Trade-In Your Ibuprofen for Cannabis

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Pain from inflammation can and will likely affect all adults at some point in their lives, and for some, become chronic conditions that interfere with a normal quality of life.

Over-the-counter (OTC) and prescription anti-inflammatory medications are easily available, readily prescribed, and very commonly used.  The most common anti-inflammatory medications are called NSAIDs: nonsteroidal anti-inflammatory drugs.  Based on consumer survey responses, more than 17 million Americans take NSAIDs on a daily basis, with more than 70 million prescriptions and more than 30 billion OTC NSAID tablets sold annually in the United States.  

OTC NSAIDS include aspirin, ibuprofen, naproxen and prescription NSAIDs include celecoxib, diclofenac, etodolac and ketoprofen.  NSAIDs work by blocking enzymes called COX-1 and COX-2.  These enzymes produce a group of compounds that our cells make called prostaglandins.  Prostaglandins made by COX-1 enzymes activate your platelets (for blood clotting) and protect the lining of your stomach and intestines.  Prostaglandins made by COX-2 enzymes are made in response to injury or infection, regulating inflammation.  Most NSAIDs work non-selectively on both enzymes (except for celecoxib which is a COX-2 inhibitor).  This lack of selectivity becomes an issue because pain and inflammation relief from NSAIDs come from blocking COX-2, but unfortunately COX-1 is also blocked, causing unwanted adverse side effects.

can cannabis replace your ibuprofen

Side effects and complications of NSAIDs are common and serious.  In one study, the risk of NSAIDs adverse drug reactions was found to be 26% (Gor 2011).  Complications include upper gastrointestinal bleeding and ulcers, heartburn, ringing in the ears, headaches, dizziness, liver or kidney problems, leg swelling, high blood pressure, heart attack, heart failure, stroke, and death.  In June of 1999, The New England Journal of Medicine estimated that 16,500 NSAID-related deaths occur among Americans with rheumatoid arthritis and osteoarthritis every year (Wolfe 1999). Over 100,000 NSAIDs users are hospitalized per year for gastrointestinal complications. A review of 17 studies found that 11% of preventable drug-related hospital admissions could be attributed to NSAIDs (Howard 2007).  In 2005, U.S. Food and Drug Administration issued a public health advisory warning people of the increased cardiovascular risks of NSAIDS, and again in 2007 they published a medication guide for NSAIDs recommending the lowest dose possible for patients using these drugs.  In January 2016, the FDA strengthened the existing label on all NSAIDs to warn that there was an increased chance of heart attack and stroke.  Some NSAIDs, such as rofecoxib (brand name Vioxx) and valdecoxib (brand name Bextra) have been taken off the market due to their risks clearly outweighing their benefits and pharmaceutical company “misrepresentation.”

As a cannabis physician, I find these statistics and multiple FDA warnings appalling.  Using dangerous drugs instead of a healing and non-toxic plant is simply ridiculous.

Over the past two decades, multiple studies have proven the anti-inflammatory benefits of phytocannabinoids and terpenoids, compounds that abound in the cannabis plant (Pertwee, 1999, Klein 2005, Nagarkatti 2009, Booz, 2011, Xiong 2012, Mecha 2013, and more).  The plant cannabinoids have many different mechanisms of action in their anti-inflammatory properties, including the blockage of pro-inflammatory compounds that are made in the body as a result of injury or illness.  CBDA, cannabidiolic acid, the raw non-psychoactive cannabinoid precursor to CBD, showed significant COX-2 enzyme blockage when compared to placebo, NSAIDs and other cannabinoids (Takeda 2008).  Dr. Ethan Russo and Dr. Geoffrey Guy, in their excellent 2005 study, report that the phytocannabinoids work synergistically (the “entourage effect”) to provide balanced and nontoxic medicinal effects when compared with single molecule anti-inflammatories (Russo and Guy, 2005).  

Patients suffering with inflammation have many choices when it comes to cannabis medicine.  Along with the ability to choose “non-smokable” delivery methods, such as tinctures, edibles, topical balms and vaporizers, patients now have many choices of which combination of cannabinoids to use.  For instance, one can take cannabis medicine that is THC-rich, CBD-rich, combination CBD+THC, THCA, and/or CBDA.  Some cannabis medicine suppliers are combining raw and heated cannabinoids in tinctures to increase the anti-inflammatory benefits.  Many patients are benefitting from drinking the juice of raw cannabis plants.  In my medical practice, I have seen thousands of patients eliminate or reduce the need for NSAIDs, reducing their risks of side effects and possibly even death, with the use of cannabis.

A complete list of NSAIDs can be found here:
www.webmd.com/osteoarthritis/guide/anti-inflammatory-drugs#1-5

If you have high blood pressure, heart failure or chronic kidney disease, this is why you should not take NSAIDs (see number 3):
www.choosingwisely.org/societies/american-society-of-nephrology/

Photos courtesy of Allie Beckett


Sources:

Slone Epidemiology Unit. Prepared for McNeil Consumer Healthcare. Analgesic use in the adult population of the United States: Acetaminophen, aspirin, ibuprofen and naproxen. Results of a population-based telephone survey, 1998-2001. Report on file, 2001.

Gor AP, Saksena M. Adverse drug reactions of nonsteroidal anti-inflammatory drugs in orthopedic patients. Journal of Pharmacology & Pharmacotherapeutics. 2011;2(1):26-29. doi:10.4103/0976-500X.77104.

Wolfe M. MD, et al, The New England Journal of Medicine, June 17, 1999, Vol. 340, No. 24, pp. 1888-1889.

Howard RL, Avery AJ, Slavenburg S, et al. Which drugs cause preventable admissions to hospital? a systematic review. Br J Clin Pharmacol. 2007;63(2):136-147.

Pertwee, R. G. “Cannabis and cannabinoids: pharmacology and rationale for clinical use.” Pharm Sci 1997;3:539-45.

Klein, Thomas W. “Cannabinoid-based drugs as anti-inflammatory therapeutics.” Nature Reviews Immunology 5.5 (2005): 400-411.

Nagarkatti, Prakash, et al. “Cannabinoids as novel anti-inflammatory drugs.” Future medicinal chemistry 1.7 (2009): 1333-1349.

Booz, George W. “Cannabidiol as an emergent therapeutic strategy for lessening the impact of inflammation on oxidative stress.” Free Radical Biology and Medicine 51.5 (2011): 1054-1061.

Xiong, Wei, et al. “Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors.” Journal of Experimental Medicine (2012): jem-20120242.

Mecha, M., et al. “Cannabidiol provides long-lasting protection against the deleterious effects of inflammation in a viral model of multiple sclerosis: A role for A 2A receptors.” Neurobiology of disease 59 (2013): 141-150.

Takeda, Shuso, et al. “Cannabidiolic acid as a selective cyclooxygenase-2 inhibitory component in cannabis.” Drug metabolism and disposition 36.9 (2008): 1917-1921.

Russo, Ethan, and Geoffrey W. Guy. “A tale of two cannabinoids: the therapeutic rationale for combining tetrahydrocannabinol and cannabidiol.” Medical hypotheses 66.2 (2006): 234-246.

About Author

Bonni Goldstein, M.D. is a physician who specializes in cannabis medicine in Los Angeles, California. She specialized in Pediatric Emergency medicine for years before witnessing the amazing benefits of this treatment in an ill loved one. Since then, she has successfully treated thousands of adult and pediatric patients with cannabis. She regularly speaks about cannabis medicine at conferences and patient groups around the world. She is the owner and medical director of CannaCenters and medical advisor to Weedmaps.com. She is the author of the recently published book, Cannabis Revealed.

23 Comments

  1. Totally agree, I’m 62, healthy and I take no medicine other than I use cannabis. I started in 1973 and still consume and will continue. The only drawback I have is living in a state that it’s still illegal.

  2. Would like to know how to go about getting medical I’m allergic to a lot of medicines and have fought different types of cancer and been a sick person most of my life and would like the info plz and thank you

  3. Great. So what if a patient doesn’t want to get high? I did get relief but I can’t find varieties that will give me the pain reducing properties without being a blathering idiot. I smoke pot recreationally for may year but don’t really enjoy it anymore. Suffering from severe chronic pain and unable to take saids is a nightmare. I am taken care of with pain meds but they suck too.

    WHERE are the medical forms? The state of minnesota allows a pharma 50 miles away to dispense, IF you can find a doctor that will write an RX, but if you hit the WRONG DR. you get tagged as using a gateway drug and forget about ever seeing a pain med.

    All this noise about medical benefits and as soon as it was legal the best high pot is everywhere. WHERE”S THE MEDICAL?

    • Fatsnax Smoke Shack on

      There are actually online dr. That prescribe online, ive always been skeptical of these but i know several people who have gotten their script this way! Im not sure exactly of the websites but if you Google medical cannabis online doctors. There will be bunches of them so you need to check reveiws and find a good one they are there.

    • Try kratom..For pain.it works great.4-6 pills ..If it’s legal where you live.i suffer from bad back.and use to use vicodin..But this is a good substitute and not addictive..For me

  4. I don’t agree that weed is an effective pain reliever. If I have sore joints or muscle aches I have to take ibuprofen and aspirin to knock it back. I smoke more weed than 99% of the people around that smoke regularly so I am speaking from years of experience.

    • Jude Sheldon Xavier on

      That’s because your body is used to ibrupofen and other painkillers, I started taking taramazepan for sleeping and now I can’t get high from weed.

    • Fatsnax Smoke Shack on

      Cannabis definitely helps with inflammation and joint pains! I been taking pain pills and nerve pills and anti inflammatory meds for last 11 + years. I use oils from cannabis plants that are mixed with coconut oil and they work amazingly. My local dispensary provides these things that are thc rich and cbd rich or a combo of both thc and cbd. There are many different strains of cannabis now that will nock back about anything pain wise. Heck its so potent these days it’ll put you to sleep. Good luck, pills are a joke. These pharma companies are making a fortune makin us sick from the poison they are feeding us.

  5. Jude Sheldon Xavier on

    I live in pakistan, can I get a prescription for cannabis? I’ve been diagnosed with psychological disorders that are being treated with cannabis, I just can’t get a doctor to prescribe it.

  6. Michael Rondeau on

    My Grandmother who suffered terribly with arthritis, walked with a cane and her fingers were twisted to a point where she could hardly use them.
    One day at a family barbecue, she proceeded to light a joint and smoke it as a cigarette. A few minutes later, she said she wanted to get some tea. She actually stood up from the table and walked to the other side of the area without her CANE and without that much effort She poured herself a glass of tea and walked back to the table and sat down. I was SHOCKED to say in the least and I said, “Nana, I can’t believe what I just seen”.
    She said, ” Oh I always smoke when I can, because it allows me to WALK without my cane and I CAN USE my FINGERS. Only bad thing is…I can never find my slippers after! ” LOL! She was 82.

  7. Daphne McGill on

    All i can say is WoW
    Ive waited for a detailed article sith the info included in terms that easy to process
    I am a cancer patient and without my 420 and my drops id probably be not around to fight.
    Thank you 4 this amazing article

  8. Where is info for types that work? How about a little more explanation of what types of CBD to use for different ailments?
    I find it amazing that there is no recommendation for dosing on any products. Example: I just purchased a bottle of marijuana oil (THC 75%) for pain relief. No recommended instruction for dosing on the box or label. Maybe it is just the industry being new and not really knowing what their products can do.

  9. NSAIDs truly have a long history of serious side effects when used for chronic treatment. I think that a bunch of people just don’t think long-term with the pain treatment and, honestly, up till now we didn’t have an alternative for chronic pain treatment.

    Now we seem to have. I just hope that weed industry won’t brought upon itself the interests of big pharma.

  10. Monaisa boyd on

    Sure would like to see if it work. Because i pop pills 3 times a day at 800 mgs sometimes i take 2 just to get around

  11. I can’t help but laugh, watching BIG PHARMA squirming their asses off. They know they’re going to lose a load of $$$ over how cannabis is going to COST THEM so much….hehehe! I’ve been using if for migraines and chronic insomnia for years. It’s legal in California and has been for a very long time. I’m much rather use MMJ over some friggin’ man made drug!

  12. Celeste Gallagher on

    I never take pharmaceutical…they almost killed me…three years now on cbd and other cannabis strains and my problem is Advil ibuprofen. It’s horrible and causes a dependency…I’m almost off of Advil just recently I’m almost weaned off and I feel better..no more heart scares and etc etc…I’m glad I came upon this post and now I will be ok thanks for posting…

  13. Cannabis could heal the world if “we the people” would let it. Oddly enough the majority supports full legalization and it is still taboo in half the country. The government,big pharmacy, and alcohol companies are pushing their agenda for profit and have the political power to do so.We all know of the medical benefits that is why certain states have “medical” marijuana but If it is mentioned in a non-legal state to a physician then be prepared to be treated like an addict and a drug user…and guess what they will have a pill for that!!! The profit in sickness is literally killing people

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