By John Brunstein
25 Apr 2016
I have a mild presentation of Lupus (SLE) which is generally well-controlled with Plaquenil. However, I do have flare-ups for which I use Diclofenac (Voltaren) as needed for pain management. Lately, the Diclofenac is giving me GI problems. Would Cannabis be an option to control my pain without the gut issues? Also I’m not willing to smoke as I have asthma. Thanks, RT
Hello, RT. Unfortunately I’m afraid I can’t really give a specific answer to your question, since it involves a very particular set of conditions and interacting medications you’re already on. Only a licensed physician can address this. As I’ll explain further below, it’s a possibility definitely worth exploring with your doctor though, so what I would suggest is the following:
One reason why this is a good topic to bring up with your doctor is that there may be potential benefits beyond just pain relief in this case. In addition to analgesic (pain relief) effects, Cannabis has immunomodulatory effects (probably mostly through CBD, its major non-psychoactive cannabinoid) which might be beneficial in directly treating the underlying SLE. I can only say “might”, because at this point there don’t appear to be any well formulated, statistically valid studies on treatment of Lupus by SLE but there are a number of anecdotal (ie, single individual) case reports relating to this. I would definitely bring this up with your physician as well – if you do a search for ‘Lupus’ and ‘Cannabis’ you’ll find many of these reports. I would suggest doing so first, then taking copies of this information with you when you talk to your doctor. Bear in mind they may want to take some time to review the information before making any suggestions to you – that’s part of them being diligent in doing their job.
Figure 1: T-cells are one of the most well-known components in an immune response.
If you and your physician do decide Cannabis is something you would try, then you’ll want to opt for oral (“edibles”) formulations as opposed to smoked or vapourized (“vaped”). Not only is that better for your lungs, but oral dosing is more uniform and reliable (although not as fast or effective as smoking). It’s a trade off but probably a required one in your case.
I would also suggest you might want to look into a compound called palmitoylethanolamide or PEA. This is a lipid (fat-type) molecule which naturally occurs throughout the human body, and appears to have an immunomodulating role very similar to CBD, and possibly even through the same receptors. There’s quite a lot of well studied literature on PEA, and it looks very promising; it’s cheap, taken orally as capsules, doesn’t seem to have significant side effects, and isn’t regulated as a drug. Downsides are you’d probably have to order it from suppliers in Europe (where it’s much more popular than here), and studies suggest you might have to take it daily for several weeks before you notice any effect. Again, this is something you should discuss with your doctor, and in the case of PEA there are a lot of well done studies he (or she) will be able to find.
Best of luck, and I hope this answer is of some help.