Medical Marijuana and Gout; An Alternative Treatment
August 25, 201010 CommentsDisease Treatment alleve, allopurinol, arthritis, chronic kidney disease, colchicine, gout, Medical Marijuana, monoarticular arthritis, motrin, NSAIDS, orange county marijuana evaluations, polyarticular arthritis, prednisone, uric acid
Today in my Irvine office I took care of a 56 year old man who uses medical marijuana to treat his acute attacks of Gouty Arthritis. He has had 4 attacks since my initial evaluation last year and states that he can not take typical doses of NSAIDS (alleve/motrin/indomethicin) because of a history of gastric ulcers (as a result of overuse if NSAIDS). In addition to diet modification, alcohol elimination and regular exercise, this patient can expect to get moderate relief of his pain and inflammation with cannabis alone.
For those of you reading this who have no idea what gout is let me give you the basics. Gout is an acute arthritis that occurs from the build up of uric acid in the blood. Uric acid is produced in the breakdown of purines (high protein foods) and other nucleic acids. There are many foods that we eat that are high in purines. Alcohol! Meats, Fish, Lentils, Beans, Spinach and a few others. There are also medications that lead to the build up of uric acid in the blood. Diuretics (for blood pressure), low dose aspirin, and niacin. Either one of two things leads to the build up of uric acid. Either the body is overproducing it or the kidneys are not excreting it adequately. So patients with kidney disease can have issues.
What happens is the uric acid builds up and crystalizes in the joints. Typically it affects the joint of the big toe (1st MCP joint). Attacks can be extremely painful and the joint will become severely inflamed. Typically doctors will treat acute attacks with high dose NSAIDS like alleve, motrin or indomethicin. The problem for many patients is that they can not take NSAID’s because of the side effects.
Cannabis contains over 60 medically active ingredients that we know of. Collectively they are called cannabinoids of which THC is only one of the them (the main psychoactive ingredient). We know that we have receptors to these cannabinoids in our nervous system (brain and spinal cord) which are responsible for its analgesis(pain reducing) properties. We also discovered that we have receptors throughout our immune system (spleen and certain immune cells). It is by this mechanism that we suspect cannabis can reduce inflammation.
The interesting thing about cannabis is that patients experience many different effects. Some patients state that they still feel the pain but “don’t care or focus on it as much” and some patients clearly state that the pain is reduced significantly. I would imagine that there is both a reduction in inflammation in addition to an increased pain thresh hold via a direct effect on the nerves themselves. Regardless, cannabis has very few unwanted side effects. It is not toxic to any of the major organ systems (if not smoked) and there is next to no chance of physical addiction or overdose.
Although most patients do not want to experience the psychoactive effects of cannabis (euphoria, loss of coordination/balance, short term memory loss) I had an 89 year old female patient today who told me that “it actually makes me feel happy!” She suffered from debilitating pain and the vicodin was no longer working for her. In comparison to opiate medications it does not cause nausea, constipation, lack of appetite or addiction.
In the end I always tell patients “if this is something that improves the quality of your life… use it! If not, then simply don’t use it.” Most people will find SOME benefit. Improved sleep, less pain, less anxiety, a little better mood, improved appetite etc.
If you would like to be evaluated by me to see if you could benefit from using cannabis I would be happy to take care of you. Simply give us a call at 877-721-0047 or contact through our website at www.mcsocal.com
Be blessed,
Dr. Breen
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Drugs such as tramadol, ibuprofen, which are to relieve joint pains, are not effective in relieving chronic pain, because they are different components that make chronic pain subsides, these diseases as cancer, fibromyalgia, rheumatic pain, arthritis, Parkinson’s, among others, are treated with medicines like vicodin, hydrocodone, lortab which according to what indicated in findrxonline are prescribed medicines and medical prescription to be taken in a proper and adequate.
Good point. All medications have a role in treating any given symptom or disease. Opiates, NSAIDS and other medications can work great in specific circumstances. Cannabis is just another option for patients. Thanks for the comment. Dr. Breen
Great article as a 30 year sufferer of chronic gout attacks I have found few doctors understand the pain involved in an attack and hesitate to prescribe pain relief. The normal course is high dose NSAID’s without the benefits of pain relief, which usually adds Gastro-intestinal upset to an already non-tolerable situation. I have often contemplated the fact that THC may help alleviate many of the symptoms of an attack, unfortunately I live in a state that has not given me an option to utilize this type of treatment, but thank you for helping pave the way.
Bob- Hopefully soon your state will support medical cannabis. It is going to be on the ballot for many states in November and more and more politicians are supporting it because of the 14 states that already “accept” it. In the meantime… speak to your primary care physician about getting on a “Zone Diet” meal plan as it will limit the amount of inflammation in your body overall. Dr. Breen
Thanks..genuinely helpful!!
Dr, I was injured in my feet 15 years ago. They have hurt every day since the injury without relief; accept that I elevate them all day. Sucks. The doctor’s have not really looked for a problem accept for x-rays. My newest complaint led me to the VA’s podiatrist again. It thinks maybe I have an issue with some type of gout. Evidently there are several categories like everything else around life.Yours mentioned mostly the big toe unless that was another website description. The Podiatrist has also ordered a bone scan per my strong request. Like your above reference patient I too have stomach issues. Mainly acid reflux. It is a real problem. It would be nice to be on an effective pain medicine that would not fuck with your mind like weed does but the things are probably highly addictive and I don’t want that crap.
Unfortunately there are not a lot of great treatments for chronic pain. There ARE strains of cannabis that are less psychoactive and in medical doses patients report being very clearheaded.
I am a gout suffer I am also a mmjp I have found that making creme from marijuana using the oil gives me the greatest relief and is better than the poison (colchicine) that they were giving me. It was worse than the gout! Cannabis has its place in medicine its about time doctors realize that.
I have suffered through acute gout attacks for nearly 25 years, and have tried many drugs and remedies with the advice of several doctors.
I have only been able to “conquer” this insidious disease with the use of my own very clean (17ppm) spring water, some diet modification, and the use of recommended medical cannabis.
I DO NOT however “smoke” or vaporize cannabis at these times, as this seems to magnify the pain (maybe just in my head).
I instead use about 2-4 oz of cannabis to make a 5gal. bucket of hot “tea” to soak an affected area imediately apon feeling gout symptoms; and then I use a topical salve to compliment this for pain and swelling relief.
Other than this morning, which is why I came to this site, I have been realitively free of any acute gout attacks for two years.
By the way, the tohpi (calcium deposites just under the skin) on my lower legs and feet have all but disappeared!