Pain Org Issues Statement on Rescheduling Marijuana

Pain Org Issues Statement on Rescheduling Marijuana

by Staff

The American Society of Regional Anesthesia and Pain Medicine (ASRA) issued a formal statement calling for the rescheduling of marijuana and called for more research to determine its safety and effectiveness this week.

The organization notes that there is a lack of evidence regarding the long-term effects of marijuana use, and overlapping state and federal laws create huge obstacles for physicians who may want to prescribe it.  Under the current federal law, clinical research on marijuana is hindered, and physicians are faced with difficult ethical and legal questions.

“Many patients could potentially benefit from its use,” said ASRA Board member Samer Narouze, MD, PhD. “Neuropathic pain is probably the indication with the most convincing clinical evidence,” he said.

“Other indications with promising results include anxiety, depression, seizures, cancer pain, and HIV-related pain.  However, because medical marijuana lacks the FDA quality and safety oversight, there is inconsistency in doses, which can pose potential risk to patients,” Narouze added.

The ASRA Board of Directors approved the “ASRA Statement on Cannabis” at a recent meeting of its board of directors.   In the statement, ASRA “pleads to the National Institutes of Health (NIH) to implement special guidelines to encourage grant applications and the conduct of well-designed clinical research on the medical utility of various Cannabis preparations.”

Marijuana is classified as a Schedule 1 substance with “no currently accepted medical use and a high potential for abuse,” according to federal law. As a result, it cannot be readily studied in clinical trials. There is a dearth of information regarding the long-term effects of marijuana use, specifically its effects on learning and cognitive function. “Cannabis use disorder” is a recognized disorder in patients who continue to use cannabis despite clinically significant impairment.

With respect to pain management, the statement noted, “a small evidence base is available in the peer-reviewed literature and consists of clinical studies and systematic reviews/meta-analyses evaluating cannabis as an analgesic to alleviate pain associated with clinical conditions, including (but not limited to) neurological disorders, cancer, and rheumatic diseases.”

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Authored by: Staff

There are 17 comments for this article
  1. Mark Ibsen at 9:39 pm

    DE schedule.
    Reschedule just makes cannabis able to be dispensed from a pharmacy.
    Big Pharma in charge.
    It’s harmless

    Charles Mahan:
    CDC recommends against testing for mmj now.

  2. Chuck at 2:32 pm

    In response to Charles MAHAN,

    Very humiliating is it not?

  3. Chuck at 2:29 pm

    I am so glad to have found NPR. The articles are intelligent and informative and the commentors are obviously pain veterans. As far as pot goes it is certainly a beneficial adjunct to any pain treatment regimen but because of quality control issues and lack of studies especially regarding interactions with other medications I caution folks to go slow and small doses. I think there will prove to be a good mix of high cbd to low thc beneficial recipe for pain relief here but we have to get over the prejudices against it and now the juggernaut of recreational use legalization which has crushed the medical research.

  4. Mike Wagner at 4:54 pm

    Finishinging my post,

    with the cut backs of opiates coming, I am going to have to find something, as the pain this disease it is documented it is worse than bone cancer pain, I have known a lot of people in the past 10 years that died of cancer pain and not one of them had much pain as most us us. I am 75 that you might say is end of life and with many serious pain problems, nothing really stops it, but it helps it, I cannot use any over the counter pain products as they are more dangerous than most pain prescriptions, I have had at least 100 hours of accupuncture, even 6 weeks at 3 times a week in Asia by the real experts, they said there was no help, I have had so many hours of pt therapy, I used the breathing and meditation that the surgeon in Seattle Wa. that screwed me up during surgery, he lost his insurance shortly after and has now wrote books that pain is all in your head, I believe he is in need of money so he claims to help pain people with the things I have tried before I ever took a pain pill, He is so wrong pushing this on people in severe pain, some of his ideas will help about as much as opiates do, I don’t believe people in serious pain would ever sell or give away there prescription, it is other people, I had a lady friend say if you go to Az next to the Mexican boarder you can buy all the opiates you can pack and cheap.

  5. Mike Wagner at 4:40 pm

    My son has a legal marjuana store here in wa state and he stocks over 2000 items,
    they used me with some of there CBO types that people are uwsing that dont get you high, but people claim it helps with pain, over several days of trial, not one item helped me with arachnoiditis spine pain..

  6. Dave at 1:07 pm

    The ASRA and government should leave it to democracy to decide and not science. bviously science and scientists have failed the American people with regard to settling issues with marijuana, opioids and Kratom. And its not only self serving of ASRA to call for more research – its cruel toward thse who might benefit from having access to marijuana now.
    The ASRA like other so called expert groups, would like their organizations to decide for the rest of society- and only after profiting from research for many years. People in pain cannot and should not wait for years after organizations like ASRA are rich from research and the public is still waiting for permission from ASRA or govt to access these pain relieving subtances.
    So frankly I dont think much of the morality or caritas of the ASRA.

  7. kathy a overcast at 12:59 pm

    Melissa, could you please email me or respond back here about the spinal cord stimulator, My Dr. has been trying to convince me to get one. I have multiple disk issues as well as spinal arthritis and degeneration, and stenosis. I also have fibromyalgia, I take norco and Fentanyl patch, I have other chronic disorders and don’t like the fact that I would be unable to get MRI’s in the future if it should be needed for some other problem. I also have a boyfriend who’s brother had a stimulator for years, and last year some how the battery’s leaked inside of him and went to his kidney’s and he almost died, this scares me. Do you have a low frequency or high frequency stimulator. My Dr. says the high frequency do not have the associated tingling pain or feeling that is constant. so I’m just looking for your opinion of if the stimulator helped you a lot, or a little or what you think about it. my email is kathyovercast57@gmail.com or reply back here, whatever makes you most comfortable. I’d like to also mention to you, about and herb that has done wonderful things for me and many many other people in chronic pain, Right now a big controversy over it, because the DEA is in big pharma’s pocket and tried to ban our herb recently, even though it is not dangerous and only about as addicting as coffee. when you research it you will find some bias information, but read all that you find, because this wonderful plant has been a life saver for me and many others. So many people fought this ban on “Kratom” that we had 160,000 people sign a petition to the white house, and had like 51 congressmen and 12 senators helping us suspend the ban on this herb, at least for now. If your interested in hearing more about it let me know. But please get back to me on the spinal stimulator, please.

  8. Doug at 12:19 pm

    My brother in-law passed away from complications due to stomach cancer almost a year ago. Luckily he lived in Oregon where the use of Marijuana is legal. After some extensive research and communication with other users of Marijuana for medical use by my sister, who by the way has been a naturalist for years, she created a salve using the CBD oils extracted from the Marijuana plant. Every ingredient in her salve was grown in her own green houses except of course the bee’s wax which was supplied by a local Bee Keeper. This salve did wonders for my brother in-laws extremity pain and actually reduced the amount of Morphine he needed daily.
    At first I thought that this salve had more of a placebo effect on him. That was until he passed away and I flew out to Oregon to help my sister get her affairs in order and clean up her property to sell it. I’m a chronic pain sufferer who has had several failed back and neck surgeries and I suffer from fibromyalgia as well. After a day of working around the property is could barely get out of bed the second day and that was after I took my opioid pain medication. Every joint in my body was on fire and I didn’t think that I would be able to do a thing that day. My sister talked me, a non believer in the effects of Marijuana at that time into trying her salve. I massaged it into my knees, elbows, wrists and hands. To my extreme surprise, about 30 minutes later my pain has eased enough so I could get back to work.
    So yes as a previous non believer in the medicinal usage of Marijuana. I now believe that, YES, Marijuana needs to be rescheduled and nation wide research should start immediately. Researchers need to work with naturalists like my sister, and medicines need to be made to help those of us who suffer from chronic pain. The errogence of agencies like the DEA, CDC and FDA needs to be not only stopped, but needs
    to be investigated as well.

  9. Sandy Geer at 11:25 am

    This is utterly ridiculous. There is no overdosing or addiction associated with medical marijiuana. All of this poison we are putting in our systems by taking the DRUGS provided by the BIG PHARMA (who are in the back pockets of the FDA/DEA/CDC are killing us little by little. How many accidents and deaths do you see from alcohol every year, yet it’s still legal. I’m living with extremely chronic fibromyalgia, RSD, a slew of other chronic pain diseases or illnesses as a result of fibromyalgia, and I’m going to get an EEG and an EMG this coming week to determine if I have neuropathy. I live in a state where MMJ is not legal, but I just visited a state where it was. It was the best thing for my pain. You all need to take a REAL POLL on the chronic pain people who live in legal states to find out their opinions, as opposed to blaming the 30 or so people who die from either OD’ing on heroin or other synthetic drugs that were bought off the street. There will ALWAYS be drugs on the street. Why punish those us who take our meds responsibly and are looking for something else to avoid taking the poison the Big Pharma is putting into our system?? I’m saying that you all need to get your sh*t together and do REAL research and not just go by what you personally believe in. It would certainly create more jobs and more taxes for the USA.

  10. Melissa Buyense at 10:42 am

    Let me start off by saying that I’m not 50 year old woman that escaped by RSD otherwise known as CRPS. I have used marijuana by self-medicating since I was 20 for a total of 30 years. Since I moved to Texas 3 years ago I have not been able to use marijuana since it is not legal in this state. When I used marijuana only at night it alleviated the nerve pain associated with my disease. Since I’ve moved here I’ve had a spinal cord stimulator put in had countless surgeries done on my back for the blocks work to no avail. I currently take pain medication in conjunction with the spinal cord stimulator and didn’t know they helped as much as the marijuana did. I played with you to please look into this because it really helped me and I am suffering today because it’s only recognized for suffering as in cancer glaucoma things of that nature. I long for the day when marijuana will be legal in all 50 states so that anybody feeling the pain that I do can get some help some relief without having to depend on narcotics on a daily basis. I missed being able to get a good night’s sleep to have the relief for my nerves and it really helped with my depression. I hate relying on Pharmaceuticals to get a temporary relief that leaves my body off-kilter feeling sick and I know used to anybody because I just sit on a chair or lay in the bed just no relief.

  11. Hayden Hamby at 10:26 am

    I have attempted to manage pain for over 23 years. I have had two “failed” back surgeries, I am forced to live in constant pain. I have been through all procedures from physical therapy, chiropractic, steroid shots, infusions, injections, and oral medicine and all these after I was told that I must have surgery(ies). I don’t think even the educated pain management doctors fully comprehend how hard it is to live with continuous pain. There is a saying that pain can’t kill you. I have watched several documentaries and actually enough pain…..can kil you. In enough pain I understand “vital reaction” can cause the blood vessels in the brain to hemmorage. Now I am not educated enough to know this, I am just repeating some information from a physician from a documentary I have seen on television. I understand that this effect happens when the pain level exceeds what the brain can process. So in fact pain …..can kill. Granted, I don’t think I don’t know of a case personally where someone actually had this “vital reaction” to severe pain killing them, but the point I am making is that chronic pain is an extremely serious situation to be in. I realize that drugs of the narcotiuc pain nature will probably always be abused by a percent of the populas whether in pain or not. There ARE a great deal of people in chronic pain from either disease, accidents, and corrective surgery that wish to function within thir families, friends, and even a great deal of us that keep working and providing because they have no choice. Some like myself enjoy work. I have been self employed for a little over 30 years and I am distressed at the idea of “one shoe fits all”. The authorative agencies in America have decided that they know what is best for every individual chronic pain patient and that is to cut ALL of them back on their medications without ANY other resource to turn to attempt to manage pain. Marijuana seems works for seems to work on some types of chronic pain along with other afflications of the body. Several states are adopting some limited use medically and some states even recreational use for the “herb”. A human being in permanate pain, all 100 million of us in America deserve to choose what we place in our bodies. I don’t drink alcohol, but I respect my fellow humans decision to do so and as far as I know “drinking” is for RECREATIONAL use ONLY! Finally I think physicians are educated in monitoring the “best” dosage of pain medications and pain relief alternatives to to try to achieve a tolerable outcome for chronic pain patients. Can the authority not be entrusted to these physicians who choose to practice medicine in the pain control area to individually asess each individual patient and monitor how each individual patient is affected and achieve the best results? Is it not more intelligent to “monitor” the various physicians that distribute the different pain medications to their individual patients rather than reduce every chronic pain patients medication “across the board”. Fortunately and unfortunately the human body adapts to most oral pain medication dosage, some medications quicker than others but shoudn’t this adpting process be left to monitor to the qualified physicians judgment for each individual patient? A chronic pain sufferer (and that is proper terminology) NEVER gets completely out of pain, but it can be managed however “one shoe does NOT fit all”

  12. kathy a overcast at 9:32 am

    I honestly believe that it is the FDA and the political establishment that the pharmaceutical companies are paying off that is keeping marijuana from being legalized at the federal level. They all complain about the supposed opiate epidemic but at the same time big pharma wants to keep us all on their meds so they can make money . And the big pharma is paying off the politicians to make this happen. Somehow the DEA is in there to on all of this, too. why else even with the mounting evidence the marijuana positively does have medical uses and has been proven over and over again to have therapeutic value, but the DEA refuses to take it off of the schedule 1 listing so that it can better be studied in the medical community. Recently (on Aug 30) the DEA proposed and emergency ban on a completely 100 % safe herb known as kratom. Because they proposed their intent as and emergency scheduling this was going to happen within a 30 day time frame and not allow public comment or anything. Kratom is used by roughly 2 to 300,000 people in this country for pain, for depression, anxiety, ptsd,to withdrawal from opiate and heroin addiction, for RA and Oa, for fibromyalgia, and MS and parkinson. Many many people have found this herb to be useful with so many afflictions, it is about as addictive as coffee, a person can not get respiratory depression from it, and the worst that can happen if you take to much is you will throw it back up and feel crappy for a short time, but yet the DEA was determined to place it under emergency ban…why…we, the kratom community believe it was instigated by big pharma because so many people have been able to go off on their long term opiate use and use of many different kinds of medicines. We have fought the ban with petitions, and calls to congressmen and senators and government representatives, and now the emergency ban has been lifted for the time being. All of these actions are about greed and money, money to big pharma, money to politicians. The exact same reason that Marijuana has not been scheduled down to a lower class scheduling or been made legal on a federal level…it’s all about the money!…not the concern for our health and welfare…they could all care less about that.

  13. Ellen Falvey at 7:09 am

    I have Trigeminal Neuralagia , also known as the most painful affliction known to mankind. There is no cure. After the numbness wore off from brain surgery to remove a tumor the most excurciating pain in the world set in. Electric like shooters were going up my face. I’ve tried everything. I was deemed refracctory to all meds.. had two unsuccessful gamma knife radiosurgeries, accupuncture, chiropractic treatments. Nothing worked. On 7/14/16 a bevy of laws was passed in RI that limited the amount of opiods a doctor could prescribe.. Apparently I was at or near the maximum allowed. The only medication that came close to helping me was the oxycodone. On to the medical marijuana, it is not easy to get. Medical records, examination by the B&B’ Doctors (not cheap, not covered by insurance) more fees, drive to city to get picture taken.and you are finally ready to go to the “Compassion” Center.. I had heard that there was one strain that alleviated the pain, but didn’t make you “loopy”. That was the one I wanted. It didn’t alleviate the pain and I was “loopy”. I’ve spent well over $250 and have a drawer full of pot that doesn’t work for me. There is no research that helps get the right Pot..

  14. Karl Zaremba at 4:44 am

    I always hear that it is Big Pharma that is blocking the study of Marijuana. I cant 100% say that this is true but I have done my own personal studies on MJ effectiveness.. I have found that while I do not like the side effects of a foggy brain, the pain relief properties are very very good. With less ” high ” effects it would be much more effective and much less dangerous in the addictive category than opioids. It seems to me that every positive in life comes with a possible downside and all negatives need to be managed. As a Pain patient I am struggling with the tolerance issue and I I say lets get with it on the study and approval of Marijuana as a pain killer. People are both suffering and dying due to our inaction.

  15. connie at 4:15 am

    Cannabis Use Disorder?.What on earth is that? If they come up with a fancy enough name they can make anything sound like it’s something that they must have a pricey and most likely useless treatment for! I will be very surprised, pleasantly surprised, if the DEA ever lets go of this harmless herb that has become a huge cash cow for itself and other agenucies! Even in states where it is legal to posess for medical and recreational use there are so many hoops to jump through a person can easily find themselves afoul of the law.

  16. Charles MAHAN at 3:32 am

    I am under MD care for rheumatoid and osteoarthritis as well as gout and bursitis. Diagnosed as severe I am dosed with 40mg of oxy daily. I am required to attend my physician monthly and was surprised on my last visit with a surprise demand for urine, in order to determine whether or not I was properly administering the pain suppressent. My primary care MD informed me that I was being forbidden the use of pot, under threat of withholding the oxy. I live in Colorado so legality was not a consideration. The imperious nature of the demand was shocking; no discussion followed. I, after years of narcotic use are clearly habituated, and to not be given an alternative to repeated increase in dosages find the imperious stupidity depressing, discouraging, and befuddling.