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Chronic Inflammatory Demyelinating Polyneuropathy is an acquired inflammatory disorder of the peripheral nerve system that affects about 1-2 per 1000,000 people. Studies have shown marijuana helps manage pain associated with the disorder and reduces inflammation, thus potentially limiting the disorder’s progression.
Overview of Chronic Inflammatory Demyelinating Polyneuropathy
Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a rare peripheral nerve disorder that causes weakness and sensory loss with a loss of reflexes. The disorder is caused by damage to the myelin sheath covering the nerves.
Scientists believe that CIDP is caused by a dysfunction in the immune system, which incorrectly perceives myelin as foreign and attacks it in an attempt to rid it of the body. Myelin enwraps nerve axon, serving as insulation so that electrical impulses are able to travel efficiently. Loss or damage of myelin slows electrical impulses or causes them to become lost.
Symptoms associated with CIDP include numbness, tingling, pain, loss of reflexes and weakness. Patients commonly experience foot drop and difficulties walking.
Treatment efforts for CIDP commonly include the administration of corticosteroids, which provide anti-inflammatory effects, intravenous immune globulins, which contain naturally-occurring antibodies, and plasma exchange, which helps to remove the harmful antibodies contained in the blood. If CIDP is left untreated, approximately 30% of patients will become wheelchair dependent. Early detection and treatment is effective at significantly limiting nerve damage caused by the disorder.
Findings: Effects of Cannabis on Chronic Inflammatory Demyelinating Polyneuropathy
Studies show the cannabis is an effective therapeutic option for treating neuropathic pain caused from disorders like CIDP and suggest that cannabinoid found in cannabis could potentially help limit the disorder’s progression.
Cannabis has demonstrated the ability to significantly lower pain levels in patients suffering from neuropathic and nociceptive pain, and has even to be effective against pain that has proven refractory to other treatments (Boychuck, Goddard, Mauro & Orellana, 2015) (Ware, et al., 2010). Even minimal doses of cannabis have been shown to significantly reduce neuropathic pain (Wilsey, et al., 2013). Long-term use of cannabis for pain therapy, studies show, is safe. After a year of regular use, patients with chronic pain were found to be at no greater risk of serious adverse effects than non-cannabis users (Ware, et al., 2015).
Cannabis has been shown to suppress the over activity of the body’s immune system, suggesting that it may also help in limit the progression of CIDP. The cannabinoids found in cannabis act upon both the CB1 and CB2 receptors of the endocannabinoid system, which works to regulate the immune system. Studies have shown that the administration of tetrahydrocannabinol (THC), one of the major cannabinoids found in cannabis, can suppress both inflammatory responses and the immune system to allow the body to recovery from immune-mediated injuries like CIDP (Nagarkatti, et al., 2009).
States That Have Approved Medical Marijuana for Chronic Inflammatory Demyelinating Polyneuropathy
Currently, Illinois is the only state that has approved medical marijuana for the treatment of Chronic Inflammatory Demyelinating Polyneuropathy. However, Arkansas, New Mexico and North Dakota have approved its use to treat painful peripheral neuropathy and New York has approved its use for all neuropathies. In Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment.
Several states have approved medical marijuana specifically to treat “chronic pain,” a symptom commonly associated with Chronic Inflammatory Demyelinating Polyneuropathy. These states include: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New Mexico, Ohio, Oregon, Pennsylvania, Rhode Island and Vermont. The states of Nevada, New Hampshire, North Dakota, Montana, Ohio and Vermont allow medical marijuana to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania and Washington have approved cannabis for the treatment of “intractable pain.”
A number of other states will consider allowing medical marijuana to be used for the treatment of Chronic Inflammatory Demyelinating Polyneuropathy with the recommendation from a physician. These states include: California (any debilitating illness where the medical use of marijuana has been recommended by a physician), Connecticut (other medical conditions may be approved by the Department of Consumer Protection), Massachusetts (other conditions as determined in writing by a qualifying patient’s physician), Nevada (other conditions subject to approval), Oregon (other conditions subject to approval), Rhode Island (other conditions subject to approval), and Washington (any “terminal or debilitating condition”).
Recent Studies on Cannabis’ Effect on Chronic Inflammatory Demyelinating Polyneuropathy
- All About CIDP. (n.d.). GBS/CIDP Foundational International. Retrieved from https://www.gbs-cidp.org/cidp/all-about-cidp/.
- Boychuck, D.G., Goddard, G., Mauro, G., and Orellana, M.F. (2015 Winter). The effectiveness of cannabinoids in the management of chronic nonmalignant neuropathic pain: a systematic review. Journal of Oral & Facial Pain and Headache, 29(1), 7-14. Retrieved from https://goo.gl/Wh839K.
- De Filippis, D., D’Amico, A., and Iuvone, T. (2008, May). Cannabinomimetic Control of Mast Cell Mediator Release: New Perspective in Chronic Inflammation. Journal of Neuroendocrinology, 20 Suppl 1, 20-5. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2826.2008.01674.x/full.
- Mechoulam, R., Sumariwalla, P.F., Feldmann, M., and Gallily, R. (2005). Cannabinoids in models of chronic inflammatory conditions. Phytochemistry Reviews, 4, 11-18. Retrieved from https://goo.gl/xSBnQ8.
- Nagarkatti, P., Pandey, R., Rieder, S.A., Hedge, V.L., and Nagarkatti, M. (2009, October). Cannabinoids as novel anti-inflammatory drugs. Future Medicinal Chemistry, 1(7), 1333-49. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828614/.
- Ware, M.A., Wang, T., Shapiro, S., and Collet, J.P. (2015, September 15). Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS). The Journal of Pain. Retrieved from http://www.jpain.org/article/S1526-5900(15)00837-8/fulltext.
- Ware, M.A., Wang, T., Shapiro, S., Robinson, A., Ducruet, T., Huynh, T., Gamsa, A., Bennett, G.J., and Collet, J.P. (2010, October 5). Smoked cannabis for chronic neuropathic pain: a randomized controlled trial. Canadian Medical Association Journal, 182(14), E694-701. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2950205/.
- Wilsey, B., Marcotte, T., Deutsch, R., Gouaux, B., Sakai, S., and Donaghe, H. (2013, February). Low-dose vaporized cannabis significantly improves neuropathic pain. Journal of Pain, 14(2), 136-48. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3566631/.
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