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.
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.”
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.
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.”
If you would like further information or to speak to Dr Anthony Ordman please contact Integro Clinics:
Trigeminal neuralgia charities & organisations:
71% of CBD users self-determine dosage without professional help
A large percentage of of those who use CBD for pain determined the dosage through trial and error
A new survey has revealed that 31 per cent of respondents use CBD to treat pain – but found that 71 per cent of those do not check the dosage with professionals first.
Almost three-quarters of those surveyed said they do not seek professional advice while 29 per cent did. A further 44 per cent decided the dosage themselves based on trial and error.
CBD-infused gummies, edibles, and beverages were the most popular method of taking CBD with a further 26 per cent preferring oils or tinctures. Vapes were the least favourite method of consumption at 10 per cent.
The survey asked a series of eleven questions about dosage and use. Among the findings, it revealed that 48 per cent of participants took the same dosage every time while 26 per cent do not check the concentration of their CBD products.
Just over half the respondents used CBD for pain with 31 per cent using it every day.
Lital Shafir, head of product at Leafreport said: “After our team reviewed the findings from the dosage survey, we realized that most users are not seeking out the opinions of professionals when trying CBD, which can lead them to negative experiences.”
“Our mission at Leafreport has always been to educate consumers on the many aspects of the CBD industry, and we want to offer educational tools like extensive reports for those who want to get away from ‘trial and error’ tactics when taking CBD.”
Correct dosage and misinformation
This survey findings are similar to another conducted on cancer patients earlier this year.
The earlier survey of 100 cancer patients at an oncology care clinic revealed they are interested in trying CBD to allievate symptoms but lack information about how to take it. Both set of findings highlight the need for more education around CBD. The main symptoms listed were uncontrollable pain, depression and anxiety.
The survey of 100 patients at an oncology care clinic showed participants were interested in CBD as a way to alleviate symptoms. They listed their main symptoms as uncontrolled pain, depression and anxiety.
When asked about their understanding of CBD, 45 percent said they were unsure if there were any risks. A further 17 percent believe there was no or low risks but 25 percent “reported uncertainty of the alleged benefits of using CBD.”
New UK trials to study medical cannabis and chronic pain
A trial at the University of Manchester will study cannabinoids in patients with fibromyalgia and chronic pain
A new UK trial will explore the effects of medical cannabis in patients with fibromyalgia and chronic pain.
Primary research sites will be located in the US and the UK, with the hopes of fast-tracking traditional FDA and NHS timelines by running phase trials in parallel.
A human pilot study will be launched in coordination with an internationally recognised clinical research group based at the University of Manchester.
In addition, parallel molecular and pharmacokinetic studies will be conducted in the US with key scientists and colleagues of Dr Annabelle Manalo-Morgan, Flora’s lead scientific advisor.
“A paradigm shift is upon us where healthcare practitioners, researchers, patients, and adult-use consumers are starting to understand, accept, and embrace the therapeutic potential offered by phytocannabinoid-based medicine,” said Dr Manalo-Morgan.
“As such, there is an urgent need for more research to better understand the molecular and biochemical effects of cannabis at the cellular level, to begin to apply its implications as a pharmaceutical drug.”
According to an announcement earlier this month, Flora intends to work with government regulators, as well as academic institutions to initiate academic studies in order to reduce costs and develop new cannabis-based drugs.
It plans to “honour the traditional FDA and NHS route in scientific processes” to deliver cannabinoids for specific disease conditions, backed by data, with an initial focus on fibromyalgia, brain health, pain, and related research.
The firm’s immediate next steps are to submit data for ethics committee review, with further details expected upon approval.
Dr Manalo-Morgan added: “I’m extremely pleased that our team recognises the importance and necessity of this research, not only to create and bring to market novel pharmaceutical cannabis products for patients around the world that are more efficacious and have a superior safety profile compared to traditional and incumbent pharmaceutical treatment options, but to also enhance long-term shareholder value.”
Pain and cannabis medicines – experts present at the Royal Society of Medicine
Experts in the field of medical cannabis present at the Royal Society of Medicine
Earlier this month, experts in the field of pain and cannabis medicines presented at the Royal Society of Medicine. Alex Fraser, patient access lead for Grow Pharma, reviews the event.
Real-life in-person events are few and far between in these days of Covid. This is just one of many reasons why we at Grow Pharma were so excited to be a part of last week’s educational event at the Royal Society of Medicine hosted by Integro Medical Clinics.
Aptly titled; Pain and cannabis medicines: Everything you want to know (but were afraid to ask), the event, held on Monday 11 October, was a day-long agenda of presentations from some of the leading experts in their respected fields, primarily medical cannabis prescribing, regulation, pharmacology and research.
Grow was honoured be asked to sponsor the event alongside Aurora Cannabis, LVL Clinics and The Centre for Medicinal Cannabis.
As well as sponsoring, I had the personal pleasure of kicking the day off with a presentation on the history of cannabis and route to legalisation on prescription in the UK (not a brief subject to fit into 20 minutes). I was also asked to host one of the sessions later in the day introducing Integro’s stellar team of cannabis-prescribing specialist doctors. I’m still in awe to have shared a stage with so many individuals that I respect so much.
It was fantastic to hear from Professor Raphael Mechoulam calling in via Zoom. The world-renowned Israeli biochemist, now in his 90s, discovered THC and the endocannabinoid system (ECS) and as such is a true legend in the field. Also speaking were the ever-passionate Dr Arno Hazekamp, an independent consultant with extensive experience in the field including seven years as Dutch medical cannabis pioneer Bedrocan’s head of research and the insightful Paul Chrisp of NICE, an organisation it would be negligible not to include in a high-profile medical cannabis event.
However, it was the clinical team at Integro that were most fascinating. Integro clinical lead and pain specialist Dr Anthony Ordman played the charming host throughout and gave a hugely informative presentation on the uses of different formulations of cannabis medicines. Integro Clinic’s specialist nurse, Sophie Hayes, gets a special mention for organising the impressive line-up of speakers on top of delivering a comprehensive talk on the practicalities of caring for patients prescribed cannabis medicines.
Dr Basil Almahdi spoke passionately about the potential of cannabis medicines in the treatment of migraines. Pain specialist Dr Sally Ghazaleh and gynaecologist Srinivas Vindla gave insights on the use of cannabis medicines in the context of women’s health. Neuropsychiatrist Dr Mayur Bodani presented on mental health and cannabis medicines.
Oncologist Dr Andrew Gaya gave a powerful talk on the use of cannabis medicines for patients undergoing cancer treatment. He also gave an important review of the evidence to date for cannabinoids treating cancer and reducing tumour size (an area where prescriptions are not currently allowed, and research is still in its infancy).
Dr Gaya spoke about the positive impact seen in one of his patients who had undergone six years of progressive cancer and various treatments finishing by pointing out that the patient was doing well enough that they were present in the room for the talk on their own case study (for those interested the patient has an anonymised Instagram account covering their journey since being prescribed cannabis medicines).
Dr Ayesha Mian of the CMC gave a talk on education for clinicians. Pharmacologist John Brew from cannabis-prescribing clinic LVL Health spoke about their focus on research. Dr Matt Brown was unfortunately taken ill not long before the event but was replaced last-minute by former colleague Eleanor Owen-Jones to give a perspective on clinical research in cannabis medicines.
Each talk was important, illuminating and insightful and, in the coffee breaks, lunch and drinks that followed, attendees, including doctors interested in prescribing, industry professionals from some of the world biggest producers of cannabis medicines as well as regulators, nurses and other HCP’s weren’t shy about expressing how impressed they had been with the whole day.
Among the many cannabis-prescribing clinics we work with at Grow, it does feel Integro have taken it upon themselves to lead the pack. Not only with events like this, but in their day-to-day practice and patient care. They are the only clinic that provides a Monday-Friday 9-5 nurse phone line to support their patients and, from speaking with patients on a daily basis – often in relation to the good and bad experiences with the various clinics – I can’t remember a patient having a bad word to say of Integro or their team.
Since the event I’ve updated a list of cannabis clinics I use to help inform patients and noted the number of these now in the UK and Channel Islands has trebled since the start of 2021.
Nearly three years since the law change, it’s certainly been a long time coming, but with events like this and clinics like Integro, patients can be assured that they are in safe hands as medical cannabis in the UK starts to grow more rapidly.
For more information visit www.integroclinics.com or email: Contact@integroclinics.com
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