Journal of the California Cannabis Research Medical
Cannabis Alleviates Symptoms
of Chrohn's Disease
Patients in a pilot study report wide-ranging benefits and reduced
reliance on drugs with adverse effects.
By Jeff Hergenrather, MD
reported by patients in the CCRMG Pilot Study on Crohn's
disease, 2005. Graph at left compares the severity
of symptoms for vomiting, depression, nausea, gut pain,
and fatigue by patients when using cannabis (bars in
front row) and without using cannabis (bars in rear
row). Graph at right shows effect of cannabis on appetite
and activity. Graphs represent mean paired values.
FLARE-UPS in Chron's disease are
graphed with respect to severity (bars at left) and frequency
(bars at right) with and without the use of cannabis.
Bars in front row are with cannabis; bars in rear row
are without cannabis.
A pilot study of the effect of cannabis on Crohn’s disease was
conducted in California this summer by physicians in the Society of
Cannabis Clinicians. Crohn’s is an inflammatory bowel disease
which is disabling and difficult to treat. The cause has not been
With co-authors Tod Mikuriya, MD, and David Bearman,
MD, and statistical support from Milton Harris, PhD, I developed a
questionnaire to assess
the changes that Crohn’s patients experience when they use cannabis
on an “ad lib” basis. We and SCC colleagues identified
32 Crohn’s patients. Eighteen expressed willingness to participate
and 12 completed questionnaires.
Our results were reported at the International Association for Cannabis
as Medicine conference at Leiden University in the Netherlands in September.
For all signs and symptoms evaluated in the study, the patients described
marked improvements with the use of cannabis. Beneficial effects were
reported for appetite, pain, nausea, vomiting, fatigue, activity, and
depression. Patients also reported that cannabis use resulted in weight
gain, fewer stools per day and fewer flare-ups of less severity.
Each patient rated all of these signs and symptoms on
a 0-10 scale both on and off of the use of cannabis. The average or
were then compared with paired T tests to show the average improvement
patients report for each category of study. A probability value
was recorded for each measurement to show how likely or unlikely
results could be expected to occur randomly. All probability
values, P values, reported were found to be significant ( P= < .05
) for the categories measured.
Crohn’s disease remains a disease of unknown etiology.
It occurs in about seven out of 100,000 population, typically
European decent. What can be said about it is that the immune
system in the
GI tract is overreactive, misguided and destructive to the
intestine. Components in cannabis are thought to exert some of their
effects by interacting with cannabinoid receptors in the intestine.
Cannabis-using Crohn’s patients not only report
significant relief of their symptoms, they are also able to reduce
amount of immunosuppressive
medications that have been a mainstay of conventional treatment.
Imuran, methotrexate, 6 MP, and Remicade (an anti-TNF drug)
are greatly reduced.
Asacol and Pentasa brands of Mesalamine, an anti-inflammatory
medication with immuno-modulating properties is also reduced
in many cases.
Steroids are noted to be reduced and often eliminated.
The immunosuppressives cause the same side effects that the disease
causes: nausea, vomiting, abdominal pain, and diarrhea. Mesalamine
frequently was reported to cause rash, itching, and photosensitivity.
Steroids have a host of common side effects including anxiety, depression,
irritability, nausea, vomiting, abdominal pain; and, with chronic use,
bone thinning, glucose intolerance, peptic ulcers, and the Cushingoid
Though our results are reliable and statistically significant, they
could be ignored as invalid because of the nature of the study. The
patients were self-selected, presenting to their doctor for approval
to legalize their use of cannabis. They all used their own cannabis
of unknown quality and quantity. There were no control groups of
patients who did not use cannabis; nor were there any placebo-controlled
trials with a group of patients using cannabis stripped of its active
Despite the fact that this pilot study deviates from the “gold
standard” study involving a treated group matched to a control
group of untreated patients double-blinded (where neither the researcher
nor the patient knows if they are getting the “real medicine” or
not), the patients who responded nonetheless, unequivocally report
improvement in their symptoms and quality of life.
Some of the patients’ responses include these telling remarks:
“A terrific reliever of Crohn’s symptoms.”
“A more easily controlled medication than offered by pills.”
“Alcohol has been a big problem for me that I don’t have
“Only positive effects, no negative effects.”
“ Best appetite stimulant, very good calming effect.”
“Cannabis provides relief without knocking me out or other bad
side effects that I had with steroids.”
“I’ve committed myself to this form of therapy, and my quality
of life has improved by leaps and bounds.”
“I’ve struggled for years with opiate addiction from chronic
pancreatitis —cannabis lets me control my pain without being
a slave to opiates.”
“Marinol bothered my stomach —I don’t get sick, constipated,
or vomit with cannabis.”
Our results are supported by a study published in the August 2005 issue
of the journal Gastroenterology. Researchers at the University of Bath
determined that cannabinoids activate the CB1 and CB2 receptors in
the gut lining, promoting it to heal the inflamed lining of the gastrointestinal
Whereas the researchers in England are looking to synthesize
cannabis-like drugs that have these therapeutic benefits, California
are in a situation where the natural medicine is available
of us feel we don’t need chemists from the pharmaceutical
industry to reinvent these molecules. Cannabis works very well
suffering. Patients using it show significant improvement in
their symptoms, weight,
and the frequency of stools.
Crohn’s disease is so debilitating and life-threatening
and so difficult to manage with conventional medications
it is very
encouraging to find that cannabis is proving to be an effective
We hope to continue beyond the pilot study as more Crohn’s
patients become aware of the beneficial effects of cannabis.
Continuing to pretend
that cannabis has no health benefits, that it is addictive
and dangerous to society as portrayed by the Controlled
Substances Act of 1970,
should be and is an embarrassment to civilized human beings.
be removed from scheduling and prescribed as any other