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“Chronic pain patients feel let down” – UK’s first digital pain clinic joins Project Twenty21

The UK’s first fully digital pain clinic is giving millions of patients another option

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Leva is the UK's first fully digital pain clinic

The UK’s first fully digital pain clinic is offering another option for the millions of patients who live with chronic pain and have lost hope in conventional healthcare.

Since it launched this year, the doctors at Leva Clinic have seen dozens of patients living with debilitating chronic pain, who are desperate to find a way to control their condition.

Having reached the end of the line in terms of what treatment is available on the NHS, many feel let down by conventional medicine and have lost all hope in ever successfully managing their pain. 

“Patients with chronic pain are often left to cope on their own, they often don’t benefit from the kind of support that they need,” says Dr Benjamin Viaris de Lesegno, chief medical officer and co-founder of Leva.

“Due to the complexity of their conditions and the underfunding of the NHS, a lot of patients with chronic pain feel that they’ve been let down. 

“Once you’ve reached the end of what the NHS defines as the chronic pain pathway, there’s nothing left for those patients. 

“These are patients who have lost all hope.”

In the UK, chronic or persistent pain – defined as pain that lasts for more than three months – is thought to affect between one third and half of the population.

Guidelines from the National Institute for Health and Care Excellence (NICE) now advise doctors against the prescribing of common painkillers, including paracetamol and opioids, for patients with chronic primary pain conditions.

Instead regulators recommend interventions such as exercise programmes and psychological therapies such as CBT and acceptance and commitment therapy (ACT). 

This has left many patients either looking for alternative options – or living in fear of being left without any pain medication at all. 

Leva aims to “hold the hands” of these patients as its team of specialists work with them to find the right treatment.

“Patients are constantly on the lookout for new ways to control their pain, whether that’s diet and exercise or other ways to manage the symptoms that are making their life so difficult,” says Viaris de Lesegno.

Dr Benjamin Viaris de Lesegno, chief medical officer and co-founder of Leva.

“We’re really driven to try to support patients with chronic pain in every way possible.”

An increasingly popular alternative therapy among chronic pain patients is medical cannabis.

But due to what bodies such as NICE and the International Association for the Study of Pain (IASP) have described as a “lack of high quality evidence” for its efficacy in the treatment of chronic pain, access remains limited to private clinics in the UK.

Aware that private healthcare remains out of reach for many chronic pain patients, Leva has recently joined Drug Science’s Project Twenty21 in order to make its unique approach to care accessible to more people.

With around 50 percent of the patients currently enrolled on the project being treated for chronic pain, Viaris de Lesegno believes there is a need for a clinic which is specifically focused on pain management.

Unlike other cannabis clinics, Leva sees this as just one of the treatment options, offering a holistic approach to care through psychology, physiotherapy, digital tools and where suitable, novel therapeutics such as cannabis medicines.

“Pain is the biggest indication for medical cannabis around the world, not only in the UK,” he says.

“Medical cannabis is one of the options available for the doctor, but it shouldn’t be the only treatment option.

“A pain clinic that has the capacity to support patients in every way – and that includes psychology, physiotherapy and other pharmacological management – as well as medical cannabis, is the best way to help patients with chronic pain, even if for now, it is only available through the private market.”

Patients on Project Twenty21 will have free access to Leva’s digital pain management program, an app which can be used any time to offer advice and education on the self-management of their pain.

As well as an initial consultation and pharmacological management review, patients have the option to progress their treatment further with the multidisciplinary team, including a nurse, physiotherapist and a psychologist. 

And the fact that the clinic is fully digital means patients no longer face geographical barriers, giving them access to some of the UK’s most highly regarded specialists in the field.

“We definitely think of ourselves not as a medical cannabis clinic but as a pain clinic,” said Leva’s CEO, Eric Bystrom.

Leva CEO, Eric Bystrom

“We build a very long term relationship with our patients and be there at every point of their pain journey.

“You get your pain team from day one and together you create your bespoke care plan.”

As part of Project Twenty21 Bystrom and Viaris de Lesegno are keen to contribute to the creation of the UK’s largest body of evidence for the efficacy of medical cannabis.

They believe that this holistic approach to treatment is the way forward in opening up wider access to cannabis medicines. 

“A lot of doctors are suspicious of medical cannabis,” Viaris de Lesegno explains.

“If you go to a doctor with a ‘miracle drug’ that will treat everyone perfectly, no one will believe you. 

“Whereas if you say you have implemented medical cannabis within a dedicated care plan that includes psychology, physiotherapy and other pharmacological treatments, that sounds much more plausible to any clinician.”

It is also hoped that this approach will allow for more patients, who haven’t ever considered cannabis as an option to benefit from it. 

Head of communications, Project Twenty21, Mags Houston

Eric added: “To our knowledge, the medical cannabis market in the UK has so far been made up of patients who are highly knowledgeable and understand cannabis very well.

“With this approach we’re also aiming to treat those patients who have never even thought that medical cannabis could be something that helps them, to open up an avenue that they hadn’t even considered was available to them.”

This is something that those behind Project Twenty21 are also keen to see more of.

“A more holistic clinical model is something Drug Science is very much behind, as it opens up the pathways for patients who are ‘cannabis-naive’, in other words they have never tried cannabis before,” says the project’s head of communications, Mags Houston.

“We really hope that this approach will get the attention of those who haven’t previously considered medical cannabis.”

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Houston continues: “Leva is giving the doctor the freedom to prescribe from a range of treatment options, not only medical cannabis. This way the doctor can do their job properly, by finding and recommending the best treatment option to suit that patient’s individual needs, and the patient can decide if it’s right for them.”

She adds: “We really want to see medical cannabis normalised as an option when choosing the best form of treatment, and this should hopefully encourage other doctors to come forward and to want to learn more about prescribing medical cannabis.”

Find out more about Project Twenty21

 

Fibromyalgia

UK Fibromyalgia announce two-part webinar about arthritis, fibromyalgia and cannabis medicines

The two-part webinar about arthritis and fibromyalgia will also feature patient’s voices

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Fibromyalgia: A stethoscope on a wooden surface surrounded by cannabis leaves

UK Fibromyalgia, Integro Clinics, Primary Care Cannabis Network, CPASS and PLEA are proud to present a collaborative two-part webinar discussing fibromyalgia, arthritis and cannabis medicines.

An estimated 1.5-2 million people are living with fibromyalgia and 10 million with arthritis in the UK. The management of the symptoms of these conditions can take a long time to diagnose correctly and can take even longer before they are effectively brought under control.

This two-part series aims to educate attendees on the experiences and lives of those living with fibromyalgia and arthritis, as well as show the benefits that cannabis medicines and CBD can have in alleviate some of the symptoms of these conditions.

Steven is one of three patients, who will be speaking at the second episode of the webinar.

He is a medical cannabis patient with fibromyalgia. He shares his story from first being diagnosed to gaining his medical cannabis prescription, and how his life has improved since then.

UK Fibromyalgia: A blue and white logo for the charity UK Fibromyalgia

Fibromyalgia: Steven’s Story

Steven first developed FSH Muscular Dystrophy in 2014 and was diagnosed in 2016, after an initially incorrect diagnosis of Brachial Neuritis. Then in 2015, he developed fibromyalgia, which restricted him to a wheelchair, when outside his home.
His FSH Muscular Dystrophy had caused him severe nerve damage leading to his arm dropping forwards at the shoulder and giving him huge pain. He was prescribed Naproxen, Amitriptyline, Pregabalin, Tramadol and Baclofen.

All had limited effects on his pain and had horrible side effects. So much so that he was taken off them leaving him with very little to treat the symptoms of his fibromyalgia.

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He said: “Fibromyalgia arrived during a very stressful period in my life, triggered by a car crash. Four months after the accident, I was admitted to the hospital having difficulties with walking and pain in my back, hips and legs. I had already exhausted all other common pain killers because of the treatment I had already received for FSH muscular dystrophy, which had started a year before.”

Having come off these medicines, Steven then had six weeks of physiotherapy, which didn’t help and caused him great pain. After this, he was not referred to any doctors or for psychological help, which he should have been as per NICE guidelines. It was at this point that he turned to medical cannabis, and in June 2019, he received his first prescription.

Steven discovered that using medical cannabis allowed him to gain back his mental and physical strength. It allowed him to sleep better and recoup.

Cannabis and Fibromyalgia

Steven said: “I got my first medical cannabis prescription in June 2019 and it was the best decision I’ve ever made to treat my illness. Over time the brain fog that I was perpetually in receded. I can compare my fibromyalgia with a volcano, that was bubbling and active – the cannabis soothed and quietened it. It allowed my stiffness and fatigue to reduce, and my body began to recover and flourish. Whole aspects of my personality that had switched off returned. Mentally and physically, I was healing, and I had the space to be me.

He added: “The consistent quality and regular supply of medical cannabis, as opposed to black-market cannabis, was vital. It allowed me to get a constant level of relief that allowed me to rebalance my vulnerable body and mind. With each month of use, symptoms would reduce or completely go and my kids all commented on the massive change in my energy levels.”

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Steven will be part of the round table panel in the second episode of the webinar and will discuss why he believes medical cannabis should be more widely accessible for patients when conventional medicines no longer help.

He explained: “I want to help raise the profile of medical cannabis as an effective form of treatment for Fibromyalgia at the same time as helping to raise awareness of the condition. Because it destroys people’s lives, it destroys families, careers, takes parents, partners, friends & loved ones away from us and locks them in a constant cycle of pain, anxiety and fatigue. It is a very destructive illness yet mostly invisible because these people are isolated at home suffering & unable to talk about it.

“This webinar is an opportunity to shed light on the topic of fibromyalgia and bring more attention to this illness and exactly how it affects people.”

 

To register for this free event please follow the links to get your tickets:
Part 1: https://www.eventbrite.co.uk/e/168090997699
Part 2: https://www.eventbrite.co.uk/e/168112536121

Dr Anthony Ordman, senior clinical adviser at Integro Medical Clinics Ltd said: “Integro Medical Clinics always recommends remaining under the care and treatment of your GP and specialist for your condition, while using cannabis-based medicines, and the Integro clinical team would always prefer to work in collaboration with them.”

If you would like further information or to speak to Dr Anthony Ordman please contact Integro Clinics:

Website: www.integroclinics.com
Email: Contact@integroclinics.com
Twitter: @clinicsintegro

Read more: Integro Medical Clinic on living with and managing arthritis pain

UK Fibromyalgia: A banner for collaborative content

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70 percent of dystonia patients find medical cannabis improves sleep – study

Researchers aimed to examine the effect of medical cannabis on dystonia muscle activity and related pain in patients

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Dystonia: A blue brain lit up by a blue light to highlight parkinsons disease

A new study revealed that consumption of medical cannabis in adults with dystonia may improve symptoms and alleviate pain related to the condition.

The study on dystonia was presented as part of the International Congress of Parkinson’s Disease and Movement Disorders Virtual Congress 2021 which was held between 17 to 22 September.

The researchers aimed to examine the effect of medical cannabis on dystonia muscle activity and related pain in patients with Israeli Ministery of Health (MOH) approved cannabis license.

Dystonia causes uncontrollable and often painful spasms associated with Parkinson’s Disease. It also causes uncontrollable blinking, shaking and can cause the body to twist into unusual positions. It is a lifelong condition but the symptoms can be controlled with medication.

Dystonia study

Researchers from Tel Aviv University contacted 23 patients with an approved license from the MOH to assess scale, demographics, cannabis use and treatment effects using a 5-point Likert scale. The Likert scale is a type of scale. It’s a question with a series of answers that range from one extreme to another. Patients self-report their answers as to where they fall on the scale.

The study consisted of 11 women and 12 men who reported using cannabis for a maximum of 3.5 years and a minimum of at least 1.5 years. The dose amounts ranged between approximately 42.7 and 2.5 per month. A total of 48 percent of the participants revealed they used cannabis oil extract while 47.8 smoked dried buds and a further 8.7 percent used both.

The results

A large percentage of participants at 70 percent said they found an improvement in their sleep. The self-report efficacy of medical cannabis was 3.3 out of five and for those experiencing pain, 3.7 out of five. Those who said they experienced an improvement also reported using a higher THC dose. They found smoking medical cannabis more effective than consuming oil.

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The adverse effects reported included dry mouth, worsening mood, anxiety with hallucinations and suicidal ideation in three participants. these participants stopped receiving medical cannabis due to the effects.

The researchers recorded limitations as the inclusion of patients with differing dystonia symptoms, uncontrolled dosing and administration methods along with the small study size.

The concluded: “Medical cannabis seems to improve symptoms of dystonia and related pain. A higher daily dose of THC and smoking rather than sublingual oil are significantly more efficacious.”

Read more: Cannabis patients show an improvement in anxiety and pain

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Pain

Trigeminal neuralgia: How cannabis can help with the excruciating pain

Although it is rare, approximately 1 in 10,000 people develop the condition each year

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Trigeminal Neuralgia: A bottle of CBD oil against a dark background with two cannabis leaves beside it.

Trigeminal neuralgia (TN) is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain.

Although it is rare, approximately 1 in 10,000 people develop this condition each year.

The main symptom of trigeminal neuralgia is a sudden attack of severe, sharp, shooting facial pain. The pain may last only a few seconds to a few minutes, but can occur repeatedly, during an attack. The pain is often described as excruciating, like an electric shock. The attacks can be so severe that you’re unable to move while they’re happening. Pain can also arise in other areas that are supplied by the trigeminal nerve, such as the cheek, jaw, eye and forehead.

Initially, it can present itself as short, slight pain, but TN can develop and have more enduring impacts, which can take the form of longer-lasting, more intense pain. The condition affects more women than men and is more likely to affect people who are over 50.

Helen, a patient at Integro Medical Cannabis Clinics, recounts her story from first using conventional medicines to receiving her medical cannabis prescription. Since then, she has seen a significant improvement in her quality of life.

At Integro Clinics, our doctors have seen the positive benefits that cannabis medicines can have in managing our patient’s symptoms of trigeminal neuralgia.

Trigeminal Neuralgia: Helen’s Story

Helen began to suffer from TN 15 years ago, which has meant that she has been unable to work since completing her master’s degree at university. Chronic back pain, which then spread up to her neck, triggered Helen’s TN, which began with agonising migraines.

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Helen describes her pain as always starting on the left side of her face.

“Trigeminal neuralgia comes as a permanent headache around my left eye, it feels like I actually have pain in my eye. The pain spreads into my forehead and my jaw as well. It is a constant, mild pain, but if my neck gets stiff, or if I get stressed, it becomes a more severe pain. My TN means I’m light sensitive and I can only use the computer for short periods at a time. If I am looking at the screen for too long, my headaches get worse, and then as a result the pain in my face flares up.” – Helen

Helen was prescribed anticonvulsants by her doctor, such as pregabalin. She did not find that they eased the pain and they caused short term memory loss.

She added: “When I came off the pregabalin tablets, I realised that they had not actually helped me. I was still feeling the same pain as when I was on the medicine. The only thing that changed was that my short term memory started to get better.”

Trigeminal Neuralgia (TN) : A glass pipette against a pink background. The pipette is filled with a yellow oil

Helen wanted to find an alternative way to manage her pain but did not want to suffer the side effects of using conventional medicines again. After searching through Facebook pages on TN, Helen found out that medical cannabis was legal and available on prescription and could actually help her without any horrible side effects.

“I eventually discovered that cannabis clinics existed on Facebook. I started as a patient at one clinic, but I soon realised that the oil they prescribed wasn’t working for me. So, I then became a patient at Integro and this is where I started to see the benefits of medical cannabis. The team at Integro really helped me to find the best combination of THC and CBD that works for me. I felt like I was listened to and they wanted to help me, rather than just seeing me as being a fussy patient.

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The CBMP’s that I’m taking now has made a huge difference in my life. They relax the muscles in my neck which means that my TN is triggered far less than before. I also get a better night’s sleep which in turn reduces the symptoms of my TN. Even though the pain is still there, it’s much less severe, I can actually read a book or look at my computer screen for longer than I could before. Cannabis has really given me my life back.” – Helen

Chornic pain and cannabis

Dr Anthony Ordman, Senior Consultant at Integro Medical Clinics, has seen how cannabis medicines can help patients suffering from TN. The cannabis helps them to manage their symptoms and relieve their pain so they can get on with activities such as reading, or working on a computer screen

“In trigeminal neuralgia, nerve cells fire off in an uncontrolled way which sends pain signals to the brain, experienced as severe pain in the face and mouth.

“Only one conventional medicine will help, carbamazepine, which doesn’t always help completely. Cannabis medicines help to settle down the over-excited nerves and to dampen down their excessive firing. But then it also helps with the secondary effects of TN such as muscle tension, low mood, poor sleep and so on.”

He added: “At Integro Clinics, we aim to never cause any adverse effects or dependency, but the same can’t be said for conventional medicines. Integro Medical Clinics Ltd always recommends remaining under the care and treatment of your GP and specialist for your condition, while using cannabis-based medicines, and the Integro clinical team would always prefer to work in collaboration with them.”

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If you would like further information or to speak to Dr Anthony Ordman please contact Integro Clinics:

www.integroclinics.com
Email: Contact@integroclinics.com
Twitter: @clinicsintegro

Trigeminal neuralgia charities & organisations:

Trigeminal Neuralgia Association UK
Oral and Facial Pain
Facing Facial Pain

Read more: Integro Medical Clinic: living with and managing arthritis pain

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