Cannabis usage in those who suffer from rheumatoid arthritis is suggested to reduce inflammatory factors which causes a trademark symptom of the disease, chronic pain.
Research by Irish company, GreenLight Medicines, indicated that the chemical compound in the cannabis plant known as cannabinoids reduce certain causes of inflammation which contribute to some symptoms that define rheumatoid arthritis.
Usage of cannabinoids is indicated to interfere with the pathology of the disease, therefore this compound “may also reduce sensitisation of nerve endings to pain,” said PhD David Gibson, Chief Scientific Officer in GreenLight Medicines Ltd., which is the first Irish pharmaceutical company to focus on the clinical use of phyto-cannabinoids and other plant-based compounds.
The Cannabis Chemicals
Cannabinoids interact with the system in the human body known as the endocannabinoid system (ECS).
“Human produce their own cannabinoids throughout life which are thought to regulate mood, appetite, pain and inflammation via the ECS,” said Gibson.
Tetrahydrocannabinol (THC) is a type of plant-based cannabinoid which produces the ‘high’ associated with cannabis use. Research suggests the chemical can cause paranoia, psychosis and that misuse can cause schizophrenia in later life, although this point is highly contested Cannabidiol (CBD), is less psychoactive and is used to reduce anxiety, inflammation and provide pain relief. CBD can be bought as an oil in Ireland.
It is unclear how this research by GreenLight Medicine Ltd. will impact the usual course of treatment for those with rheumatoid arthritis as “clinical trials conducted on cannabinoids to date are inconclusive on whether they are effective in this condition,” added Gibson.
This is the result of several variables such as “doses used in the trials, modes of delivery, poor trial design,” he continued.
Current Irish Treatments
The current course of treatment used for people with the disease is long term immunosuppressant medications such as methotrexate, biological drugs which are taken as an injection or intravenously and taking large doses of steroids. Other methods of treatment are also used.
Several side affects are related to these drugs. For example, taking copious amounts of steroids over numerous years can lead to adrenal insufficiency and restricted development. Methotrexate can cause vomiting, nausea, diarrhoea and hair loss in some cases.
“At this point there isn’t enough evidence in terms of the efficacy or safety of CBD as a treatment option. This is also the view of the Arthritis Foundation in the US and the UK,” said Head of Communications and Advocacy at Arthritis Ireland, Brian Lynch.
Some research in this area which has been conducted in the past few years suggests there are health benefits to using CBD, especially when using it to treat certain illnesses. However, there is no substantial body of work that provides overwhelming evidence that CBD could be used as an alternative to treat rheumatoid arthritis.
Gibson believes however that “there is lots of anecdotal evidence to suggest it can help with pain and recent reports from Canada and US suggest many people accessing medical cannabis do so because of musculoskeletal pain experienced through arthritis and pain.”
There is still controversy over prescribing cannabis for medicinal use. Several protests have been held in Ireland to try and legalise weed and the initiative is consistently backed by the Green Party, especially when it comes to using it for medical purposes.
However, others state there is not enough evidence in relation to the health benefits of cannabis. Subsequently, due to a lack of comprehensive research, it is difficult to distinguish the benefits or negatives when it comes to treating certain illnesses with it.
The Health Products Regulatory Authority Ireland (HPRA) published a report on the medicinal use of cannabis, as requested by Minister for Health Simon Harris. Its findings suggest using the drug as a treatment method is still controversial.
The report proposed there is insufficient evidence to prove cannabis should be officially legalised and used as a safe and effective pharmaceutical drug at present. Some research indicates it pacifies certain patients with chronic conditions, which is why the HPRA suggested more that clinical research take place and access programmes for these specified cases should be created.
Irish Medicinal Cannabis
On the recommendations of the report, Harris announced that a medicinal cannabis access programme will be established, one of the demographics that qualify to potentially avail of medicinal marijuana are those who suffer from chronic pain.
Under these guidelines, those diagnosed with rheumatoid arthritis may avail of the drug through the programme regardless of the recent research on the connection between cannabis and arthritic inflammation.
Since the announcement of the access plan two years ago, progress on prescribing patients with medicinal cannabis was stunted until recently. The government did not want to further the plan until they secured a quality assured supplier of medicinal cannabis. Such a supplier was found earlier this year and consequently the government will begin to enact the plan.
Regarding cannabinoids being used to treat rheumatoid arthritis, more research needs to be done in this area.
GreenLight Medicines Ltd. plan to conduct clinical trials in 2020 on inflammatory and immune related conditions with lead compounds showing efficacy in the pre-clinical research programmes, according to their website.