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Orthopaedic Surgeon Supports Cannabis as Medicine

Dr. Frank D’Ambrosio is an author and orthopaedic surgeon with over 30 years of experience treating and operating patients. He works at the California Orthopedic and Spine Medical Group and is a staunch medical marijuana advocate. Here, he explains why cannabis could work as a therapeutic option for spinal injuries.

I have been an orthopaedic surgeon for around 30 years now, meaning that I tend to injuries to the musculoskeletal system. This includes bones, joints, ligaments, tendons, muscles and nerves. Anyone who knows anything about orthopaedics will also realise that I work with spinal injuries, too – one of the most complicated parts of the human body to operate on, and one of the parts where so much pain stems from.

As part of my job, I have seen patients for whom a life of pain is a very real prospect. Unfortunately, for many, this may also mean a life of being addicted to very addictive and dangerous opiate- or opioid- based painkillers.

I started paying more and more attention to cannabis, and the increasing amounts of evidence proving its efficacy in dealing with a broad spectrum of health issues. Sure, the medical world knew marijuana had uses for cancer, AIDS/HIV and glaucoma sufferers, but it didn’t just stop there.

Evidence started to come out about marijuana’s uses for combating epilepsy, nervous system conditions like multiple sclerosis (MS) and Alzheimer’s disease, mental health problems like depression and anxiety, Crohn’s disease and lots more besides. There was also the discovery of the endocannabinoid system (ECS) in the early 90s – a system that turns out to be immensely important for keeping the body’s physiological processes in equilibrium (homeostasis).

The laws considering cannabis to be a Schedule 1 drug with no medical benefit had started to look more and more like a farce. Then, about 5 years ago, I started to dedicate more of my time to medical marijuana and becoming an advocate for patients – sick people who were essentially denied medicine because of draconian government policies.

As for my specialty area of orthopaedics, marijuana has plenty of uses. In my area of work, addictive & dangerous painkillers are prescribed on a daily basis, sometimes without even a second thought. This has lead to a prescription drug crisis that sees thousands of people die needlessly from overdoses every week. Moreover, those who start using painkillers like percocet, vicodin and oxycodone today are likely to become the morphine and heroin addicts of tomorrow.

For many painful conditions concerning the musculoskeletal system, being prescribed painkillers is the norm. Marijuana is perhaps the perfect replacement. There are several good reasons for this, including:

  • Opioids and opiates block out opiate receptors (delta, kappa, mu zeta and nociceptin) entirely – to such an extent that the body stops producing its own natural painkiller, endorphin. Marijuana not only works on the ECS, but on the opiate receptors in the body, too – without the addiction.
  • Opiates are effectively useless for nerve pain, whereas cannabis is not. This is because marijuana works on the ECS, and opiates/opioids do not.
  • There are a huge number of cannabinoids and terpenoids- not all of which are psychoactive – that have beneficial medical properties. Lavender, for example, is a great stress-buster, whilst the non-psychoactive cannabidiol (CBD) is a proven anti-inflammatory and neuroprotective.

This makes marijuana a better medication for a broad-spectrum of illnesses and diseases, unlike opiates/opioids.

  • Opiates/opioids are not ideal for chronic pain, and its side-effects are far more extreme than those arising from marijuana use.
  • Back pain in particular is difficult to manage, and carrying out surgery on spines can be not only risky but ineffective due to the number of complications that can arise (i.e. it can sometimes make things worse rather than better).

What’s more is that it is sometime extremely difficult to find out where back pain is coming from. This can make such pain difficult to manage, and figuring out the right medications can be a risky business. Marijuana can help overcome such obstacles.

We must also look at the different types of pain, and how marijuana can help …

  • Somatic Pain – This is where pain signals travel through to the brain via the peripheral nerves from the injured area. Typically experienced as a constant, dull ache localized in a particular area.

Somatic pain is caused by the nociceptor (pain-detecting) nerve cells responding to damaging stimuli by sending signals to the spinal cord and brain. Cannabinoid receptors modulate nociceptive thresholds, inhibit production of inflammatory molecules and display synergistic effects with other systems that influence analgesia, most notably the endogenous opioid system.

  • Visceral Pain – When tissues or organs are stretched or disturbed due to disease or injury. Pain signals are sent from specific areas of the gut, and produces a feeling of deep pressure in the abdomen. Visceral pain can sometimes be experienced as referred pain, meaning pain that seems to be coming from a different area of the body.

Visceral pain triggers the same nociceptor cells that somatic pain does, except the receptors triggered are in the gut. Such pain usually indicates damage or problems with the internal organs. This is also why marijuana can treat stomach conditions like irritable bowel disease (IBS), Crohn’s disease and other conditions that cause bowel inflammation.

  • Neuropathic Pain – Pain that arises from nervous system injury, disease or damaged, often experienced as a “burning” sensation.

Neuropathic pain results from damage to the peripheral nerves or central nervous system (CNS) itself. Nociceptors aren’t involved in detecting this type of pain, hence the ineffectiveness of opiate-based painkillers for this kind of pain. Instead, pain is caused by overactive, underactive and damaged nerve cells.

Examples include the “shingles”, nerve trauma, phantom limb pain, carpal tunnel syndrome, widespread nerve damage, neuropathic diabetes and many more. Nervous system pain is, however, connected to the ECS, and marijuana can help regulate pain signals sent by the nervous system. Both THC and CBD help regulate the ECS.

  • Psychogenic Pain – Stress, depression and anxiety can both exacerbate existing pain and cause pain. Stress can also contribute to inflammation, which is why it is one of the main triggers to look for in conditions like IBS. Marijuana has plenty of stress-busting (e.g. myrcene, lavender) terpenes that can help with the psychological side of pain management.

Basically, there are few (if any) plants in the world with the pharmacological complexity of cannabis. The huge number of different phytocannabinoids – all with both distinct and similar medical uses – make cannabis very unique indeed. I have not seen any other medication in the world with such broad therapeutic potential as marijuana.

Unfortunately, the precise science of how cannabis works is still unknown. However, the testimonies from thousands (and millions) of patients the world over suggest that cannabis is a very good analgesic, anti-anxiety, anti-stress and anti-inflammatory medication. More research needs to be carried out on cannabis, which remains difficult whilst it is a Schedule 1 drug.

Seedsman

With an international team of writers and over a decade of experience in the industry, Seedsman aim to bring you the very latest in Cannabis news from across the globe.

  • Hilary

    Glad to see good doctors speaking out on something many patients already know. The trick is to get pharmaceutical companies out of the way. Cannabis should be the first option for pain management.

    • Meh

      Well put. Cannabis should be on the front lines of pain management, certainly.

  • Lisa Brady

    It’s Great to see A Medical Consultant prepared to Actually mention the Benefits of using Marijuana whilst in the U.K. They just continue to prescribe Opiates and don’t even really look at Pain management with the Patient if you mention Marijuana they simply refuse to enter any dialogue whatsoever infact if you ever get fed up being poked and prodded just bring it up,They won’t bother you anymore.Surely they must be publishing there findings somewhere thanks for the Article

    • Doctor Frank

      Many doctors are legally bound to not talk about this sort of stuff whilst they’re “on the job”. In countries where marijuana is illegal, a doctor recommending marijuana may well find themselves in prison!
      However, in private, their attitudes may well be quite different.

      • Lisa Brady

        Yes I’m sure your right but it’s great when one like David Knut the Neurologist who sat on the Select committee to get our medical marijuana act through unfortunately they failed to reach a conclusion so it seems it will be another few years yet.

        • Doctor Frank

          A few years, yes, but I think there will be a “critical mass” of opinion, and most countries will have to make up their mind about this issue in sooner than many might think. As more and more nations start to legalize, tax and regulate, being left “out of the loop” could do more harm than good.

          There is already a sort of “domino effect” in play across not only the United States, about across much of North, Central and South America as well. Canada and Mexico, for example, are moving towards legalized medical and/or recreational use.

          As for Europe, there are obviously some social, cultural and economic differences. Where countries like Holland, Spain and Portugal (and increasingly Germany, too) have spearheaded some of the changes we have seen today, some countries in Europe seem rather more “reserved” about embracing a more open cannabis market.

          There are also different rules and regulations regarding food and medicine across different nations to consider as well. What may pass for medicine in one country may not for another. I’m sure there are lots of people around the world being stopped at airports for carrying around even vital, life-saving medications!

  • Robert Western

    I live in Utah were it is illegal. My wife had a kidney surgery witch was scheduled for about two hours instead she was under for eleven hours left open overnight surgery another four hours next day. They had to drive tacks into her spine to clog bleeding she has been on morphine Percocet for three years now I’ve been giving her cabanas joints seems to help with appetite depression Paine wish I could find somebody to help me get her some compensation for her pain and suffering she keeps getting a infection in her blood ever since surgery has been hospitalized four times now pick lines at home for months after each hospital episode I’m glad for marijuana it helps her deal with the whole dam thing

    • Doctor Frank

      Let’s hope legalization reaches Utah, Robert. Cases like your wife’s is where legalization starts.

      • Robert Western

        Fifty seven percent voted yes but was vetoed sucks when the people vote don’t count wish I could find some one to help her because the last three years have not been fun

  • Larry

    Have been addicted to pain pills due to migraines and syatica. But now do not take pain pills at all haven’t in 7 years. Cannibas has so many uses! Thanks to Seedsman it is available to use all! Thanks you guys!

    • Robert Western

      Good job I hope it works for my wife she has already cut down on her pharmaceutical. Meds more natural green

    • Doctor Frank

      Yes, cannabis is definitely a replacement for opiate-based painkillers in many cases. Let’s hope the move to get people off highly addictive prescription drugs.

  • Dr. Kish

    “he was already building his reputation as the most sued surgeon in Nevada. And when he came home to California he had a record of 39 lawsuits and 21 settlements”

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