Healthy Options: Medicinal cannabis effective for pain, and more

Stephen Banister, M.D., began practicing medicine 45 years ago — initially providing general medicine and primary care.

When he realized that prescriptions and surgery weren’t helping enough of his patients and that the side effects were making some of them feel even worse, he shifted his focus to holistic, including herbal, medicine.

He was always looking for ways to most effectively treat his patients by the least harm, so with the 1996 passage of Proposition 215 — also known as the Medical Use of Marijuana Initiative and the Compassionate Use Act — he integrated medicinal cannabis into his practice.

Today, Banister is considered a pioneer in the field and is often called upon to educate doctors, lawyers, and patients about the safety and effectiveness of medical marijuana.

In this week’s “Healthy Options,” we share a short interview with Dr. Stephen Banister, whose career has covered primary care, holistic medicine, narcotic pain management, and the use of medicinal cannabis.

How has your practice changed since the passage of Proposition 215?

Initially, all I knew was that cannabis was good for treating nausea, but it turned out that some of my patients were using it for other things, such as pain, sleep, ADD, and ADHD. 

There were no books or valid studies back then, so I began collecting data to confirm the results I was hearing about. The biggest change in my practice was that many of my patients could decrease or eliminate the use of expensive prescription medications that were often causing more harm than good due to the side effects. For instance, if you have chronic, severe pain and you’re on a narcotic, you can typically drop the dosage by about 25 percent or more when you start using cannabis. 

Many people suffer from chronic pain. How effective is cannabis for pain management?

A: The number-one reason people come to me is to find relief from some sort of pain, like migraines or low-back pain. Prior to 1997, I would manage pain with narcotics.

However, the results of a study I conducted of 500 patients who I treated with cannabis showed that pain could be managed effectively in a way that was safer. Regardless of the cause of the pain, on a 0-10 scale, pain was reduced an average of 4.3 points. 

So it was clear that cannabis is a very useful pain medicine.

Now there have been several studies to confirm the use of cannabis for managing pain.

What are some of the other uses for medicinal cannabis?

Because the cannabis plant has so many healing properties, the list is extensive. 

Besides the cannabinoids like THC and CBD having individual properties, there are also terpenes—simple organic molecules that are present in all living organisms that give cannabis and other plants their smell.

Research is showing that many of the terpenes have healing properties. Limonene, for example, increases serotonin and suppresses cancer cells, and myrcene helps sleep. 

In addition to pain, some of the things cannabis is known to treat are arthritis, anxiety, ADD, PTSD, depression, glaucoma, gastrointestinal disorders, insomnia, Multiple Sclerosis, nausea, PMS, and certain types of seizures like Dravet’s Syndrome — a hard-to-treat pediatric epilepsy disorder — and some types of autism.

The more we learn about this complex plant, the more treatment options we discover.

Once people obtain a prescription, what is the best way for them to use medical cannabis?  

Although many people smoke cannabis, there are better delivery options — ones that are clean and avoid ingestion of carbon monoxide and other particulates and chemicals.

Vaporizing or heating the dried cannabis and inhaling the vapor is a better option than smoking.

Edibles are an even better method, because they last twice as long as inhalation and so are `ideal for treating chronic pain. 

Topically applying cannabis is relatively new, but it works for many painful conditions like arthritis, tendinitis, bursitis, and low-back pain — and it doesn’t alter your state.

We’re currently seeing an 80 percent positive result using cannabis salves.

If someone wanted to try cannabis for a condition you’ve mentioned, what would they need to do?

They would need to make an appointment with a cannabis doctor who can evaluate their condition, and, if it’s appropriate, write a prescription.

They can then obtain their medicine at a dispensary (the closest ones to our area are in Sacramento).

Or, they can save a lot of money and grow their own medicine. 

People respond differently to various strains, so there is a bit of trial and error that occurs until the dosage and therapeutic effects of the various cannabinoids are understood.