Spine Doctors in South Florida


Medical Marijuana and CBD as an alternative to treat pain

Medical Marijuana became legal in the state of Florida on January 3, 2017. Amendment 2 allows for patients with qualifying debilitating medical conditions to be able to both purchase and use medical marijuana along with THC-rich CBD products. In March of 2019, medical marijuana patients were also allowed to smoke Marijuana. Medical Marijuana cards are available to Florida residents and part-time Florida residents who seek relief from chronic health conditions. More than 450,000 patients have Medical Marijuana cards in the state of Florida.

Conditions included within Florida’s legal guidelines for qualifying patients are:

  • Cancer
  • Epilepsy
  • Glaucoma
  • PTSD
  • ALS
  • Crohn’s Disease
  • Parkinson’s Disease
  • Multiple Sclerosis
  • Chronic Debilitating Conditions such as anxiety, insomnia, chronic pain, and fibromyalgia

A qualified doctor may also recommend a patient for a medical marijuana card according to the following verbiage in the amendment: “Any ailment/condition “of the same severity/symptoms” and “Any terminal condition diagnosed by a doctor other than the issuing physician.” Once a patient is recommended for an MMJ card, the doctor enters their information into the Florida Medical Marijuana Registry and patients need to be recertified every 30 weeks – around 7 months.

Dr. María Alejandra De La Peña, MD is a board-certified Anesthesiologist with subspecialty certification in Pain Medicine who is able to offer MMJ recommendations in the Ft. Lauderdale area. Known for her specialty and skills in cutting-edge regenerative medicinal therapies and techniques, the use of marijuana and CBD may be implemented as a companion or standalone treatment when it comes to resolving pain and restoring a patients’ health.

Since medical marijuana lacks the side effects of more traditional pharmaceuticals, it’s a great alternative for patients who are unable to take pills or receive injections. With cannabis products, there is also little risk of dependency or overdose.

The components of marijuana that pain studies put the focus on are cannabidiol (CBD) and tetrahydrocannabinol (THC). THC most closely resembles the cannabinoid chemicals that are already found in the body. THC stimulates the brain’s already present cannabinoid receptors – the CB1 and CB2 receptors – which activate the brain’s reward system resulting in reduced pain levels. However, THC is a psychoactive compound and is what produces a “high” once it binds to cannabinoid receptors.

CBD, on the other hand, does not cause a “high” CBD also interacts with pain receptors in the brain while delivering anti-inflammatory effects. It’s important to understand the roles that both CBD and THC play in managing pain. Most smokable marijuana flowers are THC-dominant. With other products such as vaping, ratios indicating the amount of CBD compared to THC.come into play when it comes to pain relief.

A 1:1 ratio is when CBD and THC are present in equal amounts. This is a good option for many types of pain – including neuropathic pain but does produce intoxicating effects.

5:1 – These more balanced products provide optimized levels of both CBD and THC for medicinal use, based on the fact that higher doses of CBD are often needed for relief

10:1 – Higher CBD is an alternative for patients who feel the 5:1 ratio to be too intoxicating.

20:1 – Even higher CBD levels are a good option for managing inflammation pain.

There is a myriad of different types of medical cannabis products available with differing THC percentages. If smoking or vaping are not preferred options, CBD and cannabis products can be consumed as edibles, capsules, and oils or used topically such as tinctures and lotions

CBD acts to reduce pain by acting on a number of different biological processes within the body. CBD has been shown to work as an anti-inflammatory, antioxidant, and analgesic. Studies show that CBD increases the body’s levels of anandamide – a chemical associated with regulating pain in the body. Two areas of pain relief include:

Neuropathic pain is pain caused by nerves that have been damaged. This type of pain is common in injuries to the back – such as herniated discs. CBD works by lowering inflammation. Additionally, CBD targets the α3 glycine receptors which are important targets for nociceptive regulation at the spinal level. Additionally, a study in rats found that CBD did reduce inflammation in the brain, thereby providing some neuroprotective benefits. Interestingly, the study also found that CBD may be able to reduce the number of immune cells that build up in the spinal column – thereby also resulting in a reduction of inflammation, and therefore pain.

Arthritis pain
Pain from Rheumatoid arthritis as well as osteoarthritis may find relief with the use of CBD products. The Arthritis Foundation conducted a poll which found that 80% of respondents were currently using CBD or had in the past. Of those using it, respondents reported improved physical function, improved sleep and well-being, and modest improvement in pain and stiffness. According to the American Arthritis Foundation, effects from CBD are usually felt within 15 to 45 minutes of consumption.

The type of product best suited for pain relief depends on the type of pain and condition as well as how the CBD is consumed. Individual body chemistry also plays a role. That’s why it is important to consult with a knowledgeable physician.

María Alejandra De La Peña, MD can guide patients through every step when it comes to obtaining a Medical Marijuana card and exploring the various options for optimum pain relief.

CBD, Cannabis, and Medical Marijuana are additional tools in the vast toolbox that Dr. De La Peña is able to put at the disposal of her patients who are suffering from pain – both chronic and acute.

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