Cannabis for treatment of peripheral neuropathy

Brief history of cannabis as a medication

As far back as I can remember, cannabis was something to avoid if you were a law abiding citizen. It was illegal for most of my lifetime and considered a gateway drug, leading to all sorts of problems for those that used it.

Now all you read about these days is how cannabis helps this and that. So, how did it go from zero to hero in what seems like a relatively short period of time? Believe it or not, throughout history cannabis was more often the hero. The first documented use of cannabis for medicinal purposes was in Asia in 2800 BC by Emperor Shen Nung, the patriarch of Chinese medicine.

From that period onward it was also used for medicinal purposes by the Greeks, Romans, Indians and the British, just to name a few. The Khoisan people were using it long before Europeans landed on the shores of Africa. It was even rumoured to have been used by Queen Victoria for menstrual cramps.

Labelled a dangerous drug

Eventually in the early 1900s it was labelled a dangerous drug and became heavily taxed, regulated and eventually outlawed in some Western countries.

In 1921, it was outlawed in South Africa under the Customs and Excise Duty Act. Some of the many reasons for this were due to an increase in recreational use, its link to crime and pressure from political and religious groups to have it banned.

Continued research

After the introduction of stronger pain medication, such as aspirin and opioids, cannabis was deemed no longer useful as a medicine and it was removed from most pharmacopeia.

Scientists still continued their research into the possible uses for cannabis. They isolated the compound cannabidiol (CBD) in the 1940s and tetrahydrocannabinol (THC) in 1964. It wasn’t until the 1980s that they discovered receptors for both of these in the human body. Finally, they were able to start to determine some of the effects these two substances had on humans.

Various Acts passed

In 1996 the Compassionate Use Act was passed in California (US) permitting medicinal use of cannabis for epilepsy unresponsive to other medications. Since that time the list of conditions it can be used for has grown along with the number of States that conceded to the Act.

In 2016 the Adult Use of Marijuana Act was passed in California. Again other States followed suite. Many other countries around the world have also decriminalised it or legalised the use of cannabis for medicinal purposes.

It wasn’t until 2018 that South Africa legalised the private cultivation, possession and personal use of cannabis under the Cannabis for Private Use bill. Parliament’s Justice and Constitutional Development committee are tasked with amending the act to legalise and regulate the cultivation of medicinal cannabis with consideration of legalising it for recreational use by the end of 2022. This is a potential R28 billion a year industry for the country, not to mention the much-needed jobs this could create.

Unfortunately, at this point in time you can only get a license to cultivate cannabis for medicinal purposes and require special permission to obtain it for medical use.

Research continues to shows that CBD and THC can have a therapeutic effect on many different ailments, such as how it can help reduce symptoms associated with peripheral neuropathies.

Peripheral neuropathy in people with diabetes

A neuropathy is a damaged nerve or group of nerves causing numbness, weakness and/or pain. Peripheral means something on the periphery, such as your feet, legs, hands and arms. Unfortunately, 60-70% of people with diabetes will develop some form of peripheral neuropathy.

Neuropathy symptoms can vary from a burning sensation, numbness, weakness, sensitivity to touch, decreased ability to feel temperature or shooting pain. Annoyingly, symptoms can become worse at night when you’re trying to sleep.

This nerve damage can happen after a prolonged period of time with high and uncontrolled blood glucose levels. The damage can be made worse if a person also has high cholesterol and high blood pressure because this can further compromise blood flow to the nerves.

The best way to avoid peripheral neuropathies is to monitor your chronic conditions and maintain a normal blood glucose level. Once a nerve is damaged it can’t be repaired and you’re only able to treat your present symptoms while trying to prevent them from getting worse.

Finding the right cannabis for your neuropathy pain

There have been multiple studies conducted that have shown cannabis can be effective in reducing the symptoms of peripheral neuropathies. Most studies were done with combination of prescription strength (Schedule 6) CBD and THC.

The general conclusions have been that it helps with pain relief and inflammation while the THC can decrease anxiety and alter the perception of pain. This is good news for those neuropathy sufferers that haven’t had relief with conventional medication.

At this time, over-the-counter products containing maximum 600 mg CBD with maximum 20 mg daily dose per pack and 10 parts per million or <0.001% of THC are available to the general public in South Africa.

You can find these products at pharmacies or health shops and you won’t need a prescription to buy them. They come in different forms such as creams, drops or sprays. You can approach your pharmacist for assistance in finding which one would work best for you. This is regulated by the South African Health Products Regulatory Authority (SAHPRA).

Obtaining prescription strength cannabis

However, if you find these products are not effective enough you can get your doctor to apply to SAHPRA requesting permission to obtain prescription strength cannabis.

With a Section 21 application, your doctor can request unregistered medication if you qualify. Medicinal cannabis approval is usually granted by SAHPRA for the following four diagnoses: HIV/AIDS, anxiety, cancer and chronic pain.

Once you receive approval under Section 21, you’re issued with a medical card and are able to fill your prescription.

Since all of these laws and regulations are fairly new, not all doctors are aware of how to go about this process. It was only in September 2021 that the first person in the country received approval for medicinal strength cannabis.

You can go into the following link to find a doctor near you that is aware of how to apply for a Section 21 application for you and then prescribe Schedule 6 cannabis once your application is approved.

If this seems like too much trouble, you may want to wait and see what happens later this year. Hopefully in the not-too-distant future, you will be able to go to your local GP for a prescription then have it filled at your local pharmacy.

References

MEET THE EXPERT

Sr Lynette Lacock received her Bachelor’s Degree in Nursing and Biofeedback Certification in Neurofeedback in the US. She has over 30 years’ experience in healthcare which has enabled her to work in the US, UK and South Africa. Initially specialising in Cardiothoracic and Neurological ICU, she now works as an Occupational Health Sister. She is passionate about teaching people how to obtain optimum health while living with chronic conditions.

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Lynette Lacock explains how cannabis has been used as medication in the past and the use of it for treatment of peripheral neuropathy today.