Cannabis and Sickle Cell Disease

    This article reprinted courtesy of Duber Medical. To get your Ohio medical marijuana card, go to DuberMedical.com. Receive $10 off when you use discount code “MedicateOH”.

    Could Medical Marijuana help improve the symptoms of people who suffer from Sickle Cell Disease (SCD)?

    New research suggests that it can. A 2020 study also found that cannabis was a relatively safe intervention in comparison to opioids. Opioids have long been a first-line but controversial treatment for SCD. 

    What is Sickle Cell Disease?

    Sickle cell disease (or sickle cell anemia) is an inherited red blood cell disorder that comes with an array of troublesome, painful symptoms. Each year, about 1,000 children are born with sickle cell anemia in the United States. It primarily affects African Americans, but other racial groups can inherit the condition as well. SCD causes the patient’s cells to become misshapen, looking similar to the crescent shape of a sickle, which is where the disease gets its moniker. Sickle red blood cells die sooner than normal cells, meaning less oxygen gets transported throughout the patient’s body. 

    Sickle cells often clog smaller blood vessels, resulting in acute or chronic pain, infection, and even serious cardiovascular issues. The sickle cells can restrict blood flow, significantly increasing the risk of a stroke. Because the red blood cells of sickle cell patients also have a shorter lifespan, it can leave sufferers in constant short supply. 

    The pain that sickle cell patients experience is complex, with both neuropathic as well as inflammatory characteristics. Contributors to the pain include oxidative stress, hypoxia and reoxygenation, vascular dysfunction, and end-organ damage. The only potential cure for sickle cell anemia is a bone marrow transplant. Opioids are typically prescribed to help manage this pain. However, the rise in opioid deaths has prompted doctors to prescribe them less frequently, leaving sickle cell patients with fewer options.

    Could Cannabis Be Helpful? 

    An incomplete understanding of the mechanisms underlying SCD pain has contributed to a lack of effective treatments. A 2020 study published in the journal Hematology attempted to begin understanding if cannabis could be an effective treatment for SCD. The study’s objective was to assess whether cannabinoids may alleviate pain and address the underlying pathophysiologic changes in SCD patients.

    The double-blind, placebo-controlled, randomized trial of 2020 was the first to assess medical marijuana’s potential for pain alleviation in people with sickle cell disease. The cannabis used in the trial was obtained from the National Institute on Drug Abuse — part of the National Institutes of Health — and contained equal ratios (1:1) of THC and CBD.

    Twenty-three SCD patients completed the trial, inhaling either vaporized cannabis or a vaporized placebo during two, five-day sessions.

    Researchers assessed participants’ pain levels throughout the treatment period. They discovered that in some patients, the effectiveness of cannabis appeared to increase over time. As the study period progressed, subjects reported that pain interfered less and less with activities, including walking and sleeping. 

    Researchers also observed a statistically significant drop in how much pain affected the participants’ moods. Although they don’t receive much attention compared to the physical pain symptoms of SCD, mood disorders are prevalent side effects for patients with sickle cell disease. Depression, anxiety and other psychiatric issues can also develop, often intertwined with the social, economic and healthcare disparities experienced by those with the disease.

    How Does Cannabis Work to Help SCD Symptoms?

    Cannabinoids have analgesic and anti-inflammatory properties that may help to treat mast cell activation, leukocyte trafficking and adhesion, neurogenic inflammation, oxidative stress, endothelial activation, and hyperalgesia via cannabinoid receptors 1 and 2, according to the 2020 study. Several other trials have suggested that cannabis may effectively treat neuropathic pain. 

    In addition to the analgesic effects of THC, the main psychoactive cannabinoid in cannabis, there are anti-inflammatory and analgesic properties purportedly associated with cannabidiol.

    “These trial results show that vaporized cannabis appears to be generally safe,” said University of California, Irvine researcher Kalpna Gupta, co-leader of the study and professor of medicine on the faculty of UCI’s Center for the Study of Cannabis. “They also suggest that sickle cell patients may be able to mitigate their pain with cannabis—and that cannabis might help society address the public health crisis related to opioids. Of course, we still need larger studies with more participants to give us a better picture of how cannabis could benefit people with chronic pain.”

    Cannabis Strains for Sickle Cell Disease

    Every patient responds to cannabis differently, but certain strains have been identified by SCD patients as being particularly helpful for their condition. Not all strains are appropriate for all patients, so you should talk to your doctor(s) about what might be right for you. 

    When considering strains to treat SCD, those with a high THC content or equal levels of THC and CBD tend to be most effective. Jack Herer (Sativa), Pineapple Express (Hybrid), and Harlequin (Hybrid) may be good options. 

    It’s unknown how many patients use cannabis to treat their sickle cell anemia. A Facebook group and nonprofit organization, Sickle Cell Warriors, lends a forum for firsthand accounts of the cannabis experience. SickleStrong Inc. also connects patients trying to remedy the blood disorder through natural methods including medical marijuana.

    If you struggle with sickle cell disease and would like to consider cannabis to aid in your treatment, reach out to medicateOH@gmail.com to be matched with a medical marijuana physician in your area.

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