Myth Busting Legalization: Stigma

THCa filled cannabis paste used by an Autoimmune Arthritis patient.

Myth: A legal medical cannabis program means public perception has changed and everyone is on board.

Years ago, I started using cannabis to help regulate my pain.  The patient-demonizing “War on Opiates” was just getting started, and filling my valid prescription was becoming harder and harder.  Fast forward a few months, and I had completely weaned off 60mg oxymorphone and 30mg oxycodone daily.   After about 3 months of using cannabis consistently, I randomly noticed that I was healing faster and able to do more.  My inflammation markers were nonexistent, and after 18 months of unresponsiveness to Actemra, it magically started working better.    At the time, I had no idea that autoimmune and inflammatory diseases were some of the bigger responders to cannabinoid therapy. 

Upon further research I found studies like this one from GW Pharmaceuticals which claim, “ Conclusions. In the first ever controlled trial of a CBM in RA, a significant analgesic effect was observed, and disease activity was significantly suppressed following Sativex treatment.”  At that point the light bulb came on and I realized that the combination of cannabis and my biologic were most likely working in harmony.

This was amazing and the best I’d felt in decades.  I was so excited and went to talk to my rheumatologist.  His response was that he didn’t believe that mumbo jumbo, but he was happy I was off opiates.  Okay.  Then I made it public that I was using cannabis.  Suddenly, everyone I knew started sending me memes with Cheech & Chong or Scooby-Doo stoner innuendos.  Sure, they were funny, but I realized that the stigma of cannabis prevented people from taking it seriously as a therapy. 

Cannabis has been around for thousands of years, and was in everyone’s medicine cabinet until the late 1930’s.  After that, we’ve had nothing but harm studies and DARE curriculum taught from an early age.  Only recently has most of the World started to take cannabis seriously as a therapeutic agent, and here are some things to expect if you consider trying cannabis in a medical context. 

  1. Most of the public thinks medical cannabis patients are stoners.  If you are public with use, expect people to assume you are using cannabis recreationally.  Most patients use cannabis to either improve quality of life or increase functioning.  THC has been shown to have powerful anti-inflammatory properties, and helps modulate tumor necrosis factor alpha (TNF-a).  Not everyone will understand, and most assume you are just medicating the pain away by getting “high”.   They will talk about brownies, munchies, and watching movies with couchlock.  Unfortunately, this is just the natural process of change, and you will inadvertently become an educator.  Laws may have changed, but perception takes so much longer to change.
  2. Doctors don’t want the liability of dealing with cannabis, and most aren’t familiar with the endocannabinoid system.   Don’t expect them to know how any of this works.  The endocannabinoid system (eCS) is a major body system.  Pre-clinical research shows the system works on a cellular level and helps maintain energy homeostasis, modulates the immune system and healing, and governs several functions in our bodies.  Most doctors know absolutely nothing about how it works.  Research has exploded in the last decade, but this is a small blip in the time it will take to get to a point where we are regularly conducting human trials.  In addition, physicians have DEA prescribing licenses and those are Federal licenses.  There is always a risk that dabbling in cannabis could result in loss of the license.  In this moment in time, we are on our own when it comes to finding our own therapy balance.
  3. Pain management often discriminates and will not allow cotherapy.  Even in legal states like Washington, Colorado, Maine, and New Mexico, many pain management clinics do not allow for the use of opiates and cannabis together.  This robs the patient of using cannabis to help wean down off opioids slowly and makes them choose.  Study after study has shown that cannabis can assist with lowering doses of opiates needed or even replacing them all together.  Make sure you talk with your pain management provider about their policy before using cannabis, even CBD isolate.  You could lose access if your provider is not on board.
  4. Most hospitals don’t allow cannabis onsite. In 2016, I had a c1-3 fusion and wanted to use cannabis for pain control rather than opiates.  Not only was that request denied, but my bags were searched, and all my cannabis was put into a locker.  Even when I was being discharged and asked for my locker contents, the security guard questioned me like I was a criminal.  I live in Colorado and both medical and recreational access is allowed.  This hospital not only treated me like I was a murderer, but seriously pushed IV narcotics when I didn’t need them.  The nurse even made a quip about “using it while I had it”.   If I needed the dilaudid, I would have used it.  I didn’t and it gave me side effects I didn’t need on top of a fusion.  Talk about being high!  After trying it once, I made them take the pump from the room.   

Realizing that just because our laws had changed, didn’t mean perspectives had changed was a huge adjustment.  Colorado has had their medical program for nearly 20 years, yet the stigma of “the stoner just wanting to get high” still dominates.  I was incredibly naïve when I first started my cannabis journey and have learned so much since then.  Being persistent and willing to learn on my own has helped change the perceptions of nearly everyone I meet.  From neighbors to law makers and doctors to patients, perceptions and stigma are changing.  That doctor who didn’t believe that cannabis “mumbo jumbo” became a believer and three years later sold a CBD topical recipe to a large manufacturer.  You never know how important your story will be when it comes to changing perceptions. 

Cannabis is like any other therapy and doesn’t work for everyone.  With the stigma still pervasive, many patients won’t even try.  Slowly but surely things are changing for the better.  Patients are starting to come out of the woodwork in droves, and the professional medical community is taking notice.  Conferences like Marijuana for Medical professionals are filling up with curious doctors and practitioners.  Interest in researching cannabis and disease is exploding, and finally stigmas are starting to change.  Despite all of this, cannabis has still been worth it.  Access has bought me some time being functional, and for that, I’m forever grateful.

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