Cannabis is known for reducing pain and inflammation in many applications. Recently researchers set out to see if it would help in treating the severe, painful episodes of an acute sickle cell crisis.
WHAT IS SICKLE CELL DISEASE?
Sickle cell disease is a chronic condition that targets the body’s red blood cells and is characterized by episodic pain in the joints, fever, leg ulcers, and jaundice, among other symptoms. In the United States, SCD affects about one in 650 African Americans and about half as many Latin Americans.[ref](http://norml.org/news/2005/09/22/patients-with-sickle-cell-disease-find-relief-from-cannabis-study-says) 06/12/2015[/ref]
During a crisis, red blood cells (RBC) distort into a sickle-shape rather than the normal discoid profile. The RBC’s sickle shape makes it stiffer and less able to squeeze through tiny capillary beds. If enough of them become stuck, blood flow to the distal watershed regions becomes compromised. Should this happen to an upper limb for example, the end result is a sometimes hypoxic, and always a painful arm.
To understand how agonizing this is, try inflating a blood pressure cuff on your arm and leave it inflated for 5 minutes. The pain that develops is from hypoxia as you occlude blood flow to your arm.
As an anesthesiologist, we occasionally administered special “nerve blocks” such as a stellate ganglion block, to vasodilate the arteries in the affected upper limb and to provide powerful pain relief. Of course these procedures carry certain risks and many MD’s will not consult us for them. It’s expensive and time consuming. Otherwise morphine and hydration are standard protocols for sickle cell crisis.
SURVEY REVEALS SICKLE CELL PATIENTS USE CANNABIS FOR PAIN AND ANXIETY RELIEF
A formal survey was completed in London in 2005;
Eighty-six hospitalized patients with SCD participated in the survey. Thirty-six percent of respondents reported having used cannabis in the past 12 months to relieve symptoms associated with the disease. Of these, 52 percent said that they had used cannabis to reduce pain, and 39 percent reported that it mitigated their anxiety and feelings of depression.
The majority of patients (58 percent) expressed their willingness to participate in clinical trials of cannabis as a medicine.
We conclude that research in the use of cannabinoids for pain relief in SCD would be both important and acceptable to adult patients.[ref]Br J Haematol. 2005 Oct;131(1):123-8.[/ref]
PRELIMINARY RESEARCH SHOWS PROMISE
Dr Kalpna Gupta is an associate professor of medicine at the University of Minnesota. She has been conducting research on mice with sickle cell disease and feels that cannabinoids have good outcomes in treating pain.
After being awarded a nearly ten million-dollar grant from the NIH, their team was forced to leave Minnesota where it is illegal to conduct human trials using cannabis, for California.
Here, they will be working with well-known researcher Dr Donald Abrams of UCSF (San Francisco) to conduct phase 1 and 2 clinical trials on 35 selected patients. The trial hopes to answer the following postulates:
1. Inhaled cannabis will significantly reduce chronic pain in patients with SCD.
2. Inhaled cannabis will significantly alter the short-term side effects experienced by patients who take opioids for SCD.
3. Inhaled cannabis will significantly alter markers of inflammation and disease progression in patients with SCD compared to placebo.
After considerable red tape from the FDA, the trial is underway. This is one of the reasons we need to enact federal legislation so that entire research teams do not have to waste time and expenses moving 2000 miles to parachute into cannabis-free territory. It’s ridiculous I know, but something we must endure until a change is made in our regulatory system.
Meanwhile, Georgia is the first state to recognize sickle cell disease as an indication for medical cannabis:
The disease affects over 7,000 Georgians each year, most of whom are African-Americans. With Georgia’s large African-American population, getting sickle cell anemia included as one of the qualifying medical conditions for medical marijuana was of particular need.[ref](http://georgiamarijuana.org/2015/04/25/georgia-medical-marijuana-law-first-to-include-sickle-cell-anemia/) 06/12/2015[/ref]
While insufficient scientific data is available for any conclusions to be drawn on using cannabis in treating the pain and inflammation of a sickle cell crisis, one can always try it and see if it helps in overcoming the severe pain, anxiety and stress that sickle cell patients must endure on a regular basis. Feel free to add comments if this strategy is successful for you.