Saturday, December 2, 2017

Medical Cannabis Benefits: Treating Rheumatoid Arthritis (RA)

While arthritis involves the painful inflammation of one’s joints, Rheumatoid Arthritis is an autoimmune disease (a condition in which the individual’s own immune system attacks itself) characterized by chronic and systemic inflammation throughout several parts of the sufferer’s skeletal system and body. It is a severely disabling ailment that often comes with chronic pain. The ailment is not restricted to just one’s joints, but may also affect one’s skin, eyes, lungs, heart, blood, and or nerves.

There are more than 100 different forms of arthritis and related diseases. The most common types include osteoarthritis (OA), rheumatoid arthritis (RA), psoriatic arthritis (PsA), fibromyalgia and gout.

The exact cause of Rheumatoid Arthritis is unknown, although genetics, diet, hormonal, and environmental factors are all believed to contribute to its development in sufferers. The disease affects everyone differently and it may develop gradually or quickly. Current medical advances do, however, offer a number of treatments and therapies aimed at tackling the symptoms of RA as well as with helping the disease go into remission.

Using Cannabis to Treat Rheumatoid Arthritis

Cannabis is a complex medicinal plant that may actually be used to treat a variety of debilitating symptoms caused by a surprisingly large number of ailments. Its usefulness as a non-lethal medicine (you cannot die from an overdose of cannabis) cannot be overstated and its versatility in terms of how it can be consumed and as to how it can be useful for so many illnesses is something to be excited about. However, it is important to remember that consulting with your primary care physician should be your first priority when considering incorporating cannabis into one’s medical regiment and that cannabis is to be used as an adjunct therapy and not a replacement. It is also your responsibility to communicate with your doctor as to how your use of cannabis has affected your health and of your progress with utilizing medical cannabis.

With that said, studies have shown that cannabis may be quite useful for treating individuals suffering from Rheumatoid Arthritis for the following reasons: reducing joint pain and swelling; suppression of joint destruction; and with helping to prevent progression/worsening of the disease.

Preclinical trials suggest that cannabis can help limit the damage of different types of arthritis. In an animal trial, cannabidiol (CBD), a major cannabinoid found in cannabis, effectively blocked the progression of arthritis. Researchers found that CBD protected joints against severe damage and concluded that CBD offers a potent anti-arthritic effect.

Other studies have found that synthetic cannabinoids offer strong anti-inflammatory and immunosuppressive properties and reduce joint damage in mice with osteoarthritis. Most recently, cannabinoid treatments were found effective for reducing osteoarthritis-related cartilage breakdown.

Research has also shown that cannabis can help manage the pain and inflammation associated with arthritis. CBD, and another major cannabinoid found in cannabis — tetrahydrocannabinol (THC) — activate the two main cannabinoid receptors (CB1 and CB2) of the endocannabinoid system within the body. Studies have shown the cannabinoid receptor system present in the synovium of joints could be a therapeutic target for addressing the pain and inflammation associated with osteoarthritis and rheumatoid arthritis. These two receptors regulate neurotransmitter release and central nervous system immune cells to reduce pain. Activating the CB1 receptor has been specifically found to reduce pain sensitivity in the osteoarthritic knee joints of rats. One study found that cannabis-based medicine significantly improved pain during joint movement, pain while at rest, and quality of sleep in patients with rheumatoid arthritis. Numerous preclinical studies have confirmed cannabis’ anti-inflammatory and pain-relieving effects and they support the idea that the endocannabinoid system is involved in alleviating pain associated with arthritis.

Currently, Arkansas, California, Illinois (osteoarthritis, rheumatoid arthritis), and New Mexico have approved medical cannabis for the treatment of arthritis. However, in Washington D.C., any condition can be approved for medical cannabis as long as a DC-licensed physician recommends the treatment. In addition, various other states will consider allowing medical cannabis to be used for the treatment of arthritis with the recommendation from a physician. These states include: 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”).

Several states have approved medical cannabis specifically to treat “chronic pain,” a symptom commonly associated with arthritis. These states include: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New Mexico, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, and West Virginia. The states of Nevada, New Hampshire, North Dakota, Montana, Ohio and Vermont allow medical cannabis to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania, Washington, and West Virginia have approved cannabis for the treatment of “intractable pain.”

Activating CB2 receptors reduces osteoarthritic knee pain.
Cannabinoid CB2 Receptors Regulate Central Sensitization and Pain Responses Associated with Osteoarthritis of the Knee Joint.

CBD found to have anti-inflammatory and immunosuppressive effects, and therefore shown to be a potent anti-arthritic.
The nonpsychoactive cannabis constituent cannabidiol is an oral anti-arthritic therapeutic in murine collagen-induced arthritis.

Beneficial Cannabinoids and Terpenoids Useful for Treating Rheumatoid Arthritis

The cannabis plant offers a plethora of therapeutic benefits and contains cannabinoids and terpenoid compounds that are useful for treating the painful symptoms of RA. Many of the current studies and research surrounding cannabis as a treatment for Rheumatoid Arthritis are focused on the anti-inflammatory properties of Cannabidiol (CBD) and on the usefulness of Tetrahydrocannabinol (THC) as an effective pain-reliever.

In one study by Malfait et al., published in March of 2000

it was stated that, “Taken together, these data show that CBD, through its combined immunosuppressive and anti-inflammatory actions, has a potent anti-arthritic effect in CIA (collagen-induced arthritis).”

With that said, the following list also denotes which cannabinoids and terpenoids work synergistically with each other for possible therapeutic benefit. It may be beneficial to seek out strains that contain these cannabinoids and terpenoids.

Americans For Safe Access Condition-based Booklets
These booklets summarize the history of medical cannabis and the recent research used to treat a variety of conditions, including Cancer, Multiple Sclerosis, Chronic Pain, Arthritis, Gastrointestinal Disorders, Movement Disorders, HIV/AIDS, and conditions related to Aging. (About Americans For Safe Access)


Cannabis can ease the pain and reduce the swelling of arthritis without the side effects caused by frequent NSAID or opiate use.

Article: "How to Qualify for Medical Cannabis in New Mexico"


Understanding medical cannabis.Elemental Wellness Center, 2014 Jul.

Cannabinoids for treatment of chronic non-cancer pain; a systematic review of randomized trials.Lynch, Mary E., et al.

British Journal of Clinical Pharmacology, 2011 Nov, 72(5): 735-744.

Smoked cannabis for chronic neuropathic pain: a randomized controlled trial. Ware, Mark A., et al.

Canadian Medical Association Journal, 2010 Aug 30, 182(14): 694-701.

Characterisation of the cannabinoid receptor system in synovial tissue and fluid in patients with osteoarthritis and rheumatoid arthritis.Richardson, Denise, et al.

Arthritis Research & Therapy, 2008, (online article).

Cannabis, pain, and sleep: lessons from therapeutic clinical trials of Sativex, a cannabis-based medicine.Russo, Ethan B, et al.

Chemistry & Biodiversity, 2007 Aug, 4(8): 1729-1743.

The use of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis.Wright, S, et al.

Oxford Journals: Rheumatology, 2006 Jun, 45(6): 781 (correspondence).

Preliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis.Blake, D.R, et al.

Oxford Journals: Rheumatology, 2006 Jan, 45(1): 50-52.

Arthritis and cannabinoids: HU-210 ad Win-55,212-2 prevent IL-1 ?-induced matrix degradation in bovine articular chondrocytes in-vitro.Mbvundula, Estery C., et al.

Journal of Pharmacy and Pharmacology, 2006 Mar, 58(3): 351-358.

Standardized extracts of cannabis for treatment of arthritis and migraine.Darmstadt, K.G.

BIOforum Europe, 2005 Jul, (online article).

Cannabinoid-based drugs as anti-inflammatory therapeutics.Klein, Thomas W.

Nature Reviews Immunology, 2005 May, 5: 400-411.

Oral anti-inflammatory activiy of cannabidiol, a nonpsychoactive constituent of cannabis, in acute carrageenan-induced inflammation in the rat paw.Costa, Barbara, et al.

Naunyn-Schmiedberg’s Archives of Pharmacology, 2004 Mar, 369(3): 294-299.

The nonpsychoactive cannabis constituent cannabidiol is an oral anti-arthritic therapeutic in murine collagen-induced arthritis.Malfait, A. M., et al.

Proceedings of the National Academy of Sciences of the United States of America, 2000 Mar 10, 97(17): 9561-9566.