From telegraph.co.uk
Retired GP Franni, 68, spent decades suffering from chronic pain and tried everything from yoga to surgery. Then she found medical cannabis
Chronic pain is corrosive. It made my life almost unbearable. My sciatica (caused when the sciatic nerve, which runs from the lower back to the feet, is compressed) meant I endured severe constant pain down my buttock and leg. Gradually it got so bad, it was agony to sit for periods of time, which as a GP is a big problem.
I tried a standing desk for years, which was exhausting, and if I ever did home visits, I’d often end up talking to my patients at their front door because I couldn’t manage any steps. Eventually, at 59, I was forced to take early retirement.
It was hard to look forward to doing anything. Nothing seemed fun. My wife would suggest going out to dinner, but I’d be reluctant because I knew I’d spend the evening in pain. Sitting on a train or plane was awful, going to the cinema or theatre was also out of the question. The pain was all-consuming, and it made me dismal. That was hard for my wife. Even though she is incredibly supportive, it’s no fun being married to someone who says no to every proposed social event.
Over the years I’ve had all kinds of interventions: steroid injections, endless pain killers, physio… I’ve tried massage, acupuncture, yoga, Pilates. When I was 50, I had major surgery on my spine. Unfortunately, it didn’t work, plus it meant I was off work for a year, which was terrifying as I had no income. That made me feel frantic.
After my operation, the specialist had prescribed tramadol, a very powerful opiate, for the pain. Almost immediately I started hallucinating. Words were coming out of people’s mouths as blue ribbons and the hospital room had turned into a jigsaw puzzle. It’s also a tachyphylaxis drug, which means it is addictive – you take one tablet, then three weeks later you need two, then six weeks later you’re up to four. I was still in pain after the surgery so I went to the GP who suggested I go back on tramadol, but I refused to through that again.
By this point I was in a bad way. Then a friend came to visit me and suggested I try cannabis for pain relief. At that stage I was open to anything that might help. So, I smoked a joint, and found the pain didn’t actually go away but it seemed to move somewhere else, if that makes sense. It was more bearable, and I was able to get off the sofa and walk around quite comfortably.
Because the cannabis was so helpful, and the side effects were negligible – I felt slightly hungrier and a teensy bit woozy, like you might feel after a couple of glasses of wine – I was interested in trying it again. But we all know how problematic it is to get hold of the stuff. Not only is it illegal, there is a dark and dangerous culture around street cannabis. So I started doing some research, and discovered Alternaleaf, one of the UK’s largest medicinal cannabis clinics (medical cannabis was legalised for certain conditions in the UK in November 2018). I reached out to them, and I haven’t looked back.
The clinic adheres to strict UK regulations, and so I was given a thorough assessment with a registered GMC (General Medical Council) clinician and consultant in pain medicine. To gauge my suitability, I had to demonstrate that I suffered from a diagnosed chronic condition, and that at least two other conventional treatments had not previously worked.
We talked for almost two hours – where else would you get that attention? – and a personalised plan was compiled with a tailored prescription for my needs. Even though the clinic is private, the costs are extremely reasonable. Consultations start at £39. Then every three months, my situation is reviewed and, if I have questions or concerns in between, there is an opportunity for them to be addressed.
It is possible to get medical cannabis on the NHS but only for certain conditions such as severe epilepsy, not chronic pain, and an extremely low number of patients have received it since it was legalised. Very few people are aware this is even an option; I feel passionately that there should be more access to this treatment.
As a person trained in orthodox medicine, others might think my choices are strange. But the standard system hasn’t worked for me and so I’ve been forced to seek help elsewhere.
I’m also regularly asked if I am permanently stoned. The answer is no. The aim is not to get high, but to treat the condition. Another typical concern is around the so-called addictive side of cannabis. The majority of addicts on the street are addicted to opiates, drugs that are often prescribed to patients. Opiates work by sticking to the receptors in our brains and nervous system; that’s how they block pain. Tolerance can build rapidly and so you need more and more.
Medical cannabis has many different strains and specialist doctors can prescribe patients, depending on their condition. There is little evidence to suggest that medical cannabis is physically addictive. It is always prescribed under specialist clinical supervision and while psychological addiction is possible, as it is with anything linked to oxytocin (like food, social media or sex), risks are mitigated by using controlled amounts of cannabinoids like CBD and THC under medical supervision.
I’d say to anyone who is in chronic pain, give medical cannabis a go. You know how debilitating continual pain can be; it destroys lives. Of all the options I’ve been given, this seems like the one with the least negative side effects. I will admit, there are times when my short-term memory goes, but it soon comes back and, at 68, I’m pretty sharp for my age. I learnt Japanese on Duolingo last year. That was great fun.
Generally, I’ll vape my medication, or sometimes I use edibles. If I have a busy day, I’ll microdose so my head is completely clear, but the pain is parked elsewhere. Recently, I’ve been volunteering at a local garden, doing manual work. That would have been unimaginable a few years ago.
Back when I was considering retirement, the future felt bleak; stretched out before me, always in pain and miserable. I often wondered if there was any point in enduring it all? But now my world has changed immensely. I’ve been to Japan, Costa Rica, and Crete just recently; I help out at a sheep farm which opens to the public for lambing. At a time in my life when my existence could have gotten smaller and smaller, medical cannabis has opened everything up for me.
What is medical cannabis?
Medical cannabis is a medicine which contains natural chemicals called cannabinoids, such as THC and CBD. It is used and produced to treat a medical condition and is legal with a prescription, explains Dr Laura Carro Santos, a lecturer at the UCL School of Pharmacy. It is produced under strict guidelines and differs from recreational cannabis which is a Class B drug and illegal in the UK.
What does it actually do?
Medical cannabis interacts with the body’s endocannabinoid system which helps regulate functions like pain, mood, appetite and immunity.
Many of its constituents are known to have anti-inflammatory effects “impacting on different ‘targets’ in our body,” explains Michael Heinrich, a professor of ethnopharmacology and pharmacognosy at UCL. It can treat conditions like chemotherapy-induced vomiting and nausea, muscle stiffness and spasms caused by multiple sclerosis, and rare and severe forms of epilepsy, Dr Carro Santos adds.
Is it legal in the UK?
Yes, medicinal cannabis is legal in the UK. “When there is a clinical need, patients will be able to get a prescription and access appropriate cannabis-based medicines or products,” Dr Carro Santos says.
However it is only available through a prescription from specialist doctors on the General Medical Council’s register and is generally reserved for people with severe conditions that have not responded to other treatments.
Benefits of medical cannabis
“Cannabis regulated as a medicine can generally be considered to be of good quality and safe if used based on the prescription,” Prof Heinrich says.
“It has shown benefits in treating rare forms of epilepsy like Lennox-Gastaut and Dravet syndromes, easing chronic pain and helping with muscle spasticity from multiple sclerosis [MS],” adds Prof Amira Guirguis, the chair of the Royal Pharmaceutical Society’s Science and Research Committee.
“It can also support palliative care, including reducing nausea and improving sleep for cancer patients.”
Potential risks and side effects
There is an increased risk of mental health problems such as psychosis, especially in young people and those with a family history of mental illness, Prof Guirguis says. “It can worsen outcomes for individuals with psychotic disorders, as well as depression, mania and memory issues,” she adds.
Those with a history of mental health disorders should consult a specialist doctor before use.
Other possible side effects include dizziness, sedation, visual impairment, dry mouth, and slow reaction times which can increase the risk of accidents.
How much should be used to cope with chronic pain?
“Doses for chronic pain depend on the individual, type of product, and method of use,” Professor Guirguis explains.
Inhaled products work faster but do not last as long, while oral oils take longer to kick in but provide more sustained relief.
“Any treatment plans should be tailored to the patient by a specialist, considering the method of use, desired effects and any potential interactions with other medications,” she concludes.
https://www.telegraph.co.uk/health-fitness/conditions/bones-joints/sciatica-medical-cannabis/
