People know marijuana as a recreational drug, but it has played a medicinal role for thousands of years. Some studies and anecdotal evidence suggest that marijuana or its extracts may help with the symptoms of pain, including the pain that occurs with fibromyalgia.

In the United States, the use of marijuana, or cannabis, remains illegal in many states.

However, marijuana contains many substances, including at least 120 active ingredients, some of which show promise for treatments. These include cannabidiol (CBD) and tetrahydrocannabinol (THC).

The use of CBD may be legal, although sometimes a prescription is necessary.

THC is the psychoactive ingredient in cannabis. CBD does not have psychoactive properties. Both CBD and THC appear to have useful medicinal properties.

One possible use of these chemicals could be as a form of pain relief. As such, they might have benefits for people with fibromyalgia.

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Some active ingredients in marijuana can improve certain symptoms in people with fibromyalgia.

People who live with fibromyalgia may experience pain, headaches, and nausea, among other symptoms. Studies have shown that active ingredients in marijuana can improve these symptoms in some people.

However, few studies have focused on the effects of marijuana or its extracts as a specific management method for fibromyalgia, and the existing literature has reached mixed conclusions.

Research published in 2011 indicated that using cannabis might have beneficial effects on certain symptoms of fibromyalgia.

The study examined people who were "using cannabis" rather than focusing on a medicinal extract or a specific chemical.

However, a 2016 review of studies found that too little evidence was available to recommend any marijuana-based treatments for managing symptoms in people with rheumatic diseases, such as fibromyalgia.

In 2018, an Australian study did not find that using cannabis reduced pain or the need for opioids among people with a range of conditions. However, this study, as with many others, focused on people who use marijuana recreationally rather than medical use.

Up to 90 percent of people with fibromyalgia are women. However, at least one study has found that marijuana provides better pain relief for men than women.

Some evidence confirms that a few of the ingredients in marijuana may help relieve the chronic pain, nausea, muscle spasms, and nerve pain associated with multiple sclerosis (MS).

Cannabis may emerge as effective for easing similar symptoms in those with fibromyalgia.

Medical marijuana may be an option for people with fibromyalgia. It contains compounds that could offer relief from some of the symptoms.

The ingredients THC and CBD have received the most attention. THC is similar to cannabinoid chemicals that occur naturally in the body. It works by stimulating cannabinoid receptors in the brain. This activates the brain's reward system and decreases pain levels.

At least one study suggests that THC may help relieve headaches. It also influences the areas of the brain associated with memory and coordination.

Unlike THC, CBD is not psychoactive and does not bind to cannabinoid receptors. In other words, it does not produce the feelings of pleasure and euphoria, also known as the high, that THC often causes.

Marijuana-based medication

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The whole plant is not approved for use as medication. However, certain extracts may be effective for some conditions.

The term "medical marijuana" refers to the use of either the whole, unprocessed cannabis plant or its extracts to treat illness.

The U.S. Food and Drug Administration (FDA) have not approved the use of the whole plant for any condition.

However, in June 2018, the FDA did approve a purified form of CBD, under the brand name Epidiolex, to treat two conditions: Lennox-Gastaut syndrome and Dravet syndrome.

These conditions involve seizures that do not improve after taking other medications. To purchase CBD products for these conditions, a prescription is necessary.

Synthetic THC is also present in treatments that have FDA approval for nausea and vomiting, as well as some kinds of anorexia.

In some countries, Sativex, or nabiximol, is available on prescription as an oral spray for people with multiple sclerosis (MS) whose symptoms have not responded to other treatments. It contains CBD and THC and treats pain and muscle spasms. Sativex is not available in the U.S.

Scientists are continuing to conduct research and clinical trials to find out whether medical marijuana is safe and effective for a range of conditions.

When is marijuana suitable?

People use marijuana for a wide range of conditions, although research has only confirmed its benefits for a few.

Currently, good scientific evidence confirms the benefits of its use in treating chronic pain, including nerve pain and muscle spasms.

According to the National Institute on Drug Abuse, research is underway to find out if compounds in marijuana might help with the following:

  • appetite loss and anorexia
  • conditions that affect the immune system, including HIV
  • multiple sclerosis
  • inflammation
  • pain
  • seizures
  • substance use disorders
  • mental health conditions

Mouse studies have indicated that purified extracts of marijuana may slow the growth of cancer cells in one kind of brain tumor. A combination of CBD and THC extracts helped kill cancer cells in mice during radiation treatment.

More research is necessary to confirm these uses.

People who wish to try marijuana as a treatment for pain symptoms for fibromyalgia should check their state's laws in relation to the use of cannabis.

Since the FDA have not approved marijuana and most of its related products, consumers should take care when obtaining and using a product, as no regulations control the quality or contents of the products.

People grow marijuana as a plant. They do not synthesize it carefully in a laboratory. Therefore, the amounts of potentially beneficial compounds vary from one batch of plants to another. The effectiveness of symptom relief may also vary as a result.

People should consult their doctor for advice about using any alternative or complementary therapy, including marijuana, because it may not be safe and effective for everyone. For example, the ingredients in marijuana could interact with other medications.

Marijuana products may have fungus or mold that can do serious harm to the lungs and overall health. Manufacturers and vendors might add other drugs. People using marijuana face a risk of contamination as a result.

A healthcare provider may be able to recommend a reputable source or product.

Possible side effects

Some of the potential adverse effects with marijuana use include:

  • dependence, when a person needs to use more to gain the same effect
  • withdrawal symptoms
  • increased heart rate
  • breathing problems
  • dizziness
  • impaired reaction times
  • issues with concentration, learning, and memory
  • mental illness in those with a predisposition to it
  • interactions with other drugs

These effects increase with long-term use. However, the use of some individual substances — such as CBD — may not carry all these risks.

Clinical trials did not find any signs of dependency, for example, in people using the CBD-based Epidiolex.

Therapies that receive FDA approval may well be safe, due to the long and rigorous process of clinical trials. Pay close attention to the patient information leaflet, however, as all drugs can have side effects.

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Lifestyle adjustments can help improve the pain and mood symptoms that accompany fibromyalgia.

The following lifestyle adjustments may help relieve symptoms of fibromyalgia:

  • Exercise: Gentle exercises, such as walking, swimming, and pilates, may help to decrease pain symptoms.
  • Stress reduction: Meditation, progressive muscle relaxation, and breathing exercises can help reduce stress.
  • Massage: The National Fibromyalgia and Chronic Pain Association state that massage therapy can improve chronic pain and fibromyalgia symptoms.
  • Acupuncture: Some research indicates that tailored acupuncture can ease symptoms in some people.
  • Sleep: Sleeping and waking at the same time each day can help to ease fatigue. A doctor may be able to suggest other options.
  • Behavior modification therapy: A therapist can help a person with fibromyalgia learn new coping skills and define and set limits, improving quality of life and self-esteem.

Fibromyalgia can involve a wide variety of symptoms, so a single treatment will probably not work for everyone who has the condition. Treatments also vary in effectiveness between individuals.

For most people, a combination of medication and lifestyle changes is most beneficial.

Drugs that can help to relieve symptoms include pain relief medication, either over-the-counter (OTC) or on prescription, and antidepressants, which may help with pain, fatigue, and depression.

Anyone considering marijuana or another complementary treatment should speak to a doctor first to ensure the safety of the treatment and product.

Q:

I hear that marijuana might help with fibromyalgia, but how would I use it safely?

A:

The first step is to obtain it legally. While you are trying to manage a chronic disease, you don’t need legal issues as well.

Talk to a healthcare professional about the choices and legal options in your state. Taking marijuana in food, such as in brownies, will prevent damage to the lungs that marijuana smoke can cause.

A safe first step might be using just the CBD oil. Document your pain levels for the week before you begin, and continue after starting on CBD oil, noting changes to pain, energy, and well-being.

If you are finding some relief, this might be a good choice to continue including in your treatment plan.

Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.