Permanent End To Chronic Pain
Many patients self-report their use of cannabis for the relief of their chronic pain and a record of these has been kept recently. Two specific observations have been made. Firstly, a significant number of these patients have spinal pain as a result of trauma. The injuries have never been severe enough to cause neurological damage. However, all have experienced soft tissue damage and including one with a vertebral crush fracture. A common feature has been a combination of muscle spasm, excessive superficial spinal tenderness (hyperalgesia, allodynia) and lack of sleep.
Despite intensive research on the neurobiological mechanisms of chronic pain, this therapeutic area remains one of the least satisfactorily covered by current drugs. There is considerable preclinical evidence that hyperalgesia and allody-nia following peripheral tissue or nerve injury is not only due to an increase in the sensitivity of primary afferent nociceptors at the site of injury but also depends on NMDA receptor-mediated central changes in synaptic excitability (Zieglg nsberger and Tolle 1993 Sandk hler and Liu 1998 Eide 2000 Parsons 2001 Fundytus 2001). 1996). There is evidence for tonic NMDA receptor activation in inflammatory hyperalgesia (Boxall et al. 1998) and in the mechanisms underlying the reduced effectiveness of opioids in chronic neuropathic pain states (Mao et al. 1995 Cai et al. 1997 Fan et al. 1998 Yashpal et al. 2001). Several controlled trials in patients with peripheral neuropathic pain have shown positive effects of acute injections of ketamine on...
Not since prohibition began in 1937 has there been such a large body of knowledge. Millions now know that medical marijuana provides safe, effective relief for a wide array of ailments, from chronic pain and migraines to glaucoma, epilepsy, multiple sclerosis and the debilitating effects of chemotherapy and AIDS.
Although they are commonly used in the adjunctive management of chronic pain, benzodiazepines are generally not analgesic per se. One exception may be the stabbing lancinating neuropathic pain that often responds to anticonvulsants, including clonazepam. Nevertheless, the use of benzodiazepines in pain syndromes is generally contraindicated, and clonazepam, although often effective, should be used with caution (SEDA-17, 42). This is because of the availability of other agents with comparable or superior efficacy and the significant incidence of adverse effects of clonazepam, including depression, self-poisoning, cognitive impairment, and dependence (2), as well as the potential for diversion.
Chronic pain, by its persistent and pathological form, appears to have no biological function. It imposes physical, emotional, and social stresses of severe magnitude. The patient's response to chronic pain is very different than to acute pain. Physical deterioration is often seen, and is actually aggravated by resorting to excessive medication. There is some indication that the pain threshold and therefore tolerance of pain actually decreases, possibly due to a depletion of endorphins.1 In some cases the underlying pathology, if any, for chronic pain cannot be found.
Medical Conditions Medical conditions obviously need appropriate treatment. Hyperthyroidism may take weeks to get under control when first diagnosed. Hypnotics or benzodiazepines may improve sleep and your quality of life while this is occurring. Cardiac and respiratory problems can impair sleep because they may interfere with the amount of oxygen you are getting. Obviously the primary medical problem needs to be treated. Pain may make it hard to sleep, and analgesics may not be enough help. Hypnotics and benzodiazepines may be helpful in the short run. If you experience chronic pain, antidepressants make a more sensible choice.
The psychotomimetic effects of ketamine, apart from encouraging illicit use, can lead to distressing psychic disturbances, particularly in children (13) there can be nightmares, delirium, and hallucinations (25). Oral keta-mine is an effective analgesic in patients with chronic pain. In 21 patients with central and peripheral chronic neuropathic pain treated with oral ketamine, the starting dose was ketamine 100 mg day, titrated upward by 40 mg day increments every 2 days until a satisfactory effect was achieved, or until adverse effects became limiting (19). Nine patients discontinued ketamine because of intolerable adverse effects, including psychotomimetic symptoms, such as elevator'' effect or dissociative feelings, somnolence or insomnia, and sensory changes such as taste disturbance and somatic sensations.
More recently, it has become clear that the RVM can facilitate as well as dampen pain (reviewed by Porreca et al. 2002). Stimulation of the RVM at relatively low current intensities increases the responses of spinal dorsal horn neurons to noxious stimuli. The role of this facilitation in chronic pain is suggested by studies showing that blockade of the RVM with lidocaine reduces abnormal tactile responses in rats with neuropathic pain (Pertovaara et al. 1996). Other studies of inflammatory and neuropathic pain converge in showing that descending facilitation is an important component of pathological pain.
Small doses of sedating TCAs (e.g., amitriptyline, doxepin) are sometimes used as hypnotics. Patients with chronic pain may particularly benefit from this treatment strategy TCAs are frequently used to potentiate the benefits of traditional pain medications. They are potent inhibitors of REM sleep, and their discontinuation is often associated with REM rebound. Anticholinergic and adrenergic side effects and toxicity in overdose must be weighed against potential benefits. Mirtazapine is a newer sedating antidepressant that targets both the noradren-ergic and serotonergic systems. It may be a useful alternative to the tricyclic antidepressants as it is less anticholinergic and less toxic in overdose. Mirtazapine has strong antihistaminic activity that may cause significant weight gain with chronic use.
Morphine is widely used to sedate people and to ease anxiety. The drug is commonly given to treat acute pain from injury or surgery and chronic pain from assorted afflictions. The hurting does not actually go away, but people become less aware of it. In addition to pain control, morphine also has anti-inflammatory actions and can suppress coughing.
Efficacy and safety of these drugs in 86 randomized controlled clinical trials in more than 10 000 patients with acute or chronic pain (228). Topical NSAIDs were significantly more effective than placebo for pain relief. Local tolerability was good local skin reactions were rare (3.6 ) and systemic effects even rarer (less than 0.5 ). Local or systemic unwanted effects of sufficient severity to cause withdrawal from the study were also rare (0.5 ) and no more common than with placebo.
Additionally, cannabinoids have been studied for their potential in the treatment of severe acute and chronic pain (Brower, 2000 Walker et al., 1999). Recent animal research indicates that cannabinoids control pain by direct interaction with the receptors on the rostral ventromedial medulla (RVM) of the brain, which modulates pain perception. Cannabinoids act as analgesics by preventing pain perception via the activation of RVM cells which function to suppress pain signaling (Klein et al., 1998). The analgesic activity of cannabinoids has prompted much research designed to explore their therapeutic potential.
(2) a chronic or debilitating disease or medical condition or its treatment that produces one or more of the following cachexia or wasting syndrome severe or chronic pain severe nausea seizures, including but not limited to those characteristic of epilepsy or severe and persistent muscle spasms, including but not limited to those characteristic of multiple sclerosis and Crohn's disease agitation of Alzheimer's disease or
Malec (1982) reported that 21 out of 24 SCI patients with spasticity who had tried cannabis found it had alleviated their symptoms. A recent survey of MS patients in the UK and USA found that between 30 and 97 experienced relief in symptoms with cannabis, depending on the particular symptoms (Consroe et al. 1997). In descending order of improvement, these were spasticity, chronic pain, acute paroxysmal phenomena, tremor, emotional problems, anorexia weight loss, fatigue states, double vision, sexual dysfunction, bowel and bladder symptoms, vision dimness, difficulty with walking and balance, and memory loss.
Narcotic addiction in patients with chronic pain. Anaesthesia 1981 36(6) 597-602. 13. Coote JC, Hughes AM, McKane M, et al. Drug consumption in chronic pain patients. Br J Pharm Pract 1986 9 193. 135. Budd K, Brown PM, Robson PJ. The treatment of chronic pain by the use of meptazinol administered into the epi-dural space. Postgrad Med J 1983 59(Suppl 1) 68-71.
Arrested in 1999, he could still walk, which he attributes to the medical use of marijuana. After serving 19 months, Rathbun came out of Montana State Prison confined to a wheelchair. Byron Stamate spent three months in a California jail for growing marijuana for his disabled girlfriend (who killed herself so that she would not have to testify against Byron). Gordon Farrell Ethridge spent 60 days in an Oregon jail for growing marijuana to treat the pain from his terminal cancer. Oklahoman Will Foster served over four years in prison (of an original sentence of 93 years) for growing marijuana for chronic pain. Quadriplegic Jonathan Magbie, who used marijuana to ease the constant pain from the childhood injury that left him paralyzed, died in a Washington, D.C., jail in September 2004 while serving a 10-day sentence for marijuana possession.
Cannabinoid- and opioid-induced analgesia have been well characterized in animal models predictive of human analgesic action (Pertwee, 2001). The antinociceptive effects of VR1 receptor blockers in two models of inflammatory hyperalgesia suggest that endovanilloids might be produced also by peripheral tissues and act in concert with locally enhanced temperature and acidity during inflammation (Huang et al., 2002). The discovery of endogenous molecules activating opioid, cannabinoid, and vanilloid receptors indicate the involvement of these receptors in pain modulation and may lead to the identification of novel neurobiological substrates in the regulation of central, spinal, and peripheral pain pathways. Most desirable analgesic agents will be those that do not cause addiction and other side effects but are potent in ameliorating intense and chronic pain. These targets will therefore include those mechanisms associated with pain relief involving peripheral, spinal, or central...
Intrathecal and intracerebral drug administration differs fundamentally from systemic drug administration in terms of pharmacokinetic characteristics determining brain tissue concentration, where the available dose reaching the target organ is 100 . But the concentration distribution is not even among different brain tissue and result in steep concentration gradient (170,171). Intrathecal drug delivery has been used in the intracerebroventricular administration of glycopeptide and aminoglycoside antibiotics in meningitis, intraventricular treatment of meningeal metastasis, intrathecal injection of baclofen for treatment of spasticity and the infusion of opioids for severe chronic pain.
Intolerable adverse effects or inadequate analgesia occur in 10-15 of patients with chronic pain given continuous intrathecal morphine. Hydromorphone is a semisynthetic derivative of morphine used extensively in the management of cancer pain. It is more soluble than morphine, has a slightly shorter duration of action, and is about five times more potent when given systemically. In a retrospective review of 37 patients with chronic non-malignant pain (mostly from failed lumbosacral spine surgery) treated with intrathecal hydromorphone there was an analgesic response in six of the 16 patients who were switched from morphine to hydro-morphone because of poor pain relief (42C). Opioid-related adverse effects, such as nausea, vomiting, pruritus, and sedation, were also reduced by hydromorphone in the 21 patients who were switched to hydromorphone because of morphine-related adverse effects, especially 1 month after use. These results should be treated cautiously, because of the limitations...
At stake, and, shortly after surgery, I was let go. Not because I did something wrong at work, but because my work limitations didn't meet the requirements of the owners anymore. It didn't matter I was their nursery manager of five years. It didn't matter I was the reason that many people drove out of their way to get reliable service with accurate information at their company. The mind was willing, but the body was not. So, I went on toward new horizons. Three months went by with little pain, but then the pain started to come back, limiting my mobility again and creating chronic showers of needle-like stabbing pain. I didn't understand What is this I asked. I had corrective surgery, but now I have the pain back Fast-forward six years to now, and I still battle with chronic pain. But there is a difference now I can control the pain and improve the sleepless nights. So what changed, you ask Cannabis is a tool, plain and simple. It is a tool to suppress my chronic pain for a period of...
A synthetic opioid. used to alleviate both acute and chronic pain. It is an opioid, and thus its effects on the body resemble those of opium or morphine, one of opium's purified constituents. A common trade name for meperidine is Demerol. The drug acts principally on the central nervous system and on the neural elements of the bowel. It can be administered orally, in liquid or tablet form, or by intramuscular or subcutaneous injection. Its effects are felt within 15 minutes and last from 3 to 5 hours. Meperidine commonly is used to relieve pain during childbirth, although it may slow the respiratory rate of both mother and infant. Other side effects include drowsiness, light-headedness, dryness of the mouth, weakness, and nausea. The drug is also highly addictive. Nevertheless, its side effects tend to be less severe than those of morphine, making it a preferable choice in many instances. Pethidine hydrochloride C15H21NO2 HCl. Synthetic substance under international control according...
Randall was encouraged to be thankful, but silent, about his treatment. Instead, he chose a different path (Randall and O'Leary 1998, p. 134), Having won, why go mum There were souls to save. Better to trust my fellow citizens and shout in to the darkness than rely on a devious Government dedicated to a fraudulent prohibition. He chose to make it his mission to seek approval of clinical cannabis for other patients. He developed protocols for glaucoma, multiple sclerosis, chronic pain, and AIDS that he shared with prospective medical marijuana candidates. Randall proved to be a tireless and persistent researcher, ferreting out hidden facts useful to his cause. Through the Freedom of Information Act (FOIA), he discovered in 1978 that the government's cost of cannabis cultivation and production was 90 cents per ounce (28 g), with 2 3 of this cost attributable to security measures. Thus, the actual cost of production approximated 1 cent per gram (US 0.01 g).
In a recent report, Chichewizc and Welch (1999) found that A9-THC (20mg kg) and morphine (20 mg kg) induced analgesia in both vehicle treated and morphine tolerant mice. In both groups, analgesia was equally effective indicating that analgesia produced by the combination is not hampered by existing morphine treatment (no cross tolerance to the combination) . Mice were tested with A9-THC (20 mg kg) and morphine (20 mg kg) twice daily for 6.5 days and tested for tolerance and on day 8, A9-THC tolerance was observed, but morphine tolerance did not occur. These results suggest low-dose combinations of A9-THC and morphine might prevent morphine tolerance. The authors conclude that combinations of these drugs may be useful in chronic pain patients over morphine administration alone.
I'm not a pain management specialist, a physician, a psychologist, or a horticulturist, but I do have 35 years experience growing one species of plant and over fifteen years of surgical intervention, chronic pain, depression, and a never-ending number of doctor appointments. I also now have many years experience treating myself with medicinal marijuana and learning from others who have also, so I feel at least somewhat qualified to write about the subject my Quality of Life .
The key signs of addiction are morbid craving and a mental focus on obtaining and using the heroin. The entire life of an addict revolves around obtaining the drug. Equating addiction with physical dependence simplifies the diagnosis. Physical dependence can be measured by its withdrawal symptoms, whereas craving cannot be measured. Having symptoms of withdrawal does not make a user an addict. For instance, in a medical setting, patients who use opioids to treat chronic pain usually do not have problems leaving the drug after their pain is gone. If a person does not want to take the drug, he or she is not addicted.
These properties make them ideally suited for their role as a coincidence detector underlying Hebbian processes in synaptic plasticity such as learning, chronic pain, drug tolerance and dependence (Collingridge and Singer 1990 Trujillo and Akil 1995 Danysz and Parsons 1995 Collingridge and Bliss 1995 Dickenson 1997). Novel techniques revealed a differential distribution of NMDA receptors along apical dendrites of neocortical neurons (Frick et al. 2001) and suggest a very localized generation of glutamate-induced synaptic plasticity (Dodt et al. 1999 Frick et al. 2004). Two major subunit families designated NR1 and NR2, as well as a modulatory subunit designated NR3, have been cloned. Most functional receptors in the mammalian CNS are formed by combination of NR1 and NR2 subunits that express the glycine and glutamate recognition sites, respectively (Hirai et al. 1996 Laube et al. 1997).
Bioavailability and Analgesic Effect of Sustained Release Cetobemi-done Capsules in Cancer Patients with Chronic Pain of Malignant Origin. Acta Oncologica (Stockholm, Sweden) 31 (1992) 577-83. Ohqvist, G., et al. A Comparison between Morphine, Meperidine and Ketobemidone in Continuous Intravenous Infusion for Postoperative Relief. Acta Anaesthesiol-ogica Scandinavica 35 (1991) 44-48. Steentoft, A., and K. Worm. Cases of Fatal Intoxication with Ketogan. Journal Forensic Science Society 34 (July-September 1994) 181-85. Wolff, T., et al. Analgesic Treatment in Acute Myocardial Infarction. A Double-Blind Comparison of Ketobemidone + the Spasmolytic A29 (Ketogan) and Morphine. Acta Medica Scandinavica 223 (1988) 423-30.
At present there seems to be a consensus that competitive AMPA and NMDA receptor antagonists a low chance of finding therapeutic applications. Antagonists showing moderate affinity and satisfactory selectivity for certain NMDA receptor subtypes seem to have a more favourable profile. From the therapeutic point of view, the real challenge is not only to improve the symptoms of diseases, but also to interfere with their pathomechanism, i.e. prevent progression. The most promising symptomatic indications for NMDA receptor antagonists seem to be various forms ofdementia, alcohol abuse, and possibly some forms of chronic pain such as phantom pain and postoperative pain, in particularly in combination with opioids. Clinical evidence for neuroprotec-tive activity of glutamate antagonists in chronic neurodegenerative diseases is scarce. Results with NMDA receptor antagonists in clinical trials of stroke and trauma have been very disappointing. Some degree of hope remains for NR2B-selective...
Of 130 patients with chronic malignant and chronic benign pain attending a pain relief unit over 3 years, 9 (18 ) were considered to be addicted to analgesics on subjective evaluation (12). Of 71 patients with chronic pain referred to a pain relief center, 86 were taking analgesics, 58 opioids, and 68 psychotropic agents 49 of those taking opioids were considered to be dependent (13).
Although cannabinoids have been used for pain relief for centuries, the basis for their analgesic effects were poorly understood until recently. During the last decade a prodigious output of research papers from many laboratories has elucidated many of the major features of cannabinoid analgesia. These studies have not only provided a detailed understanding of the network of neural and inflammatory cells that serve as the targets of cannabinoids, the literature has also begun to address the more difficult question of the physiological role of endocannabinoids in pain regulatory circuits. The low levels of CBRs in brainstem regions that control vital heart rate and respiratory function provided an anatomical basis for the low toxicity of cannabinoids (Herkenham et al. 1991). However, the psychoactivity of direct-acting CB1R agonists proved to be a major barrier to their use as therapeutic tools in the pharmacotherapy of chronic pain. More encouraging results have arisen from a number...
There are many possible uses for cannabinoids in pain relief. Not only is the whole field of chronic pain open to such a new potential analgesic, but also its place in palliative care needs exploring. Acute pain, particularly acute back pain may be another valuable use of it. Sedation in Intensive Care is another possibility although this area is littered with agents that have come and gone. The anti-inflammatory effects may preclude its use here. Perhaps the traditional use of benzodiazepines for premedication prior to surgery could be challenged
Opioids are a class of drugs used therapeutically to treat pain, coughs and diarrhea. They are also abused because of the euphoric effects that they produce. The prototypical opioid is morphine. From morphine, the synthetic opioid diacetylmorphine or heroin is produced. Although heroin remains the most commonly abused opioid, there are other opioids that are abused. For instance, methadone is an opioid used to treat opioid addiction and is also used to treat chronic pain. Advantages to the therapeutic use of methadone include good oral bioavailability and a much longer half-life than morphine. Oxycodone is another synthetic opioid that is used to treat pain. Recently, a sustained release form of oxycodone was produced as a way of utilizing the efficacy of oxycodone, but with a longer duration of action. Because of the abuse of this sustained release form, the higher dose form was subsequently removed from the market by the manufacturer. Another synthetic opioid, fentanyl, is used in...
Individual differences in levels of pain, in the transition from acute to chronic pain, in susceptibility to neuropathic pain after nerve damage and in analgesic effectiveness may have a genetic basis. There is marked variability in animal genetic strains in terms of the sequelae of tissue and nerve damage and even in their responses to morphine. Given the huge range of human phenotypes, this may indicate important individual differences in susceptibility to pain and analgesia but we have no way of monitoring this possibility.
You should check your local laws and see if you qualify as a medical user. There are many ailments that marijuana can reasonably be used for. Depression, chronic pain, insomnia, glaucoma, MS, cancer therapy, HIV, appetite depression and muscle relaxation to name a few. Strong marijuana can lower blood pressure significantly. Many medical users find that even a very small amount of marijuana can greatly alleviate their symptoms.
Alaska Measure 8 protects patients diagnosed with cachexia cancer chronic pain epilepsy and other disorders characterized by seizures glaucoma HIV or AIDS multiple sclerosis and other disorders characterized by muscle spasticity and nausea. Other conditions subject to approval by the Department of Health and Social Services. Patients (or caregivers) may possess no more than one ounce of usable cannabis and cultivate no more than six plants, no more than three mature. Senate Bill 94 mandates that all patients must enroll the confidential state-run registry and possess a valid ID card or they cannot argue affirmative defense of medical necessity. Arizona Prop. 200 attempted to allow doctors to prescribe schedule I controlled drugs. However, federal law forbids physicians from prescribing cannabis, so this statute offers no legal benefits whatsoever. Colorado Amendment 20 protects patients with cachexia cancer chronic pain chronic nervous system disorders epilepsy and other disorders...
Natural Pain Management
Do You Suffer From Chronic Pain? Do You Feel Like You Might Be Addicted to Pain Killers For Life? Are You Trapped on a Merry-Go-Round of Escalating Pain Tolerance That Might Eventually Mean That No Pain Killer Treats Your Condition Anymore? Have you been prescribed pain killers with dangerous side effects?