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Fibrous dysplasia is a bone disorder that causes healthy bone to be replaced with fibrous tissue. Studies have shown marijuana can help manage the pain associated with the disorder.
Overview of Fibrous Dysplasia
Fibrous dysplasia is a chronic, uncommon bone disorder where scar-like tissue develops in place of normal bone. As a result, the bone is weakened and susceptible to deformation or fracture. The condition begins before birth, according to the American Academy of Orthopaedic Surgeons, and is caused by a gene mutation. Despite the abnormal bone forming before birth, the condition typically isn’t known until childhood when the abnormal fibrous tissue has grown and expanded, causing symptoms to arise.
There is no cure for fibrous dysplasia and surgical treatment is often necessary to help curtail its progression. Medications are commonly used to decrease the activity of the cells that are responsible for dissolving bone. When surgery occurs, the affected bone is stabilized with metal implants to fix breaks or deformities and to prevent further breaking, and the fibrous tissue is scooped out and replaced with bone grafting. Over time, however, the bone grafting is often absorbed and replaced again with the fibrous tissue.
The affected bone gradually becomes weaker as the fibrous tissue expands, eventually causing pain. The weakened area of the bone is often painful and so can the nearby healthy, and sometimes weight bearing leg and pelvis bones, because they’re adjusting and carrying more of the load.
Findings: Effects of Cannabis on Fibrous Dysplasia
Cannabis can help those with fibrous dysplasia to manage the pain associated with their condition. Two of the major cannabinoids in cannabis, tetrahydrocannabinol (THC) and cannabidiol (CBD), are effective at lowering acute and chronic pain (Jensen, Chen, Furnish & Wallace, 2015) (Baron, 2015). THC and CBD activate the cannabinoid receptors in the body, and these receptors regulate the release of neurotransmitter and central nervous system immune cells to manage pain levels (Woodhams, Sagar, Burston & Chapman, 2015).
Cannabis has demonstrated the ability to significantly lower pain levels in patients suffering from neuropathic and nociceptive pain, and has even shown it can help manage pain that has proven resistant to other treatments (Boychuck, Goddard, Mauro & Orellana, 2015). (Wallace, et al., 2015) (Lynch & Campbell, 2011). As a result, cannabis use has been found to be prevalent among the chronic pain population, with improvements in pain, sleep and mood being the most frequently reported reasons for use (Ware, et al., 2003).
States That Have Approved Medical Marijuana for Fibrous Dysplasia
Currently, Illinois is the only state that has approved medical marijuana specifically for the treatment of fibrous dysplasia.
However, several states have approved medical marijuana specifically to treat “chronic pain.” 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, Vermont, and West Virginia allow medical marijuana to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania, Washington, and West Virginia 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 fibrous dysplasia with recommendation by 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”).
In Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment.
Recent Studies on Cannabis’ Effect Fibrous Dysplasia
Baron, E.P. (2015, June). Comprehensive Review of Medicinal Marijuana, Cannabinoids, and Therapeutic Implications in Medicine and Headache: What a Long Strange Trip It’s Been… Headache, 55(6), 885-916. Retrieved from http://onlinelibrary.wiley.com/wol1/doi/10.1111/head.12570/full.
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/R28LWD.
Fibrous dysplasia. (2014, July 8). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/fibrous-dysplasia/basics/definition/con-20032196.
Fibrous Dysplasia. (2010, June). American Academy of Orthopaedic Surgeons. Retrieved from http://orthoinfo.aaos.org/topic.cfm?topic=a00083.
Jensen, B., Chen, J., Furnish, T., and Wallace, M. (2015, October). Medical Marijuana and Chronic Pain: a Review of Basic Science and Clinical Evidence. Current Pain and Headache Reports, 19(10), 524. Retrieved from http://link.springer.com/article/10.1007%2Fs11916-015-0524-x.
Lynch, M.E., and Campbell, F. (2011, November). Cannabinoids for treatment of chronic non-cancer pain; a systematic review of randomized trials. British Journal of Clinical Pharmacology, 72(5), 735-744. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3243008/.
Wallace, M.S., Marcotte, T.D., Umlauf, A., Gouaux, B., and Atkinson, J.H. (2015, July). Efficacy of Inhaled Cannabis on Painful Diabetic Neuropathy. Journal of Pain, 16(7), 616-27. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5152762/.
Ware, M.A., Doyle, C.R., Woods, R., Lynch, M.E., and Clark, A.J. (2003, March). Cannabis use for chronic non-cancer pain: results of a prospective survey. Pain, 102(1-2). Retrieved from http://journals.lww.com/pain/Abstract/2003/03000/Cannabis_use_for_chronic_non_cancer_pain__results.23.aspx.
Ware, M.A., Gamsa, A., Persson, J., and Fitzcharles, M.A. (2002, Summer). Cannabis for chronic pain: case series and implications for clinicians. Pain Research & Management, 7(2), 95-9. Retrieved from http://downloads.hindawi.com/journals/prm/2002/380509.pdf.
Woodhams, S.G., Sagar, D.R., Burston, J.J., and Chapman, V. (2015). The role of the endocannabinoid system in pain. Handbook of Experimental Pharmacology, 227, 119-43. Retrieved from http://link.springer.com/chapter/10.1007%2F978-3-662-46450-2_7.
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