Talking to your Doctor about Medical Cannabis Use for Arthritis

When considering medical cannabis as a treatment option for arthritis, an important step is talking with your doctor. "Medical cannabis" refers to any products made from cannabis or its active ingredients intended for health purposes. While cannabis can’t cure arthritis or slow disease progression, some people report that it helps alleviate their symptoms of pain, inflammation, and anxiety. Click the cards below to learn helpful tips and information on how to get started on having clear conversations with your doctor.

Bringing up medical cannabis with your doctor

 
  • Talk to a doctor that you have an established relationship with – someone you would be comfortable speaking with about other difficult topics
     
  • Come prepared for your conversation:
    • Talk about the specific symptoms or issues you want to address, such as joint pain or difficulty sleeping 
    • You can use a reputable source, like the Arthritis Society’s resources, as a starting point for the conversation 
    • Plan any questions you want to ask your doctor about using medical cannabis ahead of time 
       
  • If you have tried cannabis before:
    • Share your experience with your doctor and what you found helpful, if anything 
    • Ask about the benefits and drawbacks of medical cannabis use for arthritis 
    • Be prepared to discuss safe use of cannabis 
       
  • Your doctor may not be ready to authorize medical cannabis to patients in general.  If not, they should be open to the conversation and ideally refer you to someone with the required expertise 
     

Note: Medical cannabis is not meant to replace other medications. If your doctor determines it might be a good option for you, they will discuss how you can use it to treat symptoms alongside your existing treatment plan. 

Steps to expect

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Review of symptoms and medication history  

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A physical exam specific to the issue being addressed, such as pain 

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Contraindications: History of psychosis, allergies, pregnant and/or breastfeeding 

The medical cannabis authorization document

To access medical cannabis, you will require a medical authorization document from your doctor.

Note: A doctor may not feel comfortable authorizing or monitoring the use of medical cannabis for patients in general. In this case, it is reasonable for the patient to ask for a referral to a physician or clinic with more expertise in this area. However, medical cannabis is not a suitable treatment option for everyone.  If a doctor is comfortable authorizing medical cannabis in general but not in your particular circumstances, it’s important to understand their reasoning and why medical cannabis may be unsafe or inappropriate for you.   

Reading the document  

A medical cannabis authorization document is NOT a prescription. It will include:

  • Your information, including name and date of birth  
  • Healthcare provider’s information, including name, contact information, and license number 
  • Daily quantity in grams/day 
  • Period of use (cannot exceed one year) 
  • Healthcare provider signature 

Dosage

There is no defined effective dose for medical cannabis. This is because dosage and effectiveness will vary significantly between people. Specific guidance, such as CBD amount, THC percentage, or oil vs. dried cannabis should come from your authorizing doctor. As there are no firm guidelines on dosing, most physicians will introduce medical cannabis at low doses and reassess for benefits and possible side effects. Medical cannabis is not effective for everyone – increasing the dose may not have a greater effect. 

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 Doctors will often talk about the main components of medical cannabis: CBD and THC 

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CBD, or cannabidiol, is a non-euphoric chemical (will not make you feel “high”)

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THC, or tetrahydrocannabinol, can cause a “high” feeling, but may be helpful in small doses

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Medical cannabis products may be CBD dominant, THC dominant, or a mix of both

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Doctors may start with a CBD preparation and add THC in small amounts if appropriate 

 

Note: A very low dose of THC can be helpful without providing psychotropic effects. Your doctor can help recommend the best method of delivery and dosage to achieve helpful effects. 

Symptom management

Remember to talk to your doctor about the specific symptoms you want to address with medical cannabis. Medical cannabis will not treat your arthritis directly or replace the medication you take to manage it. 

  • Can medical cannabis help with my arthritis pain? 
    The components of medical cannabis may help promote the release of natural pain-relieving chemicals in the body, complementing other pain management techniques 
  • Will medical cannabis help me sleep?
    Cannabis may help reduce sleep disturbances. Orally ingested cannabis oils are longer-lasting than inhaled products, which could help with challenges related to remaining asleep. 
  • Can medical cannabis help with my anxiety? 
    The CBD component of cannabis may be helpful in reducing anxiety, but higher doses of THC can cause increased anxiety 
  • Will medical cannabis increase my appetite? 
    Research suggests that THC can stimulate the appetite, and may help with nausea and calm the digestive system 

What if my doctor says no?

  • Medical cannabis is not an appropriate treatment option for everyone. If your doctor feels it would be unsafe for you, it’s important to understand why 
  • Your doctor may delay authorizing medical cannabis when you’re starting new medications or have a new or evolving health issue 
  • Medical cannabis is usually a third-line treatment for arthritis symptoms. If you haven’t yet tried standard arthritis treatments, your doctor may suggest these approaches first before trying medical cannabis 
  • If your doctor is not comfortable authorizing medical cannabis in general, you can ask for a referral or seek the advice of a doctor with greater expertise in this area

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This resource was reviewed in November, 2020 with expert advice from: 

Carolina Landolt-Marticorena, MD, PhD, FRCPC 
Rheumatologist, Summertree Medical Clinic & Runnymede Healthcare Centre 
Scientific Advisor, MediPharm Labs 

This resource was made possible through an unrestricted educational grant from:
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