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Living with Psoriatic Arthritis (PsA)

Medical Marijuana--studies or personal experience--psa symptoms


#1

Aside from the pro movement for pain and such, is anyone here part of a clinical to study the effectiveness for pain, inflammation, or muscle relaxent properties? I have an interest and was wondering how you folks that have that option report how it helps or not. The state I live in is starting to issue cards. Wondering if this is a possible serious Mreplacement for my hydrocodone and muscle relaxer. Currently I cannot do without either and it barely makes life a liveable. I have read a few academic papers but frankly there is not much good info to find that is conclusive. Anyone know of some legitimate studies?


#2

I live in Ontario where it is legal for medical m. My sister in law finds it helpful and actually takes it via cookies. There are different strains for different applications. She is finding it very good for her pain. I hvnt tried it myself but am glad it is now an option.


#3

Thanks kayzpa, anyone else point to relevant research? Is this that unexplored or is it that it is not effective?


#4

It sounds like a lot of the info on medical marijuana may be anecdotal. Or at least it it’s according to my stick in the mud, older brother, who’s a pediatrician. I seem to recall seeing that there was research being done in Israel but I would need to spend some time looking for it.

Check out this link- https://www.webmd.com/pain-management/features/medical-marijuana-research-web


#5

Yes, I have read that research. I believe they are leading research in that field. It looks promising.


#6

I am wondering if any particular type of weed works better for pain? 3 years ago, a co-worker gave me a sample of their home-made cookies and tincture. I was SOOO hoping it would work. I got no help at all, didn’t make me tired or help me sleep and sure didn’t help with my pain. I tried huge amts of the tincture and still nothing. As far as weed, I don’t want to smoke, actually hate the smell and I hate the taste too in baked goods.
I am very odd as to how my body reacts to pain meds. When I had pancreatitis and gall bladder attacks at the same time, the ER said they gave me 4 times the usual morphine and it did nothing. And during my 7 days NPO in ICU, I had injection Demerol every 4 hrs, and within 3 days, the Demerol was working 5 min, then 1 min, then 5 secs.


#7

Depends on the source of your pain. MMJ is not likley to help the pain directly as it effects the opiod centers of the brain. (nothing to do with narcotics) As most know or should know. Narcos not only don’t help with PsA pain the net result when you are through being “zonked” is more pain and a very quick dependence and Hyperalgesia)

MMJ can help with inflammation (as can a good curry) but there are more effective ways.

IF you are using opiates in any measure pot isn’t going to help anything except maybe dorrito sales at the corner store.


#8

Hey, thanks for the info. Source of pain- can you explain? Can you elaborate your position?


#9

Vapping is an option that be less harmful… May be, not sure


#10

There are two major kinds of pan Nociceptive pain arises from various kinds of trouble in tissues, reported to the brain by the nervous system This is the type of pain everyone is most familiar with, everything from bee stings and burns and toe stubs to repetitive strain injury, nausea, and tumours, and Nociceptive pain typically changes with movement, position, and load. Pot can help with this kind of pain.

Neuropathic pain arises from damage to the nervous system itself, central or peripheral, either from disease, injury, or pinching. The simplest neuropathies are mechanical insults, like hitting your funny bone or sciatica, but this is a big category: anything that damages neurons, from multiple sclerosis to chemotherapy to alcoholism to phantom limb pain. It’s often stabbing, electrical, or burning, but nearly any quality of pain is possible. Unfortunately, it’s also more likely to lead to chronic pain: nerves don’t heal well. Pot and narcotics worthless.

PsA pain is mostly neuropathic but also is a bit more sinister because of how the pain is caused. Neutrophils are defender cells that are supposed to destroy bacteria that invade wounds, a normal part of the inflammatory response to injury.

With autoimmune disease neutrophils go to work even when there is no wound or the wound is sterile, not open to the outside world. They also attack a common cellular organ, mitochondria.

Inflammation is excessive for this reason: every trauma causes pain that is too loud for too long, because a significant portion of the inflammation is due to this SNAFU immune system policy of attacking mitochondria.

Because the Brain isn’t involved, again pot and narcotics are worthless.


#11

Thanks for your lengthy response. Good and informative. I would point out that the pain i experience is improved --lessened by hydrocodone. How would you explain that? I have taken nervous system nerve pain medication and found they dull your whole being without addressing the specific pain. Hydrocodone on the other hand brought the most relief. I do not think one can truly say the brain is not involved. The sum you know.


#12

I will point out that it could be a overall disease profile and not only psa. Co-occuring disease. I realize the brain is maybe not where inflammation occurs but I would dare say it could be more complicated than that.


#13

The primary ingredient in Hydrocodone is actually tylenol. They way many docs are prescribing is actually 2 5/350’s as opposed to a 10/350. The opioid simply slows down your pain response while the tylenol does the work. The slowing down also prevents you natural pain control from woking which is why you become dependent. You respond but not as well as other methods including actual disease control…

Of course if you are taking the 5/350’s and 4 or more a day, you are slowly frying you liver so that most meds are not metabolized effectively. So nothing works well


#14

Apologies for a small thread hijack, but a question - I’ve never really been able to find any info on how Tylenol works / which part of the pain system it interferes with?

It’s a question I’ve had for a long time as I don’t seem to subjectively gain any pain relief from it (don’t even keep the stuff in the cupboard).


#15

@tntlamb-- I have read actually that Tylenol is harder on your liver than opiates. So much so that sometimes the opiate only is prescribed. To deny that opiates are effective for pain management is not the whole truth of the matter. We may have to disagree on that point. One would probably not be taking pain meds if there was not a problem with the body experiencing pain. I do not believe in some sort of homeostasis where the body repairs what is wrong in the case of pain and psa. Both drugs work hand in hand to get the most effectiveness. Obviously this is why we have doctors prescribing this duo for pain treatment. The emphasis on what is primary in this medication is not in my opinion an accurate description of how it works. Opiates for pain treatment goes way back. Let’s say for instance one refuses to drink because it fries the liver. This can be said but how one approaches consumption makes the whole difference. Nothing may work well but given a choice i would choose relief every time. Suffering for the sake of suffering is not a virtue.


#16

Tylenol (acetominofin) is a strange beast it’s not really a great tool in the PsA war chest. Except when combined with other meds notably aspirin and of all things caffeine. And even ibuprofen. It is part of a class of meds called non opioid analgsics. The answer is they really don’t know how it works. BUT it does inhibit an enzyme known as cyclooxygenase (COX). COX is a catalyst for the conversion of a fatty acid contained in cell walls—arachidonic acid—to substances known as prostaglandins.

Prostaglandins serve a number of protective functions in the body, but they can also produce pain, inflammation and fever. They cause pain and inflammation after cell injury by a number of mechanisms, primarily at the site of the injury in the peripheral nervous system, that is, nerves outside the brain and spinal cord, but also in the central nervous system. They elevate body temperature by affecting the heat regulating center of a region of the brain known as the hypothalamus.

By blocking COX and, therefore, the subsequent production of prostaglandins in the central and peripheral nervous systems, non-opioid analgesics reduce both fever and inflammation.

Acetaminophen, however, differs from the other non-opioids in that it does not block COX in the peripheral nervous system to an appreciable extent. It appears to reduce pain primarily in the central nervous system by more than one mechanism, possibly in part by inhibiting a form of COX known as COX-3. In fact it is the only analgesi that goes after Cox 3.

My last shoulder replacement was a pretty experimental surgery in that I had put it off so long that several of. My muscles had little or no attachment points (“Popeye Arm”) so there was a lot of work done including some bone grafting. I was expecting a lot of pain so imagine my shock when I was told that other than in recovery and a few hours after I woul be getting no “pain meds” as they would interfere to much with healing.

When the pain management pharmacist who had come from Seattle for the occasion told me that he had consented to three dose of torodol but the rest of my pain management would be Tylenol, my shock turned to freaking. As turned out the Tylenol was actually an IV drip of Tylenol. I have never had a more pain free surgical experience AND recovery. Part of it I’m certain, had to do with fact my first PT session was less than a half hour after being returned to my room, and every 4 hour after that. They had me walking ever hour on the hour around the clock from 7:00am to 11:00pm.

But let me repeat I had a total shoulder replacement with donor bone from my hip an NO post of pain meds except IV Tylenol and no take home meds,


#17

Side note-- I agree that disease control is primary but in the real world treating symptoms that interfere with life quality can be beneficial for those of us that cannot get a handle on the disease.


#18

I have grandkids who believe in Santa Clause too. One of the reasons hydrocodone will soon be gone is because it is so ridiculously weak it is way to often overdosed. The first step was several years ago, they were forced to lower the Tylenol amount from 750mg to 350mg and the narcotic amount to 5 mg. The conversion of hydrocodone on the morphine scale is 1:1 FWIW the lowest amount of oral morphine pills is 15 mg. So basically 5 mg is very small (about30 mg of codeine) The US uses roughly 90% of the world’s hydrocodone production… The morphine equivalent is one of the reasons it is so easily overdosed. It’s high enough to create morphine resitence in as little as 7 days of use, but low enough to be essentially ineffective as a pain reliever without the Tylenol. When they go to a straight narcotics they START at 15 mg which is why it is rare and generally done only in supervised pain management ( contracts, random pill counts and pee tests etc)

FWIW the morphine equivalent of caffeine is 20:1. What that means is that you will get the same analgesic effect of a 5:350 Hydrocodone by taking Tylenol tablet from the grocery store with a Diet Coke.

Low dose opiates mixed with nonopiate analgesics is found only in the USA as a matter of generally practice. Finding a Rheumy who will topedo himself (and his ability to treat rheumatic diseases by prescribing routine narcotics is becoming increasingly difficult and in some states impossible.


#19

Thanks very much for that lamb. With the magic Cox-3 term, I was able to find some recent articles, and together with your explanation, I think I understand what is going on now.

Acetaminophen works for fever for me, so I always figured it was doing its job, I just couldn’t figure out why it didn’t reduce pain perception. I guess that not only does it depend on the source of pain, but also how each individual’s pain system works (case in point, Celebrex is far more effective than ibuprofen for me, and they are both Cox-2 inhibitors).

Now that I have had a good read though, if my chronic headaches return, I’m going to give Acetaminophen a go on those given the research.

I do find codeine works to dull the pain when I am desperate, but my time to tolerance is a measly 3 days, so there’s not much point. Better off with a 2 day steroid burst to see if I can break the flare (and lucky to have great success with Humira so I’m not always in flare anymore). Soon we in Aus will require scripts for acetaminophen/ codeine combinations too.


#20

I see but what you are saying vs. my personal experience- it is hard to blame me for using something that improves my quality of life. I have tried other pain meds and this combo works for me. Yes, I am in the U.S. so protocol may be different. Are you a doctor or something? I can’t do carbonated drinks. :slight_smile: