Update September 2015
While there is still a troubling lack of scientific studies on the effectiveness of medical marijuana for CP, anecdotal feedback among the pancreatitis patient community suggests that some people have found it helpful in coping with pain, nauseau, or sleep problems, as well as lessening the stress and anxiety associated with chronic pain. Others do not find such relief or simply do not like the psychotropic effects of marijuana. Also anecdotally, pancreatitis specialists seem more open to patients experimenting with marijuana, likely figuring that the risks are much less than prescription opiates.
The National Cancer Institute recently issued a report on cannabis and cannabinoids meant for health professionals. (Cannabinoids are the active ingredients in marijuana, which can be isolated and administered in pill, liquid or other forms.) The ultimate conclusion was that “At present, there is insufficient evidence to recommend inhaling Cannabis as a treatment for cancer-related symptoms or cancer treatment–related side effects.” However, the report did include some points relevant to our inquiry (largely from animal or small-scale human studies):
- Cannabinoids may protect against certain tumors: “Cannabinoids appear to kill tumor cells but do not affect their nontransformed counterparts and may even protect them from cell death.”
- A mouse study suggested that cannabinoids may protect against inflammation in the colon.
- Smoking marijuana may help with pain: “Two randomized controlled trials of inhaled Cannabis in patients with peripheral neuropathy or neuropathic pain of various [causes] found that pain was reduced in patients who received inhaled Cannabis, compared with those who received placebo.”
- There is conflicting evidence about whether marijuana helps with nausea and vomiting — one study showed no effect and the other helped 25% of patients.
- In very small studies (one had five people), “patients administered THC had improved mood, improved sense of well-being, and less anxiety,” as well as improved sleep.
- Marijuana won’t kill you. In sharp contrast to opiates often prescribed for pain, “lethal overdoses from Cannabis and cannabinoids do not occur.”
- Some consider marijuana addictive, but “their addictive potential is considerably lower than that of other prescribed agents or substances of abuse.”
These findings certainly suggest that the medical profession should give marijuana very serious consideration for treating pancreatitis — especially since there is virtually no risk of overdose and a relatively low risk of addiction…much less than pain medications of choice like oxycodone.
With more states legalizing marijuana for medical or recreational use, and with bipartisan bills pending in Congress to decriminalize marijuana on the federal level, hopefully scientific studies are on the way. Certainly CP patients living in medical marijuana states might want to address the issue with their doctor. (You can find a table of state medical marijuana laws here.)
Below is the original article from 2013:
One of the biggest challenges with pancreatitis is pain management. Those who suffer from chronic pancreatitis are often prescribed strong pain medications such as hydrocodone and oxycodone. Prescription painkillers are highly addictive and are responsible for over 15,000 deaths a year, amounting to a “public health epidemic” according to the Centers for Disease Control. Concerns about overuse of painkillers are mounting, and the FDA and states are considering restrictions on their availability. (CNN: FDA Advisory Panel Votes to Tighten Restrictions on Hydrocodone)
Medical marijuana is obviously gaining in acceptability and availability around the U.S. While some disagree over the long-term health effects, by any measure marijuana is much less dangerous than prescription painkillers. Recently, there have also been reports that cannabinoids (the principal active ingredients in marijuana) can not only help with pain management, but may be able to help with other symptoms (such as spasticity with multiple sclerosis) or even have the potential to stop tumor progression in certain cancers. (See an article by Dr. Sanjay Gupta supporting use of medical marijuana — “Why I Changed My Mind on Weed.”)
Whether medical marijuana can help people with pancreatitis is therefore of serious interest. Unfortunately, few studies have been done and it is difficult to find a strong (informed) opinion either for or against.
There are, however, some studies that bear on the subject. First, it seems that excessive marijuana use can cause acute pancreatitis. Reports are rare but doctors seem confident in the cause.
Second, there are some studies (mostly with mice) suggesting that certain cannabinoids can reduce inflammation in the pancreas:
- Anti-inflammatory role of cannabidiol and O-1602 in cerulein-induced acute pancreatitis in mice
- Cannabinoids ameliorate pain and reduce disease pathology in cerulein-induced acute pancreatitis — this studied HU210, a synthetic cannabinoid, on mice and patients’ cells.
Perhaps most relevant to those of us with chronic pancreatitis, a 2008 German study of isolated cells of patients with chronic pancreatitis found that introduction of cannabinoids can reduce inflammation and prevent fibrosis, or scarring. According to the authors, the results suggested that “(re-)activation of the (endo-) cannabinoid system in chronic pancreatitis may be beneficial for suppressing disease progress” (parentheses are theirs). Find it here: Cannabinoids reduce markers of inflammation and fibrosis in pancreatic stellate cells
And just to confuse matters, one study found that cannabinoids make acute pancreatitis worse in the early stage and can help at later stages: Dual, time-dependent deleterious and protective effect of anandamide on the course of cerulein-induced acute pancreatitis.
Clearly more research is needed. If there is a better route than reliance on addictive, potentially deadly prescription painkillers, pancreatitis patients need to know it.
At least one politician endorses medical marijuana for pancreatitis…as an alibi: Former House Minority Leader says marijuana is recognized as a treatment for his pancreas pain.
Update August 2013:
A report by the Controlled Substances and Tobacco Directorate at Health Canada found that studies on cannabinoids’ effect on pancreatitis were conflicting:
There are only a handful of reports on the effects of cannabinoids in experimental animal models of acute or chronic pancreatitis, and the findings from these reports are conflicting. Thus, the use of cannabinoids in the treatment of acute or chronic pancreatitis remains unclear.
The report concluded that “These contradictory findings may be due to differences in experimental methods, differences in timing of drug administration, differences in the types of agonists and antagonists that were used, differences in the route of administration, and differences in animal species.”
Time for a rigorous, controlled human study in a state where medical marijuana is legal (California?).