Does cannabis help improve the symptoms of people who suffer from Sickle Cell Disease (SCD)? New research suggests that it can. A 2020 study found that cannabis was a relatively safe intervention in comparison to opioids and other pain relieving options. Opioids have long been a first-line but controversial treatment for SCD, but their use is controversial due to the risk of addiction.
What is Sickle Cell Disease?
Sickle cell disease is also called sickle cell anemia. It’s an inherited red blood cell disorder that comes with several troublesome, painful symptoms. According to the Mayo Clinic, periodic episodes of extreme pain are one symptom. These are referred to as “pain crises”. Pain crises develops when sickle-shaped red blood cells block blood flow through tiny blood vessels to the chest, abdomen and joints. Pain varies in intensity and can last for a few hours to a few days. Some people have only a few pain crises a year. Others have a dozen or more a year.
The disorder also is a culprit for swelling of the hands and feet in some SCD sufferers. In men, it can cause priapism, a condition leading to prolonged painful erections. Some people with sickle cell anemia also suffer from chronic pain from bone and joint damage, ulcers, and other causes. 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.
Treatments for Sickle Cell Anemia
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. Bone marrow transplants have been studied as a potential cure for SCD.
Opioids are typically prescribed to help manage this pain. However, the rise in opioid addiction and death has prompted doctors to prescribe them less frequently.
Who Gets Sickle Cell Disease?
Sickle cell disease occurs more often in certain ethnic groups, including: People of African descent, including African-Americans (among whom 1 in 12 carries a sickle cell gene) and Hispanic-Americans from Central and South America. People of Middle Eastern, Asian, Indian, and Mediterranean descent also get SCD in higher frequencies than Caucasians.
About 1 in 13 black babies are born with a sickle cell trait. If that young person grows up and has a child with another person with a sickle cell trait, the likelihood of a fully formed version of sickle cell is increased by virtue of recessive/dominant traits.
Each year, about 1,000 children are born with sickle cell anemia in the United States. Red blood cells provide the growing body with the oxygen and nutrients needed for growth, so children’s SCD can be particularly traumatic. A shortage of healthy red blood cells can slow growth in babies and children and delay puberty in teenagers.
Could Cannabis Be Helpful? A 2020 Study Sheds Light
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 cannabis’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 associated with cannabidiol (CBD).
“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) have been suggested by MMJ patients as 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 cannabis.
Where the 2020 study concluded that cannabis was helpful for SCD, other studies found contrary results, including this study done in 2022. It’s important to note that not all SCD patients will respond positively to cannabis therapy. Patients should review the idea with their medical team before attempting to add cannabis as a therapy.
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 cannabis practitioner in your area.
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