The Malta Independent 26 May 2019, Sunday

The use of medical cannabis to deal with chronic pain

Giulia Magri Tuesday, 23 April 2019, 11:24 Last update: about 2 months ago

Data indicates that 20% of Malta’s adult population experiences chronic pain. Such pain is present in 1 in 10 persons aged 45 years and over. Almost 40% of the younger cohort reported a higher level of impairment to their social activities due to their physical or emotional state. Chronic pain brings about numerous issues and problems people dealing with chronic pain disorders or diseases; some might face disbelief or problems with work. The medication used to treat such disorders at times brings more problems than solves them. Giulia Magri met up with three individuals who all face chronic pain, who discuss and open up the challenges they have faced in dealing with this pain and to ensure that they have a good quality of life.

Reasons for anonymity of interviews

One of the participants explained that although they have a strong opinion about the use of medical marijuana to treat chronic pain, they preferred to not have their name on a newspaper. “Many people have blinkers on and do not wish to see the reality of using marijuana for medical use, but only see drugs as harmful.”

The interviewees said that the stigma of chronic pain and the use of medical marijuana does affect their daily lives. “This is something which doesn’t just happen to me, but many others are facing, and that this medicine is helping us function in our daily lives.”



The pain caused by fibromyalgia can keep me in bed for days

Clare*was only diagnosed with Fibromyalgia three years ago, and has been dealing with the pain throughout her whole life. Fibromyalgia is a chronic disorder associated with pain in muscles and joints, fatigue and concentration problems. Like Clare, many are either misdiagnosed for another disease or are just unaware that such a condition exists.

She explained that before being diagnosed with fibromyalgia, she would have many days where she did not have the energy to leave the house. “Before we installed a stair lift, we even considered moving house. Even just walking around the corner can be too much.”

She said that she had files full of medical tests that never led to a proper diagnosis and it wasn’t until she came across a television programme where someone diagnosed with the chronic disorder began describing the symptoms. “I realised these are similar to my own symptoms, and then I was diagnosed with fibromyalgia. At first you feel happy, because finally you can put a label to your pain and people will believe that you are not inventing or exaggerating what you are feeling.”

She said that inside she could feel her energy and inspirations, but that she was trapped in a body which could not do anything. “There were many times when I had to decide whether I was going to get out of bed to shower or to prepare a meal for my family.”

She explained that the pain she felt also made her question her probability of proper employment. “I enrolled at University as a mature student, but I was worried that because of my fibromyalgia all my hard work and studies would be for nothing.”

Claire explained that she was fully dependent on others, and she felt extremely confused and lost as the pain would also affect her mentally. “Many times, I would consider if it is worth living, to face another day in so much agony.”

Clare said that the prescribed medication would only make her worse. Although the pain might dwindle slightly, the side effects were too much to handle, as her vision would become blurred and she felt more tired than she did before.

“I am thankful to hear about the cannabidiol (CBD) and how it treats chronic pain, anxiety and depression.” She said that with the help of CBD she can now get out of bed, get in her car, work and continue her daily life also as a mother and wife.

When asked whether it was difficult to obtain the CBD, she expressed that unlike in Malta, CBD could be purchased over the counter in health shops all over Europe. “In Malta you have to go through a long procedure and a lot of hassle to obtain CBD, and it does not help that the medication is not available in pharmacies.”

She explained that it is not fair to have to choose between buying CBD illegally or go through all the misery of a life without CBD.  Although she has the control card, in Malta there is only one type of marijuana medication and it is very expensive.

She explained that there is not enough focus on chronic pain patients. “After suffering for so many years, now that I can finally control and treat my pain. Why is it so difficult to obtain this medication? Our country considers all components of this drug as narcotic/psychotropic, when in fact it is even emphasised by the World Health Organisation that CBD is a form of safe medication. This form of medication has been hidden from us for all these years, as we continue to suffer for no reason when there is proper treatment.”

Claire explained that she has encountered medical staff who are not well-informed regarding CBD or medical marijuana, whilst the Government focuses on bringing companies to produce marijuana.

“There is all this hype to bring these companies to Malta, but then there is no focus on the patients and their own well-being.”

The fact that patients like her have to obtain their medication from abroad brings on another form of stress that they will get caught or get in trouble with the authorities. “Why should I always have this feeling of guilt and worry when this medication could help me to continue working and be there for my family?”

She stressed that people need to become more aware of this medication, and that at the end of the day many other forms of medication can be abused of and used recreationally.


Pain was stopping me from continuing with my business

Around 9 years ago Brian*, a company owner, ended up in a very serious motorbike accident, which he explained could have ended his life, as he had extremely serious injuries. After spending two months at ITU and three weeks in hospital, he was sent back home and prescribed Tramadol painkillers.

“I am a businessman and before my accident I was always on the go, facing long and hectic days. The moment I was discharged from hospital I had to somehow get back into this routine.”

Although physically Brian was still recovering from the accident, mentally he had to remain focused, but the prescribed medication was making that more difficult day by day. The Tramadol painkillers would fog up his concentration and knock him out that many times he did not know what day of the week it was, let alone  be able to focus on his work.

Although he then changed his medication to Codeine, the dosage had to  be increased and his concentration would go down. “I then ended up taking alcohol to soothe my pain and to leave me able to concentrate on work.”

He explained that he alternated between alcohol and medication for four years, until one day he noticed an inflamed rash on his skin. After numerous tests he was informed his liver was giving up.

“The mixture between codeine and alcohol was helping me in the short term but destroying me in the long run and this was no way to live.” He tried to find out another means of controlling his pain.

He described the pain to be something which was present from his waking moments, and one which he would fall asleep with; it is always present. “My pain ranges from headaches, backaches, my hip and ribs are in constant pain - pain which can grind you down if you do nothing about it.”

After speaking to people and researching, Brain decided to buy a vaporizer and marijuana to see how it would help his pain. “It is not the first time I tried marijuana. When I was much younger, I had tried it a couple of times, but not with the intention of treating pain. At the beginning I had to buy the marijuana illegally, but it began to help me straight away.”

Like Clare, he said that medical marijuana is not as easy to obtain as people believe it is. There are long procedures, numerous appointments and that the marijuana itself is not cheap; that sometimes prices would even reach to €15 for a gram. “I am aware that there is a huge difference in the quality of the medical marijuana compared to what one finds on the street, especially because you know where it is coming from - it makes a huge difference.”

He said that gaining medical advice on how to treat his pain with marijuana has also helped greatly for him. He added that more people need to be aware of the benefits of such medication, especially people who suffer from constant pain and wish to continue their career, family and life in general.


The main issue with my disease is explaining to my employees what I am suffering from

Andrew* suffers from Chron’s disease (an inflammatory bowel disease), where from time to time he would suffer from intense flare-ups in his bowels. He too, expressed that medical marijuana has settled and treated the pain brought about by the disease. He explained that with the help of CBD, he could control the pain and be able to have an appetite to eat, which due to the severe pain of the flare ups he would not eat for weeks. “You feel very weak; I was on an elemental diet to help treat my inflammation for a good two weeks now.”

 Apart from the medical marijuana, Andrew also goes to the hospital to get regular check-ups and also takes an injection himself. He explained that the marijuana has helped him overcome his disease and that he is able to get out of bed and continue with his daily life. Although he feels comfortable taking his medication out in public, he vaporizes the CBD before going out, because he does not feel very comfortable knowing people might judge him.

“Of course, having Chron’s disease brings up certain challenges, like what kind of work I can do, since at times I feel fatigue or I need to excuse myself often to go to the bathroom. My employee needs to take these things into consideration and not everyone might accept this.”

He explained that not everyone understands what he suffers from, and he also faces daily challenges in society, such as the lack of clean public toilet facilities on the island.


Not even your own family can understand your pain

One interviewee explained that they mainly face difficulty explaining their condition and pain to employees, out of fear that they would think that they are making up excuses or are lazy.

When asked to describe how to tackle the stigma of suffering from chronic pain, one interviewee explained that it is not something so easy to tackle. “Your own family cannot understand what you are feeling, so feel alone. Having a label to what you feel it can help a bit, but if your own family cannot relate to you, how will outsiders even begin to understand?”


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