Three Consecutive Patients
in a Therapeutic Cannabis Medical Practice
By Philip A. Denney, MD
R.C., a 53-year-old insurance attorney, sustained a cervical spine fracture at C-4 and C-5 in a surfing accident in a surfing accident in 1991. The injury required surgical fusion with bone grafting and internal fixation, resulting in chronic pain. He has used cannabis successfully for pain mangement over the last eight years at a stable dose of 1/4 ounce per week. He weaned himself completely from narcotics and benzodiapenes (Valium). “That stuff was killing me.” He denies any adverse effects of cannabis use.
Comment: This is a very typical patient in my practice. Chronic pain is the presenting complaint for as many as 1/2 my patients. -PAD
B.M., a 20-year-old student, presents with a diagnosis of Crohn’s Disease discovered at age 15. He gives a history of chronic abdominal pain, severe weight loss and rectal bleeding, poorly controlled with multiple medications. He was introduced to cannabis by another Crohn’s Disease patient two years ago and noted immediate improvement. He has had significant weight gain, marked reduction in abdominal symptoms including rectal bleeding and has had no hospitalizations since beginning therapeutic cannabis. He uses 1/2 ounce per week and has stopped all pain medications. He continues to use Asacol to treat his underlying disease.
Comment: Chronic gastrointestinal diseases, particularly those with painful cramping, nausea or anorexia, respond well to cannabis in my experience. -PAD
R.S., a 31-year-old nanny with a history of longterm morbid obesity, underwent gastric bypass surgery in 2001. Post-operatively she experienced anorexia and severe nausea, resulting in profound weight loss (from 260 lbs down to 96 lbs). She was treated with multiple medications. “They even sent me to a psychiatrist.” When a feeding tube and parenteral nutrition were discussed, a friend insisted that she try cannabis. R.S. reports that cannabis controlled her nausea, “better than any other medication I’ve tried.” Her weight has stablized at 120 lbs. She states that cannabis not only helps her nausea and appetite, but has helped her deal with the life-changing effects of her profound weight loss.
Comment: another example of the benefit of cannabis use in gastro-intestinal disorders. Also illustrates the benefits for patients with life-changing illnesses. -PAD
O’Shaughnessy’s Spring 2004