Cannabis Case Study: Neuropathy
May 25, 2021
Tracey Smyser, PharmD

Introduction

Patient demographic
74 year old cannabis-naïve female with multiple disease states and surgeries

Case Presentation

Medical History and Allergies

  • Several Back Surgeries
  • Knee Replacements in both knees
  • History of hypertension, hypothyroidism and arthritis

Allergies:
Penicillin and Statin drugs

Medications:
Levothroid, Losartan, Celebrex, Calcium supplement, Vitamin D, Vitamin B, Biotin, Multivitamin, Glucosamine

Illicit substances or alcohol use:
Patient does not use nicotine and/or illicit substances. Pt does not consume alcohol.

History of Cannabis use:
Patient used cannabis when she was younger.

Chief complaint(s):
Patient complains of pain in lower back and bilateral knees which she would like help managing.

Restrictions of use (personal and DOH):
Patient has a form of consumption preference for topicals. Tinctures are a possibility in the future, but not at this time.

Management

Formulation (s):

  1. Soothe topical cream 5:1 (THC:CBD)
  2. Ease topical cream 10:1 (CBD:THC)

Dose:

  1. Soothe cream: Apply to the affected area of back pain as needed for pain relief.
  2. Ease cream: Apply to the affected area of pain as needed for arthritic pain relief.

Frequency:

  1. Soothe cream: As needed
  2. Ease cream: As needed

Other comments:
Both creams can be used together, but only if needing to boost a specific cannabinoid (i.e. CBD). Explained that when starting, to alternate applications to maintain pain relief throughout the day but also to confirm that each product is helping with what needs to be alleviated.

Discussion

Patient feels she gets adequate pain control with using both creams throughout the day. Patient may consider the use of a tincture in the future like Ease 10:1 tincture if she feels like her pain becomes unmanageable. For now, the patient feels the creams are helping with managing pain day to day. Patient is getting pain relief from topicals. With some patient demographics, utilizing a product that provides a localized effect can be beneficial as opposed to ingesting/inhaling cannabis.

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