Fibromyalgia patients self-medicating with cannabis may have poor mental health outcomes


Fibromyalgia patients self-medicating with cannabis may have poor mental health outcomes


According to new research, 10% of fibromyalgia (FM) patients use marijuana for medicinal relief to combat FM symptoms, such as unexplained fatigue, and insomnia, widespread pain and other somatic symptoms.

Fibromyalgia is a chronic pain syndrome that affects around 3% of the population and is more common in women. Herbal cannabis has been used for centuries as a painkiller, but nowadays it is mainly used outside of conventional medicine.

New research published in Arthritis Care & Research, indicates that patients who self-medicate with herbal cannabis have poorer mental health and although experts believe that cannabinoids may have some therapeutic effect, they do warn individuals against the use cannabinoids until any health issues and psychosocial effects are clarified. According to the experts, because FM pharmacologic pain therapies provide only modest effects, some patients decide to self-medicate with more non-traditional therapies, such as marijuana.

Leading researcher, Dr. Mary-Ann Fitzcharles, a professor of medicine at McGill University and consulting rheumatologist at Canada's Montreal General Hospital of the McGill University Health Centre (MUHC) admitted:

"Medical studies of cannabinoids in management of disease, including FM, have been limited. Marijuana is the most common form of cannabinoid, but an illegal substance in most countries, making it difficult to investigate without possible prosecution for possessing an illicit substance.

Dr. Fitzcharles and her team decided to examine 457 FM patients who were being treated at MUHC's Alan Edwards Pain Management Unit. All study participants self-reported on their cannabinoid use. The team validated the participants FM diagnosis, examining links and trends of participants' self-medication with medical marijuana, prescription cannabinoids, or both.

Participants' pain levels were assessed using the visual analog scale (VAS), whilst their functional ability was examined using the Fibromyalgia Impact Questionnaire (FIQ). In addition, a psychologist assessed all participants in terms of prior or current psychiatric conditions according to the Diagnostics and Statistical Manual of Mental Disorder (DSM-IV).

302 participants were confirmed as suffering from FM, whilst 155 patients, i.e. those in the non-FM group were assigned with another primary diagnosis. The team established that from a total of 457 participants, 13% used cannabinoids and 80% used herbal marijuana to combat their symptoms. An analysis revealed that 24% of the cannabinoid users took prescription cannabinoids, like nabilone and dronabinol, whilst 3% used herbal cannabis and prescription cannabinoids. Those smoking marijuana reported a daily consumption of up to 6 grams, although 72% stated they used 1 gram or less per day. The findings established that one third of all males (36%) used cannabinoids.

The findings further revealed that the use of herbal cannabis was associated with unstable mental illness in 36% of users as compared with 23% of non-users (p=0.002), whilst 17% of users were found to seek opiod drugs in comparison with only 4%, of non-users (p=0.001), and that 26% of users were male compared with 7% of non-users (p=0.0002). The researchers also observed that 77% of cannabis users were unemployed, receiving disability payments, which according to the team may be because of ineffective pain control to improve functionality or more serious functional disabilities.

Dr. Fitzcharles concludes, saying:

"While self-medicating with cannabinoids may provide some pain relief to FM patients, we caution against general use of illicit drugs until health and psychosocial issues risks are confirmed. Physicians should be alert to potential negative mental health issues in FM patients using illicit drugs for medical purposes. Some herbal cannabis users may be dishonestly using a FM diagnosis to justify self-medicating with illegal drugs."


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Section Issues On Medicine: Disease