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Doctor Chip
Doctor Chip, Board Certified Physician
Category: Medical
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Experience:  20 yrs practice, surgery, general medicine, addiction medicine, pain
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can marinol be prescribed for cronic pain management

Customer Question

can marinol be prescribed for cronic pain management?
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 3 years ago.
The basic indications for marionol are
anorexia in HIV patients
Nausea in cancer patients undergoing chemotherapy

There is not an official indication for pain management, so this would be an off-label or non-approved use.
So it could be done, but most doctors would not use a controlled substance in an off-label way.

Good luck
Always ask from clarification as needed, Please Click Accept to give answer credit. Come back if needed. Bonuses and positive feedback most helpful. Answers for informational purposes only.
Customer: replied 3 years ago.

knowing that it works and the other choices are crap. would you as a doctor prescribe for this purpose. I'm LDS and without a prescription I can't take sacrament.

but I don't like narcotics at all.

thank you for your advice.

Expert:  Dr. Thomas, MD replied 3 years ago.
I am not a pain management specialist but it is a moot question since this is a question and answer site, for informational purposes only.
There might be some doctors out there who would prescribe it for this purpose.
Most would not.
A pain management specialist who sees that nothing else works might do this, but you would have to work with that doctor in terms of treatment
good luck again
Always ask from clarification as needed, Please Click Accept to give answer credit. Come back if needed. Bonuses and positive feedback most helpful. Answers for informational purposes only.

Edited by DrThomasMd on 2/19/2011 at 6:45 PM EST
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 55962
Experience: Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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Customer: replied 3 years ago.

you a doctor. you treat patients with pain.

hypothetically have been treating me with soma's and I have a fractured L2 and for years I have managed on motrin and alieve. but for the last 1 year they don't work.

soma and vicadin work but leave me so drugged out I hate them.

would you as my doctors go out on a limb, so to speak , prescribe because mmj is ilegal <federally) and you know small amounts of mmj does work for me. and I am still able to function well, with good mentality. knowing that and the fact that without your prescription I can't take Sacrament, without your help.

Expert:  Dr. Thomas, MD replied 3 years ago.
This is really beyond my personal experience.
I have never had to go to this length to get someone out of pain, but this is using a team of practitioner's from physiatrists [physical medicine and re-habilitation doctors] to osteopaths who perform OMT, acupuncturists, and pain management specialists.
So, no, I would try a comprehensive pain management approach.
I've never had it fail except in rare instances at which point I refer to a specialist.
So, no, since I am not a pain management specialist, with training in the meds, I would refer to another to make that appraisal.
I am positive that some docs do it though, and appropriately, and this is why I would refer to a knowledgeable specialist.
good luck again
Always ask from clarification as needed, Please Click Accept to give answer credit. Come back if needed. Bonuses and positive feedback most helpful. Answers for informational purposes only.
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 55962
Experience: Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
Dr. Thomas, MD and 5 other Medical Specialists are ready to help you
Customer: replied 3 years ago.

I will tell you why.

I haven't made more than $14k for the last 6 years. So no insurance.

I have never had so much as a speeding ticket. 55years old.

I can't afford any of your sugestions. so what would you do?

Not forgetting your oath.

Expert:  Dr. Thomas, MD replied 3 years ago.
I'm going to let other experts answer that question as I believe I have already answered it.
So hang on as I opt out of the question, don't post, so it will then be open to all experts to answer
Customer: replied 3 years ago.

you certainly have.

your love of money and personal protection rules your heart.

I will pay you.

hoping our Lord humbles you sufficiently so you can show compassion

without thought of opinions of others.

Sincerely,

Jonathan L. Peterson

Expert:  Dr. Thomas, MD replied 3 years ago.
actually
no need to pay
your deposit is not used until you accept the question
so it can still be used on this post for you to hopefully find a more satisfactory answer
I am unlocking the question again as it locks when you post
good luck to you
Customer: replied 3 years ago.

there are millions of us without insurance and cronic pain.

marinol is cannibis based drug.

yet mmj can't be used legally anywhere for pain or anything else because of FDA.

So tell me how this is not about money.

tell me you think I should take vicodin and somas still?

Expert:  Doctor Chip replied 3 years ago.
Hi--this is not about money, because I don't expect you to pay for my response, but you should know that Marinol will be very expensive for you even if you find a doctor who will prescribe it. If the others work, even a bit, they are a lot cheaper.
Customer: replied 3 years ago.

you see my good doc.

If I have a prescription for marinol I can then use MMJ and be justified.

thank you.

Expert:  Doctor Chip replied 3 years ago.
OK. Just hope you realize the money we experts make on this site, considering the time it takes us, is very small and most of us are here just to try to help.
Customer: replied 3 years ago.

it's all about compassion and what is best for your patients.

I don't like using MMJ or any other drug.

I have to use something.

will you stand up for your patients?

I would never want any person of any age to use drugs to escape life's true meaning and blessings do to drug use.

Expert:  Doctor Chip replied 3 years ago.
I'm all for relieving pain in the most appropriate and effective way possible, so, yes, I do stand up for my patients.
Customer: replied 3 years ago.

how can all you good doctors stand fast on this. when we tell you

alcohol, soma's, vicadin, oxy and the rest hurt us spiritually and leave us empty.

when a little MMJ can make the pain bearble without stealing our soul.

Expert:  Doctor Chip replied 3 years ago.
What makes you think cannabis doesn't do the same?
Customer: replied 3 years ago.

I still feel like me. I still have the spirit with me (but not if I take too much) but not if I try to get really loaded.

I quit for the last 2 months trying somas (for sleep only, I don't like them either) and no daytime pain meds. and now this new drug MOBIC because I hurt worse than ever.

I just slept 12 hours still in some pain but would like to go back to sleep for another 12.

had to make myself pray. I love to pray when I wake up. Drugs are bad,(the ones that relieve pain).

Can't take Sacrament ( I'm LDS and will obey my church rules -no illegal drugs) and I am so unhappy that you doctors will not help us. I'm from Idaho and trying to be legal I have California res. but the church is plain on this subject. Federal Law superseeds State laws and I am left with no good choices. I would never want any ones child to try or use drugs not recommended by a licensed Doctor.

your brother,

jonathan

Expert:  Doctor Chip replied 3 years ago.
Fair enough, but you should know that the other medications, with, perhaps the exception of SOMA, are used in many patients without the side effects you mention, so they obviously are not 100% effective in stealing one's soul.
Customer: replied 3 years ago.

what meds take away pain without those side effects that ruin lives.

 

I totally disagree with you.

alcohol, hydrocondones, oxy make life a dream. and when you stop using them you feel like a junkie without his junk.

I quit mmj and was fine the next day. No withdrawl symtoms. but dealing with mild to moderate pain from pre-exsisting cronic injury pain. Pain killers

don't steal your soul

just weakin our spiritual power over our decision making ability and it just makes most of us more indifferent to life, more selfish, less caring about the things in life we did care about before continual use of meds for that purpose.

and actuall feel less healthy,.

Expert:  Doctor Chip replied 3 years ago.
True, perhaps, but I have seen cannabis do the same with others from time to time, so the argument swings both ways. And, I think you'd be surprised to meet people that seem in total control of their lives and thinking clearly and yet are taking the medications you abhor. Your experience with certain medications doesn't mean it's the same for everyone, and, you'd find a lot of people willing to debate you on your thoughts. But, then, everyone's entitled to their opinion.
Customer: replied 3 years ago.

I know that is true. everyone is different in reaction to substance.

but do you value the opinion of junkies or alcoholics,

 

would you believe a junkie or an alcoholic that tells you he is just fine with his meds.

and the truth is if I use more than just enough to tollerate pain rather than escape pain intirely I would be no different than a junkie too.

Expert:  Doctor Chip replied 3 years ago.
But there are many patients who are not addicts and do just fine on these meds. Your prejudice is showing a bit here.
Doctor Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 22212
Experience: 20 yrs practice, surgery, general medicine, addiction medicine, pain
Doctor Chip and 5 other Medical Specialists are ready to help you
Customer: replied 3 years ago.

I do have prejudice toward all drugs of pain control.

 

so you have patients that use vicodin or oxycotin and do just fine?

 

do they use alcohol too? I'm betting you don't ask.

and they sure aren't volunteering that the double medicate or many times have

more than one doctor.

all people I have ever met that use narcotics have to increase dosage to maintain

comfort level. and using painkillers inables them to damage themselves without knowing the level of damage until after that dose is used up. So by controlling the pain,

inabling them to exercise or what ever. they find they hurt worse (I'm sure thats not true for everyone) and wish they had a less chemically based medicine.

you must admit taking those drugs are harmful to total total health systems.

So how can Marinol (cannibis based) be legal and Cannibis be of no Medical benifit,

except that Pharmacutical /pharmacies can't make money off of it.

There fore it is up to you the Medical Professionals to stand up for a much less destructive drug with out the horrible side effects by prescribing Marinol for pain relief there by stating to the world that MMJ does have medical benifit requardless of what pharmicutical/FDA would lead the law abiding citizen to believe.

 

Finally just look in the eyes of any cronic pain relieved patient that takes 6 or more vicadin per day and then tell me that they aren't junkies.

not to mention what medically is happening to their health over it. (liver damage etc.)

Sincerely,

jonathan

 

mind you I am still not using my legal, (in california only) MMJ and now I can't walk more than 30 min with out pain enough that I must stop. I used swimming pool exercise for 3 years but about 8 months ago I started having back and neck pain so no more pool but walking up to an hour was tolerable (enjoyable) but now I can't . I also believe the mmj helped with joint and tendon pain as well. because of worsening since I stopped 2 months now.

 

Expert:  Doctor Chip replied 3 years ago.
What made you think opiates damage the liver? Have you actually talked to any of what you call junkies (which, by the way, is a very prejudiced and judgmental term) who are legitimate pain patients who actually do function well on their medications?
Customer: replied 3 years ago.

Opiates should be used to help pain or other prescribed uses. I just don't want to use them instead of less destructive meds for now.

vicadin is full of Acetaminophen . liver damage

as I said before .. if pain management is to get to the special place where pain is just supressed life is not bad. but being human we want to feel no pain even feel wonderful.

great if you are dying. other wise it is difficult to not get overly high.

yes many do function well. but take those opiates away for one day and you will see junkie like behaviors. I don't want to take their meds from them. 10 years from now I will probably be screaming if I don't get them too.

I am not ready for opiates except if I lift 50 lbs or if I tried running, or reach for something on the floor, etc.

I would hope I will be able to gradually go to the heavy doses and not start with

2 vicadins 4 times a day. and a stiff drink.

a little mmj and 1 2 times a day would be much better than that. same going for oxycotin which is worse.

I am legitimate pain med user. If I use opiates more than one or two days in a row I feel sick just like alcohol only worse. That is me. I don't like any drug period. but pain makes life joyless even if you know their is much to be thankful for.

so make sure you don't judge me with out looking at medical history.

Many Cronic Pain Medication users can maintain I am glad for them . But many many people end up just like the millions of alcoholics that maintained for years but wind up a alcoholic/junkie.

I would always advise on the compassion side of judgement.

and wouldn't deny pain treatment for any person suffering. Just try to get them through the pain without being so screwed up they can't even talk to you. but never let them suffer. I would never let a patient suffer if up to me. LPN school 6 months 1981. I love people even addicts. wouldn't want to live with them though.

Junkie= obvious addictive behaviors or severe impairment.

I am in pain now from sitting a typing. if I it gets any worse I will take a soma or some other legally prescribed drug. which I wish I didn't want or need.

so I do have a bias for any drug use. But I'm not going to suffer because I don't like them..and I would never use that term for someone treating pain.

but anyone dependant on drugs to maintain life enjoyment is in some way addicted.

 

Sincerely,

jonathan

Expert:  Doctor Chip replied 3 years ago.
I said opiates, not opiates with acetaminophen. And, I'm curious--what's your definition of addiction, and do you think that withdrawal symptoms from opiates is the same as addiction?
Customer: replied 3 years ago.

addiction.

person runs out of drug.

would steal from their mother not to hurt.

Expert:  Doctor Chip replied 3 years ago.
What if I told you that I have had pain patients on opiates that decided they didn't want to take them any more and withstood the withdrawal without any of the behavior you're referring to? And your definition of addiction doesn't match mine.
Customer: replied 3 years ago.

their are people of great character everywhere.

and they are admired by me and many.

I would be in a great deal of pain before I would steal.

but I don't have addictive personality with drugs at least.

but I'm really not talking about withdrawl.

I'm talking about pain period.

if their pain was great enough. they would steal their mama's meds and that is that.

I do enjoy talking to you and other doctors. Intellegent, well read. and generally not the a- holes I find most lawyers to be.

I am in pain and i don't even use caffine so if I don't respond for the next hour it is because I had to lay down.

I am able to work for these last few years because I work on PC's and get break when ever I need too.

 

thx

jonathan

 

sincerely,

jonathan

Expert:  Doctor Chip replied 3 years ago.
I understand, and I like talking to you. Here's a question for you to contemplate before we continue--why do you think you're so animated and vehement about the use of opiates for pain relief? Not talking about others--just you.
Customer: replied 3 years ago.

I am needing opiates myself at times when I hurt .

and I don't like it. I can only assume many others feel the same way.

I could slip on the ice and I would have to use it from now on myself.

Like I really believe ..

If in treating pain anyone can ride the fence, so to speak, they will stay cognitive and functional. but with narcotics it is a difficult challege because life influences will make you over medicate to compensate and then your at a new level to medicate and not feel the need to over medicate as a normal state of being.

human nature.

----

I just sent this to the Chairman of FDA and whitehouse staff.

----------------------

Dear FDA chairman: Shelly Burgess Dear White house staff

Can you please do the right thing for all patients that have to manage pain.

Allow Doctors to decide whether MMJ has medical benifits for their patients.

How can marijuana have no medical benifits and still be the basis of MARINOL.

Please put it on the same schedule as prescribable narcotics.

You and I both know it is less dangerous than: Morphine, cocaine, oxycotin, hydrocodone and so many other horribly addictive drugs.
switch methaphetamine with Cannibis on the schedule. That is one bad drug.

Neither one of us wants our children or any one elses to use drugs for escape from life.
That is why I became drug free for 20 years, for my children, even though I did
suffer often with pain that would not ease with over the counter meds.

-------------
I don't tollerate soma/vicadin or any other pains meds very well (similiar to alcohol). motrin or alieve don't work any more.
fractured L2 many years ago now has to be medicated. 20 years sober but at 55 and no insurance ($14k per year income , but no personal welfare since 1992) my choices are limited for treatments as well.
permenant wrist injury, 2 motorcyle accidents (not my fault on either),neck injuries,both knees, one shoulder, arthitis in elbows, neck, shoulders, wrists, toes and hands.
need I say more. Not so much as a speeding ticket in adult life either.
I will tell you many millions of people are dying of alcoholism because of self medicating their pain. I don't tollerate alcohol it makes me sick (I thank God for that blessing).
and because of my religion I can take vicadin, soma, oxy (what ever) and take sacrament but not the least
destructive one. Even though one of my doctors would prefer it for me. the one not afraid of DEA/FDA.
Help us. Just about everyone I know that worked in Construction for years now needs MMJ to not become some form of Drug Addicted Junkie.
I have 2 brothers and 3 nephews that are hopelessly addicted alcoholics and how I wish they used MMJ instead of Alcohol. They are worthless human beings as soon as
they get to their 2nd drink of the day. Which is everyday. Except for the one with liver failure onset..he quit being hospitalized dying 2 years ago.
that saved his life but his health is destroyed and so is his brain.

thank you,
Sincerely

Jonathan L. Peterson
1232 Oakley Ave.
Burley, ID 83318
2084311202

 

Expert:  Doctor Chip replied 3 years ago.
Do you think some of your bias comes from you family members/ problems?
Customer: replied 3 years ago.

Not really.none of them are narcotic addicts. I am sure they would if they had some. if a person in pain uses x amount of narcotics and seems pretty normal.

then it is a perfect choice for them at that time. and for me too. If your stumbling around incoherant I would say use less or use something else if available.

I just want to put off that desination drug of daily use as long as I can. But you can bet I want to have some in my medicine cabinet for when I need it. I'm going to take 1/2 soma so my back musles will stop aching.

and when I do, (I don't want to be called a junkie either) but I know I would rather suppliment those narcotics with mmj to slow the need for maximum dosage as long as possible. Keep in mind I used pot for recreational and anxiety everyday for 17 years until I quit. so my children would not be exposed to pot or beer (one or two beers afterwork everyday, never smoked infront of them ever - I would do some work in my shop) which I used during my 20 years of construction jobs. aug 2 1989 stopped it all because I loved my kids. and my oldest stole 10 budwisers and some very good pot. and I wasn't going to supply him or the rest of my kids with any drug or say that drugs are ok to use for pleasure.

cold turkey ( made Cliff watch while I poured out the rest of the beers and burned the pot reserves- )and never looked back even though I did have to deal with pain and a couple of times I did get vicodin when hurt but would stop using before bottle was empty. Making a point to them less is better. none is best.

and I still believe that. but narcotics is a God Send when moderate to severe pain is present.

 

what about the FDA letter. do you agree?

 

I do want myself and everyone else on the planet to have compassion for others.

leaving the judging to God.

I really want doctors to help in this area.

 

do you agree with my accessment of MMJ and FDA inconsistancies?

 

more fun to talk to you and hurt than laydown and rest.

:)

I do hope you will do your part to give doctors and patients the choices for pain control.

and realize that cannibis is a better drug than narcotics if cannibis works for them better than narcotics or in combination with narcotics (for that particular patient) for a happier healthier life.

last month an 18 year old hs grad. was killed by alcohol poisoning. just got drunk with a buddy and that life is gone . the friend got sick and threw up. he didn't and he died.

God will bless us for every charitable thing we do for others.

I'm really not doing this just for me.

Although I would like to take Sacrament at church (LDS ruling is break no federal law- and take sacrament). Using recomended MMJ won't keep me out of heaven. Or stop me from doing what is right for me to control pain and have mobility. But today I can just use a little soma to get through my back pains/ neck pains/hip pains, etc. Still smiling a little bit. Trying to obey the law of the land is always the safest route.

your friend

jonathan

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