Marijuana and Chronic Pain
by Martin Martinez

Severe chronic pain is usually treated with opioid narcotics and various synthetic analgesics, but these drugs have many limitations. Opioids are addictive and tolerance develops. The most commonly used synthetic analgesics - aspirin, acetaminophen (Tylenol), and nonsteroidal antiinflammatory drugs (NSAIDs) like ibuprofen -are not addictive but they are often insufficiently powerful. Furthermore they have serious toxic side effects including gastric bleeding or ulcer and in the long run a risk of liver or kidney disease. Stomach bleeding and ulcers induced by aspirin and other NSAIDs are the most common serious adverse drug reactions reported in the United States. These drugs may be responsible for as many as 76,000 hospitalizations and more than 7,600 deaths annually. Acetaminophen is increasingly prescribed instead because it largely spares the digestive tract, but it can cause liver damage or kidney failure when used regularly for long periods. Medical researchers have estimated that patients who take one to three acetaminophen tablets a day for a year or more account for about 8% to 10% of all cases of end-stage renal disease, a condition that is fatal without dialysis or a kidney transplant.

Given the limitations of opioids and non-addictive synthetic analgesics, one might have expected pain specialists to take a second look at cannabis, but the medical literature again suggests little recent reconsideration. Cannabis may be especially useful for the kinds of chronic pain that people who survive catastrophic traumatic accidents have to live with the rest of their lives.

Martin Martinez is such a patient:

High school friends of mine made a daily springtime habit of smoking marijuana just outside the principal’s office windows, purposely blowing in billows of pungent smoke on the afternoon breeze. Being chased out of the yard by irate school officials heightened the drug’s effects as young hearts raced to join their buddies bursting with laughter. An outsider among outsiders, I was not fond of such games. Nor was I interested in the use of pot for purely social or recreational uses. Marvelous insights captivated my mind when stoned. As I grew older my use of cannabis developed beyond intuitive meditation and became the catalyst of many profound mystical experiences. Later in life I found that the moderate use of cannabis did not interfere with demanding physical tasks and skills such as building construction and home remodeling. While a large dose of marijuana would tend to make me feel less active, a smaller dose invigorated my vitality. I also rode a motorcycle in my youth. I felt that a small dose of marijuana actually increased my motor skills. By the age of 27 I had driven many thousands of miles while mildly stoned and had never caused an accident. Then one night a reckless driver swerved into my lane and crashed into me at a combined speed of 60 miles per hour. I was not expected to survive.

I suffered dozens of severe injuries in the crash, including 25 orthopedic fractures and massive skull fractures which severely crippled several cranial nerves. Two months after the crash I lay in bed a crumpled mass of pain. My IV fed me up to 10 milligrams of morphine every 7 minutes, 24 hours a day, but still I had trouble sleeping because the pain was so intense. I was told that I was not going to recover mobility and that I would spend the rest of my life connected to a medical facility. I could barely speak due to the nerve damage to my voice and throat. The constant pain in my eyes was excruciating. I was given morphine and other narcotics which incapacitated me, but did not reduce the pain in my eyes. Swallowing was a challenge which often resulted in choking and coughing fits lasting many minutes. As the weeks went by I began to suspect that the medications I was given were actually contributing to my neurological impairments by inhibiting concentration and depressing neurological responses. In addition, I was painfully aware that narcotics had a disastrous effect on my intestines.

One day I was visited by an outpatient who had AIDS. He told me a little about the medical uses of marijuana and he gave me a joint. I waited till late at night when the nurses were busy elsewhere. I smoked the joint in secret and my heart raced so much I feared that I might burst the scars of my recent surgery. But then the contraband was gone, the scent was dissipated, and outraged nurses still had not discovered me, so my heart rate slowed to a comfortable purr. I felt relaxed and at ease, but not stupefied. I could still sense the deep scars of my damaged nerves, but I was somehow mentally distanced from the pain in a way that morphine did not offer. I slept that night more soundly than I had since the crash.

I left the primary hospital as soon as I could talk my doctors into releasing me. I returned to my hometown and became an outpatient at a facility there. I continued to use narcotics and other pain medications prescribed by my doctors, but over the months and years I gradually replaced several prescription medicines with the use of cannabis. Nearly all of the drugs I had been given by doctors seemed to depress my mind and body, and the addictive quality of narcotics created numerous unpleasant psychological effects. Unlike narcotics, cannabis use imparted positive mental and physical stimulation, called euphoria, that encouraged my rapid recovery.

With the use of cannabis replacing sensory-depressive narcotics, I found myself recovering far beyond the expectations of my first 27 doctors. Five years after the crash I took some college courses and then began to work again. By the time I was well enough to maintain a full time carpentry job I was smoking hundreds of dollars worth of cannabis per month. Ten years after the crash, having spent in excess of $10,000 per year on unreliable qualities of cannabis, I was arrested for growing my own.

In my trial the prosecution proved that I was growing what they considered to be a "huge" amount of marijuana. The fact that I had possession of 88 plants was assumed to be evidence that I was a drug dealer. I proved that I had a legitimated medical necessity for the use of marijuana and that I also had a very substantial income in real estate development which precluded a profit motive. Using the harvest estimates of the Drug Enforcement Administration agent who testified against me and the consumption estimates of the physician who testified for me, the amount of cannabis seized might have lasted me up to two years and saved me up to $20,000. Eight of the jurors in my trial were sympathetic and voted to acquit me on the grounds of medical necessity. Four of the jurors agreed with the State’s contention that I had intended to sell my medicine. A mistrial was declared and I remained free.

Two months later police officers returned to my home. They held me and searched the premises without a warrant, discovering a much smaller cannabis garden than they had seized the year before. A vindictive State prosecutor arrived at my house and intentionally confiscated confidential communications to and from my attorneys. I spent a second birthday in a row deathly sick in bed after having been released from jail. Physically, emotionally, and economically bankrupt, unable to afford the enormous cost of another trial, and unable to obtain a public defender due to my ownership of severely over-mortgaged real estate, I accepted a "no jail-time" plea bargain deal which was broken the day before sentencing. The medical affidavits of Dr. Grinspoon and four additional physicians had no apparent influence on the imperious court. I was sentenced to 90 days in jail for the criminal act of cultivating cannabis for my own medical use.