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Medical marijuana treats chronic pain in adults, LI study finds

C-4 marijuana is weighed at the Greener Crossing

C-4 marijuana is weighed at the Greener Crossing Medical Marijuana Care Giver Center in Detroit on March 9, 2017. Credit: AP/Todd McInturf

Medical marijuana is a potent method of treating chronic pain in older adults who had been relying on opioids, a Long Island doctor has found in a research project of people mostly in their 60s who suffered from a wide range of pain syndromes.

The survey by Northwell Health coincides with the New York State Department of Health declaring opioid use a qualifying condition for medical marijuana. People can be weaned from opioids by treating chronic pain with medical cannabis, state health officials said Tuesday.

Local doctors already have compelling evidence that medical marijuana helps wean chronic pain patients from heavy-duty narcotic medications.

“What we found was that the patients overwhelmingly had a reduction in their pain with medical cannabis and a reduction in their use of painkillers of all kinds,” said Dr. Diana Martins-Welch, a co-author of the study. She is a specialist in geriatric and palliative medicine at the health system’s division in Manhasset.

She and her colleagues conducted a survey of medical marijuana users between the ages of 61 and 70 and found that 65 percent of them reported relief from chronic pain caused by a wide range of conditions.

Some patients had osteoarthritis, others had painful hips and knees that, for a variety of medical reasons, could not be replaced with artificial joints. Still others suffered from spinal stenosis, which generally occurs when the spaces within the spinal column narrow significantly, putting pressure on spinal nerves. The result is excruciating, round-the-clock pain for which many doctors routinely have prescribed an opioid.

Despite the favorable findings, more studies of medical marijuana and its pain-relieving properties are needed because not enough information is contained within the overall medical literature on which doctors rely, Martins-Welch said.

Medical students receive no instruction on medical marijuana, Martins-Welch said, adding that much of her own knowledge was self-taught.

“The big difference between opioids and medical cannabis is that there is an anti-inflammatory component to cannabinoids,” she said, referring to the medically active constituents of cannabis that are capable of relieving inflammation, which underlies many pain syndromes.

The New York State Department of Health, meanwhile, has announced that it will develop a regulatory amendment to the state’s Compassionate Care Act and add opioid use as a qualifying condition for medical marijuana. That action ultimately could help wean patients off opioid drugs by using medical cannabis to treat chronic pain.

“The opioid epidemic in New York State is an unprecedented crisis, and it is critical to ensure that providers have as many options as possible to treat patients in the most effective way,” Dr. Howard Zucker, the state’s health commissioner, said in a statement.

Dr. Maria Carney, chief of geriatric and palliative medicine for the Northwell Health network, says finding alternatives to opioids is critical.

“From an advocacy point of view I am trying to make it easier for doctors to prescribe other pain-management methods so that we can use opioids more responsibly. It’s easier for me to order a fentanyl patch, which is an opioid than it is to order a lidoderm patch, which is not an opioid,” she said.

Insurance coverage is another conundrum, Martins-Welch added Tuesday.

Most health insurers will cover the cost of an opioid medication, she said, but will not cover the cost of medical marijuana, which at about $200 to $300 per month, is a prohibitive amount for some patients to pay.