Part II provides additional guidance for using MMJ to treat the most common chronic pain conditions. Patients challenged with a diagnosis other than those presented in Part II can begin applying what they learned in Part I. If possible you can also use the recommendations for a similar condition, or those listed in Chapter 5, “Inflammation,” to obtain significant pain relief.
Once you are feeling as if the pain is under reasonably good control and is no longer a major distraction or the central focus of your life, you may be interested in taking the next steps toward long-lasting pain relief. In addition to “Medical Marijuana Recommendations,” which discusses the products, strains, and delivery methods most effective for every condition, each chapter in Part II includes “Holistic Medical Treatment and Prevention (HMTP).” By adhering to this treatment program, you should be able to reduce consumption of MMJ from daily (or multiple times per day) to less frequent use.
As you learned in Part I, there can be unpleasant psychological consequences to daily use of marijuana, especially with high-THC (sativa) or even moderate-THC (hybrid) products. The evidence indicates a significant link between daily use of cannabis and depression, memory loss, cognitive impairment (including the inability to discriminate time intervals and space distances), and information processing. From my own observation and that of many psychotherapists, I would add anxiety, impulsivity, irritability, and anger to this list of symptoms. Depression is associated with low levels of dopamine (a chemical in the body responsible for feelings of pleasure), and although an immediate effect of THC is an increase in dopamine, chronic use of marijuana causes the brain to reduce dopamine production. The decreased dopamine might then trigger a need for more marijuana to relieve the depression, thus creating a dependence that can be both behavioral and physical. Seven to 10 percent of daily users will develop dependence.
Part II, especially the HMTP Program, will help you to avoid dependence by addressing the causes of your chronic pain, thus reducing the need for MMJ. “Getting high” is a pleasurable habit, but if this medicine is not needed for pain relief, then daily use is excessive and can become a problem. It may manifest as a subtle change in behavior that you’re not even aware of, but which is often obvious to your spouse or partner. As your pain subsides, I would suggest gradually reducing your use of marijuana to two to three times per week; and even less frequently if there is further resolution. One of the rules that I live by, for experiencing a state of optimal health: Everything in moderation, including moderation.
In the HMTP section of each chapter you will also find the following subsections: “Risk Factors and Causes”; “Physical Health Recommendations,” including diet, vitamins, supplements, and herbs; and “The Issues in Your Tissues: Mental and Emotional Health Recommendations,” which highlight beliefs, attitudes, and emotions associated with your specific condition. Rather than merely relieving symptoms temporarily, holistic medicine is largely a self-care practice focused on identifying and addressing each of the underlying causes of your disease. These might be dietary, anatomical/postural, environmental, mental, emotional, or spiritual factors that manifest as pain or dysfunction in your body. By treating each of the contributors to your pain, you will be practicing whole-person, holistic, or body-mind-spirit medicine. This practice is essential not only for longer-lasting pain relief, but especially if you’re interested in preventing recurrences or flare-ups of your pain, possibly curing the chronic condition, and leading a vibrantly healthy life. I call it fully alive medicine.
The HMTP Program, with MMJ as an integral component, is a healing and spiritual growth process that begins with your commitment to become a much better caretaker of yourself. Think of it as taking on a new full-time job described as: learning to love and nurture myself at a higher level than I’ve ever known. I call it training to thrive, and it’s been my full-time job since 1980, when at the age of thirty-three I was told I’d have to live with the misery of chronic sinusitis forever. Since then I’ve cured the sinusitis and have experienced a quality of life I describe as fully alive.
The adventure of this lifetime begins by taking your first of many baby steps. I suggest you read the chapter(s) focused on your specific condition(s) as well as Chapters 5 and 15. Chapter 5 addresses inflammation, a universal contributor to chronic pain. The MMJ recommendations presented in this chapter can be helpful for treating nearly all of the chronic pain conditions in subsequent chapters.
I would also suggest completing the Candida Questionnaire, before moving on to the chapter with your specific diagnosis. If you find that you are an appropriate candidate for treatment—i.e., you score high on the questionnaire—I recommend you follow through on the Candida Treatment program outlined in Chapter 5, regardless of what your chronic pain condition happens to be. Candida overgrowth is an especially frequent contributor to fibromyalgia, IBS, ulcerative colitis, and Crohn’s disease. It can also be a factor contributing to osteoarthritis, as well as depression and insomnia.
The single most important part of Chapter 5 is the diet—anti-inflammatory, alkalinizing, candida-controlling, and hypoallergenic. This diet is applicable to nearly all of the conditions included in Part II. Wherever it differs, specific dietary recommendations will be made in the “Diet” section of that chapter.
This is also a healthy, nutritious diet, one that is recommended for anyone interested in optimal health. In addition to what you learn in Chapter 5, you should adhere to the MMJ and holistic medicine recommendations for your particular diagnosis, presented in one of the following chapters.
The most common emotional pain conditions—depression, anxiety, and insomnia—are presented in Chapter 15. To some extent, each of us can relate to one or more of these energy-depleting conditions, since most chronic pain patients have some degree of each of these three. Increased anxiety nearly always accompanies chronic pain, which then contributes to insomnia, and the subsequent sleep-deprivation can increase both depression and anxiety, causing more pain. Fortunately, in most instances it doesn’t take long for MMJ to break this debilitating cycle.
After reading Chapter 15, you can begin implementing the recommendations in Part II. Give yourself at least six to eight weeks after beginning the HMTP Program before applying the practices described in Part III. This length of time is needed to be certain that you’re maintaining a consistent improvement, and experiencing less pain. The realization that you’re actually getting better, after all the months or years of suffering, is a powerful motivator for exploring more deeply the mental, emotional, and spiritual aspects of health presented in Part III.
I advise my patients that a minimum commitment of three months is required to complete the basic HMTP Program (Parts II and III). If you’ve experienced significant improvement in your physical condition—i.e., your pain has been reduced and you’re using less (or no) medication, sleeping better, and have fewer symptoms (other than pain)—you will most likely be interested in continuing with the holistic treatment program.
In order to measure your progress during the first three months, I suggest you maintain a symptom chart. I recommend either the one below, which I use in my practice, or you can make your own. When you record the numeric rating of your pain or symptom (0 = no pain or symptom, 10 = incapacitating), you are evaluating your average level for that week, both with and without MMJ. The same is true for measuring your ability to function and your mood, sleep (number of hours), and quality of life. For example, if your pain level while using MMJ during that week averages between a 3 or 4, then record it as a 3.5, and if without MMJ it is consistently between a 6 and 8, then record it as a 7. If you are also taking a pain medication or supplements, then they too should be noted on your chart.
For each of the chronic pain conditions, there are other symptoms beside pain that will also be affected by MMJ, medication, and/or supplements. Please note these other uncomfortable symptoms on your symptom chart using the same numeric rating system.
Chronic Pain Symptom Chart |
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Function |
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Quality of Life |
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Other Symptoms |
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Medications |
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Supplements |
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To determine which MMJ products are most effective for you, it is helpful to keep a record of the different products you’ve used and their effect on your pain. Record your pain level before and after using each product. For example, if your pain is a 9 before vaporizing Harlequin and a 4 after, then record it as 9 → 4. You can use the MMJ log below or create your own.
MMJ Log |
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Example: Vaporize Harlequin |
11/1/17 9 → 4 |
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As you know, cannabis medicine is still in its early infancy. There have been too few studies to definitively state that a particular MMJ product works well for treating a specific chronic pain condition. The vast majority of the MMJ recommendations I’ve made in the following chapters are based on my clinical experience working with more than seven thousand chronic pain patients. I’ve also received valuable input from the owner and manager of a medical dispensary in Boulder that is establishing the industry standard for dispensaries. They have diligently listened to their customers, recorded their feedback, and continually upgraded their inventory to provide the most therapeutic products for the most common chronic pain conditions, all of which are presented in this book.
By keeping these records, both the symptom chart and the MMJ log, you will have an opportunity to help yourself and millions of others suffering with the same chronic pain condition. If you’ve had success in relieving your pain with MMJ, and are interested in participating, I’d like you to contact me using the information found in Resources. I will in turn keep you informed via email about the most current information regarding the MMJ products and dietary and supplement recommendations that are the most therapeutic for your specific condition.
The art and science of medicine is continually evolving, and by sending me this information you can help me and many others learn what products are effective in treating the most common chronic pain conditions.
Healing is a dynamic process, one that’s unique to each individual. I can help guide you, but it’s your level of commitment to the life-changing holistic treatment program outlined in Parts II and III that will determine your degree of success.
I’m well aware that you may have several other full-time jobs—the one from which you earn a living, plus the one you serve as a spouse, parent, or possibly a caretaker of a loved one. We all wear multiple hats. But now I’m asking you to make the practice of exceptional self-care your highest priority. Those closest to you will benefit from the depth of this commitment to yourself. Payment for your efforts will not necessarily come with money, although you are quite likely to perform your occupational responsibilities better than you did previously. Your new job will instead reward you with an abundance of vitality, love, happiness, and a heightened sense of being fully alive. This is the intended outcome of the practice of holistic medicine, and it is not dependent on whether or not you cure the physical problem.
Part II is essentially a body-mind quick-fix. Several of the recommended supplements, especially those from the Metagenics and Xymogen companies, can only be obtained through a health care practitioner. I am making these available in Resources.
As you progress, hope is rekindled. You will become empowered and deepen your commitment to your unique path of self-healing, simply because you are choosing to receive and feel worthy of this degree of nurturing attention from yourself. Part II provides you with an opportunity to practice the art of self-care, with your primary focus on the body and relieving pain.
The art and science of holistic medicine embraces the intimate connection between body, mind, and spirit. As a result of this understanding, for more than forty years the practice of holistic medicine has been remarkably effective for treating, preventing, and often curing chronic disease. While conventional medicine has excelled in treating acute and life-threatening illness and injury, it has been largely ineffective for curing chronic ailments, the most common of which is chronic pain. The focus of the holistic practitioner, and my intention for Parts II and III, is to help guide patients and readers to identify the multiple causes of their condition, and work in partnership with them to heal their dis-ease.
The words heal, health, and holy are all derived from the Anglo-Saxon haelen. It means “to make whole.” Doctor is Latin for “teacher.” As a holistic physician, my job description is literally teacher of wholeness.
In America today, there are more than three thousand physicians (MDs and DOs) who have been certified by the American Board of Integrative Holistic Medicine (ABIHM). The foundational beliefs infusing the art, science, and practice of integrative holistic medicine are that unconditional love is life’s most powerful healer, and its corollary, that the perceived loss of love is our greatest health risk. Distilled down to two words: LOVE HEALS! And there is no one better suited to dispense that medicine than you.
But I can understand that after reading Part II you might be interested in more personal guidance with the Holistic Medical Treatment and Prevention Program. Fortunately there are enough ABIHM physicians to serve the majority of America’s chronic pain sufferers. You can find one near you by going to www.abihm.org and clicking on “Find an ABIHM Certified Physician.”
In Part II you will begin to learn the art of nourishing, nurturing, and rejuvenating your body, essentially loving your dysfunctional body part. And in Part III I will present you with several healing practices for inspiring your mind, opening your heart, and soothing your soul. Throughout the remainder of the book, medical marijuana will serve you in myriad ways. It is truly a remarkable holistic medicine, one which will facilitate a most enjoyable healing journey!
To give you an idea of how life-changing the holistic approach can be, I’ll share with you the story of Barbara J., a fifty-two-year-old legal assistant, who came to see me primarily for an MMJ evaluation. A friend with an MMJ card had given her a small amount of an indica strain to smoke for relief of her arthritis pain. Her pain level was consistently between a 4 and a 6 unless she took Celebrex or ibuprofen, in which case it was reduced to between a 2 and a 4. She was concerned about the side effects of these drugs and was shocked at how well the MMJ worked to relieve her pain (reduced it to a 1 to a 2) and helped her to feel better in general (more relaxed, less anxiety).
After smoking it a few times, she decided she wanted to have access to the higher-CBD cannabis products available only at the medical dispensaries. For this she would need a physician recommendation and an MMJ license.
I reviewed her medical history and symptoms, in addition to the diagnosis of osteoarthritis (diagnosed by her primary care physician) and the symptoms of pain and stiffness in her hip, knee, and low back. She also mentioned that she had extreme fatigue, muscle aches, insomnia, moderate depression, and mental fog (inability to concentrate). These latter symptoms made me suspicious of candida overgrowth, and subsequently her score after completing the Candida Questionnaire was 210, in the “Almost certainly yeast-connected” category (see Chapter 5).
After suggesting she try several of the MMJ products in Chapter 6, I also gave Barbara a handout describing the candida-control, anti-inflammatory diet and some antifungal supplements and probiotics. In addition I instructed her to begin testing the pH of her urine to monitor her body’s level of acidity (higher acidity fuels inflammation).
Barbara returned in six weeks and was quite pleased to report that she felt much better. After a few difficult days during the first week with a die-off reaction (yeast organisms release toxins as they die), she was amazed at how dramatically her overall condition had improved. Her pain level was down to a 2 to a 4 without taking anything (MMJ or the drugs), her energy level had increased from a 3 to a 6, the muscle aching was completely gone, and she was sleeping much better (using MMJ most nights before bed).
At this second visit I presented some of the mental and emotional issues that Louise Hay, author of You Can Heal Your Life, believes are connected to arthritis and candidiasis, such as sensitivity to criticism, frustration, and anger. The anger is often directed at oneself in the form of self-criticism. Barbara acknowledged that she was very hard on herself, and was shocked at the accuracy and specificity of this mind-body connection. She left the office with homework to create a short list of affirmations reflecting her goals as the next step on the path toward creating her ideal life.
I recently saw Barbara for the renewal of her MMJ license, one year after her first visit, and she looked noticeably different. There was much more vitality in her face and eyes, she had lost about twenty pounds, and she seemed to be more positive and energetic. She was still taking the maintenance dose of the arthritis supplements and a probiotic daily; she had continued on a somewhat modified (not quite as restrictive) candida-control, anti-inflammatory diet; and she was still using MMJ most nights for sleep, and occasionally during the day (on weekends), simply to get high (not for the purpose of pain relief). Her only occasional symptom was joint pain, which was rarely above a 2 and typically occurred when she was more stressed.
She reported feeling “like a new person.” Her energy level was back to normal; she was exercising three to five days a week (without any pain); and she was much happier, with a more positive attitude and a much greater sense of control over her life.
Barbara is an excellent example of a patient who combined MMJ with holistic medicine and obtained a great outcome. She was able to relieve her pain while healing her life.