Medical Marijuana for Ankylosing Spondylitis

Reviewed by: HU Medical Review Board | Last reviewed: June 2022 | Last updated: July 2022

Medical marijuana comes from the cannabis plant. The cannabis plant has been used in a variety of ways for thousands of years, and cannabis and its derivatives are being looked at as a potential therapy for many conditions. Traditionally, the smoking form of cannabis has been called marijuana, although some oral formulations are now also called marijuana.

Cannabis for recreational or medicinal use is illegal by federal law in the United States. Contrary to the federal policy, several individual states have passed laws making medical marijuana legal, and a few states have also made recreational use of marijuana legal. Each individual should consult with their doctor and the laws of the state they reside in before considering the possibility of using medical marijuana.

Our ankylosing spondylitis advocates have written about medical marijuana and CBD as ways that they manage their pain.

Active ingredients in medical marijuana

The active compounds in the cannabis plant are called cannabinoids. There are dozens of cannabinoids in the cannabis plant, and the two most well-known cannabinoids are THC (delta-9-tetrahydrocannabinol) and CBD (cannabidiol). THC has been associated with reduction of nausea and pain, increased appetite, and psychological effects like euphoria and altered sensory perception, which can make users feel “high” or intoxicated. CBD does not produce intoxicating effects, but it produces sedative effects that can help reduce pain, nausea, and inflammation.1,2

How does medical marijuana work in the body?

Scientists have discovered that the human body has an endocannabinoid system (ECS). (“Endo” means internal or within the body.) The ECS is distributed throughout the body and plays a part in regulating many functions, including pain, immune function, inflammation, and bone health. The ECS is comprised of the cannabinoids the body produces, the receptors on which they act, and the enzymes that are involved. THC and CBD have similar shapes to the internal cannabinoids and work on the same receptors.1

Medical marijuana research

While several studies have been done on medical marijuana for different conditions, there is a lack of high-quality research. With cannabis being illegal nationally in the U.S., there has been a lack of funding for research, as well as concerns about the legality of research. In addition, different preparations and manufacturers of medical marijuana can produce widely different levels of THC and CBD, and it is not yet known which preparations or what level of THC and CBD are best for different patients. More research is needed to fully understand the potential risks and benefits of cannabis and to understand how it may or may not be helpful for people with spondyloarthritis like ankylosing spondylitis.

Research studies that have been done on medical marijuana suggest that it may help with chronic pain and chemotherapy-induced side effects like nausea and vomiting.2

What are the side effects of medical marijuana?

Common side effects seen in research studies of medical marijuana include dizziness, drowsiness, feeling faint or light-headed, fatigue, headache, impaired memory, and disturbances in attention, concentration, thinking, and decision-making. More research is needed to understand the long-term safety of medical marijuana. Some people should not use medical marijuana, including those who are allergic to cannabis and those who have or are at a high risk of schizophrenia or other psychotic illnesses.2

Medical marijuana preparations

Medical marijuana comes in a variety of forms, including inhaled, oral, and topical preparations. Smoking marijuana can have many of the same cancer-causing chemicals as tobacco smoke, and inhalation by vaporization is another option. Oral ingestion of medical marijuana is available in edibles (like candies or other sweets), cannabis oils, or tinctures that are delivered under the tongue. Topical applications are available in ointments and balms which can be smeared on the skin.2

As with any complementary therapy, it’s best to talk to your doctor before trying something new. Your doctor is the best resource for understanding all the treatments you are taking and advising you on how to try complementary therapies safely.

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