|MARIJUANA AND PAIN AND SPASM FROM A SPINAL INJURY
Robert A. Sutton
My name is Robert A. Sutton. I am forty-two years old and I live in Hedgesville, West Virginia. From 1966 to 1970, I served in Ethiopia with the Army Security Agency, a military component of the National Security Agency, intercepting radio traffic and other telecommunications. After leaving the Army I attended Anne Arundel Community College, where I received my Associate of Arts degree. Then I attended Morgan State College in Baltimore and graduated with a Bachelor of Science degree in 1974.
In 1980, while working construction as a carpenter, I fell and landed on my feet. The fall ruptured my L-5 (lumbar) vertebra and narrowly missed severing my lower spinal cord. I returned to work, but the compressed vertebra radiated pain and caused the muscles in my lower back and legs to cramp and spasm. In an effort to control these symptoms, my family doctor prescribed tranquilizers, sedatives, painkillers, and mood-altering drugs.
In December 1981 the disc ruptured again and pressed against a major nerve running to my legs. My left leg became extremely weak and I couldnt walk without experiencing terrible pain. I lost my mobility and my ability to work. I have been classified as "temporarily, but totally, disabled" and have not been able to return to work.
The deluge of drugs I was taking failed to control the chronic pain or still the spasms in my lower back and left leg. In 1982, desperate to escape this pain and hoping to regain some mobility, I underwent a discectomy to reduce pressure on the nerves. This is a standard procedure in which the surgeon opens the back, exposing the spine, slices open the ruptured disc, and removes a soft, spongy material.
The operation was a partial success. The pain and spasms in my left knee were less intense and more easily controlled. But the sponge-like material that was removed has an important function: it helps to buffer impacts on the spinal column caused by normal walking and working. Without this material, stress on the spine itself is greatly increased. Shortly after the operation I began experiencing severe pain, muscle cramping and spasms in my right leg. The leg became weak and my mobility failed to improve significantly. Another consequence of the operation was chronic, constant deep-seated pain throughout my lower back, sometimes dull and throbbing, sometimes needle-sharp and excruciating. I could literally feel my vertebrae rubbing against each other in a grinding sensation that made nearly all movement painful. This pain in turn triggered spasms in the major back muscles.
The physicians took more X-rays and told me that in addition to my disc problem I was developing spondylosis, a form of bone degenerating osteoarthritis that affects the spinal column. This disease causes calcification of the normally soft tissue between the vertebrae and results in intense pain and an accelerating loss of flexibility in the spine. The doctors told me my spine would become weaker, my mobility problems would increase, and so would the resulting pain and spasticity. They were right. The pain and spasms from the fall, the ruptured disc, and the operation remained constant and at times unbearable, despite my heavy use of painkilling drugs, muscle relaxants, and tranquilizers.
After more X-rays and visits to the doctor, my physicians recommended Transcutaneous Electric Nerve Stimulator (TENS), which blocks the sensation of pain by disrupting the signal between the nerves and the brain. Whenever my pain became truly unbearable I would attach electrodes from the TENS unit to my back and push a button that delivered a mild electric shock to the affected nerves. At first this provided considerable relief, but repeated use rendered it less and less effective. Within six months the TENS was no longer relieving the deep-bone pain and spasms in my lower back.
My physicians explained that the grinding I felt was actual friction between my L-5 and S-1 vertebrae. They told me it would continue and could only get worse unless something was done to eliminate it. They suggested another back operation. I was apprehensive, since the first surgery had "cured" one problem but created an even worse one. I asked a lot of questions, but came to understand that surgery was my only real option.
The surgeons performed a post-lumbar interbody fusion (spinal fusion) in April 1984. In this procedure a large sliver of bone is removed from the hip and cut into "pegs" which are wedged between the grinding vertebrae. The small pegs merge or "fuse" with both vertebrae as new bone growth fills in the remaining space. The aim is to reduce stress between the bones and relieve pressure on the nerve.
For a short time following this operation my pain seemed diminished, but then it returned with a vengeance. My physicians tried to block the pain with a new and stronger TENS unit, but it did not work. I was deeply concerned by my ever-increasing need for extremely powerful and addictive drugs, and alarmed that the pain was still becoming more intense and the spasms more difficult to control. In 1985 my physician gave me a "Use as Needed" prescription for Valium, a powerful muscle relaxant and antidepressant drug. Before long I felt addicted to it. I was using Valium not because it quelled my pain but simply because I craved it. I used it constantly, and my personality underwent a radical change. At times I would be so "doped-up" that I couldnt do anything except sit. At other times I would lose all control over my emotions and fly into frightening ragesa near-psychotic state. Despite my pervasive Valium abuse, my pain was constant. I was desperate. The prescription drugs were not preventing the pain and they were destroying my life.
I first smoked marihuana shortly after leaving the Army in 1970. I did not smoke it often, and I did not smoke it for medical reasons but only for the mild high. Following my accident I would occasionally notice that I felt better after smoking marihuana. I even realized that my pain and spasms were diminished, but I attributed these effects to the improvement in my mental attitude. By 1986, however, my reasons for smoking were undergoing a subtle change. I was smoking especially when my spasms were unusually intense. I was beginning to realize that in addition to its positive mental effects, marihuana was having a very direct physical effect on the spasms. It also eased my chronic pain.
I decided to conduct an informal experiment by reducing my intake of Valium and increasing my use of marihuana. I discovered that either smoking or eating marihuana dramatically reduced the chronic pain and spasticity in my lower back and legs. I realized that it was relaxing the large back muscles. As the spasticity deceased, so did the gnawing pain. To my great surprise, marihuana was providing far better relief than the dozens of pharmaceutically prepared drugs prescribed by my physicians.
I was able to greatly reduce, then eliminate, Valium and other powerful drugs from my medical routine. A small amount of marihuana, used daily, provided me with greater control of the spasticity and pain. And when I take marihuana I remain functional. Instead of constantly feeling "doped-up" and "out of it," I can lead a fairly normal life. My whole body feels more relaxed. Im more limber, more active, and more able to get around the house, go outside, and visit with friends. I am no longer withdrawn and distant. Marihuana also permits me to get a nearly full nights sleep. Before taking marihuana I had been using powerful sedatives to sleep, but I was constantly waking up because of pain or spasms. Just a small amount of marihuana before bedtime allows me to sleep soundly and wake up feeling rested.
It bothers me that marihuana is illegal, but the only alternative is constant, uncontrollable spasticity and pain, so the choice is simple. But marihuanas illegality creates practical problems. When my need for prescription painkillers and tranquilizers declined dramatically, my doctors did not ask why and I certainly did not tell them, because I felt it would complicate our relationship and they might become apprehensive about treating me.
Inhibiting patient-physician communication is not the only problem. Because marihuana is illegal, it is unregulated, extremely expensive, and at times unavailable. To resolve some of these problems, I determined to grow marihuana myself. I live in a rural area and have a small plot of land. I took some seeds, planted them, and was able to grow enough to meet my medical needs. I did not sell any. Why would I sell a drug I medically needed?
This year I grew twenty-five plants, enough to make it through the winter and spring until next planting season. I was arrested and charged with felony cultivation and possession of marihuana, a crime punishable by five years in prison. The arrest forced me to discuss my situation with my doctors, who are surprisingly supportive. They understand the difficult time Ive had with chronic pain and knew I was doing something for it. Now they know what it is, and at least we are able to communicate honestly.
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