: Although most evidence
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suggests that cannabis use does not increase the risk of cancer, including lung, head, and neck cancer, it may increase the risk of a specific type of testicular cancer.
Dependence: Cannabis use has the potential to lead to substance dependence.
Respiratory problems: Smoking cannabis may increase the risk of chronic cough. However, experts are unsure whether cannabis use links with asthma, chronic obstructive pulmonary disorder (COPD), or worsening lung function.
Obtaining medical cannabis
Medical cannabis is illegal at the federal level, but many states currently allow its use for individuals with qualifying health conditions. The laws surrounding medical cannabis vary among states. Still, they may permit doctors to prescribe it for conditions such as chronic pain, cancer, Parkinson’s disease, and other conditions that affect an individual’s quality of life.
People who want to obtain medical cannabis must first register for a medical cannabis card. The first step is to talk with a doctor who can determine whether a person would benefit from medical cannabis. Once the doctor approves the request, an individual can sign up for their state’s medical cannabis registry.
Although the process varies among states, people can typically register for an online account to submit their application, provide proof of their doctor’s approval, and pay a fee.
Once the individual receives their medical cannabis card, they can buy medical cannabis either online or at dispensaries.
Other treatments for RA
Although living with RA can be challenging and affect an individual’s quality of life, various treatment options are available to minimize its impact and help manage the symptoms.
Often, doctors prescribe the chemotherapy medication methotrexate as the first-line treatment for RA. This is because it changes the immune response and can, over time, positively affect the course of the disease. Therefore, doctors classify methotrexate as a disease-modifying antirheumatic drug (DMARD).
Hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine) are other available DMARDs.
Depending on the person’s response to non-biologic DMARDs, doctors may also recommend biologic DMARDs. These medications, including abatacept (Orencia) and golimumab (Simponi), affect
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specific immune cells and modify the inflammatory response.
Other medications may include nonsteroidal anti-inflammatory medications (NSAIDs) and prescription corticosteroids, such as methylprednisolone or prednisone.
Summary
Cannabis contains numerous active compounds that could benefit individuals living with rheumatoid arthritis.
Substantial evidence suggests that medical cannabis can help ease chronic pain. It may also help ease the depression and anxiety that can accompany long-term health conditions.
Despite this evidence, comprehensive, large-scale studies are lacking. Further research is necessary to help determine the full implications of cannabis use and the potential risks and side effects.
Anyone considering trying medical cannabis to help RA symptoms should discuss the implications with a doctor and check the legality of the drug in their state.

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